biopsiesprostateform.ascx

医疗决策支持系统

<%@ Register TagPrefix="val" Namespace="Caisis.UI.Core.Classes" Assembly="Caisis.UI" %>
<%@ Register TagPrefix="val" TagName="DataEntryCommonFields" Src="../../../Core/DataEntryForms/DataEntryCommonFields.ascx" %>
<%@ Register TagPrefix="uc1" TagName="helpToolTip" Src="../../../Core/Help/helpToolTip.ascx" %>
<%@ Control Language="c#" AutoEventWireup="false" Codebehind="BiopsiesProstateForm.ascx.cs" Inherits="Caisis.UI.Modules.Prostate.DataEntryForms.BiopsyProstateForm" TargetSchema="http://schemas.microsoft.com/intellisense/ie5" %>
<val:DataEntryCommonFields id="commonFields" runat="server"></val:DataEntryCommonFields>
<table align="center" class="pdFormTable" width="440" border="0">
	<input type="hidden" tabindex="101" id="BiopsyProstateId" runat="server" NAME="BiopsyProstateId">
	<input type="hidden" tabindex="102" id="BxSummary" class="pdFormField" runat="server" NAME="BxSummary">
	<tr>
		<td class="pdFormFieldLabel"><val:PDLabel id="BxCPT_Code_PdLabel" Text="CPT Code:" Field="BxCPT_Code" Required="No" runat="server" /></td>
		<td><input type="text" tabindex="1" id="BxCPT_Code" class="pdFormField" runat="server" maxlength="50" NAME="BxCPT_Code"></td>
	</tr>
	<tr>
		<td nowrap class="pdFormFieldLabel"><val:PDLabel id="BxCPT_Description_PdLabel" Text="CPT Description:" Field="BxCPT_Description" Required="No" runat="server" /></td>
		<td colspan="3"><input type="text" tabindex="2" id="BxCPT_Description" class="pdFormField" maxlength="250" runat="server" NAME="BxCPT_Description"></td>
	</tr>
	<tr>
		<td class="pdFormFieldLabel"><val:PDLabel id="BxDateText_PdLabel" Text="Date:" Field="BxDateText" Required="No" runat="server" /></td>
		<td><input type="text" tabindex="3" id="BxDateText" class="pdFormField" onblur="fuzzyDate(BxDateText);" runat="server" NAME="BxDateText"><img id="BxDateTextCal" runat="server" src="../../../Images/Calendar/cal.gif" width="16" height="16" border="0" alt="select date" align="absMiddle"></td>
		<td colspan="2" align="left" class="pdFormFieldLabel">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<input type="checkbox" tabindex="99" id="BxPending" value="1" runat="server" NAME="BxPending"><val:PDLabel id="BxPending_PdLabel" Text="Pending:" Field="BxPending" Required="No" runat="server" /></td>
	</tr>
	<tr>
		<td class="pdFormFieldLabel"><val:PDLabel id="BxDate_PdLabel" Text="" Field="BxDate" Required="No" runat="server" /></td>
		<td colspan="3"><input type="text" readonly tabindex="103"  id="BxDate" class="pdFormField" runat="server" NAME="BxDate"></td>
	</tr>
	<tr>
		<td class="pdFormFieldLabel"><val:PDLabel id="BxType_PdLabel" Text="Type:" Field="BxType" Required="Yes" runat="server" /></td>
		<td colspan="3"><select tabindex="5" id="BxType" class="pdFormField" runat="server" NAME="BxType" /></td>
	</tr>
	<tr>
		<td class="pdFormFieldLabel"><val:PDLabel id="BxIndication_PdLabel" Text="Indication:" Field="BxIndication" Required="No" runat="server" /></td>
		<td colspan="3"><val:ComboBox tabindex="6" Id="BxIndication" RefBy="BxIndication" runat="server" /></td>
	</tr>
	<tr>
		<td class="pdFormFieldLabel"><val:PDLabel id="BxSystematic_PdLabel" Text="Systematic:" Field="BxSystematic" Required="No" runat="server" /></td>
		<td colspan="3" align="left"><input type="checkbox" tabindex="7" id="BxSystematic" value="1" runat="server" NAME="BxSystematic"></td>
	</tr>
	<tr>
		<td colspan="4">&nbsp;</td>
	</tr>
	<tr>
		<td colspan="2" align="center" class="adminPageTitle">Original</td>
		<td colspan="2" align="center" class="adminPageTitle"><img src=../Images/shim.gif width="70" height="1">Reviewed</td>
	</tr>
	<tr>
		<td align="right" class="pdFormFieldLabel"><val:PDLabel id="BxPathNum_PdLabel" Text="Path #:" Field="BxPathNum" Required="No" runat="server" /></td>
		<td><input type="text" tabindex="8" id="BxPathNum" class="pdFormFieldShort" maxlength="50" runat="server" NAME="BxPathNum"></td>
		<td align="right" class="pdFormFieldLabel"><val:PDLabel id="BxPathNumRevd_PdLabel" Text="Path #:" Field="BxPathNumRevd" Required="No" runat="server" /></td>
		<td><input type="text" tabindex="37" id="BxPathNumRevd" class="pdFormFieldShort" maxlength="50" runat="server" NAME="BxPathNumRevd"></td>
	</tr>
	<tr>
		<td class="pdFormFieldLabel"><val:PDLabel id="BxPosCores_PdLabel" Text="Pos Cores:" Field="BxPosCores" Required="No" runat="server" /></td>
