📄 urotestrplndfu.ascx
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<%@ Control Language="c#" AutoEventWireup="false" Codebehind="UroTestRplndFU.ascx.cs" Inherits="Caisis.UI.Modules.Testis.PaperForms.UroTestRplndFU" TargetSchema="http://schemas.microsoft.com/intellisense/ie5"%>
<div align="left">
<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">*U14*</div>
<div class="VerticalBarCodeAcctType"><% =BarCodeAcctType %></div>
<div class="VerticalBarCodeDate"><% =BarCodeDate %></div>
</div>
</div>
<div align="center"><font style="font-size: 13px;">CONTAINS PROTECTED HEALTH INFORMATION - HANDLE
ACCORDING TO MSKCC POLICY</font> </div>
<table width="700" border="0" cellspacing="0" cellpadding="0">
<tr>
<td class="FormOuterTableTopRow"><table align="center" border="0" width="700" cellpadding="4" cellspacing="0">
<tr>
<td width="375" align="center" valign="middle" class="FormInnerRowRightBorder"><img src="../../Images/FormImages/<%= institutionShortName%>_FormLogo.gif" width="80" alt="" border="0" align="left"><span class="blackBoldText"><%= institutionName%><br>
Urology RPLND Follow-Up Patient</span><br>
</td>
<td width="325" 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 %>
</td>
<td align="left"><strong>
<% =patientMRN %>
</strong>
<% =patientDOB %>
</td>
</tr>
<tr>
<td colspan="1" align="right">
<% =patientNameLabel %>
</td>
<td colspan="1" align="left"><strong>
<% =patientLastName %>, <% =patientFirstName %> <% =patientMiddleName %>
</strong></td>
</tr>
<tr>
<td align="right" valign="top">
<% =patientAddressLabel %>
</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 height="20" class="FormOuterTableRow"><img src="../../Images/shim.gif" border="0" width="4" height="11"><span class="blackBoldText">Date:
<% =apptClinicDate %>
<img src="../../Images/shim.gif" border="0" width="220" height="1">Physician:
<% =apptPhysicianName %>
</span></td>
</tr>
<tr>
<td class="FormOuterTableRow"><table align="center" border="0" width="100%" cellpadding="4" cellspacing="0">
<tr>
<td width="50%" height="20" align="left" class="FormInnerRowNoBorder">Referring M.D. <%= institutionShortName%>:
</td>
<td width="50%" height="22" align="left" class="FormInnerRowNoBorder">Non-<%= institutionShortName%>:
</td>
</tr>
</table></td>
</tr>
<tr>
<td class="FormOuterTableRow"><img src="../../Images/shim.gif" border="0" width="4" height="15"><span class="blackBoldText">Chief
Complaint</span><img src="../../Images/shim.gif" border="0" width="400" height="1">
<input name="DateLastGnRH4" type="checkbox" id="DateLastGnRH4" value="yes">
Late Relapse<br> <br> <br>
</td>
</tr>
<tr>
<td height="240" valign="top" class="FormOuterTableRow"><img src="../../Images/shim.gif" border="0" width="4" height="15"><span class="blackBoldText">HPI</span><br>
<table cellpadding="4" cellspacing="0" border="0">
<tr>
<td class="FormPopulatedSmallerText" 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> </td>
</tr>
</table>
<br>
<img id="HpiSpacer" runat="server" src="../../Images/shim.gif" border="0" width="4" height="1">
<span class="smallGrayText"><img src="../../Images/shim.gif" border="0" width="4" height="1">Special
Features:</span><span class="blackBoldText"> </span></td>
</tr>
<tr>
<td valign="top" class="FormOuterTableRow"><table width="700" border="0" cellspacing="0" cellpadding="0">
<tr>
<td width="360" valign="top" class="FormInnerRowRightBorder">
<table width="350" border="0" cellspacing="0" cellpadding="0">
<tr>
<td colspan="3"><span class="blackBoldText">Medications</span>
<img src="../../Images/shim.gif" border="0" width="65" height="1">
<input name="DateLastGnRH" type="checkbox" id="DateLastGnRH" value="yes">
Unchanged Since Last Visit</td>
</tr>
<tr align="center">
