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| # | Location | File | Last Modified |
|---|---|---|---|
| 1 | Fri Jun 9 19:51:40 2017 UTC | ||
| 2 | eHealth_Exch (eHealth Exchange Enhancements) Build 3 docs & code_May_2017.zip\VAP_CIF_CODE0502.zip\VAP_CIF_CODE0502\VAP_CIF_CODE0502\nvap-web\src\main\webapp\WEB-INF\web | customizeLetter.jsp | Fri Apr 21 20:03:30 2017 UTC |
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| 1 | <%@taglib uri="http: //java.sun .com/jsp/j stl/core" prefix="c" %> | |||||
| 2 | <%@taglib uri="http: //java.sun .com/jsp/j stl/functi ons" prefi x="fn"%> | |||||
| 3 | <%@taglib uri="http: //java.sun .com/jsp/j stl/fmt" p refix="fmt "%> | |||||
| 4 | <%@taglib tagdir="/W EB-INF/tag s/cpp" pre fix="cpp"% > | |||||
| 5 | <%@taglib tagdir="/W EB-INF/tag s/date" pr efix="date "%> | |||||
| 6 | ||||||
| 7 | <script> | |||||
| 8 | jQuery (document) .ready(fun ction () { | |||||
| 9 | // Help text for signat ure block. | |||||
| 10 | jQ uery('#sig nature').a ttr("place holder","F irst name Last name \nFacility Role \nCo ntact Info rmation"); | |||||
| 11 | }); | |||||
| 12 | </script> | |||||
| 13 | ||||||
| 14 | <div class ="form-con tainer"> | |||||
| 15 | <field set> | |||||
| 16 | <l egend>Opti ons</legen d> | |||||
| 17 | <f orm action ="PatientD etails.do_ sec" metho d="POST" e nctype="mu ltipart/fo rm-data" o nsubmit="r eturn doSu bmit(this) "> | |||||
| 18 | <input t ype="hidde n" id="del ayCollecti on" name=" delayColle ction" val ue="<c:out value="${ delayedCon sent.delay ReasonColl ection}"/> " /> | |||||
| 19 | <div> | |||||
| 20 | <lab el for="pa tientName" >Patient</ label> | |||||
| 21 | <inp ut type="h idden" id= "patientNa me"> | |||||
| 22 | <str ong> | |||||
| 23 | <c:out val ue="${pati entDemogra phics.firs tName}"/> | |||||
| 24 | <c:if test ="${!empty patientDe mographics .middleNam e}"><c:out value="${ fn:substri ng(patient Demographi cs.middleN ame,0,1)}" />. </c:if >${patient Demographi cs.lastNam e} | |||||
| 25 | <c:out val ue="${pati entDemogra phics.suff ix}"/> | |||||
| 26 | </st rong> | |||||
| 27 | <br /><br /> | |||||
| 28 | </div> | |||||
| 29 | <div> | |||||
| 30 | <lab el for="au thenticati ngFacility "> | |||||
| 31 | Authentica ting Facil ity | |||||
| 32 | <img alt=" Required f ield" src= "res/star- icon_grey_ bg.png" /> | |||||
| 33 | </la bel> | |||||
| 34 | <sel ect id="au thenticati ngFacility " name="au thenticati ngFacility " style="w idth: 585p x; overflo w: auto;"> | |||||
| 35 | <c:forEach var="f" i tems="${al lowedFacil ities}"> | |||||
| 36 | <optio n value="< c:out valu e="${f.fac ilityStati on}"/>" | |||||
| 37 | <c :if test=" ${f.facili tyStation eq default UserFacili ty.facilit yStation}" > | |||||
| 38 | selected | |||||
| 39 | </ c:if>> | |||||
| 40 | <c :choose> | |||||
| 41 | <c:when test="${f. facilityNa me != ''}" > | |||||
| 42 | <c:o ut value=" ${f.facili tyName}"/> | |||||
| 43 | </c:when > | |||||
| 44 | <c:other wise> | |||||
| 45 | <c:o ut value=" ${fn:split (f.facilit yDns, '.') [0]}"/> | |||||
| 46 | </c:othe rwise> | |||||
| 47 | </ c:choose> | |||||
| 48 | (< c:out valu e="${f.fac ilityStati on}"/>) | |||||
| 49 | </opti on> | |||||
| 50 | </c:forEac h> | |||||
| 51 | </se lect> | |||||
| 52 | <br /> <br /> | |||||
| 53 | </div> | |||||
| 54 | <div> | |||||
| 55 | <c:i f test="${ delayedCon sent != nu ll}"> | |||||
| 56 | <input typ e="hidden" name="typ e" id="typ e" value=" delayed" / > | |||||
| 57 | <label for ="delayRea sons"> | |||||
| 58 | Delay Reason<c:i f test="${ fn:length( delayedCon sent.delay ReasonColl ection) > 1}">s</c:i f>: | |||||
| 59 | </label> | |||||
| 60 | <div style ="display: inline-blo ck" id="de lays"> | |||||
| 61 | <c:for Each var=" dr" items= "${delayed Consent.de layReasonC ollection} "> | |||||
| 62 | <c :out value ="${dr.nam e}"/>  ;<br /> | |||||
| 63 | </c:fo rEach> | |||||
| 64 | </div> | |||||
| 65 | </c: if> | |||||
| 66 | <c:i f test="${ consent != null}"> | |||||
| 67 | <c:choose> | |||||
| 68 | <c:whe n test="${ consent.op toutDate = = null}"> | |||||
| 69 | <i nput type= "hidden" n ame="type" id="type" value="ex piring"/> | |||||
| 70 | </c:wh en> | |||||
| 71 | <c:oth erwise> | |||||
| 72 | <i nput type= "hidden" n ame="type" id="type" value="re voked" /> | |||||
| 73 | </c:ot herwise> | |||||
| 74 | </c:choose > | |||||
| 75 | </c: if> | |||||
| 76 | </div> | |||||
| 77 | <div> | |||||
| 78 | <br /> | |||||
| 79 | <lab el for="si gnature"> | |||||
| 80 | Signature | |||||
| 81 | <img alt=" Required f ield" src= "res/star- icon_grey_ bg.png" /> | |||||
| 82 | </la bel> | |||||
| 83 | <tex tarea id=" signature" name="sig nature" on keyup="ena bleLetterG enerate('s ignature') ;" style=" width: 300 px; height : 60px;">< /textarea> | |||||
| 84 | <br /><br /> | |||||
| 85 | <lab el for="ma rkMailed"> Mark as ma iled</labe l> | |||||
| 86 | <inp ut type="c heckbox" t itle="Mark as mailed " name="ma rkMailed" id="markMa iled" valu e="true" s tyle="padd ing-left: 50em;" />< br/><br/> | |||||
| 87 | </div> | |||||
| 88 | <div> | |||||
| 89 | <cen ter> | |||||
| 90 | <input id= "Generate" class="bu tton" type ="submit" disabled=" disabled" value="Gen erate" nam e="generat eLetter" t itle="Gene rate" oncl ick='close AndReload( );'> | |||||
| 91 | </ce nter> | |||||
| 92 | </div> | |||||
| 93 | </ form> | |||||
| 94 | </fiel dset> | |||||
| 95 | </div> |
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