196 lines
7.4 KiB
PHP
196 lines
7.4 KiB
PHP
<?php session_start();
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include('includes/config/config.php');
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include_once("includes/functions.php");
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include_once("log_entry.php");
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mysqli_query($conn, 'SET character_set_results=utf8');
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error_reporting(0);
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$query = "select * from company_profile where company_id = 5";
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$result = mysqli_query($conn, $query);
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$row_for_company = mysqli_fetch_array($result);
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@extract($row_for_company);
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?>
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<!doctype html>
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<html lang="en">
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<head>
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<title>REFERRAL LATTER</title>
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<meta charset="utf-8">
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<meta name="viewport" content="width=device-width, initial-scale=1, shrink-to-fit=no">
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<!-- Bootstrap CSS -->
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<link rel="stylesheet" href="https://stackpath.bootstrapcdn.com/bootstrap/4.3.1/css/bootstrap.min.css"
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integrity="sha384-ggOyR0iXCbMQv3Xipma34MD+dH/1fQ784/j6cY/iJTQUOhcWr7x9JvoRxT2MZw1T" crossorigin="anonymous">
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<style>
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.print {
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position: absolute;
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right: 11%;
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}
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@media print {
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#printPageButton {
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display: none;
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}
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}
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body {
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font-family: Arial, Helvetica, sans-serif
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}
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table {
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border-collapse: collapse;
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}
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.canteen {
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background-color: #8E44AD;
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/* position: relative; */
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left: 20%;
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text-align: center;
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padding-left: 10%;
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padding-right: 10%;
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color: white;
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}
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</style>
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</head>
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<body>
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<center>
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<table>
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<tr>
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<td>
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<div class="container">
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<div class="container">
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<div class="container">
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<?php
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include "pdf_ohc_header.php";
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?>
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<button id="printPageButton" class="btn btn-success print"
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onClick="window.print();">Print</button>
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<br>
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<hr>
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<br>
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<h4 class="canteen">REFERRAL LETTER</h4>
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<br><br><br>
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<h5>Dear Dr: ______________________</h5>
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<br>
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<h5>Referring Mr./Mrs/Miss : <u>______________________</u>
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Age : <u>_______ </u> Yrs With</h5>
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<h5>Complaints of : <u>________________</u></h5>
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<br>
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<wrap>
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<h5>On examination, he/she has : __________________________________________
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</h5>
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</wrap>
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<br>
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<h5>The investigations done show : <u>___________________________</u> </h5>
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<br>
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<h5>My Clinical impression is : <u> ___________________________ </u></h5>
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<br>
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<h5><b>I have given the following treatment :-</b></h5>
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<h5>____________________*____________________</h5>
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<h5>____________________*____________________</h5>
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<h5>____________________*____________________</h5>
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<h5>____________________*____________________</h5>
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<br><br>
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<h5><b>He/She is referred to you for your expert opinion and advise. Kindly examine the
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patient and advise/do the needful. Please inform me about the progress of the
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patient.</b></h5>
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<br><br>
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<h5 style="text-align: left;">
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<b>
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Thanking you,
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</b>
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</h5>
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<br><br>
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<h5 style="text-align: right;">
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<b>
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Yours sincerely,
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</b>
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</h5>
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<br><br><br>
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<h5 style="text-align: right; right: 10%;">
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(Signature)
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</h5>
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<br>
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<h5 style="text-align: right;">
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<b>
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Dr. T K ZANKAT
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</b>
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</h5>
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<h5 style="text-align: right;">(CMO. GHCL PVT Ltd.)</h5>
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<br><br><br>
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<h5>P.S :</h5>
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<br>
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<h5>
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<b>
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He/She is allergic to
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</b>
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<u>
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……………………………………………………………….…………
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</u>
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</h5>
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<h5>
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<b>
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He/She is suffering from
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</b>
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<u>
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……………………………………………………………….…………
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</u>
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</h5>
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<h5>
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<b>
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for which he/she is taking
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</b>
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<u>
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……………………………………………………………….…………
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</u>
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</h5>
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</div>
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</div>
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</div>
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</td>
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</tr>
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</table>
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</center>
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<div style="height: 100px;"></div>
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<script src="https://code.jquery.com/jquery-3.3.1.slim.min.js"
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integrity="sha384-q8i/X+965DzO0rT7abK41JStQIAqVgRVzpbzo5smXKp4YfRvH+8abtTE1Pi6jizo" crossorigin="anonymous">
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</script>
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<script src="https://cdnjs.cloudflare.com/ajax/libs/popper.js/1.14.7/umd/popper.min.js"
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integrity="sha384-UO2eT0CpHqdSJQ6hJty5KVphtPhzWj9WO1clHTMGa3JDZwrnQq4sF86dIHNDz0W1" crossorigin="anonymous">
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</script>
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<script src="https://stackpath.bootstrapcdn.com/bootstrap/4.3.1/js/bootstrap.min.js"
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integrity="sha384-JjSmVgyd0p3pXB1rRibZUAYoIIy6OrQ6VrjIEaFf/nJGzIxFDsf4x0xIM+B07jRM" crossorigin="anonymous">
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</script>
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</body>
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</html>
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