<form name="fitness_form_employee" id="fitness_form_employee" enctype="multipart/form-data" action="#" method="post" role="form-horizontal"> <div class="row"> <div class="col-xs-12 widget-container-col" id="widget-container-col-1"> <div class="widget-box box box-warning" id="widget-box-1"> <div class="widget-header"> <h5 class="widget-title"> Fitness Form Patient - <?= $patient_name ?> <i style="margin-left:10px; cursor: pointer; " class="fa fa-user" target="_blank" id="profile_link" onclick="open_dashboard(<?= $emp_id ?>)"></i> </h5> <div class="widget-toolbar"> <div class="clearfix"> <div class="pull-right tableTools-container"> <div class="dt-buttons btn-overlap btn-group"> <a class=" forwardButton dt-button buttons-csv buttons-html5 btn btn-white btn-primary btn-bold save_button" onclick="$('#forward_status').val('<?= $__STATUS_DOCTOR_ATTENDED ?>');" id='forwardButton' tabindex="0" aria-controls="dynamic-table" data-original-title="" title=""><span><i class="fa fa-floppy-o bigger-110 blue"></i> <span>Approve & Close</span></span></a> <input type="hidden" class="form-control" id="forward_status" name="forward_status"> <input type="hidden" class="form-control" name="sickness_id" id="sickness_id" value="<?= $sickness_id ?>" required /> <a class="dt-button buttons-print btn btn-white btn-primary btn-bold" onclick="exporttopdf();" tabindex="0" aria-controls="dynamic-table" data-original-title="" title=""><span><i class="fa fa-print bigger-110 grey"></i> <span class="hidden">Print</span></span></a> <a class="dt-button buttons-print btn btn-white btn-primary btn-bold" data-action="fullscreen" tabindex="0" aria-controls="dynamic-table" data-original-title="Maximize" title="Maximize"><span><i class="fa fa fa-expand bigger-110 grey"></i> <span class="hidden">Maximize</span></span></a> <input type="hidden" name="attendedStatus" id="attendedStatus" <?php if ($rolecode == 'DOC') { ?> value="<?php echo $__STATUS_DOCTOR_ATTENDED ?>" <?php } ?> <?php if ($rolecode == 'RCP'|| in_array('RCP',$Rolecodes)) { ?> value="<?php echo $__STATUS_RECEPTIONIST_ATTENDED ?>" <?php } ?> /> <input type="hidden" name="doctor_last_attended" id="doctor_last_attended" <?php if ($rolecode == 'DOC') { ?> value="<?php echo $_SESSION['user_id'] ?>" <?php } else { ?> value="<?php echo $row['doctor_last_attended'] ?>" <?php } ?> /> </div> </div> </div> </div> </div> <div class="panel-body"> <div class="row"> <div class="col-sm-3"> <label class="control-label" for="appointment_id"><strong style="font-size: 11px">Fitness No:</strong></label> <?php if (isset($past_ticket_no)) { $ticket_no = $past_ticket_no; } else { $ticket_no = creatingTicketNoFitness(); } ?> <input id="ticket_no" type="hidden" name="ticket_no" value="<?php echo $ticket_no ?>" /> <div class="input-group col-sm-12"> <?php echo $ticket_no ?> <input type="hidden" name="emp_id" id="emp_id" value="<?= $emp_id ?>"> </div> </div> <input class=" form-control" name="certificate_type" id="certificate_type" placeholder="Certificate Type" type='hidden' value="<?= $certificate_type?>"> <!-- <select class=" form-control" name="certificate_type" id="certificate_type" placeholder="Certificate Type" value="" hidden required> <option value="" selected disabled>PLEASE SELECT CERTIFICATION TYPE </option> <option value="rest" <?php if ($certificate_type =="rest") { echo "selected"; } ?>>REST CERTIFICATE</option> <option value="duty" <?php if ($certificate_type =="duty") { echo "selected"; } ?>>DUTY CERTIFICATE</option> <option value="fitness" <?php if ($certificate_type=="fitness") { echo "selected"; } ?>>FITNESS CERTIFICATE</option> <option value="experience" <?php if ($certificate_type == "experience") { echo "selected"; } ?>>EXPERIENCE CERTIFICATION</option> </select> --> <!-- <div class="col-sm-3"> <label class="control-label" for="appointment_date"><strong style="font-size: 11px">Token No</strong></label> <div class="input-group"> <input id="token_no" name="token_no" type="text" value="<?php echo $row['token_no'] ?