<script src="https://ajax.googleapis.com/ajax/libs/jquery/3.4.1/jquery.min.js"></script>
<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/4.7.0/css/font-awesome.min.css">
<head>
<style>
.tbl1 {
border: 2px solid black;
border-collapse: collapse;
font-weight: 800;
padding: 15px;
}
.tbl2 {
border-collapse: collapse;
font-weight: 800;
padding: 15px;
}
</style>
</head>
<div id="medical_examination_form" style="display: none;">
<?php
include('includes/config/config.php');
include_once("includes/functions.php");
//error_reporting(0);
function getModifiedString($var)
{
$var = trim($var);
$pos = stripos($var, ":");
$initial_str = substr($var, 0, $pos);
$str = substr($var, $pos);
$updated_str = "<b>" . $str . "</b>";
return $initial_str . " " . $updated_str;
}
$sql_form_type_data = "select a.*,b.ticket_no,b.approve_date,b.doc_attend,b.medical_attend,b.fit_unfit_status,b.doc_findings,p.* from form_data a inner join checkup_form b on a.checkup_id=b.checkup_id left join patient_master p on p.id=b.emp_id where a.checkup_id='" . $_REQUEST['checkup_id'] . "'";
error_log("query " . $sql_form_type_data);
$result_form_type_data = mysqli_query($conn, $sql_form_type_data);
$row_form_type_data = mysqli_fetch_assoc($result_form_type_data);
@extract($row_form_type_data);
?>
<div style="margin-top: 20px">
<table width="100%">
<tr>
<td colspan="2" align="center" style="font-weight:900;">FORM NO- 33</td>
</tr>
<tr>
<td colspan="2" align="center">[Prescribed under Rules 68-T and 102]</td>
</tr>
<tr>
<td colspan="2" align="center" style="font-weight:900;">Certificate of fitness for employment in hazardous process and operations</td>
</tr>
<tr>
<td colspan="2" align="center">(To be issued by Factory Medical Officer)</td>
</tr>
</table>
<div style="margin-top: 20px">
<table width="100%" class="tbl3" style="border-spacing: 10px;">
<tr>
<td>
<?php
echo getModifiedString($para_one);
?>
</td>
</tr>
<tr>
<td>
<?php echo getModifiedString($para_two) ?>
</td>
</tr>
<tr>
<td>
<?php echo getModifiedString($para_three) ?>
</td>
</tr>
<tr>
<td>
<?php echo getModifiedString($para_four) ?>
</td>
</tr>
<tr>
<td>
<?php echo getModifiedString($para_five) ?>
</td>
</tr>
<tr>
<td>
<?php echo getModifiedString($para_six) ?>
</td>
</tr>
<tr>
<td>
<?php echo getModifiedString($para_seven) ?>
</td>
</tr>
<tr>
<td>
<?php echo getModifiedString($para_eight) ?>
</td>
</tr>
<tr>
<td>
<?php if (strcmp($para_one_1, " a) Hazardous process:") == 0) {
echo $row_form_type_data['hazardous_process'] == 'Y' ? " a) Hazardous process: Yes" : " a) Hazardous process: No";
} else {
echo $para_one_1;
}
?>
</td>
</tr>
<tr>
<td>
<?php if (strcmp($para_one_2, " b) Dangerous operation:") == 0) {
echo " b) Dangerous operation: " . $row_form_type_data['dangerous_process'];
} else {
echo $para_one_2;
}
?>
</td>
</tr>
<tr>
<td style="word-wrap:normal;">
<?php echo $para_one_3 ?>
</td>
</tr>
<tr>
<td style="word-wrap:normal;">
<?php echo $para_one_4 ?>
</td>
</tr>
<tr>
<td style="word-wrap:normal;">
<?php echo $para_one_5
?>
</td>
</tr>
<tr>
<td>
<?php echo $para_one_6
?>
</td>
</tr>
</table>
</div>
<div style="margin-top: 100px">
<table width="100%" class="tbl3" style="margin-top:20px; font-size: 16px;">
<tr>
<td>
<img src="data:<?php echo $row_form_type_data['image_type'] ?>;base64,<?php echo base64_encode($row_form_type_data['emp_sign']) ?>" style="width: 120px; height: 40px;" />
