-
Notifications
You must be signed in to change notification settings - Fork 0
/
Copy pathform_edit_rek.php
105 lines (98 loc) · 2.64 KB
/
form_edit_rek.php
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
<!DOCTYPE html>
<html>
<head>
<title>Edit Rekam Medis | Web Klinik 08</title>
<link rel="stylesheet" href="css/form.css">
</head>
<body>
<div class="judul">
<h2>Edit Rekam Medis</h2>
</div>
<center>
<br />
<a href="rmedis.php">
<button>
< Lihat Semua Data</button>
</a>
</center>
<form action="proses_edit_rek.php" method="post">
<?php
include "koneksi.php";
$nama_pasien = $_GET['nama_pasien'];
$query = mysqli_query($koneksi, "SELECT * FROM rkmedis WHERE nama_pasien = '$nama_pasien'") or die(mysqli_error($koneksi));
$data = mysqli_fetch_array($query);
$query1 = "SELECT nama_pasien FROM pasien";
$query2 = "SELECT nama_dokter FROM dokter";
$result1 = $koneksi->query($query1);
$result2 = $koneksi->query($query2);
?>
<table>
<tr>
<td></td>
<td>
<h3>Edit Rekam Medis</h3>
</td>
</tr>
<tr>
<td>No Rekam</td>
<td><input type="text" name="no_rek" value="<?php echo $data['no_rek'] ?>" required></td>
</tr>
<tr>
<td>Nama Pasien</td>
<td>
<select name="nama_pasien" class="selectt" required>
<option value="">Pilih Nama Pasien</option>
<?php
if ($result1->num_rows > 0) {
while ($row = $result1->fetch_assoc()) {
echo "<option value='" . $row['nama_pasien'] . "' $selected>" . htmlspecialchars($row['nama_pasien']) . "</option>";
}
} else {
echo "<option value=''>Tidak ada data pasien</option>";
}
?>
</select>
</td>
</tr>
<tr>
<td>Tanggal Kunjungan</td>
<td><input type="date" name="tgl_kunjung" value="<?php echo $data['tgl_kunjung'] ?>" class="selectt" required></td>
</tr>
<tr>
<td>Nama Dokter</td>
<td>
<select name="nama_dokter" class="selectt" required>
<option value="">Pilih Nama Dokter</option>
<?php
if ($result2->num_rows > 0) {
while ($row = $result2->fetch_assoc()) {
echo "<option value='" . $row['nama_dokter'] . "' $selected>" . htmlspecialchars($row['nama_dokter']) . "</option>";
}
} else {
echo "<option value=''>Tidak ada data dokter</option>";
}
?>
</select>
</td>
</tr>
<tr>
<tr>
<td>Keluhan</td>
<td><input type="text" name="keluhan" value="<?php echo $data['keluhan'] ?>" required>
</td>
</tr>
<tr>
<td>Diagnosis</td>
<td><input type="text" name="diagnosis" value="<?php echo $data['diagnosis'] ?>" required></td>
</tr>
<tr>
<td>Terapi</td>
<td><input type="text" name="terapi" value="<?php echo $data['terapi'] ?>" required></td>
</tr>
<td></td>
<td><button type="submit">Simpan</button></td>
</tr>
</table>
</form>
</body>
</html>