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@Cheten
Created March 1, 2016 05:30
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How do I create a JSP Form to use during Patient Registration, Below is the HTML version of the form
<htmlform> <!-- Examination Form 2015 Antenatal--> <macros>
paperFormId = (Fill this in) </macros>
<style>
.section {
border: 1px solid$headerColor;
padding: 2px;
text-align: left;
margin-bottom: 1em;
}
.sectionHeader {
background-color: $headerColor;
color: $fontOnHeaderColor;
display: block;
padding: 2px;
font-weight: bold;
}
table.baseline-aligned td {
vertical-align: baseline;
}
</style>
<h2>History on Booking(v1.0)</h2>
<section headerLabel="1. Encounter Details">
<table class="baseline-aligned">
<tr>
<td>Date:</td>
<td><encounterDate default="today" /></td>
</tr>
<tr>
<td>Location:</td>
<td><encounterLocation /></td>
</tr>
<tr>
<td>Provider:</td>
<td><encounterProvider /></td>
</tr>
<tr>
<td>Patient Name:</td>
<td><lookup class="value" expression="patient.personName" /></td>
</tr>
</table>
<!-- End of Encounter Section Details -->
<!-- Start of Examination Section here -->
<!-- End of Encounter Section Details -->
</section>
<!-- Start of Antenatal History Section here -->
<section headerLabel="2. Examination">
<table border="1" cellspacing="0" class="baseline-aligned">
<tr>
<td>
<table border="1" cellspacing="0">
<tr>
<td>
<table>
<tr>
<td><b>Reason For Visit:</b></td>
<td><obs conceptId="CIEL:48" style="radio"
answerConceptIds="460,1499"
answerLabels="Planning Pregnancy, Currently Pregnant, Other" />
</td>
</tr>
</table>
<table>
<tr>
<td><b>If Pregnant, was <br />pregnancy intended?
</b></td>
<td><obs conceptId="CIEL:48" style="radio"
answerConceptIds="1065,1066,1067"
answerLabels="Yes, No, Unknown" /></td>
</tr>
</table>
</td>
</tr>
<tr>
<td>
<table>
<tr>
<td><b>Last Menstrual Period:</b> <encounterDate
default="today" /></td>
</tr>
</table>
</td>
</tr>
<tr>
<td>
<table>
<tr>
<td><b>Date of Delivery:</b> <encounterDate
default="today" /></td>
</tr>
</table>
</td>
</tr>
<tr>
<td>
<table>
<tr>
<td><b>Blood Type:</b></td>
<td><obs conceptId="CIEL:48" style="radio"
answerConceptIds="460, 5088,5089, 5090, 5092,1001, 1002,1004"
answerLabels="A+, A-, B+, B-, 0+, 0-,AB+, AB-" /></td>
</tr>
</table>
</td>
</tr>
</table>
</td>
<td>
<table border="1" cellspacing="0">
<tr>
<td>
<table>
<tr>
<td><b>HIV Test:</b></td>
<td><obs conceptId="CIEL:138405" style="radio"
answerConceptIds="1065,1066,1067"
answerLabels="Yes, No, Unknown" /></td>
</tr>
</table>
</td>
</tr>
<tr>
<td>
<table>
<tr>
<td><b>Partner's HIV Status:</b></td>
<td><obs conceptId="CIEL:138405" style="radio"
answerConceptIds="1065,1066,1067"
answerLabels="Negative, Positive, Unknown" /></td>
</tr>
</table>
</td>
</tr>
</table>
</td>
<td>
<table>
<tr>
<td><b>Recent Contraceptive Use:</b> <br /> <obs
conceptId="CIEL:48" answerConceptId="460" answerLabel="None"
style="checkbox" /> <br /> <obs conceptId="CIEL:460"
answerConceptId="460" answerLabel="Oral Contraception"
style="checkbox" /> <br /> <obs conceptId="CIEL:460"
answerConceptId="460" answerLabel="Condoms" style="checkbox" />
<br /> <obs conceptId="CIEL:460" answerConceptId="460"
answerLabel="Natural Planning / Rhythm" style="checkbox" /> <br />
<obs conceptId="CIEL:460" answerConceptId="460"
answerLabel="Diaphragm" style="checkbox" /> <br /> <obs
conceptId="CIEL:460" answerConceptId="460"
answerLabel="Depo-Provera" style="checkbox" /> <br /> <obs
conceptId="CIEL:460" answerConceptId="460"
answerLabel="Norplant" style="checkbox" /> <br /> <obs
conceptId="CIEL:460" answerConceptId="460" answerLabel="Surgery"
style="checkbox" /> <br /> <obs conceptId="CIEL:460"
answerConceptId="460" answerLabel="Other" style="checkbox" /> <br />
</td>
</tr>
</table>
</td>
<td>
<table>
<tr>
<td><b>Previous Pregnancy:</b> <br /> <obs
conceptId="CIEL:48" answerConceptId="117399"
answerLabel="Hypertensive Disorders" style="checkbox" /> <br />
<obs conceptId="CIEL:48" answerConceptId="117399"
answerLabel="Low Birth Weight Baby" style="checkbox" /> <br />
<obs conceptId="CIEL:48" answerConceptId="117399"
answerLabel="Neonatal loss" style="checkbox" /> <br /> <obs
conceptId="CIEL:48" answerConceptId="117399"
answerLabel="Miscarriage / Still birth" style="checkbox" /> <br />
<obs conceptId="CIEL:48" answerConceptId="160865"
answerLabel="Previous Cesarean " style="checkbox" /> <br /> <obs
conceptId="CIEL:48" answerConceptId="117399"
answerLabel="Antepartum Hemorrhage" style="checkbox" /> <br />
<obs conceptId="CIEL:230" answerConceptId="160210"
answerLabel="Postpartum Hemorrhage" style="checkbox" /> <br />
<obs conceptId="CIEL:230" answerConceptId="123841"
answerLabel="Postterm delivery" style="checkbox" /> <br /> <obs
conceptId="CIEL:48" answerConceptId="117399"
answerLabel="Prolonged Labor" style="checkbox" /> <br /> <obs
conceptId="CIEL:48" answerConceptId="117399"
answerLabel="Recto-vaginal Fistula" style="checkbox" /> <br />
<obs conceptId="CIEL:48" answerConceptId="117399"
answerLabel="Severe Anaemia" style="checkbox" /> <br />
<p>
<label><uimessage
code="coreapps.consult.freeTextComments" /></label>
<obs conceptId="CIEL:162169" style="textarea" rows="5" />
</p></td>
</tr>
</table>
</td>
</tr>
</table>
</section>
<submit/>
</htmlform>
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