42 lines
3.0 KiB
Plaintext
42 lines
3.0 KiB
Plaintext
<%@ Page Title="New Prescription" Language="C#" MasterPageFile="main.master" CodeBehind="preNew.aspx.cs" Inherits="FWA_MAIN.preNew" %>
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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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<h1 style="text-align: center; font-size: 44px">New Prescription</h1>
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<div class="patDiv">
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<div class="patDiv">
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<div class="patDiv" style="padding-left: 150px; padding-right: 5px;width: 100px">
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<div class="indivPatDiv" style="text-align: right"><label class="buttonLabel">Rx Number: </label></div><br/>
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<div class="indivPatDiv" style="text-align: right"><label class="buttonLabel">Number of Refills: </label></div><br/>
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<div class="indivPatDiv" style="text-align: right"><label class="buttonLabel">Number of Past Refills: </label></div><br/>
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<div class="indivPatDiv" style="text-align: right"><label class="buttonLabel">Physician ID: </label></div><br/>
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<div class="indivPatDiv" style="text-align: right"><label class="buttonLabel">Medication ID: </label></div><br/>
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<div class="indivPatDiv" style="text-align: right"><label class="buttonLabel">Patient ID: </label></div><br/>
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<div class="indivPatDiv" style="text-align: right"><label class="buttonLabel">Prescription Start Date: </label></div><br/>
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<div class="indivPatDiv" style="text-align: right"><label class="buttonLabel">Prescription End Date: </label></div><br/>
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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="txtRxNum"></asp:TextBox></div><br/>
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<div class="indivPatDiv"><asp:TextBox runat="server" CssClass="defaultTXT" ID="txtNumRefill"></asp:TextBox></div><br/>
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<div class="indivPatDiv"><asp:TextBox runat="server" CssClass="defaultTXT" ID="txtPastRefill"></asp:TextBox></div><br/>
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<div class="indivPatDiv"><asp:TextBox runat="server" CssClass="defaultTXT" ID="txtPhysID"></asp:TextBox></div><br/>
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<div class="indivPatDiv"><asp:TextBox runat="server" CssClass="defaultTXT" ID="txtMedID"></asp:TextBox></div><br/>
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<div class="indivPatDiv"><asp:TextBox runat="server" CssClass="defaultTXT" ID="txtPatID"></asp:TextBox></div><br/>
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<div class="indivPatDiv"><asp:TextBox runat="server" CssClass="defaultTXT" ID="txtPreStart"></asp:TextBox></div><br/>
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<div class="indivPatDiv"><asp:TextBox runat="server" CssClass="defaultTXT" ID="txtPreEnd"></asp:TextBox></div><br/>
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</div>
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</div>
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</div>
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<br/>
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<div class="patDiv" style="margin-left: 500px">
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<div style="margin-right: 10px; display: inline-block"><asp:Button runat="server" CssClass="standardbtn" ID="btnSavePat" Text="Create"/></div>
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<div style="display: inline-block"><asp:Button runat="server" CssClass="standardbtn" ID="btnCancelPat" Text="Cancel" OnClick="btnCancelPre_OnClick"/></div>
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</div>
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</asp:Content> |