>" /> </div> </div> --> <div class="col-sm-3"> <label for="role">Appointment Date</label> <div class="input-group col-sm-12"> <input class="form-control" name="sickness_date" id="sickness_date" type="datetime-local" value="<?= $row['sickness_date']?>" /> <!-- <span class="input-group-addon"> <i class="fa fa-calendar bigger-110"></i> </span> --> </div> </div> <div class="col-sm-3"> <label for="role">Approval Date</label> <div class="input-group col-sm-12"> <input class="form-control" name="approval_date" id="approval_date" type="date" value="<?= $row['approval_date'] ?>" /> <!-- <span class="input-group-addon"> <i class="fa fa-calendar bigger-110"></i> </span> --> </div> </div> <div class="col-sm-3"> <label class="control-label" for="followup_to_opd"><strong style="font-size: 11px">Follow up to(if Applicable)</strong></label> <div class="input-group col-sm-12"> <?php if ($rolecode != 'DOC' && $row['doctor_attended_flag'] == 'Y') { ?> <?php echo ($row['followup_to_opd'] == '0') ? "None" : $row['followup_to_opd'] ?> <input type="hidden" id="followup_to_opd" name="followup_to_opd" value="<?php echo $row['followup_to_opd'] ?>" /> <?php } else { ?> <select class="form-control col-sm-12" id="followup_to_opd" name="followup_to_opd"> <option value="">None</option> <?php $sql = "select CONCAT(ticket_no,' ',DATE_FORMAT(appointment_date,'%d-%b-%Y %l:%i %p ')) as nameCol,appointment_id from employee_appointment where emp_id ='$flex_opd_id' order by appointment_date"; error_log("odddddd" . $sql); $resultSet = mysqli_query($conn, $sql); while ($row1 = mysqli_fetch_array($resultSet)) { echo "<option value='" . $row1['appointment_id'] . "' selected=selected>" . $row1['nameCol'] . "</option>"; } ?> </select> </div> <?php } ?> </div> </div> <div class="space-6"></div> <div class="row"> <div class="form-group col-sm-3 "> <label for="role">Treatment Start Date</label> <div class="input-group col-sm-12"> <input class="form-control" name="from_date" id="from_date" type="date" value="<?= $row['from_date']?>" /> <!-- <span class="input-group-addon"> <i class="fa fa-calendar bigger-110"></i> </span> --> </div> </div> <div class="form-group col-sm-3"> <label for="role">Treatment End Date </label> <div class="input-group col-sm-12"> <input class="form-control" name="to_date" id="to_date" type="date" value="<?=$row['to_date']?>" /> <!-- <span class="input-group-addon"> <i class="fa fa-calendar bigger-110"></i> </span> --> </div> </div> <div class="form-group col-sm-3"> <label for="role">Unfit From Date</label> <input type="hidden" class="form-control" name="sickness_id" id="sickness_id" value="<?php echo $row['sickness_id'] ?>" required /> <div class="input-group col-sm-12"> <input class="form-control" name="date_absent" id="date_absent" type="date" value="<?=$row['date_absent']?>" /> <!-- <span class="input-group-addon"> <i class="fa fa-calendar bigger-110"></i> </span> --> </div> </div> <div class="form-group col-sm-3"> <label for="role">Unfit to Date</label> <div class="input-group col-sm-12"> <input class="form-control" name="date_absent_to" id="date_absent_to" type="date" value="<?=$row['date_absent_to']?>" /> <!-- <span class="input-group-addon"> <i class="fa fa-calendar bigger-110"></i> </span> --> </div> </div> </div> <div class="space-6"></div> <!-- <div class="row"> <div class="form-group col-sm-3 "> <label for="role">Justifiable From Date</label> <div class="input-group"> <input class="form-control" name="justifiable_from" id="justifiable_from" type="text" /> <span class="input-group-addon"> <i class="fa fa-calendar bigger-110"></i> </span> </div> </div> <div class="form-group col-sm-3"> <label for="role">Justifiable To Date </label> <div class="input-group"> <input class="form-control" name="justifiable_to" id="justifiable_to" type="text" /> <span class="input-group-addon"> <i class="fa fa-calendar bigger-110"></i> </span> </div> </div> <div