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医疗决策支持系统

                    <% =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 class="FormOuterTableRow"><img src="../../Images/shim.gif" border="0" width="4" height="15"><span class="blackBoldText">Date: <% =apptClinicDate %>
        <img src="../../Images/shim.gif" border="0" width="220" height="1">Physician: <% =apptPhysicianName %></span></td>
    </tr>
	<tr>
		<td>
			<table width="100%" border="0" cellpadding="0" cellspacing="0" dwcopytype="CopyTableCell">
          <tr> 
			  <td class="FormOuterTableRow">
			  	<table width="100%" border="0" cellspacing="0" cellpadding="2">
                <tr> 
					<td colspan="3" class="FormInnerRowBottomBorder"><span class="blackBoldText">Social History</span></td>
				  </tr>
				  <tr> 
					<td align="center" class="FormInnerRowBottomBorder"> <img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" vspace="0"> 
					</td>
					<td class="FormInnerRowBottomBorder">Recreational drugs:<br> </td>
					<td class="FormInnerRowBottomBorder">Details: ________________________________________________________________</td>
				  </tr>
				  <tr> 
					<td align="center" class="FormInnerRowBottomBorder"> <img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" vspace="0"></td>
					<td class="FormInnerRowBottomBorder">Alcohol<br></td>
					<td class="FormInnerRowBottomBorder">Amount: __________________ / week</td>
				  </tr>
				  <tr> 
					<td width="30" align="center" class="FormInnerRowBottomBorder"> <img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" vspace="0"></td>
					<td width="130" class="FormInnerRowBottomBorder"> Cigarettes</td>
					
                  <td width="580" class="FormInnerRowBottomBorder">______ pack-years<img src="../../Images/FormImages/shim.gif" border="0" width="50" height="1">Quit: ________ years ago</td>
				  </tr>
				  <tr> 
					<td align="center" class="FormInnerRowBottomBorder"> <img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" vspace="0"></td>
					<td colspan="2" class="FormInnerRowBottomBorder">Can the Patient Walk Up 2 Flights of Stairs without Chest Pain?&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
					  <img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" vspace="0" align="absmiddle"> 
					  Yes&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" vspace="0" align="absmiddle">No</td>
				  </tr>
				  <tr> 
					<td align="center" valign="top"> <img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" vspace="0"></td>
					<td colspan="2" valign="top"><span class="blackBoldText"><img src="../../Images/FormImages/shim.gif" border="0" width="1" height="12"></span>Other:</td>
				  </tr>
				</table>
				</td>
			</tr>
		  </table>
		</td>	
	</tr>	
	<tr> 
      <td height="30" align="center" class="FormPatientSectionEnd">Clinical Staff Only Beyond This Point</td>
    </tr>
    <tr bgcolor="#ffffff"> 
      <td height="200" valign="top" class="FormOuterTableRow"><img src="../../Images/shim.gif" border="0" width="4" height="12"><span class="blackBoldText">HPI</span><br> 
        <table width="100%" cellpadding="4" cellspacing="0" border="0">
          <tr> 
            <td class="HPIText" valign="top"> <asp:Repeater ID="hpi" runat=server OnItemDataBound="hpiItemDataBound"> 
                <ItemTemplate> 
                  <%# DataBinder.Eval(Container.DataItem, "patientHPI") %>
                  <br>
                  <asp:Literal ID="StartNextHpiColumn" Runat="server" />
                </ItemTemplate>
              </asp:Repeater> <asp:Repeater ID="HpiProstatectomies" runat=server OnItemDataBound="HpiProstatectomiesItemDataBound"> 
                <ItemTemplate> <strong> 
                  <%# DataBinder.Eval(Container.DataItem, "OpType") %>
                  </strong> on 
                  <%# DataBinder.Eval(Container.DataItem, "SurgDateText") %>
                  <asp:Label ID="CaseSurgeonLabel" Runat="server">by 
                    <%# DataBinder.Eval(Container.DataItem, "SurgCaseSurgeon") %>
                  </asp:Label>
                  <br>
                  <asp:Literal ID="StartNextHpiColumn" Runat="server" />
                </ItemTemplate>
              </asp:Repeater> <asp:Label ID="PreTxPot" Runat="server" /> <asp:Repeater ID="hpiProtocols" runat=server OnItemDataBound="appendToHpiItemDataBound"> 
                <ItemTemplate> Protocol 
                  <%# DataBinder.Eval(Container.DataItem, "ProtocolNum") %>
                  <%# DataBinder.Eval(Container.DataItem, "PtProtocolStatus") %>
                  <br>
                  <asp:Literal ID="StartNextHpiColumn" Runat="server" />
                </ItemTemplate>
              </asp:Repeater> <asp:Repeater ID="hpiBiopsies" runat=server > 
                <ItemTemplate> Biopsy:&nbsp; 
                  <%# DataBinder.Eval(Container.DataItem, "BxDateText") %>
                  &nbsp;&nbsp; 
                  <%# DataBinder.Eval(Container.DataItem, "BxType") %>
                  &nbsp;&nbsp;Result:&nbsp; 
                  <%# DataBinder.Eval(Container.DataItem, "BxResult") %>
                  &nbsp;&nbsp; 
                  <%# DataBinder.Eval(Container.DataItem, "bxQuality") %>
                  <br>
                  <asp:Literal ID="StartNextHpiColumn" Runat="server" />
                </ItemTemplate>
              </asp:Repeater> <asp:Label ID="NVB_Left" Runat="server" /> <asp:Label ID="NVB_Right" Runat="server" /> 
            </td>
          </tr>
        </table>
		</td>
    </tr>
	<tr> 
		<td align="left" class="FormOuterTableRow"><span class="blackBoldText">Surgical History</span></td>
	</tr>
	<tr> 
      <td class="FormOuterTableRow">
	  <table align="center" border="0" width="700" cellpadding="0" cellspacing="0">
	  	<tr>
			<td width="500">
				<table align="left" width="100%" border="0" cellpadding="2" cellspacing="0">
