Personal tools
Navigation
 

FH Outpatient Anticoagulation Orders P1 and 2 HTML

HTML icon Outpatient Anticoagulation Orders P1-2.html — HTML, 35 kB (36484 bytes)

File contents

<html>
<head>
<title>Outpatient Anticoagulation Orders Page 1&2 </title>

	<link rel="stylesheet" type="text/css" media="print" href="${oscar_image_path}JSMPC.css" />


<style type="text/css" media="print">
 .DoNotPrint {
	 display: none;
 }
 .noborder {
	 border : 0px;
	 background: transparent;
	 scrollbar-3dlight-color: transparent;
	 scrollbar-3dlight-color: transparent;
	 scrollbar-arrow-color: transparent;
	 scrollbar-base-color: transparent;
	 scrollbar-darkshadow-color: transparent;
	 scrollbar-face-color: transparent;
	 scrollbar-highlight-color: transparent;
	 scrollbar-shadow-color: transparent;
	 scrollbar-track-color: transparent;
	 background: transparent;
	 overflow: hidden;
 }
 </style>
 
  <script language="javascript" type="text/javascript">
		/****************************
		startup functions 
		****************************/
		function startUp()
		{			
			// shows the forms on development machine from notepad ++ - saves you from uploading to the server to input alignments
			var strLoc = window.location.href.toLowerCase();
			if(strLoc.indexOf("https") == -1)
			{
				//page1
				var src = document.getElementById('BGImage').src;				
				document.getElementById('BGImage').src = src.replace('$%7Boscar_image_path%7D','');
				// page2
				var src2 = document.getElementById('BGImage2').src;
				document.getElementById('BGImage2').src = src2.replace('$%7Boscar_image_path%7D','');
				
			}
			setDocumentTitle('Outpatient Anticoagulation Orders Page 1&2',document.getElementById('Surname').value);
		}
		
		function setDocumentTitle(Title,Surname)
		{
			// set document title
			document.title = Title + ' - ' + Surname;					
							
		}
		

		/****************************
			submit and print functions 
		****************************/
		function printSubmit()
		{
			printLetter();
			releaseDirtyFlag();			
			submission();
		}

		function printLetter()
		{
			// hide the bottom buttons
			if (document.getElementById('BottomButtons').style.display == '')
				document.getElementById('BottomButtons').style.display = 'none';
			// print the letter
			window.print();
		} 

		function submission()
		{
			setFlag();
			setTimeout('document.FormName.submit()',1000);			
		}

		function setFlag()
		{
		// indicate that the form has been submitted
		if (document.getElementById("newForm").value == 'True')
			document.getElementById("newForm").value = 'False';
		}
		
		function showButtons()
		{
			//show the bottom buttons if they are hidden
			if (document.getElementById('BottomButtons').style.display == 'none')
				document.getElementById('BottomButtons').style.display = '';
		}
		
		/****************************
			checkbox functions 
		****************************/
		function changeValue(x)
		{
			if (document.getElementById(x).value == '')
				document.getElementById(x).value = 'X';
			else
				document.getElementById(x).value = '';
		}

		function displayKeyCode(evt,x)
		{
			var charCode = (evt.which) ? evt.which : event.keyCode
			// any key press except tab will constitute a value change to the checkbox
			if (charCode != 9)
			{
				changeValue(x);
				return false;
			}
		}
		</script>


<script language="javascript">
function formPrint(){
			window.print();
} 
</script>

<!-- scripts to confirm closing of window if it hadn't been saved yet -->
<script language="javascript">
//keypress events trigger dirty flag
var needToConfirm = false;
document.onkeyup=setDirtyFlag;
function setDirtyFlag(){
		needToConfirm = true;
}
function releaseDirtyFlag(){
		needToConfirm = false; //Call this function if doesn't requires an alert.
//this could be called when save button is clicked
}
window.onbeforeunload = confirmExit;
function confirmExit(){
	 if (needToConfirm){
		 return "You have attempted to leave this page. If you have made any changes to the fields without clicking the Save button, your changes will be lost. Are you sure you want to exit this page?";
	 }
}
</script>


		<!-----------------script for current time--------->
<script language="javascript">

