|
|
<script>
|
|
|
$(function() {
|
|
|
$( ".css_date" ).datepicker({
|
|
|
showWeek: true,
|
|
|
dateFormat: 'dd/M/yy',
|
|
|
firstDay: 1
|
|
|
});
|
|
|
$('.shedule_time_PK').timepicker({
|
|
|
timeOnlyTitle: 'Choose Time',
|
|
|
timeText:'Time',
|
|
|
hourText:'Hour',
|
|
|
minuteText:'Minute',
|
|
|
secondText:'Second',
|
|
|
currentText:'Now',
|
|
|
closeText:'Done'
|
|
|
|
|
|
});
|
|
|
});
|
|
|
</script>
|
|
|
<style>
|
|
|
.box-table-a
|
|
|
{
|
|
|
font-family: "Verdana";
|
|
|
font-size: 10px;
|
|
|
margin: 0px 0 0px 0;
|
|
|
width: 650px;
|
|
|
text-align: left;
|
|
|
border-collapse: collapse;
|
|
|
}
|
|
|
.box-table-a th
|
|
|
{
|
|
|
font-size: 10px;
|
|
|
font-weight: normal;
|
|
|
padding: 5px 0px 5px 0px;
|
|
|
background: #fff;
|
|
|
border: 1px solid #000;
|
|
|
color: #333;
|
|
|
}
|
|
|
.box-table-a td
|
|
|
{
|
|
|
padding: 8px 3px 8px 5px ;
|
|
|
background: #fff;
|
|
|
border: 1px solid #000;
|
|
|
color: #333;
|
|
|
border-top: 1px solid transparent;
|
|
|
}
|
|
|
.box-table-a tr:hover td
|
|
|
{
|
|
|
background: #fff;
|
|
|
color: #333 ;
|
|
|
}
|
|
|
.inputxt_20{
|
|
|
width: 20px;
|
|
|
border: 0px !important;
|
|
|
border-bottom:1px solid #000 !important;
|
|
|
padding: 0 !important;
|
|
|
font-size: 10px !important;
|
|
|
text-align: center !important;
|
|
|
}
|
|
|
.inputxt_75{
|
|
|
width: 75px;
|
|
|
border: 0px !important;
|
|
|
border-bottom:1px dashed #000 !important;
|
|
|
padding: 0 !important;
|
|
|
font-size:10px !important;
|
|
|
text-align: center !important;
|
|
|
}
|
|
|
.inputxt_40{
|
|
|
width: 40px;
|
|
|
border: 0px !important;
|
|
|
border-bottom:1px solid #000 !important;
|
|
|
padding: 0 !important;
|
|
|
font-size: 10px !important;
|
|
|
text-align: center !important;
|
|
|
}
|
|
|
.cbx_css{
|
|
|
width: 50px;
|
|
|
border: 1px solid #000;
|
|
|
font-size: 10px;
|
|
|
font-family:Verdana;
|
|
|
}
|
|
|
.css_comments{
|
|
|
width: 190px;
|
|
|
border: 0px solid #f00 !important;
|
|
|
font-size: 10px;
|
|
|
font-family:Verdana;
|
|
|
padding: 0 !important;
|
|
|
margin: 0 !important;
|
|
|
}
|
|
|
</style>
|
|
|
<div style="display: block; width: 100%; text-align: center; font-family: Arial; font-size: 14px; font-weight: bold; padding-top: 10px; padding-bottom: 5px;">
|
|
|
28 Day Cycle#1<br/>PK Sampling Record<br/>During First Month of Each Cohort <br />Only
|
|
|
</div>
|
|
|
<div style="clear: both; height: 20px; width: 100%"></div>
|
|
|
<table class="box-table-a" width="100%">
|
|
|
<thead>
|
|
|
<tr>
|
|
|
<th align="center" scope="col">Date<br/>DD/MM/YYYY</th>
|
|
|
<th align="center" scope="col">Interval Hour</th>
|
|
|
<th align="center" scope="col">Schedule<br/>Time<br/>Hr:Min</th>
|
|
|
<th align="center" scope="col">Actual time<br/>Hr:Min</th>
|
|
|
<th align="center" scope="col">Comments</th>
|
|
|
</tr>
|
|
|
</thead>
|
|
|
<tbody>
|
|
|
<tr>
|
|
|
<td align="center"><input type="text" name="arr_date[]" class="inputxt_75 css_date" onfocus="if(this.value=='DD/MMM/YYYY') this.value='';" onblur="if(this.value=='') this.value='DD/MMM/YYYY';" value="DD/MMM/YYYY"/></td>
|
|
|
<td align="center">0<br/>(Pre-dose)</td>
|
|
|
<td align="center"><input type="text" name="shedule_time[]" class="shedule_time_PK inputxt_40" onfocus="if(this.value=='00:00') this.value='';" onblur="if(this.value=='') this.value='00:00';" value="00:00" /></td>
|
|
|
<td align="center"><input type="text" name="txt_dateObt[]" class="shedule_time_PK inputxt_40" onfocus="if(this.value=='00:00') this.value='';" onblur="if(this.value=='') this.value='00:00';" value="00:00" /></td>
|
|
|
<td><input type="text" name="txt_dateRep[]" class="css_comments"/></td>
|
|
|
</tr>
|
