212 lines
11 KiB
PHP
212 lines
11 KiB
PHP
<!DOCTYPE html>
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<html lang="en">
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<head>
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<meta charset="UTF-8">
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<meta name="viewport" content="width=device-width, initial-scale=1">
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<title>Add Patient</title>
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<link href="https://cdn.jsdelivr.net/npm/bootstrap@5.3.0/dist/css/bootstrap.min.css" rel="stylesheet">
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<link rel="stylesheet" href="https://cdn.jsdelivr.net/npm/bootstrap-icons@1.11.3/font/bootstrap-icons.min.css">
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<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/6.5.0/css/all.min.css">
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<script src="https://cdn.jsdelivr.net/npm/bootstrap@5.3.0/dist/js/bootstrap.bundle.min.js"></script>
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<link rel="stylesheet" href="<?= base_url('css/app.css') ?>">
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<link rel="stylesheet" href="<?= base_url('css/dashboard.css') ?>">
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<link rel="stylesheet" href="<?= base_url('css/add_doctor.css') ?>">
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</head>
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<body class="app-body overview-layout">
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<?php $validationErrors = validation_errors(); ?>
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<?php
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$isEdit = $isEdit ?? false;
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$patient = $patient ?? null;
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$user = $user ?? null;
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?>
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<aside class="ov-sidebar" id="sidebar">
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<div class="ov-brand"><h1><i class="bi bi-hospital me-1"></i> DoctGuide</h1><span>Control Panel</span></div>
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<nav class="ov-nav">
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<div class="ov-nav__section">Main</div>
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<a href="<?= base_url('admin/dashboard') ?>" class="ov-nav__link"><i class="bi bi-speedometer2"></i> Dashboard</a>
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<div class="ov-nav__section">Manage</div>
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<div class="ov-nav__dropdown">
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<a href="#" class="ov-nav__link d-flex justify-content-between align-items-center" onclick="toggleNavDropdown(event, this)">
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<span><i class="bi bi-person-badge"></i> Doctors</span>
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<i class="bi bi-chevron-down dropdown-icon"></i>
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</a>
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<div class="ov-dropdown-menu">
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<a href="<?= base_url('admin/doctors') ?>" class="ov-nav__sublink">Doctor List</a>
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<a href="<?= base_url('admin/doctors/add') ?>" class="ov-nav__sublink">Add Doctor</a>
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</div>
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</div>
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<div class="ov-nav__dropdown active">
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<a href="#" class="ov-nav__link d-flex justify-content-between align-items-center" onclick="toggleNavDropdown(event, this)">
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<span><i class="bi bi-people"></i> Patients</span>
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<i class="bi bi-chevron-down dropdown-icon"></i>
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</a>
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<div class="ov-dropdown-menu">
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<a href="<?= base_url('admin/patients') ?>" class="ov-nav__sublink">Patient List</a>
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<a href="<?= base_url('admin/patients/add') ?>" class="ov-nav__sublink">Add Patient</a>
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</div>
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</div>
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<a href="<?= base_url('admin/appointments') ?>" class="ov-nav__link"><i class="bi bi-calendar2-check"></i> Appointments</a>
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<a href="<?= base_url('admin/activity-log') ?>" class="ov-nav__link"><i class="bi bi-clipboard-data"></i> Activity Log</a>
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</nav>
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<div class="ov-sidebar__footer"><a href="<?= base_url('logout') ?>"><i class="bi bi-box-arrow-left"></i> Logout</a></div>
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</aside>
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<div class="ov-main" id="mainContent">
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<header class="ov-topbar">
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<div class="d-flex align-items-center">
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<button class="ov-toggle-btn" onclick="toggleSidebar()" title="Toggle Sidebar"><i class="bi bi-list" id="toggleIcon"></i></button>
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<p class="ov-topbar__title mb-0">Patient Profile</p>
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</div>
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</header>
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<main class="ov-content">
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<?php if (session()->getFlashdata('error')): ?>
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<div class="alert alert-danger app-alert"><?= esc(session()->getFlashdata('error')) ?></div>
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<?php endif; ?>
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<div class="ov-panel" style="max-width: 1080px;">
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<div class="ov-panel__header">
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<h2 class="ov-panel__title"><?= $isEdit ? 'Edit Patient Account' : 'Create Patient Account' ?></h2>
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<a href="<?= base_url('admin/patients') ?>" class="btn btn-sm btn-outline-secondary px-3">Back to patients</a>
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</div>
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<div class="ov-panel__body">
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<span class="badge bg-light text-dark border mb-3 p-2">Fields marked with <span class="text-danger">*</span> are required.</span>
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<form method="post" action="<?= $isEdit ? base_url('admin/patients/edit/' . encrypt_id($user['id'])) : base_url('admin/patients/add') ?>" class="app-form" novalidate>
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<?= csrf_field() ?>
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<div class="row g-3">
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<div class="col-md-6">
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<?= view('components/name_field', [
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'fieldName' => 'first_name',
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'fieldLabel' => 'First name',
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'fieldId' => 'first_name',
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'fieldValue' => old('first_name', $first_name ?? ''),
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'required' => true,
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'validationErrors' => $validationErrors,
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'placeholder' => 'Enter first name',
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]) ?>
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</div>
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<div class="col-md-6">
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<?= view('components/name_field', [
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'fieldName' => 'last_name',
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'fieldLabel' => 'Last name',
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'fieldId' => 'last_name',
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'fieldValue' => old('last_name', $last_name ?? ''),
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'required' => true,
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'validationErrors' => $validationErrors,