<!-- hide javascript

function StartClock12() {
Time12 = new Date();
Cur12Hour = Time12.getHours();
Cur12Mins = Time12.getMinutes();
The12Time = 0;
The12Time = (Cur12Hour > 12) ? Cur12Hour - 12 : Cur12Hour;
The12Time += ((Cur12Mins < 10) ? ':0' : ':') + Cur12Mins;
The12Time += (Cur12Hour > 11) ? ' PM': ' AM';
window.status = The12Time;
setTimeout('StartClock12()',1000);
}

// done hiding -->
</script>

<script language="javascript" type="text/javascript">
function onLoad(){
      if (document.getElementById("counter").value ==''){
       (document.getElementById("counter").value = 1);
	   StartClock12();

       (document.FormName.Time.value=The12Time);
	   
      }  

}
</script>

<!-- Calendar Code -->


<link rel="stylesheet" type="text/css" media="all" href="../share/calendar/calendar.css" title="win2k-cold-1" />


<!-- main calendar program -->


<script type="text/javascript" src="../share/calendar/calendar.js">
</script>


<!-- language for the calendar -->


<script type="text/javascript" src="../share/calendar/lang/calendar-en.js">
</script>


<!-- the following script defines the Calendar.setup helper function, which makes
       adding a calendar a matter of 1 or 2 lines of code. -->


<script type="text/javascript" src="../share/calendar/calendar-setup.js">
</script>

<!-- end calendar code -->



</head>


<body onload="startUp();onLoad()" onMouseDown="showButtons();">




<form method="post" action="" name="FormName" id="FormName" >


<div id="page1" style="position:relative; left:0px; top:0px; width:750px;" class="pagebreak">


<img id='BGImage' src="${oscar_image_path}outpatientanticoag1.png" style="position: relative; left: 0px; top: 0px; width:750px">



	<input type="hidden" name="counter" id="counter">

	<input type="hidden" name="Surname" id="Surname" oscarDB=patient_nameL>
	
<textarea name="Label" id="Label" class="noborder" style="position:absolute; left:460px; top:20px; width:260px; height:120px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px; text-align:left; text-decoration:underline; background-color:white;"  oscarDB=label></textarea>


<input name="allergies_des" id="allergies_des" type="text" class="noborder" style="position:absolute; left:63px; top:205px; width:654px; height:30px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px; text-align:left; text-decoration:underline; background-color:white;"  oscarDB=allergies_des>


<input name="Today" id="Today" type="text" class="noborder" style="position:absolute; left:109px; top:254px; width:195px; height:21px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px; text-align:left; text-decoration:underline; background-color:white;"  oscarDB=today>


<input name="Time" id="Time" type="text" class="noborder" style="position:absolute; left:385px; top:254px; width:180px; height:21px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px; text-align:left; text-decoration:underline; background-color:white;" value="">


<input name="DVT" id="DVT" type="text" style="position:absolute; left:102px; top:295px; width:16px; height:16px; border:1px solid #000000; font-weight:bold; text-align:center; background-color:white;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);setDirtyFlag()" onkeypress="javascript:return displayKeyCode(event,this.id);" >


<input name="DVTSite" id="DVTSite" type="text" class="noborder" style="position:absolute; left:178px; top:293px; width:144px; height:21px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px; text-align:left; text-decoration:underline; background-color:white;" value="">


<input name="AFib" id="AFib" type="text" style="position:absolute; left:102px; top:314px; width:16px; height:16px; border:1px solid #000000; font-weight:bold; text-align:center; background-color:white;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);setDirtyFlag()" onkeypress="javascript:return displayKeyCode(event,this.id);" >


<input name="PE" id="PE" type="text" style="position:absolute; left:102px; top:333px; width:16px; height:16px; border:1px solid #000000; font-weight:bold; text-align:center; background-color:white;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);setDirtyFlag()" onkeypress="javascript:return displayKeyCode(event,this.id);" >


<input name="Other" id="Other" type="text" style="position:absolute; left:102px; top:352px; width:16px; height:16px; border:1px solid #000000; font-weight:bold; text-align:center; background-color:white;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);setDirtyFlag()" onkeypress="javascript:return displayKeyCode(event,this.id);" >


<input name="OtherText" id="OtherText" type="text" class="noborder" style="position:absolute; left:162px; top:348px; width:159px; height:21px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px; text-align:left; text-decoration:underline; background-color:white;" value="">