		<td><input type="text" tabindex="9" id="BxPosCores" class="pdFormFieldShort" maxlength="50" runat="server" NAME="BxPosCores"></td>
		<td class="pdFormFieldLabel"><val:PDLabel id="BxPosCoresRevd_PdLabel" Text="Pos Cores:" Field="BxPosCoresRevd" Required="No" runat="server" /></td>
		<td><input type="text" tabindex="38" id="BxPosCoresRevd" class="pdFormFieldShort" maxlength="50" runat="server" NAME="BxPosCoresRevd"></td>
	</tr>
	<tr>
		<td class="pdFormFieldLabel"><val:PDLabel id="BxNumCores_PdLabel" Text="# Cores:" Field="BxNumCores" Required="No" runat="server" /></td>
		<td><input type="text" tabindex="10" id="BxNumCores" class="pdFormFieldShort" maxlength="50" runat="server" NAME="BxNumCores"></td>
		<td class="pdFormFieldLabel"><val:PDLabel id="BxNumCoresRevd_PdLabel" Text="# Cores:" Field="BxNumCoresRevd" Required="No" runat="server" /></td>
		<td><input type="text" tabindex="39" id="BxNumCoresRevd" class="pdFormFieldShort" maxlength="50" runat="server" NAME="BxNumCoresRevd"></td>
	</tr>
	<tr>
		<td class="pdFormFieldLabel"><val:PDLabel id="BxPosSites_PdLabel" Text="Pos Sites:" Field="BxPosSites" Required="No" runat="server" /></td>
		<td><input type="text" tabindex="11" id="BxPosSites" class="pdFormFieldShort" maxlength="50" runat="server" NAME="BxPosSites"></td>
		<td class="pdFormFieldLabel"><val:PDLabel id="BxPosSitesRevd_PdLabel" Text="Pos Sites:" Field="BxPosSitesRevd" Required="No" runat="server" /></td>
		<td><input type="text" tabindex="39" id="BxPosSitesRevd" class="pdFormFieldShort" maxlength="50" runat="server" NAME="BxPosSitesRevd"></td>
	</tr>
	<tr>
		<td class="pdFormFieldLabel"><val:PDLabel id="BxNumSites_PdLabel" Text="# Sites:" Field="BxNumSites" Required="No" runat="server" /></td>
		<td><input type="text" tabindex="12" id="BxNumSites" class="pdFormFieldShort" maxlength="50" runat="server" NAME="BxNumSites"></td>
		<td class="pdFormFieldLabel"><val:PDLabel id="BxNumSitesRevd_PdLabel" Text="# Sites:" Field="BxNumSitesRevd" Required="No" runat="server" /></td>
		<td><input type="text" tabindex="39" id="BxNumSitesRevd" class="pdFormFieldShort" maxlength="50" runat="server" NAME="BxNumSitesRevd"></td>
	</tr>
	<tr>
		<td class="pdFormFieldLabel"><val:PDLabel id="BxGG1_PdLabel" Text="Gleason 1:" Field="BxGG1" Required="No" runat="server" /></td>
		<td><input type="text" tabindex="13" id="BxGG1" class="pdFormFieldShort" maxlength="50" runat="server" NAME="BxGG1"></td>
		<td class="pdFormFieldLabel"><val:PDLabel id="BxGG1_Revd_PdLabel" Text="Gleason 1:" Field="BxGG1_Revd" Required="No" runat="server" /></td>
		<td><input type="text" tabindex="40" id="BxGG1_Revd" class="pdFormFieldShort" maxlength="50" runat="server" NAME="BxGG1_Revd"></td>
	</tr>
	<tr>
		<td class="pdFormFieldLabel"><val:PDLabel id="BxGG2_PdLabel" Text="Gleason 2:" Field="BxGG2" Required="No" runat="server" /></td>
		<td><input type="text" tabindex="14" id="BxGG2" class="pdFormFieldShort" maxlength="50" runat="server" NAME="BxGG2"></td>
		<td class="pdFormFieldLabel"><val:PDLabel id="BxGG2_Revd_PdLabel" Text="Gleason 2:" Field="BxGG2_Revd" Required="No" runat="server" /></td>
		<td><input type="text" tabindex="41" id="BxGG2_Revd" class="pdFormFieldShort" maxlength="50" runat="server" NAME="BxGG2_Revd"></td>
	</tr>
	<tr>
		<td class="pdFormFieldLabel"><val:PDLabel id="BxGGS_PdLabel" Text="Gleason Sum:" Field="BxGGS" Required="No" runat="server" /></td>
		<td><input type="text" tabindex="15" id="BxGGS" class="pdFormFieldShort" maxlength="50" runat="server" NAME="BxGGS"></td>
		<td class="pdFormFieldLabel"><val:PDLabel id="BxGGS_Revd_PdLabel" Text="Gleason Sum:" Field="BxGGS_Revd" Required="No" runat="server" /></td>
		<td><input type="text" tabindex="42" id="BxGGS_Revd" class="pdFormFieldShort" maxlength="50" runat="server" NAME="BxGGS_Revd"></td>
	</tr>
	<tr>
		<td class="pdFormFieldLabel"><val:PDLabel id="BxResult_PdLabel" Text="Result:" Field="BxResult" Required="" runat="server" /></td>
		<td><select tabindex="16" id="BxResult" class="pdFormFieldShort" runat="server" NAME="BxResult" /></td>
		<td class="pdFormFieldLabel"><val:PDLabel id="BxResultRevd_PdLabel" Text="Result:" Field="BxResultRevd" Required="No" runat="server" /></td>
		<td><select tabindex="43" id="BxResultRevd" class="pdFormFieldShort" runat="server" NAME="BxResultRevd" /></td>