class="form-group col-sm-3"> <label for="role">Not Justifiable From Date</label> <div class="input-group"> <input class="form-control" name="date_not_just" id="date_not_just" type="text" /> <span class="input-group-addon"> <i class="fa fa-calendar bigger-110"></i> </span> </div> </div> <div class="form-group col-sm-3"> <label for="sickness">Not Justifiable To Date</label> <div class="input-group"> <input class="form-control" name="date_not_just_to" id="date_not_just_to" type="text" /> <span class="input-group-addon"> <i class="fa fa-calendar bigger-110"></i> </span> </div> </div> </div> --> <div class="space-6"></div> <div class="row"> <div class="form-group col-sm-3"> <label for="sickness">Date of Rejoining</label> <div class="input-group col-sm-12"> <input class="form-control" name="date_return" id="date_return" type="date" value="<?php echo $row['date_return'] ?>"/> <!-- <span class="input-group-addon"> <i class="fa fa-calendar bigger-110"></i> </span> --> </div> </div> <div class="form-group col-sm-3"> <label for="sickness">You Told the Dispensary About The Sickness</label> <input type="text" class="form-control" name="des_dis" id="des_dis" placeholder="" value="YES" required /> </div> <div class="form-group col-sm-3"> <label for="sickness">Do You Think You Got Sick Because of Work</label> <select class="form-control" name="des_sick" id="des_sick" placeholder="" value="" required /> <!-- <option value="" disabled selected>SELECT</option> --> <option value="YES" <?php if (strcmp($des_sick, 'YES') == 0) { echo "selected"; } ?>>YES</option> <option value="NO" <?php if (strcmp($des_sick, 'NO') == 0) { echo "selected"; } ?>>NO</option> </select> </div> <div class="form-group col-sm-3"> <label for="sickness">What Can Be Done To Prevent It In Future</label> <input type="text" class="form-control" name="des_future" id="des_future" placeholder="" value="<?php echo $row['des_future'] ?>" required /> </div> </div> <div class="space-6"></div> <div class="row"> <div class="col-sm-3"> <div class="form-group"> <label class="control-label" for="ailment"><strong style="font-size:11px">Diagnosis</strong></label> <div class="input-group"> <!-- <input name="ailment[]" type="hidden" data-placeholder="Ailments" value="<?php //echo $existingAilmentList; ?>"> --> <input type="text" class="form-control" id="ailment_new" name="ailment_new" data-placeholder="Ailments"> </div> </div> </div> <div class="form-group col-sm-3"> <label class="control-label" for="ailment_system"><strong style="font-size: 11px">Body System</strong></label> <select class="chosen-select form-control" id="ailment_system_new" name="ailment_system_new" data-placeholder="Ailment System"> <option value="">Select Body System</option> <?php echo generateOptionForMultiple('ailment_system', 'ailment_sys_name', 'ailment_sys_id', $row['ailment_system'], ''); ?> </select> </div> <div class="form-group col-sm-3"> <label for="sickness">Doctor reference no.</label> <input class="form-control" name="doc_ref_no" value="<?php echo $row['doctor_reference_no'] ?>" id="doc_ref_no" required /> </div> <div class="form-group col-sm-3"> <label for="sickness">Treatment Agency</label> <input type="text" class="form-control" name="agency" id="agency" value="<?php echo $row['agency'] ?>" placeholder="Enter Agency" required /> </div> </div> <!-- <div class="row"> <div class="form-group col-sm-3"> <label for="sickness">Weight (KG)</label> <input type="text" class="form-control" name="weight" id="weight" placeholder="" value="<?php echo $weight ?>" required /> </div> <div class="form-group col-sm-3"> <label for="sickness">B.P</label> <input type="text" class="form-control" name="bp" id="bp" placeholder="" value="<?php echo $bp ?>" required /> </div> <div class="form-group col-sm-3"> <label for="sickness">Pulse</label> <input type="text" class="form-control" name="pulse" id="pulse" placeholder="" value="<?php echo $pulse ?