<textarea name="MedicalHistory" id="MedicalHistory" class="noborder" style="position:absolute; left:347px; top:298px; width:370px; height:71px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px; text-align:left; text-decoration:underline; background-color:white;"  oscarDB=medical_history></textarea>


<input name="Weight" id="Weight" type="text" class="noborder" style="position:absolute; left:533px; top:370px; width:90px; height:21px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px; text-align:left; text-decoration:underline; background-color:white;" value="">


<input name="MRP" id="MRP" type="text" class="noborder" style="position:absolute; left:105px; top:370px; width:167px; height:21px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px; text-align:left; text-decoration:underline; background-color:white;"  oscarDB=current_user>


<input name="OtherLabTests" id="OtherLabTests" type="text" class="noborder" style="position:absolute; left:148px; top:445px; width:222px; height:21px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px; text-align:left; text-decoration:underline; background-color:white;" value="">


<input name="Dalteparin" id="Dalteparin" type="text" style="position:absolute; left:94px; top:473px; width:16px; height:16px; border:1px solid #000000; font-weight:bold; text-align:center; background-color:white;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);setDirtyFlag()" onkeypress="javascript:return displayKeyCode(event,this.id);" >


<input name="DalteparinUnits" id="DalteparinUnits" type="text" class="noborder" style="position:absolute; left:274px; top:469px; width:94px; height:21px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px; text-align:left; text-decoration:underline; background-color:white;" value="">


<input name="Enoxaparin" id="Enoxaparin" type="text" style="position:absolute; left:94px; top:691px; width:16px; height:16px; border:1px solid #000000; font-weight:bold; text-align:center; background-color:white;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);setDirtyFlag()" onkeypress="javascript:return displayKeyCode(event,this.id);" >


<input name="EnoxaparinMg" id="EnoxaparinMg" type="text" class="noborder" style="position:absolute; left:258px; top:689px; width:78px; height:21px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px; text-align:right; text-decoration:underline; background-color:white;" value="">


<input name="Warfarin10" id="Warfarin10" type="text" style="position:absolute; left:111px; top:750px; width:16px; height:16px; border:1px solid #000000; font-weight:bold; text-align:center; background-color:white;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);setDirtyFlag()" onkeypress="javascript:return displayKeyCode(event,this.id);" >


<input name="Warfarin5" id="Warfarin5" type="text" style="position:absolute; left:111px; top:767px; width:16px; height:16px; border:1px solid #000000; font-weight:bold; text-align:center; background-color:white;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);setDirtyFlag()" onkeypress="javascript:return displayKeyCode(event,this.id);" >


<input name="WarfarinMg" id="WarfarinMg" type="text" class="noborder" style="position:absolute; left:420px; top:781px; width:88px; height:21px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px; text-align:right; text-decoration:underline; background-color:white;" value="">


<input name="WarfarinDays" id="WarfarinDays" type="text" class="noborder" style="position:absolute; left:541px; top:781px; width:44px; height:21px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px; text-align:right; text-decoration:underline; background-color:white;" value="">


<input name="ElectronicallySigned" id="ElectronicallySigned" type="text" class="noborder" style="position:absolute; left:200px; top:923px; width:185px; height:24px; font-family:sans-serif; font-style:italic; font-weight:bold; font-size:14px; text-align:left; text-decoration:underline; background-color:white;" value="Electronically Signed">


<input name="DoctorPrintedName" id="DoctorPrintedName" type="text" class="noborder" style="position:absolute; left:490px; top:923px; width:192px; height:24px; font-family:sans-serif; font-style:italic; font-weight:bold; font-size:14px; text-align:left; text-decoration:underline; background-color:white;"  oscarDB=current_user>


</div>

		<div id="page2" style="position:relative; left:0px; top:0px; width:750px;" class="pagebreak">
			<img id="BGImage2" src="${oscar_image_path}outpatientanticoag2.png"  width="750px">

			


<textarea name="Label2" id="Label2" class="noborder" style="position:absolute; left:456px; top:21px; width:264px; height:144px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px; text-align:left; background-color:white;"  oscarDB=label></textarea>