|
|
<tr>
|
|
|
<td align="center" style="background-color:#A6A6A6"><input type="text" style="background-color:#A6A6A6" name="arr_date[]" class="inputxt_75 css_date" onfocus="if(this.value=='') this.value='';" onblur="if(this.value=='') this.value='';" value=""/></td>
|
|
|
<td align="center">15 min</td>
|
|
|
<td align="center"><input type="text" name="shedule_time[]" class="shedule_time_PK inputxt_40" onfocus="if(this.value=='00:00') this.value='';" onblur="if(this.value=='') this.value='00:00';" value="00:00" /></td>
|
|
|
<td align="center"><input type="text" name="txt_dateObt[]" class="shedule_time_PK inputxt_40" onfocus="if(this.value=='00:00') this.value='';" onblur="if(this.value=='') this.value='00:00';" value="00:00" /></td>
|
|
|
<td><input type="text" name="txt_dateRep[]" class="css_comments" /></td>
|
|
|
</tr>
|
|
|
<tr>
|
|
|
<td align="center" style="background-color:#A6A6A6"><input type="text" style="background-color:#A6A6A6" name="arr_date[]" class="inputxt_75 css_date" onfocus="if(this.value=='') this.value='';" onblur="if(this.value=='') this.value='';" value=""/></td>
|
|
|
<td align="center">1</td>
|
|
|
<td align="center"><input type="text" name="shedule_time[]" class="shedule_time_PK inputxt_40" onfocus="if(this.value=='00:00') this.value='';" onblur="if(this.value=='') this.value='00:00';" value="00:00" /></td>
|
|
|
<td align="center"><input type="text" name="txt_dateObt[]" class="shedule_time_PK inputxt_40" onfocus="if(this.value=='00:00') this.value='';" onblur="if(this.value=='') this.value='00:00';" value="00:00" /></td>
|
|
|
<td><input type="text" name="txt_dateRep[]" class="css_comments"/></td>
|
|
|
</tr>
|
|
|
<tr>
|
|
|
<td align="center" style="background-color:#A6A6A6"><input type="text" style="background-color:#A6A6A6" name="arr_date[]" class="inputxt_75 css_date" onfocus="if(this.value=='') this.value='';" onblur="if(this.value=='') this.value='';" value=""/></td>
|
|
|
<td align="center">2</td>
|
|
|
<td align="center"><input type="text" name="shedule_time[]" class="shedule_time_PK inputxt_40" onfocus="if(this.value=='00:00') this.value='';" onblur="if(this.value=='') this.value='00:00';" value="00:00" /></td>
|
|
|
<td align="center"><input type="text" name="txt_dateObt[]" class="shedule_time_PK inputxt_40" onfocus="if(this.value=='00:00') this.value='';" onblur="if(this.value=='') this.value='00:00';" value="00:00" /></td>
|
|
|
<td><input type="text" name="txt_dateRep[]" class="css_comments"/></td>
|
|
|
</tr>
|
|
|
<tr>
|
|
|
<td align="center" style="background-color:#A6A6A6"><input type="text" style="background-color:#A6A6A6" name="arr_date[]" class="inputxt_75 css_date" onfocus="if(this.value=='') this.value='';" onblur="if(this.value=='') this.value='';" value=""/></td>
|
|
|
<td align="center">3.75</td>
|
|
|
<td align="center"><input type="text" name="shedule_time[]" class="shedule_time_PK inputxt_40" onfocus="if(this.value=='00:00') this.value='';" onblur="if(this.value=='') this.value='00:00';" value="00:00" /></td>
|
|
|
<td align="center"><input type="text" name="txt_dateObt[]" class="shedule_time_PK inputxt_40" onfocus="if(this.value=='00:00') this.value='';" onblur="if(this.value=='') this.value='00:00';" value="00:00" /></td>
|
|
|
<td><input type="text" name="txt_dateRep[]" class="css_comments"/></td>
|
|
|
</tr>
|
|
|
<tr>
|
|
|
<td align="center" style="background-color:#A6A6A6"><input type="text" style="background-color:#A6A6A6" name="arr_date[]" class="inputxt_75 css_date" onfocus="if(this.value=='') this.value='';" onblur="if(this.value=='') this.value='';" value=""/></td>
|
|
|
<td align="center">4.083</td>
|
|
|
