302 lines
7.2 KiB
PHP
302 lines
7.2 KiB
PHP
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<html>
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<head>
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<script src="https://ajax.googleapis.com/ajax/libs/jquery/3.4.1/jquery.min.js"></script>
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<div id="opd_form_div" style="display:none">
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<form id="opd_form" name="opd_form">
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<?php
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//include autoloader;
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include('includes/config/config.php');
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include_once("includes/functions.php");
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error_reporting(E_ERROR | E_PARSE);
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error_log("id:" . $_REQUEST['appointment_idpdf']);
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$sql_employee_appointment = "select a.*,p.patient_name, p.dept_id, p.emp_code, p.father_name, p.designation_id,employer_contractor_id, patient_cat_id, gender,blood_group,emp_cadre from employee_appointment a, patient_master p where a.emp_id=p.id and appointment_id='" . $_REQUEST['appointment_idpdf'] . "'";
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error_log("sql injury pres:" . $sql_employee_appointment);
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$res_emp_appoint = mysqli_query($conn, $sql_employee_appointment);
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$rows_emp_appoint = mysqli_fetch_array($res_emp_appoint);
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@extract($rows_emp_appoint);
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$patient_name = $rows_emp_appoint['patient_name'];
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//echo $query;
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$doc_user_id = ($rows_emp_appoint['doctor_last_attended'] != null || 0 || "") ? $rows_emp_appoint['doctor_last_attended'] : $rows_emp_appoint['modified_by'];
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$doc_emp_id = getTableFieldValue('tbl_users', 'emp_id', 'user_id', $doc_user_id, '');
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$doc_name = getTableFieldValue('patient_master', 'patient_name', 'id', $doc_emp_id, '');
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$result = mysqli_query($conn, $query);
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$row = mysqli_fetch_array($result);
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@extract($row);
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$sql_doc_details = "select * from employee_signature where emp_id='$doc_emp_id'";
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$result_doc_details = mysqli_query($conn, $sql_doc_details);
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$row_doc_details = mysqli_fetch_array($result_doc_details);
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$employee_code = $rows_emp_appoint['emp_code'];
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$father_name = $rows_emp_appoint['father_name'];
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if ($rows_emp_appoint['IsEmergency'] == 1) {
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$ans = "Yes";
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} else {
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$ans = "No";
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}
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date_default_timezone_set('Asia/Kolkata');
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$date = date('Y-m-d H:i:s');
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$currentDate = date_format(date_create($date), "d-M-Y h:i:sa ");
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$ailment_names = $rows_emp_appoint['ailments_new'];
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$ailment_system_name = $rows_emp_appoint['ailment_systems_new'];
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$injury_part_names = $rows_emp_appoint['injury_parts_new'];
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$health_advices = $rows_emp_appoint['health_advices_new']; //getCommaSeperatedValuesForInClause("select health_advice_name from health_advice ","health_advice_id",$rows_emp_appoint['health_advices']);
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$tests = $rows_emp_appoint['recommended_tests_new']; //getCommaSeperatedValuesForInClause("select section_name from checkup_form_section ","section_id",$rows_emp_appoint['tests']);
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?>
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<style>
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.tbl1 {
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width: 100%;
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}
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th {
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background-color: #e1e1e1;
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font-size: 12px;
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font-style: bold;
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vertical-align: top;
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}
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td {
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text-align: left;
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font-size: 12px;
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vertical-align: top;
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}
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</style>
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</head>
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<table border="1" cellspacing="0" width="100%">
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<tr>
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<td colspan="6" width="100%" ><center><strong>FORM 6</strong></center></td>
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</tr>
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<tr>
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<td colspan="6" width="100%" align="center"><center><strong>CERTIFICATE OF FITNESS</strong></center></td>
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</tr>
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<tr>
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<td colspan="2"><strong>Serial No</strong></td>
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<td colspan="4"></td>
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</tr>
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<tr>
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<td colspan="2"><strong>Date</strong></td>
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<td colspan="4"></td>
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</tr>
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<tr>
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<td colspan="2"><strong>Name</strong></td>
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<td colspan="4"></td>
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</tr>
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<tr>
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<td colspan="2"><strong>Father's Name</strong></td>
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<td colspan="4"></td>
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</tr>
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<tr>
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<td colspan="1" width="25%"><strong>Sex</strong></td>
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<td colspan="1" width="25%"></td>
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<td colspan="1" width="25%"><strong>Age</strong></td>
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<td colspan="1" width="25%"></td>
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<td colspan="1" width="25%"><strong>Date of Birth</strong></td>
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<td colspan="1" width="25%"></td>
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</tr>
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<tr>
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<td colspan="2" height="4%"><strong>Permanent Address</strong></td>
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<td colspan="4" height="4%"></td>
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</tr>
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<tr>
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<td colspan="2" height="4%"><strong>Present Address</strong></td>
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<td colspan="4" height="4%"></td>
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</tr>
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<tr>
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<td colspan="2" rowspan="2"><strong>Identification mark</strong></td>
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<td colspan="4">1)</td>
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</tr>
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<tr>
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<td colspan="4">2)</td>
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</tr>
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<tr>
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<td colspan="6" height="5%">
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I herby certify that I have personally examined ___________________________________ son/daughter of ___________________________________ who is desirous of being employed in factory, and that his/her age as nearly as can be ascertained from my examination is _______ years and that he/she is fit for employment in factory as an adult.