<input name="Allergies2" id="Allergies2" type="text" class="noborder" style="position:absolute; left:67px; top:205px; width:654px; height:32px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px; text-align:left; background-color:white;"  oscarDB=allergies_des>


<input name="ReassessmentNumber2" id="ReassessmentNumber2" type="text" class="noborder" style="position:absolute; left:201px; top:300px; width:73px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px;text-align:left; text-decoration:underline; background-color:white;" value="">


<div style="position: absolute; left: 311px; top: 302px; ">


<input type="text" name="cal1" id="cal1"
	 value=""
	 size='7' maxlength='7' style="zIndex:7; text-decoration:underline;" >

<img src="../images/cal.gif" id="xml_vdate_cal1" />

</div>

<span class="DoNotPrint" style="position: absolute; left: 447px; top: 284px; font-family: sans-serif; font-style:normal; background-color: pink; font-weight:normal; font-size: 10px; " onClick="document.FormName.Time2.value=The12Time;">Click for Time Stamp</span>

<input name="Time2" id="Time2" type="text" class="noborder" style="position:absolute; left:447px; top:300px; width:157px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px;text-align:left; text-decoration:underline; background-color:white;" value="">


<input name="Warfarin2" id="Warfarin2" type="text" style="position:absolute; left:127px; top:328px; width:16px; height:16px; border:1px solid #000000; font-weight:bold; text-align:center; background-color:white;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);setDirtyFlag()" onkeypress="javascript:return displayKeyCode(event,this.id);" >


<input name="WarfarinMg2" id="WarfarinMg2" type="text" class="noborder" style="position:absolute; left:206px; top:324px; width:49px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px;text-align:left; text-decoration:underline; background-color:white;" value="">


<input name="WarfarinDays2" id="WarfarinDays2" type="text" class="noborder" style="position:absolute; left:296px; top:324px; width:41px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px; text-align:right; text-decoration:underline; background-color:white;" value="">


<input name="INR2" id="INR2" type="text" style="position:absolute; left:127px; top:348px; width:16px; height:16px; border:1px solid #000000; font-weight:bold; text-align:center; background-color:white;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);setDirtyFlag()" onkeypress="javascript:return displayKeyCode(event,this.id);" >


<input name="INRText2" id="INRText2" type="text" class="noborder" style="position:absolute; left:219px; top:348px; width:206px; height:22px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px;text-align:left; text-decoration:underline; background-color:white;" value="">


<input name="DiscontinueLMWH2" id="DiscontinueLMWH2" type="text" style="position:absolute; left:127px; top:366px; width:16px; height:16px; border:1px solid #000000; font-weight:bold; text-align:center; background-color:white;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);setDirtyFlag()" onkeypress="javascript:return displayKeyCode(event,this.id);" >


<input name="Discharge2" id="Discharge2" type="text" style="position:absolute; left:127px; top:385px; width:16px; height:16px; border:1px solid #000000; font-weight:bold; text-align:center; background-color:white;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);setDirtyFlag()" onkeypress="javascript:return displayKeyCode(event,this.id);" >


<input name="NextAssessment2" id="NextAssessment2" type="text" class="noborder" style="position:absolute; left:206px; top:404px; width:177px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px;text-align:left; text-decoration:underline; background-color:white;" value="">


<input name="NextAssessmentDate2" id="NextAssessmentDate2" type="text" class="noborder" style="position:absolute; left:420px; top:404px; width:80px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px;text-align:left; text-decoration:underline; background-color:white;" value="">


<input name="NextAssessmentTime2" id="NextAssessmentTime2" type="text" class="noborder" style="position:absolute; left:539px; top:404px; width:92px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px;text-align:left; text-decoration:underline; background-color:white;" value="">


<input name="GP2" id="GP2" type="text" style="position:absolute; left:169px; top:431px; width:16px; height:16px; border:1px solid #000000; font-weight:bold; text-align:center; background-color:white;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);setDirtyFlag()" onkeypress="javascript:return displayKeyCode(event,this.id);" >


<input name="ERP2" id="ERP2" type="text" style="position:absolute; left:246px; top:430px; width:16px; height:16px; border:1px solid #000000; font-weight:bold; text-align:center; background-color:white;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);setDirtyFlag()" onkeypress="javascript:return displayKeyCode(event,this.id);" >