<td width="200" height="20" class="FormInsideTableTopCell">Agent</td>
<td width="80" class="FormInsideTableTopCell">Dose</td>
<td width="70" class="FormInsideTableTopCell">Schedule</td>
</tr>
<asp:Repeater ID="medications" runat=server>
<ItemTemplate>
<tr>
<td class="FormInsideTableRegCell">
<%# DataBinder.Eval(Container.DataItem, "Medication") %>
</td>
<td class="FormInsideTableRegCell">
<%# DataBinder.Eval(Container.DataItem, "MedDose") %>
<%# DataBinder.Eval(Container.DataItem, "MedUnits") %>
</td>
<td class="FormInsideTableRegCell">
<%# DataBinder.Eval(Container.DataItem, "MedSchedule") %>
</td>
</tr>
</ItemTemplate>
</asp:Repeater>
</table></td>
<td width="340" valign="top">
<table width="340" border="0" cellspacing="0" cellpadding="0">
<tr>
<td colspan="2" class="FormInnerRowBottomBorder"><span class="blackBoldText">Allergies</span> <span>
<input name="DateLastGnRH2" type="checkbox" id="DateLastGnRH2" value="yes">
NKA
<input name="DateLastGnRH3" type="checkbox" id="DateLastGnRH3" value="yes">
Unchanged Since Last Visit</span></td>
</tr>
<tr align="center">
<td width="160" height="20" class="FormInsideTableRegCell">Allergen</td>
<td width="180" class="FormInnerRowBottomBorder">Reaction</td>
</tr>
<asp:Repeater ID="allergies" runat=server>
<ItemTemplate>
<tr>
<td class="FormInsideTableRegCell">
<%# DataBinder.Eval(Container.DataItem, "Allergen") %>
</td>
<td class="FormInnerRowBottomBorder">
<%# DataBinder.Eval(Container.DataItem, "AllergyResponse") %>
</td>
</tr>
</ItemTemplate>
</asp:Repeater>
</table></td>
</tr>
</table></td>
</tr>
<tr>
<td height="50" valign="top" class="FormOuterTableRow"><span class="blackBoldText"><img src="../../Images/shim.gif" border="0" width="4" height="15">Comorbidities</span><br/>
<asp:Repeater ID="comorbidities" runat=server>
<ItemTemplate>
<%# DataBinder.Eval(Container.DataItem, "ComorbDateText") %>
- <strong>
<%# DataBinder.Eval(Container.DataItem, "Comorbidity") %>
</strong> </ItemTemplate>
<SeparatorTemplate>; </SeparatorTemplate>
</asp:Repeater>
</td>
</tr>
<tr>
<td align="center" class="FormOuterTableRow"><table align="center" border="0" width="700" cellpadding="1" cellspacing="0">
<tr>
<td colspan="5" align="left" valign="middle"><span class="blackBoldText"><img src="../../Images/shim.gif" border="0" width="3" height="15">Medical
Therapies / Chemotherapy</span></td>
</tr>
<tr>
<td height="22" colspan="5" valign="middle" class="FormInsideTableTopLeftCell"><img src="../../Images/shim.gif" border="0" width="3" height="1">Initial
Risk Category:<img src="../../Images/shim.gif" border="0" width="20" height="1"><img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" hspace="0" vspace="0" align="absmiddle">Poor<img src="../../Images/shim.gif" border="0" width="20" height="1"><img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" hspace="0" vspace="0" align="absmiddle">Intermediate<img src="../../Images/shim.gif" border="0" width="20" height="1"><img src="../../Images/FormImages/WinCheckbox.gif" width="13" height="13" hspace="0" vspace="0" align="absmiddle">Good</td>
</tr>
<tr>
<td width="100" align="center" valign="middle" class="FormInsideTableRegCell">Start
Date </td>
<td width="100" align="center" valign="middle" class="FormInsideTableRegCell">Stop
Date </td>
<td width="125" align="center" valign="middle" class="FormInsideTableRegCell">Indication</td>
<td width="275" align="center" valign="middle" class="FormInsideTableRegCell">Regimen</td>
<td width="100" align="center" valign="middle" class="FormInsideTableRegCell">Cycles</td>
</tr>
<tr>
<td class="FormInsideTableRegCell"> </td>
<td class="FormInsideTableRegCell"> </td>
<td height="20" class="FormInsideTableRegCell"> </td>
<td class="FormInsideTableRegCell"> </td>
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