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</td>
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</tr>
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<tr>
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<td colspan="2"><strong>Reason for</strong></td>
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<td colspan="4"></td>
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</tr>
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<tr>
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<td colspan="6" height="5%">1) Refusal of Certificate:</td>
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</tr>
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<tr>
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<td colspan="6">OR</td>
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</tr>
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<tr>
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<td colspan="6" height="5%">2) Certificate being revoked</td>
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</tr>
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<tr><td colspan="6" height="1%"></td></tr>
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<tr>
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<td colspan="3" height="6%"></td>
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<td colspan="3" height="6%"></td>
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</tr>
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<tr>
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<td colspan="3"><strong>Left Hand Thumb Impression</strong></td>
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<td colspan="3"><strong>Factory Medical Officer's Stamp & Signature</strong></td>
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</tr>
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</table>
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<br>
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<table border="1" width="100%" cellspacing="0">
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<tr>
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<td colspan="4"><center>FORM 23</center></td>
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</tr>
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<tr>
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<td colspan="4"><center>Special Certificate of Fitness</center></td>
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</tr>
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<tr>
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<td colspan="4"><center>(In respect of persons employed in occupation involving use of * compounds)</center></td>
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</tr>
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<tr>
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<td colspan="1" width="25%">Serial No</td>
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<td colspan="1" width="25%"></td>
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<td colspan="1" width="25%">Dated</td>
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<td colspan="1" width="25%"></td>
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</tr>
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<tr>
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<td colspan="1">Shri</td>
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<td colspan="3"></td>
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</tr>
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<tr>
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<td colspan="1">Residing at</td>
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<td colspan="3"></td>
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</tr>
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<tr>
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<td colspan="4" height="4%">who is desirous of being employed as in the <br> and that his age, as nearly as can be ascertained from my examination is years and that he is in my opinion fit for employment in operation of</td>
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</tr>
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<tr>
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<td colspan="2"></td>
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<td colspan="2">*Chromium Compounds</td>
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</tr>
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<tr>
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<td colspan="2"></td>
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<td colspan="2">*Glass Manufacturing</td>
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</tr>
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<tr>
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<td colspan="2"></td>
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<td colspan="2">*Nitro amino compound</td>
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</tr>
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<tr>
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<td colspan="2"></td>
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<td colspan="2">*Hydrogen sulphide</td>
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</tr>
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<tr>
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<td colspan="2"></td>
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<td colspan="2">*Manganese & it's compounds</td>
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</tr>
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<tr>
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<td colspan="2"></td>
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<td colspan="2">*Benzene</td>
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</tr>
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<tr>
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<td colspan="2" rowspan="2">Identification mark</td>
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<td colspan="2">1)</td>
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</tr>
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<tr>
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<td colspan="2">2)</td>
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</tr>
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<tr>
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<td colspan="2" height="6%"></td>
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<td colspan="2" height="6%"></td>
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</tr>
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<tr>
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<td colspan="2"><strong>Left Hand Thumb Impression</strong></td>
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<td colspan="2"><strong>Factory Medical Officer's Stamp & Signature</strong></td>
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</tr>
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</table>
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</form>
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<form id="employeeDetailsFormPdf" action="" method="POST">
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<input type="hidden" name="htmlText" id="htmlText" />
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</form>
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</div>
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<script>
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formSubmit();
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function formSubmit() {
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$("#htmlText").val($("#opd_form").html());
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document.forms['employeeDetailsFormPdf'].action = "pdf_dynamic.php";
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document.forms['employeeDetailsFormPdf'].method = "post";
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document.forms['employeeDetailsFormPdf'].submit();
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}
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</script>
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