2024-03-28 19:12:34 -04:00
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<%@ Page Title="Title" Language="C#" MasterPageFile="main.master" CodeBehind="physNew.aspx.cs" Inherits="FWA_MAIN.physNew" %>
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2024-03-28 09:48:11 -04:00
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2024-03-28 19:12:34 -04:00
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<asp:Content runat="server" ContentPlaceHolderID="cph1">
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<link type="text/css" href="main.css"/>
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<style>
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.container {
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text-align: center;
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}
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.buttonGroup {
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margin-top: 20px;
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}
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.patDiv {
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text-align: center;
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}
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.buttonGroup .buttonWrapper {
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display: inline-block;
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margin-right: 10px;
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}
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</style>
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<h1 style="text-align: center; font-size: 44px">New Physician</h1>
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<div class="container">
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<div class="patDiv">
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<div class="indivPatDiv"><label class="buttonLabel">Physician ID: </label></div>
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<div class="indivPatDiv"><label class="buttonLabel">First Name: </label></div>
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<div class="indivPatDiv"><label class="buttonLabel">Last Name: </label></div>
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<div class="indivPatDiv"><label class="buttonLabel">Middle Initial: </label></div>
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<div class="indivPatDiv"><label class="buttonLabel">Zip Code: </label></div>
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<div class="indivPatDiv"><label class="buttonLabel">City: </label></div>
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<div class="indivPatDiv"><label class="buttonLabel">State: </label></div>
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<div class="indivPatDiv"><label class="buttonLabel">Date of Birth: </label></div>
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<div class="indivPatDiv"><label class="buttonLabel">Phone Number: </label></div>
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<div class="indivPatDiv"><label class="buttonLabel">Gender (M/F): </label></div>
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<div class="indivPatDiv"><label class="buttonLabel">Specialty: </label></div>
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</div>
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<div class="patDiv">
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<div class="indivPatDiv"><asp:TextBox runat="server" CssClass="defaultTXT" ID="txtPhysID"></asp:TextBox></div>
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<div class="indivPatDiv"><asp:TextBox runat="server" CssClass="defaultTXT" ID="txtFNAME"></asp:TextBox></div>
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<div class="indivPatDiv"><asp:TextBox runat="server" CssClass="defaultTXT" ID="txtLNAME"></asp:TextBox></div>
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<div class="indivPatDiv"><asp:TextBox runat="server" CssClass="defaultTXT" ID="txtMidInit"></asp:TextBox></div>
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<div class="indivPatDiv"><asp:TextBox runat="server" CssClass="defaultTXT" ID="txtZip"></asp:TextBox></div>
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<div class="indivPatDiv"><asp:TextBox runat="server" CssClass="defaultTXT" ID="txtCity"></asp:TextBox></div>
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<div class="indivPatDiv"><asp:TextBox runat="server" CssClass="defaultTXT" ID="txtState"></asp:TextBox></div>
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<div class="indivPatDiv"><asp:TextBox runat="server" CssClass="defaultTXT" ID="txtDOB"></asp:TextBox></div>
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<div class="indivPatDiv"><asp:TextBox runat="server" CssClass="defaultTXT" ID="txtPhone"></asp:TextBox></div>
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<div class="indivPatDiv"><asp:TextBox runat="server" CssClass="defaultTXT" ID="txtGender"></asp:TextBox></div>
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<div class="indivPatDiv"><asp:TextBox runat="server" CssClass="defaultTXT" ID="txtSpecialty"></asp:TextBox></div>
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</div>
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</div>
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<br/>
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<div class="patDiv buttonGroup" style="margin-left:500px">
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<div class="buttonWrapper"><asp:Button runat="server" CssClass="standardbtn" ID="btnSavePat" Text="Create"/></div>
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<div class="buttonWrapper"><asp:Button runat="server" CssClass="standardbtn" ID="btnCancelPat" Text="Cancel" OnClick="btnCancelPat_OnClick"/></div>
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</div>
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</asp:Content>
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