frm_37.php
123 lines
| 6.3 KiB
| text/x-php
|
XmlPhpLexer
|
r0 | <script> | |
$(function() { | |||
$(".txt_DRdate").datepicker({ | |||
showWeek: true, | |||
dateFormat: 'dd/M/yy', | |||
firstDay: 1 | |||
}); | |||
$('.shedule_time_DR').timepicker({ | |||
timeOnlyTitle: 'Choose Time', | |||
timeText:'Time', | |||
hourText:'Hour', | |||
minuteText:'Minute', | |||
secondText:'Second', | |||
currentText:'Now', | |||
closeText:'Done' | |||
}); | |||
}); | |||
</script> | |||
<label>28 Day Cycle# </label><input type="text" name="txt_cycle" style="width: 15px" /> | |||
<br/> | |||
<label>Dosing Record</label> | |||
<br/><br/> | |||
<table border="1"> | |||
<thead> | |||
<tr> | |||
<th>Date<br/>DD/MM/YYYY</th> | |||
<th>Study<br/>Day</th> | |||
<th>Dosing<br/>Interval</th> | |||
<th>Actual Dosing<br/>Time<br/>Hr:Min</th> | |||
<th>Comments</th> | |||
</tr> | |||
</thead> | |||
<tbody> | |||
<tr><td colspan="5">Treatment Week 1</td></tr> | |||
<tr> | |||
<td width="400px"><input type="text" name="txt_date1" class="txt_DRdate" /></td> | |||
<td><input type="text" name="txt_dateObt" value="1" style="width: 20px" /></td> | |||
<td><input type="text" name="txt_dateRep" value="1" style="width: 20px" /></td> | |||
<td><input type="text" name="txt_dateObt" class="shedule_time_DR" /></td> | |||
<td><input type="text" name="txt_dateRep" /></td> | |||
</tr> | |||
<tr> | |||
<td width="400px"><input type="text" name="txt_date1" class="txt_DRdate" /></td> | |||
<td><input type="text" name="txt_dateObt" value="3" style="width: 20px" /></td> | |||
<td><input type="text" name="txt_dateRep" value="2" style="width: 20px" /></td> | |||
<td><input type="text" name="txt_dateObt" class="shedule_time_DR" /></td> | |||
<td><input type="text" name="txt_dateRep" /></td> | |||
</tr> | |||
<tr> | |||
<td width="400px"><input type="text" name="txt_date1" class="txt_DRdate" /></td> | |||
<td><input type="text" name="txt_dateObt" value="5" style="width: 20px" /></td> | |||
<td><input type="text" name="txt_dateRep" value="3" style="width: 20px" /></td> | |||
<td><input type="text" name="txt_dateObt" class="shedule_time_DR" /></td> | |||
<td><input type="text" name="txt_dateRep" /></td> | |||
</tr> | |||
<tr><td colspan="5">Treatment Week 2</td></tr> | |||
<tr> | |||
<td width="400px"><input type="text" name="txt_date1" class="txt_DRdate" /></td> | |||
<td><input type="text" name="txt_dateObt" value="8" style="width: 20px" /></td> | |||
<td><input type="text" name="txt_dateRep" value="4" style="width: 20px" /></td> | |||
<td><input type="text" name="txt_dateObt" class="shedule_time_DR" /></td> | |||
<td><input type="text" name="txt_dateRep" /></td> | |||
</tr> | |||
<tr> | |||
<td width="400px"><input type="text" name="txt_date1" class="txt_DRdate" /></td> | |||
<td><input type="text" name="txt_dateObt" value="10" style="width: 20px" /></td> | |||
<td><input type="text" name="txt_dateRep" value="5" style="width: 20px" /></td> | |||
<td><input type="text" name="txt_dateObt" class="shedule_time_DR" /></td> | |||
<td><input type="text" name="txt_dateRep" /></td> | |||
</tr> | |||
<tr> | |||
<td width="400px"><input type="text" name="txt_date1" class="txt_DRdate" /></td> | |||
<td><input type="text" name="txt_dateObt" value="12" style="width: 20px" /></td> | |||
<td><input type="text" name="txt_dateRep" value="6" style="width: 20px" /></td> | |||
<td><input type="text" name="txt_dateObt" class="shedule_time_DR" /></td> | |||
<td><input type="text" name="txt_dateRep" /></td> | |||
</tr> | |||
<tr><td colspan="5">Treatment Week 3</td></tr> | |||
<tr> | |||
<td width="400px"><input type="text" name="txt_date1" class="txt_DRdate" /></td> | |||
<td><input type="text" name="txt_dateObt" value="15" style="width: 20px" /></td> | |||
<td><input type="text" name="txt_dateRep" value="7" style="width: 20px" /></td> | |||
<td><input type="text" name="txt_dateObt" class="shedule_time_DR" /></td> | |||
<td><input type="text" name="txt_dateRep" /></td> | |||
</tr> | |||
<tr> | |||
<td width="400px"><input type="text" name="txt_date1" class="txt_DRdate" /></td> | |||
<td><input type="text" name="txt_dateObt" value="17" style="width: 20px" /></td> | |||
<td><input type="text" name="txt_dateRep" value="8" style="width: 20px" /></td> | |||
<td><input type="text" name="txt_dateObt" class="shedule_time_DR" /></td> | |||
<td><input type="text" name="txt_dateRep" /></td> | |||
</tr> | |||
<tr> | |||
<td width="400px"><input type="text" name="txt_date1" class="txt_DRdate" /></td> | |||
<td><input type="text" name="txt_dateObt" value="19" style="width: 20px" /></td> | |||
<td><input type="text" name="txt_dateRep" value="9" style="width: 20px" /></td> | |||
<td><input type="text" name="txt_dateObt" class="shedule_time_DR" /></td> | |||
<td><input type="text" name="txt_dateRep" /></td> | |||
</tr> | |||
<tr><td colspan="5">Treatment Week 4</td></tr> | |||
<tr> | |||
<td width="400px"><input type="text" name="txt_date1" class="txt_DRdate" /></td> | |||
<td><input type="text" name="txt_dateObt" value="22" style="width: 20px" /></td> | |||
<td><input type="text" name="txt_dateRep" value="10" style="width: 20px" /></td> | |||
<td><input type="text" name="txt_dateObt" class="shedule_time_DR" /></td> | |||
<td><input type="text" name="txt_dateRep" /></td> | |||
</tr> | |||
<tr> | |||
<td width="400px"><input type="text" name="txt_date1" class="txt_DRdate" /></td> | |||
<td><input type="text" name="txt_dateObt" value="24" style="width: 20px" /></td> | |||
<td><input type="text" name="txt_dateRep" value="11" style="width: 20px" /></td> | |||
<td><input type="text" name="txt_dateObt" class="shedule_time_DR" /></td> | |||
<td><input type="text" name="txt_dateRep" /></td> | |||
</tr> | |||
<tr> | |||
<td width="400px"><input type="text" name="txt_date1" class="txt_DRdate" /></td> | |||
<td><input type="text" name="txt_dateObt" value="26" style="width: 20px" /></td> | |||
<td><input type="text" name="txt_dateRep" value="12" style="width: 20px" /></td> | |||
<td><input type="text" name="txt_dateObt" class="shedule_time_DR" /></td> | |||
<td><input type="text" name="txt_dateRep" /></td> | |||
</tr> | |||
</tbody> | |||
</table> |