<input name="Reassess2" id="Reassess2" type="text" style="position:absolute; left:331px; top:431px; width:16px; height:16px; border:1px solid #000000; font-weight:bold; text-align:center; background-color:white;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);setDirtyFlag()" onkeypress="javascript:return displayKeyCode(event,this.id);" >


<input name="ReassessOther2" id="ReassessOther2" type="text" class="noborder" style="position:absolute; left:391px; top:429px; width:232px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px;text-align:left; text-decoration:underline; background-color:white;" value="">


<input name="Signature2" id="Signature2" type="text" class="noborder" style="position:absolute; left:213px; top:453px; width:175px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px;text-align:left; text-decoration:underline; background-color:white;" value="">


<input name="Printed2" id="Printed2" type="text" class="noborder" style="position:absolute; left:498px; top:453px; width:212px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px;text-align:left; text-decoration:underline; background-color:white;" value="">


<input name="ReassessmentNumber3" id="ReassessmentNumber3" type="text" class="noborder" style="position:absolute; left:201px; top:497px; width:73px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px;text-align:left; text-decoration:underline; background-color:white;" value="">


<div style="position: absolute; left: 314px; top: 501px; ">


<input type="text" name="cal2" id="cal2"
	 value=""
	 size='7' maxlength='7' style="zIndex:7; text-decoration:underline;" >

<img src="../images/cal.gif" id="xml_vdate_cal2" />

</div>


<input name="Time3" id="Time3" type="text" class="noborder" style="position:absolute; left:460px; top:497px; width:157px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px;text-align:left; text-decoration:underline; background-color:white;" value="">

<span class="DoNotPrint" style="position: absolute; left: 460px; top: 521px; font-family: sans-serif; font-style:normal; background-color: pink; font-weight:normal; font-size: 10px; " onClick="document.FormName.Time3.value=The12Time;">Click for Time Stamp</span>


<input name="Warfarin3" id="Warfarin3" type="text" style="position:absolute; left:127px; top:527px; width:16px; height:16px; border:1px solid #000000; font-weight:bold; text-align:center; background-color:white;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);setDirtyFlag()" onkeypress="javascript:return displayKeyCode(event,this.id);" >


<input name="WarfarinMg3" id="WarfarinMg3" type="text" class="noborder" style="position:absolute; left:206px; top:523px; width:49px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px;text-align:left; text-decoration:underline; background-color:white;" value="">


<input name="WarfarinDays3" id="WarfarinDays3" type="text" class="noborder" style="position:absolute; left:296px; top:523px; width:41px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px; text-align:right; text-decoration:underline; background-color:white;" value="">


<input name="INR3" id="INR3" type="text" style="position:absolute; left:127px; top:547px; width:16px; height:16px; border:1px solid #000000; font-weight:bold; text-align:center; background-color:white;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);setDirtyFlag()" onkeypress="javascript:return displayKeyCode(event,this.id);" >


<input name="INRText3" id="INRText3" type="text" class="noborder" style="position:absolute; left:219px; top:547px; width:206px; height:22px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px;text-align:left; text-decoration:underline; background-color:white;" value="">


<input name="DiscontinueLMWH3" id="DiscontinueLMWH3" type="text" style="position:absolute; left:127px; top:565px; width:16px; height:16px; border:1px solid #000000; font-weight:bold; text-align:center; background-color:white;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);setDirtyFlag()" onkeypress="javascript:return displayKeyCode(event,this.id);" >


<input name="Discharge3" id="Discharge3" type="text" style="position:absolute; left:127px; top:584px; width:16px; height:16px; border:1px solid #000000; font-weight:bold; text-align:center; background-color:white;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);setDirtyFlag()" onkeypress="javascript:return displayKeyCode(event,this.id);" >


<input name="NextAssessment3" id="NextAssessment3" type="text" class="noborder" style="position:absolute; left:206px; top:613px; width:177px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px;text-align:left; text-decoration:underline; background-color:white;" value="">


<input name="NextAssessmentDate3" id="NextAssessmentDate3" type="text" class="noborder" style="position:absolute; left:420px; top:613px; width:80px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px;text-align:left; text-decoration:underline; background-color:white;" value="">