>" required /> </div> <div class="form-group col-sm-3"> <label for="sickness">Chest : Un-Expanded (CM)</label> <input type="text" class="form-control" name="ch_uex" id="ch_uex" placeholder="" value="<?php echo $chest_uex ?>" required /> </div> </div> <div class="row"> <div class="form-group col-sm-3"> <label for="sickness">Chest : Expanded (CM)</label> <input type="text" class="form-control" name="ch_ex" id="ch_ex" placeholder="" value="<?php echo $chest_ex ?>" required /> </div> <div class="form-group col-sm-3"> <label>Blood Group</label> <select class="form-control" name="blood_group" id="blood_group"> <option disabled selected>Please select option</option> <?php echo generateOption('blood_group', 'type', 'type', $blood, ''); ?> </select> </div> <div class="form-group col-sm-3"> <label for="sickness">Nose</label> <input type="text" class="form-control" name="nose" id="nose" placeholder="" value="<?php echo $nose ?>" required /> </div> <div class="form-group col-sm-3"> <label for="sickness">Throat</label> <input type="text" class="form-control" name="throat" id="throat" placeholder="" value="<?php echo $throat ?>" required /> </div> <div class="form-group col-sm-3"> <label for="sickness">R.S</label> <input type="text" class="form-control" name="rs" id="rs" placeholder="" value="<?php echo $rs ?>" required /> </div> <div class="form-group col-sm-3"> <label for="sickness">C.V.S</label> <input type="text" class="form-control" name="cvs" id="cvs" placeholder="" value="<?php echo $cvs ?>" required /> </div> <div class="form-group col-sm-3"> <label for="sickness">C.N.S</label> <input type="text" class="form-control" name="cns" id="cns" placeholder="" value="<?php echo $cns ?>" required /> </div> <div class="form-group col-sm-3"> <label for="sickness">Height (CM)</label> <input type="text" class="form-control" name="height" id="height" placeholder="" value="<?php echo $height ?>" required /> </div> </div> --> <div class="row"> <div class="form-group col-sm-3"> <label for="sickness">Health Status</label> <select class="form-control" name="des" id="des" placeholder="" required > <option value="NORMAL" <?php if (strcmp($des, 'NORMAL') == 0) { echo "selected"; } ?>>Normal</option> <option value="WEAK" <?php if (strcmp($des, 'WEAK') == 0) { echo "selected"; } ?>>Weak</option> <option value="SICK" <?php if (strcmp($des, 'SICK') == 0) { echo "selected"; } ?>>Sick</option> </select> </div> <div class="form-group col-sm-3"> <label for="sickness">Approval Status</label> <select class="form-control" name="approval_status" id="approval_status"> <option value="APPROVED" <?php if ($row['fitness_status'] == 'APPROVED') { ?>selected<?php } ?>>Approved fit </option> <option value="REVIEW" <?php if ($row['fitness_status'] == 'REVIEW') { ?>selected<?php } ?>>Temporary unfit-review later</option> <option value="REJECTED" <?php if ($row['fitness_status'] == 'REJECTED') { ?>selected<?php } ?>>Unfit </option> <option value="ROLE CHANGE SUGGESTED" <?php if ($row['fitness_status'] == 'ROLE CHANGE SUGGESTED') { ?>selected<?php } ?>> Role Change Suggested </option> <option value="RETURN BACK TO WORK" <?php if ($row['fitness_status'] == 'RETURN BACK TO WORK') { ?>selected<?php } ?>>Return Back To Work</option> </select> </div> <div class="form-group col-sm-3"> <label for="sickness">Approval Remarks</label> <textarea class="form-control" name="remarks" id="remarks" placeholder="Approval Remarks" required maxlength="500"><?php echo $row['comments'] ?></textarea> </div> <div class="form-group col-sm-3"> <label for="sickness">Purpose of issue Certificate</label> <textarea class="form-control" name="purpose" id="purpose" placeholder="Purpose of issue Certificate" required maxlength="500"><?php echo $row['purpose'] ?></textarea> </div> </div> </div> </div> </div> </div> </fo> <form id="pdfform" target="_blank"> <input type="hidden" id="flex_sickness_id" value="<?php echo $row['sickness_id'] ?