📄 creatediseasehistory.jsp
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<%@ page language="java" contentType="text/html;charset=UTF-8" pageEncoding="utf-8"%>
<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN">
<html>
<head>
<title>personfile page</title>
</head>
<body>
<form action="../searchds.do" method="post">
<table id="Table1" border="0" style="background-color: #a2c9ff; position:absolute; left:180px;" width="1000px">
<tr>
<td colspan="2" align="center" height="50px"><span id="Label1" style="font-size:20;color:red;">新建疾病史记录</span></td>
</tr>
<tr>
<td align="center">疾病类型</td>
<td>
<label>
<select name="dtype" size="1">
<option value="1">慢性病 </option>
<option value="2">职业病 </option>
<option value="3">精神创伤 </option>
<option value="4">传染病 </option>
<option value="5">手术外伤 </option>
<option value="6">残疾 </option>
<option value="7">其他 </option>
</select>
</label>
</td>
</tr>
<tr>
<td align="center">疾病名称</td>
<td>
<label>
<select name="dname" size="1">
<option value="1">冠心病</option>
<option value="2">脑中卒</option>
<option value="3">糖尿病</option>
<option value="4">肿瘤</option>
<option value="5">缺铁性贫血</option>
<option value="7">高血压</option>
<option value="8">肩周炎</option>
<option value="9">石棉肺</option>
<option value="10">电光性皮炎</option>
<option value="11">高原病</option>
<option value="12">航空病</option>
<option value="13">精神分裂症</option>
<option value="14">结核</option>
<option value="15">已肝</option>
<option value="16">肺炎</option>
<option value="17">阑尾炎</option>
<option value="18">低视力</option>
<option value="19">肢残</option>
<option value="20">脑残</option>
<option value="21">其他</option>
</select>
</label>
</td>
</tr>
<tr>
<td align="center">发病日期</td>
<td>
<label>
<select name="dtime" size="1">
<option value="1">1978</option>
<option value="2">1979</option>
<option value="3">1980</option>
<option value="4">1981</option>
<option value="5">1982</option>
<option value="6">1983</option>
<option value="7">1984</option>
<option value="8">1985</option>
<option value="9">1986</option>
<option value="10">1987</option>
<option value="11">1988</option>
<option value="12">1989</option>
<option value="13">1990</option>
<option value="14">1991</option>
<option value="15">1992</option>
<option value="16">1993</option>
<option value="17">1994</option>
<option value="18">1995</option>
<option value="19">1996</option>
<option value="20">1997</option>
<option value="21">1998</option>
<option value="22">1999</option>
<option value="23">2000</option>
<option value="24">2001</option>
<option value="25">2002</option>
<option value="26">2003</option>
<option value="27">2004</option>
<option value="28">2005</option>
<option value="29">2006</option>
<option value="30">2007</option>
<option value="31">2008</option>
</select>
年</label>
<label>
<select name="select4" size="1">
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
</select>
月</label>
<label>
<select name="select5" size="1">
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select>
日</label>
</td>
</tr>
<tr>
<td align="center" valign="top" width="100px">疾病史描述（限100字）</td>
<td width=""><textarea cols="60" rows="8" name="diseasehistories"></textarea></td>
</tr>
<tr>
<td align="center">诊治单位</td>
<td>
<label>
<select name="department" size="1">
<option value="1">同济医院</option>
<option value="2">人民医院</option>
<option value="3">中医院</option>
<option value="4">肿瘤医院</option>
<option value="5">其他</option>
</select>
</label>
</td>
</tr>
<tr>
<td align="center">诊治结果</td>
<td>
<label>
<select name="dstate" size="1">
<option value="1">治愈</option>
<option value="2">未愈</option>
<option value="3">好转</option>
<option value="4">转院</option>
<option value="5">加重</option>
<option value="6">死亡</option>
<option value="7">其他</option>
</select>
</label>
</td>
</tr>
<tr>
<td align="center" colspan="2" height="30px"><input type="submit" name="Button1" value="确定新建" id="Button1"style=""/> <input type="reset" name="Button2" value="重填信息" id="Button2" style=""/></td>
</tr>
</table>
<table>
<tr><td><a href="../backtodisease.do">返回</a></td></tr>
</table>
</form>
</body>
</html>
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