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@@ -95,6 +95,11 @@ $medications = $points;
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<input type="hidden" data-name="routedDosageFormMedId" value="{{@$medication->data->routedDosageFormMedId}}">
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<input type="hidden" data-name="gcnSeqno" value="{{@$medication->data->gcnSeqno}}">
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+ <input type="hidden" name="additionReasonCategory" value="{{@$medication->addition_reason_category}}">
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+ <input type="hidden" name="isRemoved" value="{{@$medication->is_removed}}">
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+ <input type="hidden" name="removalReasonCategory" value="{{@$medication->removal_reason_category}}">
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+ <input type="hidden" name="isRemovedDueToEntryError" value="{{@$medication->is_removed_due_to_entry_error}}">
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+
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<div class="mb-2">
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<label class="text-sm text-secondary mb-1">Drug</label>
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<input type="text" class="form-control form-control-sm min-width-unset prescription-medication"
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@@ -117,14 +122,52 @@ $medications = $points;
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</div>
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<div class="mb-2">
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- <label class="text-sm text-secondary mb-1">Existing / New</label>
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- <select class="form-control form-control-sm" name="additionReasonCategory" required>
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+ <label class="text-sm text-secondary mb-0">Historic / Preexisting / New</label>
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+ <select class="form-control form-control-sm additionReasonCategory_ui" name="additionReasonCategory_ui" required>
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<option value="">-- select --</option>
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- <option value="ON_INTAKE" {{$medication->addition_reason_category === 'ON_INTAKE' ? 'selected' : ''}}>Existing (Patient was already on this)</option>
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- <option value="DURING_VISIT" {{$medication->addition_reason_category === 'DURING_VISIT' ? 'selected' : ''}}>New (Prescribed during this visit)</option>
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+ <option value="HISTORIC" {{$medication->addition_reason_category === 'ON_INTAKE' && $medication->is_removed ? 'selected' : ''}}>Historic</option>
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+ <option value="PRE_EXISTING" {{$medication->addition_reason_category === 'ON_INTAKE' && !$medication->is_removed ? 'selected' : ''}}>Preexisting</option>
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+ <option value="NEW" {{$medication->addition_reason_category === 'DURING_VISIT' ? 'selected' : ''}}>New (Prescribed during this visit)</option>
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</select>
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</div>
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+ <div class="d-flex align-items-start">
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+ <div class="w-50 mb-2">
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+ <div class="start_date_ui" style="display: none">
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+ <label class="text-sm text-secondary mb-0">Start Date</label>
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+ <input type="date"
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+ data-name="start_date"
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+ class="form-control form-control-sm min-width-unset">
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+ </div>
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+ </div>
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+ <div class="w-50 pl-2 mb-2">
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+ <div class="prescriber_ui" style="display: none">
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+ <label class="text-sm text-secondary mb-0">Prescribed By</label>
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+ <input type="text"
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+ data-name="prescriber"
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+ class="form-control form-control-sm min-width-unset">
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+ </div>
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+ </div>
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+ </div>
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+ <div class="d-flex align-items-start">
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+ <div class="w-50 mb-2">
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+ <div class="removalEffectiveDate_ui" style="display: none">
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+ <label class="text-sm text-secondary mb-0">End Date</label>
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+ <input type="date"
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+ name="removalEffectiveDate"
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+ class="form-control form-control-sm min-width-unset">
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+ </div>
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+ </div>
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+ <div class="w-50 pl-2 mb-2">
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+ <div class="removalReasonMemo_ui" style="display: none">
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+ <label class="text-sm text-secondary mb-0">Removal By/Memo</label>
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+ <input type="text"
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+ name="removalReasonMemo"
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+ class="form-control form-control-sm min-width-unset">
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+ </div>
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+ </div>
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+ </div>
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+
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<div class="mb-2">
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<label class="text-sm text-secondary mb-1">Description</label>
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<textarea rows="1" data-name="description" class="form-control form-control-sm">{{@$medication->data->description}}</textarea>
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@@ -288,12 +331,6 @@ $medications = $points;
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</div>
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</div>
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</div>
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- <!--<div class="row mb-2">
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- <div class="col-12">
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- <label class="text-sm text-secondary mb-0">Description</label>
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- <textarea rows="1" data-name="description" class="form-control form-control-sm"></textarea>
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- </div>
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- </div>-->
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<div class="row mb-2">
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<div class="col-12">
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<label class="text-sm text-secondary mb-0">Historic / Preexisting / New</label>
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