>" name="flex_sickness_id"> </form> <script> //$('#ailmentD').trigger('chosen:updated'); $('#ailment_system_new').trigger('chosen:updated'); $('#ailment_name').trigger('chosen:updated'); $(".select2").select(); jQuery(function($) { <?php if ($_SESSION['RoleCode'] == "DOC") { ?> $("#forwardButton").on("click", function() { $("#attendedStatus").val($("#forward_status").val()); validation($("#forward_status").val()); }); <?php } else { ?> // validation() <?php } ?> if (!ace.vars['old_ie']) // $('#sickness_date').datetimepicker({ // //use this option to display seconds // format: 'DD/MM/YYYY h:mm:A', //use this option to display seconds // <?php if (isset($row['sickness_date']) && $row['sickness_date'] != '0000-00-00 00:00:00') { ?> // defaultDate: new Date("<?php echo $row['sickness_date'] ?>"), // <?php } else { ?> // defaultDate: new Date(), // <?php } ?> // // maxDate: new Date(), // icons: { // time: 'fa fa-clock-o', // date: 'fa fa-calendar', // up: 'fa fa-chevron-up', // down: 'fa fa-chevron-down', // previous: 'fa fa-chevron-left', // next: 'fa fa-chevron-right', // today: 'fa fa-arrows ', // clear: 'fa fa-trash', // close: 'fa fa-times' // } // }).next().on(ace.click_event, function() { // $(this).prev().focus(); // }); // $('#from_date').datepicker({ // format: 'dd/mm/yyyy', //use this option to display seconds // //'setDate': new Date(), // endDate: "+1d", // //minDate: new Date()-10, // icons: { // time: 'fa fa-clock-o', // date: 'fa fa-calendar', // up: 'fa fa-chevron-up', // down: 'fa fa-chevron-down', // previous: 'fa fa-chevron-left', // next: 'fa fa-chevron-right', // today: 'fa fa-arrows ', // clear: 'fa fa-trash', // close: 'fa fa-times' // } // }).datepicker("setDate", new Date("<?php echo $row['from_date'] ?>")); // $('#to_date').datepicker({ // format: 'dd/mm/yyyy', //use this option to display seconds // defaultDate: new Date("<?php echo $row['to_date'] ?>"), // endDate: "+1d", // //minDate: new Date()-10, // icons: { // time: 'fa fa-clock-o', // date: 'fa fa-calendar', // up: 'fa fa-chevron-up', // down: 'fa fa-chevron-down', // previous: 'fa fa-chevron-left', // next: 'fa fa-chevron-right', // today: 'fa fa-arrows ', // clear: 'fa fa-trash', // close: 'fa fa-times' // } // }).datepicker("setDate", new Date("<?php echo $row['to_date'] ?>")); // $('#date_absent').datepicker({ // format: 'dd/mm/yyyy', // endDate: "+1d" // }).datepicker("setDate", new Date("<?php echo $row['date_absent'] ?>")); // $('#date_absent_to').datepicker({ // format: 'dd/mm/yyyy', // endDate: "+1d" // }).datepicker("setDate", new Date("<?php echo $row['date_absent_to'] ?>")); // $('#date_return').datepicker({ // format: 'dd/mm/yyyy', //use this option to display seconds // defaultDate: new Date("<?php echo $row['date_return'] ?>"), // endDate: "+1d", // //minDate: new Date()-10, // icons: { // time: 'fa fa-clock-o', // date: 'fa fa-calendar', // up: 'fa fa-chevron-up', // down: 'fa fa-chevron-down', // previous: 'fa fa-chevron-left', // next: 'fa fa-chevron-right', // today: 'fa fa-arrows ', // clear: 'fa fa-trash', // close: 'fa fa-times' // } // }).datepicker("setDate", new Date("<?php echo $row['date_return'] ?>")); $('#justifiable_from').datepicker({ format: 'dd/mm/yyyy', endDate: "+1d" }).datepicker("setDate", new Date("<?php echo $row['justifiable_from'] ?>")); $('#justifiable_to').datepicker({ format: 'dd/mm/yyyy', //use this option to display seconds defaultDate: new Date("<?php echo $row['justifiable_to'] ?>"), endDate: "+1d", //minDate: new Date()-10, icons: { time: 'fa fa-clock-o', date: 'fa fa-calendar', up: 'fa fa-chevron-up', down: 'fa fa-chevron-down', previous: 'fa fa-chevron-left', next: 'fa fa-chevron-right', today: 'fa fa-arrows ', clear: 'fa fa-trash', close: 'fa fa-times' } }).datepicker("setDate", new Date("<?php echo $row['justifiable_to'] ?>")); $('#date_not_just').datepicker({ format: 'dd/mm/yyyy', //use this option to display seconds defaultDate: new Date("<?php echo $row['not_justifiable_from'] ?