0) { $row = @mysqli_fetch_array($result); } $sql_for_treatment = "select * from guest_treatment where appointment_id='" . $_REQUEST['appointmentId'] . "'"; $result_for_treatment = @mysqli_query($conn,$sql_for_treatment); $num_rows_treatment = @mysqli_num_rows($result_for_treatment); // echo $row['emp_id']; } ?>

Ticket No:

Reporting Time at OHC

Injury Time

Injury Description

On Examination Findings

Incident Location

Business Unit	Sub Unit	Section	Sub-Section

Injury

Type	Part	Classification

Procedure

Medicine Disbursment

onchange="setFieldDisableOrEnable(this.value)" type="radio" name="medicine_disbursement" value="Y"> Yes

onchange="setFieldDisableOrEnable(this.value)" type="radio" name="medicine_disbursement" value="N"> No

Referral

Follow-up

Emergency?

Health Advices

Recommended Tests For Checkup

Additional Precautions

Employee Injury Form