<td align="center"><input type="text" name="shedule_time[]" class="shedule_time_PK inputxt_40" onfocus="if(this.value=='00:00') this.value='';" onblur="if(this.value=='') this.value='00:00';" value="00:00" /></td>
|
|
|
<td align="center"><input type="text" name="txt_dateObt[]" class="shedule_time_PK inputxt_40" onfocus="if(this.value=='00:00') this.value='';" onblur="if(this.value=='') this.value='00:00';" value="00:00" /></td>
|
|
|
<td><input type="text" name="txt_dateRep[]" class="css_comments"/></td>
|
|
|
</tr>
|
|
|
<tr>
|
|
|
<td align="center" style="background-color:#A6A6A6"><input type="text" style="background-color:#A6A6A6" name="arr_date[]" class="inputxt_75 css_date" onfocus="if(this.value=='') this.value='';" onblur="if(this.value=='') this.value='';" value=""/></td>
|
|
|
<td align="center">4.5</td>
|
|
|
<td align="center"><input type="text" name="shedule_time[]" class="shedule_time_PK inputxt_40" onfocus="if(this.value=='00:00') this.value='';" onblur="if(this.value=='') this.value='00:00';" value="00:00" /></td>
|
|
|
<td align="center"><input type="text" name="txt_dateObt[]" class="shedule_time_PK inputxt_40" onfocus="if(this.value=='00:00') this.value='';" onblur="if(this.value=='') this.value='00:00';" value="00:00" /></td>
|
|
|
<td><input type="text" name="txt_dateRep[]" class="css_comments"/></td>
|
|
|
</tr>
|
|
|
<tr>
|
|
|
<td align="center" style="background-color:#A6A6A6"><input type="text" style="background-color:#A6A6A6" name="arr_date[]" class="inputxt_75 css_date" onfocus="if(this.value=='') this.value='';" onblur="if(this.value=='') this.value='';" value=""/></td>
|
|
|
<td align="center">6</td>
|
|
|
<td align="center"><input type="text" name="shedule_time[]" class="shedule_time_PK inputxt_40" onfocus="if(this.value=='00:00') this.value='';" onblur="if(this.value=='') this.value='00:00';" value="00:00" /></td>
|
|
|
<td align="center"><input type="text" name="txt_dateObt[]" class="shedule_time_PK inputxt_40" onfocus="if(this.value=='00:00') this.value='';" onblur="if(this.value=='') this.value='00:00';" value="00:00" /></td>
|
|
|
<td><input type="text" name="txt_dateRep[]" class="css_comments"/></td>
|
|
|
</tr>
|
|
|
<tr>
|
|
|
<td align="center" style="background-color:#A6A6A6"><input type="text" style="background-color:#A6A6A6" name="arr_date[]" class="inputxt_75 css_date" onfocus="if(this.value=='') this.value='';" onblur="if(this.value=='') this.value='';" value=""/></td>
|
|
|
<td align="center">8</td>
|
|
|
<td align="center"><input type="text" name="shedule_time[]" class="shedule_time_PK inputxt_40" onfocus="if(this.value=='00:00') this.value='';" onblur="if(this.value=='') this.value='00:00';" value="00:00" /></td>
|
|
|
<td align="center"><input type="text" name="txt_dateObt[]" class="shedule_time_PK inputxt_40" onfocus="if(this.value=='00:00') this.value='';" onblur="if(this.value=='') this.value='00:00';" value="00:00" /></td>
|
|
|
<td><input type="text" name="txt_dateRep[]" class="css_comments"/></td>
|
|
|
</tr>
|
|
|
<tr>
|
|
|
<td align="center" style="background-color:#A6A6A6"><input type="text" style="background-color:#A6A6A6" name="arr_date[]" class="inputxt_75 css_date" onfocus="if(this.value=='') this.value='';" onblur="if(this.value=='') this.value='';" value=""/></td>
|
|
|
<td align="center">10</td>
|
|
|
<td align="center"><input type="text" name="shedule_time[]" class="shedule_time_PK inputxt_40" onfocus="if(this.value=='00:00') this.value='';" onblur="if(this.value=='') this.value='00:00';" value="00:00" /></td>
|
|
|
<td align="center"><input type="text" name="txt_dateObt[]" class="shedule_time_PK inputxt_40" onfocus="if(this.value=='00:00') this.value='';" onblur="if(this.value=='') this.value='00:00';" value="00:00" /></td>