<br>
Signature or left hand thumb
impression of the person examined :
</td>
<td align="right"> <?php
$doc_emp_id = $row_form_type_data['doc_attend'];
$doctor_name = getFieldfromTable('patient_name', 'patient_master', 'id', $doc_emp_id) ?>
<span style="margin-left:170px">
<?php
$sql_sign = "select * from employee_signature where emp_id='" . $doc_emp_id . "'";
$result_sign = mysqli_query($conn, $sql_sign);
$row_sign = mysqli_fetch_assoc($result_sign);
@extract($row_sign);
error_log("sign query " . $sql_sign);
?>
<img src="data:<?php echo $row_sign['image_type'] ?>;base64,<?php echo base64_encode($row_sign['emp_sign']) ?>" style="width: 120px; height: 40px;" />
</span>
<br>
Signature of the Factory Medical Officer :
</td>
</tr>
</table>
<br>
<br>
<table width="100%" class="tbl3">
<tr>
<td width="60%" align="left">
</td>
<td align="right">
<span style="margin-left:170px">
<img src="data:<?php echo $row_sign['stamp_img_type'] ?>;base64,<?php echo base64_encode($row_sign['emp_stamp']) ?>" style="width: 120px; height: 40px;" />
</span>
<p>Stamp of factory
Medical Officer with
Name of the Factory</p>
</td>
</tr>
</table>
<!-- <br> -->
<table width="100%" class="tbl3">
<tr>
<td colspan="2" align="left">Date: <b><?= date_format(date_create($row_form_type_data['approval_date']), "d-m-Y") ?></b> </td>
</tr>
</table>
<hr>
<table width="100%" class="tbl3" style="page-break-after: always;">
<tr>
<td align="right"></td>
</tr>
</table>
<br>
<table width="100%" border="1" cellspacing="0">
<tr>
<th>I certify that I examined the person mentioned above on
(date of examination)
</th>
<th>I examined this certificate unfit (If certificate is not extended , the period for which the worker is considered unfit for work is to be mentioned)</th>
<th>Signs & symptoms observed during examination.</th>
<th>Signature of the
Factory medical
Officer with date.</th>
</tr>
<tr rowspan="10">
<td height="350"><?= $row_form_type_data['fit_unfit_status'] == 'ufit' ? date_format(date_create($row_form_type_data['approval_date']), "d-m-Y") : '' ?></td>
<td></td>
<td><?= $row_form_type_data['fit_unfit_status'] == 'ufit' ? $row_form_type_data['doc_findings'] : '' ?></td>
<?php if ($row_form_type_data['fit_unfit_status'] == 'ufit') { ?>
<td><img src="data:<?php echo $row_sign['image_type'] ?>;base64,<?php echo base64_encode($row_sign['emp_sign']) ?>" style="width: 120px; height: 40px;" /></td>
<?php } else { ?>
<td></td>
<?php } ?>
</tr>
</table>
<div style="margin-top: 20px; font-size: 15px; text-transform:lowercase">
<div><b>Notes:</b></div>
<ol>
<li> If declared unfit, reference should be made immediately to the Certifying Surgeon.</li>
<li>Certifying Surgeon should communicate his findings to the occupier with 30 days of the receipt of this
reference.</li>
</ol>
</div>
</div>
</div>
<form id="medical_examination_form_pdf" action="" method="POST">
<input type="hidden" name="htmlText" id="htmlText" />
</form>
</div>
<script>
formSubmit();
function formSubmit() {
$("#htmlText").val($("#medical_examination_form").html());
document.forms['medical_examination_form_pdf'].action = "pdf_dynamic.php";
document.forms['medical_examination_form_pdf'].method = "post";
document.forms['medical_examination_form_pdf'].submit();
}
</script>