urourinfuncfu.ascx

医疗决策支持系统

    <tr> 
      <td class="FormOuterTableRow">
	  <table align="center" border="0" width="650" cellpadding="0" cellspacing="0">
          <tr> 
            <td colspan="2" valign="top" class="blackBoldText"><span class="blackBoldText"><img src="../../Images/shim.gif" border="0" width="4" height="0">Lab Tests</span> </td>
          </tr>
          <tr> 
            <td width="325" valign="top" class="FormInnerRowRightBorder"> <table width="100%" border="0" cellpadding="0" cellspacing="0" class="FormInnerRowRightBorder">
                <tr> 
                  <td width="80" align="center" valign="middle" class="FormInsideTableTopLeftCell">Date</td>
                  <td align="center" valign="middle" class="FormInsideTableTopCell">Lab Test </td>
                  <td align="center" valign="middle" class="FormInsideTableTopCell">Value</td>
                  <td width="80" align="center" valign="middle" class="FormInsideTableTopCell">Data Source</td>
                </tr>
                <asp:Repeater ID="labTests" runat=server> 
                  <ItemTemplate> 
                    <tr> 
                      <td height="15" align="center" class="FormInsideTableLeftCell"> 
                        &nbsp; 
                        <%# DataBinder.Eval(Container.DataItem, "LabDateText") %>
                      </td>
                      <td class="FormInsideTableRegCell" align="center"> 
                        &nbsp;<%# DataBinder.Eval(Container.DataItem, "LabTest") %>
                      </td>
                      <td class="FormInsideTableRegCell" align="center"> 
                        &nbsp;<%# DataBinder.Eval(Container.DataItem, "LabResult") %>
                      </td>
                      <td class="FormInsideTableRegCell" align="center"> 
                        &nbsp;<%# DataBinder.Eval(Container.DataItem, "LabQuality") %>
                      </td>
                    </tr>
                  </ItemTemplate>
                </asp:Repeater>
              </table></td>
            <td width="325" valign="top" class="blackBoldText"> <table border="0" width="100%" cellpadding="0" cellspacing="0">
                <tr> 
                  <td width="80" align="center" valign="middle" class="FormInsideTableTopCell">Date</td>
                  <td align="center" valign="middle" class="FormInsideTableTopCell">Lab Test </td>
                  <td align="center" valign="middle" class="FormInsideTableTopCell">Value</td>
                  <td width="80" align="center" valign="middle" class="FormInsideTableTopCell">Data Source</td>
                </tr>
                <tr> 
                  <td height="15" align="center" class="FormInsideTableRegCell">/<span><img src="../../Images/shim.gif" border="0" width="22" height="8"></span>/</td>
                  <td class="FormInsideTableRegCell">&nbsp;</td>
                  <td class="FormInsideTableRegCell">&nbsp;</td>
                  <td class="FormInsideTableRegCell">&nbsp;</td>
                </tr>
                <tr> 
                  <td height="15" align="center" class="FormInsideTableRegCell">/<span><img src="../../Images/shim.gif" border="0" width="22" height="1"></span>/</td>
                  <td class="FormInsideTableRegCell">&nbsp;</td>
                  <td class="FormInsideTableRegCell">&nbsp;</td>
                  <td class="FormInsideTableRegCell">&nbsp;</td>
                </tr>
                <tr> 
                  <td height="15" align="center" class="FormInsideTableRegCell">/<span><img src="../../Images/shim.gif" border="0" width="22" height="1"></span>/</td>
                  <td class="FormInsideTableRegCell">&nbsp;</td>
                  <td class="FormInsideTableRegCell">&nbsp;</td>
                  <td class="FormInsideTableRegCell">&nbsp;</td>
                </tr>
              </table></td>
          </tr>
        </table></td>
    </tr>
    <tr bgcolor="#FFFFFF"> 
      <td class="FormOuterTableRow"><span class="blackBoldText"><img src="../../Images/shim.gif" border="0" width="4" height="0">Imaging</span><span><img src="../../Images/shim.gif" border="0" width="12" height="8"> 
        <input type="checkbox" name="Films Reviewed">
        Films Reviewed<br>
        </span> <table align="center" border="0" width="650" cellpadding="0" cellspacing="0">
          <tr> 
            <td width="100" height="20" align="center" valign="middle" class="FormInsideTableTopCell">Date</td>
            <td width="125" align="center" valign="middle" class="FormInsideTableTopCell">Study</td>
            <td width="200" align="center" valign="middle" class="FormInsideTableTopCell">Results</td>
            <td width="225" align="center" valign="middle" class="FormInsideTableTopCell">Notes</td>
          </tr>
 
