[[static_erefill_header.html]]

<SCRIPT>
function Validation()
{
	var i=0;
	var ret = false;
	for(i=0; i < document.frm.elements.length; i++)
	{
		if (document.frm.elements[i].type=="checkbox") 
		{
		  if(document.frm.elements[i].checked == true)
		
		  {
		  	ret = true;
	  	}
   	}
		
	}	
	if (!ret) alert('Please select at least one checkbox');
	return ret;
}

function OnlyOne()
{
	var i=0;
	var n=0;
	for(i=0; i < document.frm.elements.length; i++)
	{
		if (document.frm.elements[i].type=="checkbox") 
	 {

		if(document.frm.elements[i].checked == true)
		{
			n++;
		}
   }		
	}	
	if (n!=1) {
		alert('Please select exactly one checkbox');
	} else {
		document.frm.action = "$orderpharmacies_url";
		document.frm.submit();
	}
}



function selectToggle(toggle) {
     var myForm = document.frm;
     for( var i=0; i < myForm.length; i++ ) { 
          if(toggle) {
               myForm.elements[i].checked = "checked";
          } 
          else {
               myForm.elements[i].checked = "";
          }
     }
}


</SCRIPT>


<!--*******************-->
<div id="content">
	<div class="container">
		<div class="row">
			<div class="col-md-12">
                     <form name="frm" action="$viewpharmacies_url"  method="get">


				<div class="pull-right log-section"><span><a href="viewnhpatients.php?nhid=$nhid&store=$storei"> Back to Patient List</a></span> | <span>Welcome </span><strong><span class="user-name">$loginname</span></strong> | <a href="logout.php"><span class="icon-in-link"></span><i class="fa fa-unlock"></i> Logout</a></div>
				<h2 class="title-divider">
				  <span>Nursing Home<span class="de-em">Add Patient Comments for $patname</span></span>
				</h2>
				
				<!-- About company -->
                        
                            {$error{<font color="#ff0000">$error</font>}}

				<div class="row">
					<div class="col-md-12">
						<table class="footable table demo table-bordered toggle-arrow">
							<thead>
								<tr>
									<th>
										Notes For : $patname									</th>
									<th>
										Last Changed
									</th>
								</tr>
							</thead>
							<tbody>
                                                       $notes
							</tbody>
						</table>
					</div>
				</div>
				

        		

                     </form>
			</div>
		</div>
              <div class="row">
                   <div style="margin:10px 5px;">
                    		  <table>
     					<tr>
                                      <td>

                                         <a class="btn btn-primary" href="viewnhpatients.php?nhid=$nhid&store=$storei" style="margin:5px;"> Back to Patient List </a>
					   </td>
                                      <td>

                                         <a class="btn btn-primary" href="viewnhpatients.php?nhid=$nhid&store=$storei" style="margin:5px;"> Add Comment </a>
					   </td>

				       </tr>
		 	         </table>
                   
      		    </div>
              </div>
	</div>
</div>

    
[[static_footer.html]]

<<note>> 

<tr>
  <td style="width:80%"><strong></strong> $note_note <br /> 
      <input name="patientid[]" type="hidden" value="$note_patid"></td>
  <td style="width:20%">$note_lastchanged <br /> </td>

</tr>
              
<</note>>