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modificada la instancia de la clase SessionModel
modificada la instancia de la clase SessionModel
arturo - - Load All Authors

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r0:1
r11:12
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frm_38.php
47 lines | 1.9 KiB | text/x-php | XmlPhpLexer
/ trunk / components / com_data / views / frm_38.php
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arturo
creando directorios base para el desarrollo
 r0 <label>Prior and Concomitant Medications</label><br/><br/>
<label>Are there any medications to be recorded on this page?</label>&nbsp;
<input type="radio" name="rbn_opt"/>Yes&nbsp;&nbsp;<input type="radio" name="rbn_opt"/>No<br/>
<label>(Including prescription, over-the-counter, herbal and vitamin products)</label><br/><br/>
<table border="0" class="tbl_general">
<thead>
<tr>
<th>Medication<br/>(generic name preferred)</th>
<th>Dose</th>
<th>Units<br/>(eg, mg,<br/>IU, mL)</th>
<th>Route,<br/>(eg, PO,<br/>SC)</th>
<th>Frequency<br>(eg, QD, BID,<br>TID, QID)</th>
<th>Date Started<br>DD/MMM/YYYY</th>
<th>Ongoing?*</th>
<th>Date Stopped<br>DD/MMM/YYYY</th>
<th>Use to Treat AE?<br/>Yes&nbsp;|&nbsp;No**&nbsp;|&nbsp;AE#s</th>
<th>**If No, List Indication</th>
</tr>
</thead>
<tbody>
<tr>
<td><input type="text" name="txt_medicat" value="" /></td>
<td><input type="text" name="txt_dose" value="" style="width: 20px" /></td>
<td>
<select name="lst_units" class="form_select">
<option value="1">eg</option>
<option value="1">mg</option>
<option value="1">IU</option>
<option value="1">mL</option>
</select>
</td>
<td><input type="text" name="txt_route" value="" /></td>
<td><input type="text" name="txt_frequency" value="" /></td>
<td><input type="text" name="txt_dtStart" value="" /></td>
<td><input type="text" name="txt_ongoing" value="" /></td>
<td><input type="text" name="txt_dtStop" value="" /></td>
<td><input type="text" name="txt_opt" value="" /></td>
<td><input type="text" name="txt_indication" value="" /></td>
</tr>
</tbody>
<tfoot>
<tr><td colspan="10"><Small>*If medication is continuing at the end of the study, place a check in the Outgoing column and skip date.</Small></td></tr>
</tfoot>
</table>
<br/><br/>
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