          <asp:Repeater ID="images" runat=server>
			<ItemTemplate>
          <tr> 
          	<td height="20" class="FormInsideTableRegCell" align="center">&nbsp;<strong><%# DataBinder.Eval(Container.DataItem, "DxDateText") %></strong></td>
            <td class="FormInsideTableRegCell">&nbsp;<strong><%# DataBinder.Eval(Container.DataItem, "DxType") %></strong></td>
            <td class="FormInsideTableRegCell">&nbsp;<strong><%# DataBinder.Eval(Container.DataItem, "DxResult") %></strong></td>
            <td class="FormInsideTableRegCell">&nbsp;<strong><%# DataBinder.Eval(Container.DataItem, "DxNotes") %></strong></td>
          </tr>
			</ItemTemplate>
			</asp:Repeater>
        </table>
		</td>
    </tr>
    <tr > 
      <td height="14" align="center" valign="bottom" class="blackBoldText">GU19<img src="../../Images/shim.gif" border="0" width="45" height="1">U23<img src="../../Images/shim.gif" border="0" width="45" height="1">CMIC 
        Approval Date: 6/04<img src="../../Images/shim.gif" border="0" width="45" height="1">rev:09/08/06<img src="../../Images/shim.gif" border="0" width="45" height="1">Page 
        <span id="PageNumber">1</span> of <span id="TotalPages">4</span><img src="../../Images/shim.gif" border="0" width="45" height="1">B/02.070.<span class="blackBoldTextSmall">19</span></td>
    </tr>
  </table>
</div>
<div align="center" style="page-break-before:always">

<div align="center">
	<div align="right" class="VerticalBarCodeDiv">
	  <div  class="VerticalBarCodeStatement"><img src="../../Images/FormImages/BarCodeLineStatement.gif" border="0" width="8" height="121"><br/>
        <img src="../../Images/FormImages/BarCodeLineStatement.gif" border="0" width="8" height="121" vspace="220"><br/>
        <img src="../../Images/FormImages/BarCodeLineStatement.gif" border="0" width="8" height="121"></div>
	<div  class="VerticalBarCodeMRN"><% =BarCodeMRN %></div>
	<div  class="VerticalBarCodeDocType">*U23*</div>
	<div  class="VerticalBarCodeAcctType"><% =BarCodeAcctType %></div>
	<div  class="VerticalBarCodeDate"><% =BarCodeDate %></div>
	</div>
</div>