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'placeholder' => 'Enter last name',
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]) ?>
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</div>
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<div class="col-md-6">
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<label class="form-label" for="email">Email <span class="text-danger">*</span></label>
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<input type="email" name="email" id="email" onblur="checkEmail()" value="<?= esc(old('email', $user['email'] ?? '')) ?>" class="form-control <?= isset($validationErrors['email']) ? 'is-invalid' : '' ?>" autocomplete="off" placeholder="example@gmail.com" required>
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<small id="emailError" class="text-danger"></small>
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<?= validation_show_error('email') ?>
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</div>
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<div class="col-md-6">
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<label class="form-label" for="phone">
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Phone <span class="text-danger">*</span>
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</label>
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<div class="input-group">
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<span class="input-group-text">+91</span>
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<input type="tel" name="phone" id="phone" pattern="[0-9]{10}" maxlength="10"
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value="<?= esc(old('phone')) ?>"
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class="form-control <?= isset($validationErrors['phone']) ? 'is-invalid' : '' ?>"
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placeholder="Enter phone number"
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autocomplete="tel"
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required>
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</div>
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<?= validation_show_error('phone') ?>
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</div>
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<div class="col-12">
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<?= view('components/password_field', ['id' => 'password']) ?>
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</div>
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<div class="col-md-6">
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<label class="form-label" for="dob">Date of Birth</label>
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<input type="date" name="dob" id="dob"
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value="<?= esc(old('dob', $patient['dob'] ?? '')) ?>"
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class="form-control <?= isset($validationErrors['dob']) ? 'is-invalid' : '' ?>"
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max="<?= date('Y-m-d') ?>">
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<?= validation_show_error('dob') ?>
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</div>
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<div class="col-md-6">
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<label class="form-label" for="gender">Gender</label>
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<?php $selectedGender = old('gender', $patient['gender'] ?? ''); ?>
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<select name="gender" id="gender" class="form-select <?= isset($validationErrors['gender']) ? 'is-invalid' : '' ?>">
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<option value="">Select gender</option>
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<option value="male" <?= $selectedGender === 'male' ? 'selected' : '' ?>>Male</option>
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<option value="female" <?= $selectedGender === 'female' ? 'selected' : '' ?>>Female</option>
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<option value="other" <?= $selectedGender === 'other' ? 'selected' : '' ?>>Other</option>
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</select>
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<?= validation_show_error('gender') ?>
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</div>
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</div>
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<div class="d-flex flex-wrap gap-4 justify-content-between mt-4">
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<a href="<?= base_url('admin/dashboard') ?>" class="btn btn-outline-secondary rounded-pill px-3">Cancel</a>
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<button type="submit" class="btn btn-app-primary px-4 py-2"><?= $isEdit ? 'Update patient' : 'Add patient' ?></button>
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</div>
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</form>
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</div>
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</div>
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</main>
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</div>
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<script>
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function toggleSidebar() {
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const sidebar = document.getElementById('sidebar');
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const main = document.getElementById('mainContent');
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const icon = document.getElementById('toggleIcon');
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sidebar.classList.toggle('collapsed');
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main.classList.toggle('expanded');
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icon.className = sidebar.classList.contains('collapsed') ? 'bi bi-layout-sidebar' : 'bi bi-list';
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}
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function toggleNavDropdown(event, element) {
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event.preventDefault();
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element.parentElement.classList.toggle('active');
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}
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function checkEmail() {
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const email = document.getElementById('email').value;
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const errorField = document.getElementById('emailError');
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const excludeId = <?= $isEdit ? (int) ($user['id'] ?? 0) : 0 ?>;
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if (email === '') {
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errorField.innerText = '';
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document.getElementById('email').classList.remove('is-invalid');
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return;
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}
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fetch("<?= base_url('check-email') ?>", {
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method: "POST",
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headers: {
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"Content-Type": "application/x-www-form-urlencoded",
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},
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body: "email=" + encodeURIComponent(email)
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+ "&exclude_id=" + encodeURIComponent(excludeId)
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+ "&<?= csrf_token() ?>=<?= csrf_hash() ?>",
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})
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.then(response => response.json())
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.then(data => {
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if (data.exists) {
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errorField.innerText = "Email already exists!";
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document.getElementById('email').classList.add('is-invalid');
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} else {
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errorField.innerText = '';
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document.getElementById('email').classList.remove('is-invalid');
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}
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})
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.catch(error => console.log(error));
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}
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</script>
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</body>
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</html>
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