47 lines
3.6 KiB
HTML
47 lines
3.6 KiB
HTML
<div class="reg-body-wrapper">
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<div class="simple-form-ui new-patient">
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<form name="myForm" class="form-horizontal well" single-submit="create()">
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<div class="box-container box-container-default">
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<legend class="registraion_legend first-registraion_legend">
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<span class="mylegend"><strong>{{::'REGISTRATION_LABEL_NEW_PATIENT' | translate}}</strong></span>
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</legend>
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<section class="clearfix">
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<div class="photo-container-wrapper" ng-if="!disablePhotoCapture">
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<span class="pull-right photo-container">
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<img class="patient-image" ng-src="{{patient.image}}" fallback-src="../images/blank-user.gif">
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<div ng-model="patient.image" capture-photo="" class="capture-photo-btn"></div>
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</span>
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</div>
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</section>
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<section>
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<article class="form-field existing-patient">
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<div class="field-attribute">
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<label class="control-label" for="patientID">{{:: getTranslatedPatientIdentifier(patient.primaryIdentifier.identifierType.name) | translate}}
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<span ng-show="::patient.primaryIdentifier.identifierType.required && !patient.primaryIdentifier.hasIdentifierSources()" class="asterick">*</span>
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</label>
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</div>
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<div ng-show="::(patient.primaryIdentifier.hasIdentifierSources() && !patient.primaryIdentifier.hasIdentifierSourceWithEmptyPrefix())" class="field-value" id="patientID">
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<select id="identifierPrefix" ng-model="patient.primaryIdentifier.selectedIdentifierSource" ng-options="identifierSource.prefix for identifierSource in ::patient.primaryIdentifier.identifierType.identifierSources" ng-change="patient.primaryIdentifier.generate()" required>
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</select>
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</div>
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<div class="field-value field-value-has-identifier">
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<input type="text" id="registrationNumber" ng-model="patient.primaryIdentifier.registrationNumber" placeholder="{{:: getTranslatedPatientIdentifier(patient.primaryIdentifier.identifierType.description)}}" non-blank="patient.primaryIdentifier.isIdentifierRequired()" pattern-validate ng-change="patient.primaryIdentifier.generate()" focus-on="patient.primaryIdentifier.hasOldIdentifier" ng-show="patient.primaryIdentifier.hasOldIdentifier || !patient.primaryIdentifier.hasIdentifierSources()">
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<div ng-show="::patient.primaryIdentifier.hasIdentifierSources() && showEnterID" class="fl">
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<div class="field-attribute hasOldIdentifier-field-attribute">
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<label for="hasOldIdentifier" class="control-label">{{::'REGISTRATION_LABEL_ENTER_ID' | translate}}</label>
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</div>
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<div class="field-value">
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<input class="input-label-inline" ng-show="::showEnterID" type="checkbox" id="hasOldIdentifier" ng-model="patient.primaryIdentifier.hasOldIdentifier" ng-change="patient.primaryIdentifier.clearRegistrationNumber()">
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</div>
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</div>
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</div>
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</article>
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</section>
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</div>
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<div ng-include="'views/patientcommon.html'"></div>
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<patient-action></patient-action>
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</form>
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<br>
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</div>
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</div> |