<input name="NextAssessmentTime3" id="NextAssessmentTime3" type="text" class="noborder" style="position:absolute; left:539px; top:613px; width:92px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px;text-align:left; text-decoration:underline; background-color:white;" value="">


<input name="GP3" id="GP3" type="text" style="position:absolute; left:169px; top:640px; width:16px; height:16px; border:1px solid #000000; font-weight:bold; text-align:center; background-color:white;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);setDirtyFlag()" onkeypress="javascript:return displayKeyCode(event,this.id);" >


<input name="ERP3" id="ERP3" type="text" style="position:absolute; left:246px; top:640px; width:16px; height:16px; border:1px solid #000000; font-weight:bold; text-align:center; background-color:white;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);setDirtyFlag()" onkeypress="javascript:return displayKeyCode(event,this.id);" >


<input name="Reassess3" id="Reassess3" type="text" style="position:absolute; left:331px; top:640px; width:16px; height:16px; border:1px solid #000000; font-weight:bold; text-align:center; background-color:white;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);setDirtyFlag()" onkeypress="javascript:return displayKeyCode(event,this.id);" >


<input name="ReassessOther3" id="ReassessOther3" type="text" class="noborder" style="position:absolute; left:391px; top:638px; width:232px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px;text-align:left; text-decoration:underline; background-color:white;" value="">


<input name="Signature3" id="Signature3" type="text" class="noborder" style="position:absolute; left:213px; top:664px; width:175px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px;text-align:left; text-decoration:underline; background-color:white;" value="">


<input name="Printed3" id="Printed3" type="text" class="noborder" style="position:absolute; left:500px; top:664px; width:212px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px;text-align:left; text-decoration:underline; background-color:white;" value="">


<input name="ReassessmentNumber4" id="ReassessmentNumber4" type="text" class="noborder" style="position:absolute; left:201px; top:708px; width:73px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px;text-align:left; text-decoration:underline; background-color:white;" value="">


<div style="position: absolute; left: 322px; top: 710px; ">


<input type="text" name="cal3" id="cal3"
	 value=""
	 size='7' maxlength='7' style="zIndex:7; text-decoration:underline;" >

<img src="../images/cal.gif" id="xml_vdate_cal3" />

</div>


<input name="Time4" id="Time4" type="text" class="noborder" style="position:absolute; left:470px; top:708px; width:157px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px;text-align:left; text-decoration:underline; background-color:white;" value="">

<span class="DoNotPrint" style="position: absolute; left: 470px; top: 732px; font-family: sans-serif; font-style:normal; background-color: pink; font-weight:normal; font-size: 10px; " onClick="document.FormName.Time4.value=The12Time;">Click for Time Stamp</span>


<input name="Warfarin4" id="Warfarin4" type="text" style="position:absolute; left:127px; top:738px; width:16px; height:16px; border:1px solid #000000; font-weight:bold; text-align:center; background-color:white;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);setDirtyFlag()" onkeypress="javascript:return displayKeyCode(event,this.id);" >


<input name="WarfarinMg4" id="WarfarinMg4" type="text" class="noborder" style="position:absolute; left:206px; top:734px; width:49px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px;text-align:left; text-decoration:underline; background-color:white;" value="">


<input name="WarfarinDays4" id="WarfarinDays4" type="text" class="noborder" style="position:absolute; left:296px; top:734px; width:41px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px; text-align:right; text-decoration:underline; background-color:white;" value="">


<input name="INR4" id="INR4" type="text" style="position:absolute; left:127px; top:758px; width:16px; height:16px; border:1px solid #000000; font-weight:bold; text-align:center; background-color:white;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);setDirtyFlag()" onkeypress="javascript:return displayKeyCode(event,this.id);" >


<input name="INRText4" id="INRText4" type="text" class="noborder" style="position:absolute; left:219px; top:758px; width:206px; height:22px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px;text-align:left; text-decoration:underline; background-color:white;" value="">


<input name="DiscontinueLMWH4" id="DiscontinueLMWH4" type="text" style="position:absolute; left:127px; top:776px; width:16px; height:16px; border:1px solid #000000; font-weight:bold; text-align:center; background-color:white;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);setDirtyFlag()" onkeypress="javascript:return displayKeyCode(event,this.id);" >