<font style="font-size: 12px;">CONTAINS PROTECTED  HEALTH INFORMATION - HANDLE ACCORDING TO MSKCC POLICY</font> 
  <table width="650" cellpadding="0" cellspacing="0" bgcolor="#FFFFFF">
    <tr > 
      <td class="FormOuterTableTopRow"> <table align="center" border="0" width="100%" cellpadding="0" cellspacing="0">
          <tr > 
            <td width="50%" align="center" valign="middle" class="FormInnerRowRightBorder"><span class="blackBoldText"><img src="../../Images/FormImages/<%= institutionShortName%>_FormLogo.gif" width="90" alt="" border="0" align="left"><%= institutionName%><br>
              Urology Urinary Function<br>
              Follow-Up </span></td>
            <td width="50%" align="center" valign="bottom"> <table  width="325" border="0" cellspacing="1" cellpadding="0" >
                <tr> 
                  <td width="65"><img src="../../Images/shim.gif" border="0" width="65" height="1"></td>
                  <td align="left" width="260"><img src="../../Images/shim.gif" border="0" width="260" height="1"></td>
                </tr>
                <tr> 
                  <td align="right"> 
                    <% =patientMRNLabel  %>
                    &nbsp;&nbsp;&nbsp;</td>
                  <td align="left"><strong> 
                    <% =patientMRN  %>
                    </strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
                    <% =patientDOB  %>
                  </td>
                </tr>
                <tr> 
                  <td colspan="1" align="right"> 
                    <% =patientNameLabel  %>
                    &nbsp;&nbsp;&nbsp;</td>
                  <td colspan="1" align="left"><strong> 
                    <% =patientLastName  %>, <% =patientFirstName  %> <% =patientMiddleName  %>
                    </strong></td>
                </tr>
                <tr> 
                  <td align="right" valign="top"> 
                    <% =patientAddressLabel  %>
                    &nbsp;&nbsp;&nbsp;</td>
                  <td align="left" valign="top"> 
                    <% =patientAddress1  %>
                    <% =patientAddress2  %>
                    <% =patientCity  %>
                    <% =patientState  %>
                    <% =patientPostalCode  %>
                  </td>
                </tr>
                <tr> 
                  <td colspan="2"><img src="../../Images/shim.gif" border="0" width="1" height="5"></td>
                </tr>
                <tr> 
                  <td colspan="2" align="center" valign="bottom" class="blackBoldText">Patient 
                    Identification</td>
                </tr>
              </table></td>
          </tr>
        </table></td>
    </tr>
    <tr> 
      <td width="650" height="20" class="FormOuterTableRow"><img src="../../Images/shim.gif" border="0" width="4" height="11"><span class="blackBoldText">Date: 
        <% =apptClinicDate %>
        </span></td>
    </tr>
    <tr> 
      <td class="FormOuterTableRow"> <table width="650" border="0" cellpadding="0" cellspacing="0">
          <tr> 
            <td align="left" valign="top" ><img src="../../Images/shim.gif" border="0" width="4" height="16"><span class="blackBoldText">Procedures: 
              Endoscopies / Urodynamics</span><br> 
              <table width="650" border="0" cellpadding="0" cellspacing="0">
                <tr align="center"  > 
                  <td width="100" class="FormInsideTableTopCell">Date</td>
                  <td width="100" class="FormInsideTableTopCell">Procedure</td>
                  <td width="310" class="FormInsideTableTopCell">Findings</td>
                  <td width="70" class="FormInsideTableTopCell">Cytology</td>
                  <td width="70" class="FormInsideTableTopCell">Source</td>
                </tr>
                <tr > 
                  <td height="28" class="FormInsideTableRegCell">&nbsp;</td>
                  <td class="FormInsideTableRegCell">&nbsp;</td>
                  <td class="FormInsideTableRegCell">&nbsp;</td>
                  <td class="FormInsideTableRegCell">&nbsp;</td>
                  <td class="FormInnerRowBottomBorder">&nbsp;</td>
                </tr>
                <tr > 
                  <td height="28" class="FormInsideTableRegCell">&nbsp;</td>
                  <td class="FormInsideTableRegCell">&nbsp;</td>
                  <td class="FormInsideTableRegCell">&nbsp;</td>
                  <td class="FormInsideTableRegCell">&nbsp;</td>
                  <td class="FormInnerRowBottomBorder">&nbsp;</td>
                </tr>
                <tr > 
                  <td height="28" class="FormInsideTableRegCell">&nbsp;</td>
                  <td class="FormInsideTableRegCell">&nbsp;</td>
                  <td class="FormInsideTableRegCell">&nbsp;</td>
                  <td class="FormInsideTableRegCell">&nbsp;</td>
                  <td class="FormInnerRowBottomBorder">&nbsp;</td>