|
|
|
<td><input type="text" name="txt_dateRep[]" class="css_comments"/></td>
|
|
|
</tr>
|
|
|
<tr>
|
|
|
<td align="center" "><input type="text" name="arr_date[]" class="inputxt_75 css_date" onfocus="if(this.value=='DD/MMM/YYYY') this.value='';" onblur="if(this.value=='') this.value='DD/MMM/YYYY';" value="DD/MMM/YYYY"/></td>
|
|
|
<td align="center">24</td>
|
|
|
<td align="center"><input type="text" name="shedule_time[]" class="shedule_time_PK inputxt_40" onfocus="if(this.value=='00:00') this.value='';" onblur="if(this.value=='') this.value='00:00';" value="00:00" /></td>
|
|
|
<td align="center"><input type="text" name="txt_dateObt[]" class="shedule_time_PK inputxt_40" onfocus="if(this.value=='00:00') this.value='';" onblur="if(this.value=='') this.value='00:00';" value="00:00" /></td>
|
|
|
<td><input type="text" name="txt_dateRep[]" class="css_comments"/></td>
|
|
|
</tr>
|
|
|
<tr>
|
|
|
<td align="center" ><input type="text" style= name="arr_date[]" class="inputxt_75 css_date" onfocus="if(this.value=='DD/MMM/YYYY') this.value='';" onblur="if(this.value=='') this.value='DD/MMM/YYYY';" value="DD/MMM/YYYY"/></td>
|
|
|
<td align="center">Pre-dose<br />of Day 3</td>
|
|
|
<td align="center"><input type="text" name="shedule_time[]" class="shedule_time_PK inputxt_40" onfocus="if(this.value=='00:00') this.value='';" onblur="if(this.value=='') this.value='00:00';" value="00:00" /></td>
|
|
|
<td align="center"><input type="text" name="txt_dateObt[]" class="shedule_time_PK inputxt_40" onfocus="if(this.value=='00:00') this.value='';" onblur="if(this.value=='') this.value='00:00';" value="00:00" /></td>
|
|
|
<td><input type="text" name="txt_dateRep[]" class="css_comments"/></td>
|
|
|
</tr>
|
|
|
<tr>
|
|
|
<td align="center" ><input type="text" name="arr_date[]" class="inputxt_75 css_date" onfocus="if(this.value=='DD/MMM/YYYY') this.value='';" onblur="if(this.value=='') this.value='DD/MMM/YYYY';" value="DD/MMM/YYYY"/></td>
|
|
|
<td align="center">24 post<br />Dose of Day 3</td>
|
|
|
<td align="center"><input type="text" name="shedule_time[]" class="shedule_time_PK inputxt_40" onfocus="if(this.value=='00:00') this.value='';" onblur="if(this.value=='') this.value='00:00';" value="00:00" /></td>
|
|
|
<td align="center"><input type="text" name="txt_dateObt[]" class="shedule_time_PK inputxt_40" onfocus="if(this.value=='00:00') this.value='';" onblur="if(this.value=='') this.value='00:00';" value="00:00" /></td>
|
|
|
<td><input type="text" name="txt_dateRep[]" class="css_comments"/></td>
|
|
|
</tr>
|
|
|
<tr>
|
|
|
<td align="center" ><input type="text" name="arr_date[]" class="inputxt_75 css_date" onfocus="if(this.value=='DD/MMM/YYYY') this.value='';" onblur="if(this.value=='') this.value='DD/MMM/YYYY';" value="DD/MMM/YYYY"/></td>
|
|
|
<td align="center">48 post<br />Dose of Day 26</td>
|
|
|
<td align="center"><input type="text" name="shedule_time[]" class="shedule_time_PK inputxt_40" onfocus="if(this.value=='00:00') this.value='';" onblur="if(this.value=='') this.value='00:00';" value="00:00" /></td>
|
|
|
<td align="center"><input type="text" name="txt_dateObt[]" class="shedule_time_PK inputxt_40" onfocus="if(this.value=='00:00') this.value='';" onblur="if(this.value=='') this.value='00:00';" value="00:00" /></td>
|
|
|
<td><input type="text" name="txt_dateRep[]" class="css_comments"/></td>
|
|
|
</tr>
|
|
|
</tbody>
|
|
|
</table>
|
|
|
<div class="tool_buttons">
|
|
|
<input type="submit" value="save" id="btn_save" name="btn_save">
|
|
|
<input type="reset" value="clear" id="btn_clear" name="btn_clear">
|
|
|
</div>
|