				  <tr> 
					<td align="left" class="FormInsideTableLeftCell"><span class="blackBoldText">Prostatectomy</span>
					<img src="../../Images/FormImages/shim.gif" border="0" width="10" height="1"><img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" vspace="0" align="absmiddle">Yes
					<img src="../../Images/FormImages/shim.gif" border="0" width="10" height="1"><img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" vspace="0" align="absmiddle">No
					<img src="../../Images/FormImages/shim.gif" border="0" width="10" height="1"><img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" vspace="0" align="absmiddle">Surgeon:</td>
				  </tr>
				  <tr> 
					<td align="left" class="FormInsideTableLeftCell">
					<img src="../../Images/FormImages/shim.gif" border="0" width="10" height="1"><img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" vspace="0" align="absmiddle">BNS
					<img src="../../Images/FormImages/shim.gif" border="0" width="6" height="1"><img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" vspace="0" align="absmiddle">UNS
					<img src="../../Images/FormImages/shim.gif" border="0" width="6" height="1"><img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" vspace="0" align="absmiddle">NNS</td>
				</tr>
				<tr> 
					<td height="20" align="left" class="FormInsideTableLeftCell">
					<img src="../../Images/FormImages/shim.gif" border="0" width="10" height="1"><img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" vspace="0" align="absmiddle">Right CN _____
					<img src="../../Images/FormImages/shim.gif" border="0" width="10" height="1"><img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" vspace="0" align="absmiddle">Left CN _____
					<img src="../../Images/FormImages/shim.gif" border="0" width="10" height="1"><img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" vspace="0" align="absmiddle">CMap Right _____
					<img src="../../Images/FormImages/shim.gif" border="0" width="10" height="1"><img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" vspace="0" align="absmiddle">CMap Left _____</td>
				</tr>
				<tr>
					<td align="left" class="FormInsideTableLeftCell">
					<img src="../../Images/FormImages/shim.gif" border="0" width="10" height="1"><img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" vspace="0" align="absmiddle">Nerve Graft
					<img src="../../Images/FormImages/shim.gif" border="0" width="10" height="1"><img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" vspace="0" align="absmiddle">Right
					<img src="../../Images/FormImages/shim.gif" border="0" width="10" height="1"><img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" vspace="0" align="absmiddle">Left
					<img src="../../Images/FormImages/shim.gif" border="0" width="10" height="1"><img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" vspace="0" align="absmiddle">Sural
					<img src="../../Images/FormImages/shim.gif" border="0" width="10" height="1"><img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" vspace="0" align="absmiddle">Genito Femoral</td>
				</tr>
				<tr>
					<td align="left" class="FormInsideTableLeftCell">
					<img src="../../Images/FormImages/shim.gif" border="0" width="10" height="1">Gleason Sum _____ / 10
					<img src="../../Images/FormImages/shim.gif" border="0" width="10" height="1">Path Stage: _____</td>
				</tr>
				<tr>
					<td align="left" class="FormInsideTableLeftCell">
					<img src="../../Images/FormImages/shim.gif" border="0" width="10" height="1"><img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" vspace="0" align="absmiddle">ECE: _____
					<img src="../../Images/FormImages/shim.gif" border="0" width="10" height="1"><img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" vspace="0" align="absmiddle">SM: _____
					<img src="../../Images/FormImages/shim.gif" border="0" width="10" height="1"><img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" vspace="0" align="absmiddle">LN: _____
					<img src="../../Images/FormImages/shim.gif" border="0" width="10" height="1"><img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" vspace="0" align="absmiddle">SV: _____</td>
				</tr>
				<tr> 
					<td height="20" align="left" class="FormInsideTableLeftCell">
					<img src="../../Images/FormImages/shim.gif" border="0" width="10" height="1"><img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" vspace="0" align="absmiddle">PSA ND
					<img src="../../Images/FormImages/shim.gif" border="0" width="10" height="1"><img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" vspace="0" align="absmiddle">PSA Elev
					<img src="../../Images/FormImages/shim.gif" border="0" width="10" height="1"><img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" vspace="0" align="absmiddle">Continent
					<img src="../../Images/FormImages/shim.gif" border="0" width="10" height="1"><img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" vspace="0" align="absmiddle">Incontinent
					<img src="../../Images/FormImages/shim.gif" border="0" width="10" height="1"><img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" vspace="0" align="absmiddle">Pads / day: _____</td>
				</tr>
				</table>
			</td>
			<td width="200" valign="top" align="left"><img src="../../Images/FormImages/shim.gif" border="0" width="4" height="1"><span class="blackBoldText">Comments</span></td>
          </tr>
		</table>
		</td>
    </tr>
	<tr> 
      <td class="FormOuterTableRow">
	  <table align="center" border="0" width="700" cellpadding="0" cellspacing="0">
	  	<tr>
			<td width="500">
				<table align="left" width="100%" border="0" cellpadding="2" cellspacing="0">
				  <tr> 
					<td align="left" class="FormInsideTableLeftCell"><span class="blackBoldText">Cystoprostatectomy</span>
					<img src="../../Images/FormImages/shim.gif" border="0" width="10" height="1"><img src="../.