uroblador.ascx

医疗决策支持系统

<%@ Control Language="c#" AutoEventWireup="false" Codebehind="UroBladOR.ascx.cs" Inherits="Caisis.UI.Modules.Bladder.PaperForms.UroBladOR" TargetSchema="http://schemas.microsoft.com/intellisense/ie5"%>




<asp:PlaceHolder id="PreOpFormHolder" runat="server"></asp:PlaceHolder>


<div id="NonBreakingForm">

<div align="center">

<div align="center">
	<div align="right" class="ORPopulation">
	  <div  class="ORDemographics">
	  <table  width="325" border="0" cellpadding="0" cellspacing="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>
              </table>
	  </div>
	</div>
</div>


<img src="../../Images/FormImages/BladderOR_Pg1_20041122.gif" width="700" height="917" border="0"></div>



<div align="center" style="page-break-before:always;">


<div align="center">
	<div align="right" class="ORPopulation">
	  <div  class="ORDemographics">
	  <table  width="325" border="0" cellpadding="0" cellspacing="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>
              </table>
	  </div>
	</div>
</div>


<img src="../../Images/FormImages/BladderOR_Pg2_20041122.gif" width="700" height="917" border="0">
</div>





<div id="LastPageInForm" runat="server" align="center" style="page-break-before:always;">
<img src="../../Images/FormImages/UrinDiversion_Pg1_20041122.gif" width="700" height="917" border="0">
</div>


</div>