<input name="Discharge4" id="Discharge4" type="text" style="position:absolute; left:127px; top:795px; width:16px; height:16px; border:1px solid #000000; font-weight:bold; text-align:center; background-color:white;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);setDirtyFlag()" onkeypress="javascript:return displayKeyCode(event,this.id);" >


<input name="NextAssessment4" id="NextAssessment4" type="text" class="noborder" style="position:absolute; left:206px; top:824px; width:177px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px;text-align:left; text-decoration:underline; background-color:white;" value="">


<input name="NextAssessmentDate4" id="NextAssessmentDate4" type="text" class="noborder" style="position:absolute; left:452px; top:824px; width:80px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px;text-align:left; text-decoration:underline; background-color:white;" value="">


<input name="NextAssessmentTime4" id="NextAssessmentTime4" type="text" class="noborder" style="position:absolute; left:569px; top:824px; width:92px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px;text-align:left; text-decoration:underline; background-color:white;" value="">


<input name="GP4" id="GP4" type="text" style="position:absolute; left:169px; top:853px; width:16px; height:16px; border:1px solid #000000; font-weight:bold; text-align:center; background-color:white;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);setDirtyFlag()" onkeypress="javascript:return displayKeyCode(event,this.id);" >


<input name="ERP4" id="ERP4" type="text" style="position:absolute; left:246px; top:853px; width:16px; height:16px; border:1px solid #000000; font-weight:bold; text-align:center; background-color:white;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);setDirtyFlag()" onkeypress="javascript:return displayKeyCode(event,this.id);" >


<input name="Reassess4" id="Reassess4" type="text" style="position:absolute; left:331px; top:853px; width:16px; height:16px; border:1px solid #000000; font-weight:bold; text-align:center; background-color:white;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);setDirtyFlag()" onkeypress="javascript:return displayKeyCode(event,this.id);" >


<input name="ReassessOther4" id="ReassessOther4" type="text" class="noborder" style="position:absolute; left:391px; top:849px; width:232px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px;text-align:left; text-decoration:underline; background-color:white;" value="">


<input name="Signature4" id="Signature4" type="text" class="noborder" style="position:absolute; left:213px; top:890px; width:175px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px;text-align:left; text-decoration:underline; background-color:white;" value="">


<input name="Printed4" id="Printed4" type="text" class="noborder" style="position:absolute; left:500px; top:890px; width:212px; height:23px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:14px;text-align:left; text-decoration:underline; background-color:white;" value="">




		</div>



<!-- The submit/print/reset buttons ------------------------------------------------------------->
<div class="DoNotPrint" id="BottomButtons">
		<table>
		<tr><td>
		<input type="hidden" id="newForm" name="newForm" value="True" />				
		Subject: <input name="subject" size="40" type="text"> 
		<input value="Submit" name="SubmitButton" id="SubmitButton" type="button" onclick="releaseDirtyFlag();submission()">
		<input value="Reset" name="ResetButton" id="ResetButton" type="reset"> 
		<input value="Print" name="PrintButton" id="PrintButton" type="button" onclick="printLetter()"> 			
		<input value="Print and Submit" name="PrintSubmitButton" type="button" onClick="printSubmit()">
		</td></tr>
		</table>
</div>
<!-- ------End of submit/print/reset buttons----------------------------------------------------->
</form>

<script type="text/javascript">

Calendar.setup( { inputField : "cal1", ifFormat : "%Y-%m-%d", showsTime :false, button : "xml_vdate_cal1", singleClick : true, step : 1 } );
Calendar.setup( { inputField : "cal2", ifFormat : "%Y-%m-%d", showsTime :false, button : "xml_vdate_cal2", singleClick : true, step : 1 } );
Calendar.setup( { inputField : "cal3", ifFormat : "%Y-%m-%d", showsTime :false, button : "xml_vdate_cal3", singleClick : true, step : 1 } );


</script>



</body>
</html>

Document Actions

 

Download button

DOWNLOAD OSCAR FOR TESTING

 

eForms button

DOWNLOAD SHARED E-FORMS


 Customize button

FIND PLUG-INS AND TWEAKS
FOR YOUR OSCAR EMR

 

Subscribe Button

SUBSCRIBE TO DISCUSSION LIST 
(SEE ALL LISTS)

  

Help button

ACCESS THE ONLINE MANUALS
(PAID SUPPORT)