>"), endDate: "+1d", //minDate: new Date()-10, icons: { time: 'fa fa-clock-o', date: 'fa fa-calendar', up: 'fa fa-chevron-up', down: 'fa fa-chevron-down', previous: 'fa fa-chevron-left', next: 'fa fa-chevron-right', today: 'fa fa-arrows ', clear: 'fa fa-trash', close: 'fa fa-times' } }).datepicker("setDate", new Date("<?php echo $row['not_justifiable_from'] ?>")); $('#date_not_just_to').datepicker({ format: 'dd/mm/yyyy', //use this option to display seconds defaultDate: new Date("<?php echo $row['not_justifiable_to'] ?>"), endDate: "+1d", //minDate: new Date()-10, icons: { time: 'fa fa-clock-o', date: 'fa fa-calendar', up: 'fa fa-chevron-up', down: 'fa fa-chevron-down', previous: 'fa fa-chevron-left', next: 'fa fa-chevron-right', today: 'fa fa-arrows ', clear: 'fa fa-trash', close: 'fa fa-times' } }).datepicker("setDate", new Date("<?php echo $row['not_justifiable_to'] ?>")); // $('#approval_date').datepicker({ // format: 'dd/mm/yyyy', //use this option to display seconds // defaultDate: new Date("<?php echo $row['approval_date'] ?>"), // endDate: "+1d", // //minDate: new Date()-10, // icons: { // time: 'fa fa-clock-o', // date: 'fa fa-calendar', // up: 'fa fa-chevron-up', // down: 'fa fa-chevron-down', // previous: 'fa fa-chevron-left', // next: 'fa fa-chevron-right', // today: 'fa fa-arrows ', // clear: 'fa fa-trash', // close: 'fa fa-times' // } // }).datepicker("setDate", new Date("<?php echo $row['approval_date'] ?>")); }); $('#ailment_new').trigger('chosen:updated'); if ($('#ailment_new')) { var ailments = new Array(); getAilments(); function getAilments() { $.ajax({ url: 'select_ailments.php', type: "GET", success: function(data) { ailments = $.parseJSON(data); }, error: function(data) { BootstrapDialog.alert('Error pulling Ailments'); return; } }); } } $(document).ready(function() { if ($('#ailment_new')) { setTimeout(function() { var tag_input_ailments = $('#ailment_new'); try { tag_input_ailments.tag({ placeholder: tag_input_ailments.attr('placeholder'), source: ailments }) //programmatically add/remove a tag var $tag_obj = $('#ailment_new').data('tag'); //$tag_obj.add('Programmatically Added'); var existingAilments = "<?php echo $existingAilmentList ?>" var existingAilments = "<?php echo getCommaSeperatedValuesForInClause('select ailment_name from ailment', 'ailment_id', $existingAilmentList) ?>" if (existingAilments != undefined && existingAilments != null && existingAilments != '') { var existingAilmentsArr = existingAilments.split(","); jQuery.each(existingAilmentsArr, function(i, val) { $tag_obj.add(val.toUpperCase()); }); } //var index = $tag_obj.inValues('some tag'); // $tag_obj.remove(index); } catch (e) { //display a textarea for old IE, because it doesn't support this plugin or another one I tried! tag_input_ailments.after('<textarea id="' + tag_input_ailments.attr('id') + '" name="' + tag_input_ailments.attr('name') + '" rows="3">' + tag_input_ailments.val() + '</textarea>').remove(); //autosize($('#form-field-tags')); } var x = $("#from_date").width(); $('.tags > input').css('width', (x + 15)); }, 500); } //end Ailments*/ }); function validation() { /* var date_absent = $('#approval_date').val(); if (date_absent == '' || date_absent == null) { BootstrapDialog.alert('Please Enter Approval Date .!!!'); return false; } var date_return = $('#date_return').val(); if(date_return == ''){ BootstrapDialog.alert('Please Enter Date Return .!!!'); return false; } */ var name = $('#ailment').val(); if(name == ''){ BootstrapDialog.alert('Please Enter Ailment Name .!!!'); return false; } save(); } $('#ailmentD').trigger("chosen:updated"); function exporttopdf() { document.forms['pdfform'].action = "fitness_certificate.php"; document.forms['pdfform'].method = "post"; document.forms['pdfform'].submit(); } </script> <?php include('common_ace.php'); ?> <?php include('support_sickness_document.php') ?> <?php include('image_popup_sickness.php') ?>