<?php //include('pdf_header_reverse.php'); include('includes/config/config.php'); include_once('includes/functions.php'); $from_date = $_REQUEST['startDate2']; $to_date = $_REQUEST['endDate2']; //include('pop_up_top.php'); ?> <link href="includes/css-js/admin.css" rel="stylesheet" type="text/css" /> <body> <style> .tbl2{ font-size:12px; border: 1px solid black; border-collapse: collapse; } .tbl2 td,th{ font-size:12px; border: 1px solid black; border-collapse: collapse; padding: 4px; } .tbl1 td,th{ font-size:12px; padding: 4px; } .btn { background-color: #4CAF50; border-radius : 5%; /* Green */ border: none; color: white; padding: 15px 32px; text-align: center; text-decoration: none; display: inline-block; font-size: 16px; margin: 4px 2px; cursor: pointer; } @media print { #printPageButton { display: none; } } </style> <table width="100%" class="tbl1"> <tr><div style="font-size:15px"> <td width="100%" align="center" style="font-size:20px"><strong>FORM 17</strong></td> </tr> <tr> <td align="center">(Prescribed under Rule 68-T and 102)</td> </tr> <tr> <td align="center">(as amended vide Notification No.1183-LW-IR-1/91 dated 27th Nov.1991)</td> </tr> <tr><div style="font-size:15px"> <td width="100%" align="center" style="font-size:20px"><strong>Health Register</strong></td> </tr> <?php $sql_1="SELECT a.*,b.patient_name,b.gender,b.dob,b.emp_code,b.hazardous_process,b.dangerous_process,b.raw_materials_exposed FROM medical_examination a left join patient_master b on a.patient_id = b.id WHERE a.checkup_id = '".$_REQUEST['checkup_id']."'"; error_log("FORM17:".$sql_1); $result_1 = mysqli_query($conn,$sql_1); $row_1 = mysqli_fetch_array($result_1); ?> <tr> <td width="30%">1.Serial No. in the register of adult worker: <?php echo $row_1['emp_code']?></td> </tr> <tr> <td align="left">2.Name of worker: <?php echo $row_1['patient_name']?></td> </tr> <tr> <td >3.Sex: <?php if($row_1['gender']=='M') echo "Male"; elseif ($row_1['gender']=='F') echo "Female";?></td> </tr> <tr> <td align="left">4.Date of Birth: <?php echo date("d-M-Y",strtotime($row_1['dob']))?> </td> </tr> </table> <br> <table border="1" width="100%" class="tbl2"> <?php $sql_17 = "select * from form_17 where checkup_id = '".$_REQUEST['checkup_id']."'"; $result_17 = mysqli_query($conn,$sql_17); $num = mysqli_num_rows($result_17); error_log("NUMBER OF ROWS::".$num); if($num > 0){ $sql="SELECT a.*,b.*,c.*,b.hazardous_process as hazardous_operation FROM form_17 a left join medical_examination c on a.checkup_id = c.checkup_id left join patient_master b on c.patient_id = b.id WHERE a.checkup_id = '".$_REQUEST['checkup_id']."'"; error_log("FORM17::" .$sql); } else { $sql="SELECT b.*,c.*,b.hazardous_process as hazardous_operation from medical_examination c left join patient_master b on c.patient_id = b.id WHERE c.checkup_id = '".$_REQUEST['checkup_id']."'"; error_log("FORM data::" .$sql); } $result = mysqli_query($conn,$sql); ?> <tr> <th width="12%" height="12%">Department/works</th> <th width="12%">Name of hazardous process</th> <th width="12%">Dangerous process/operation</th> <th width="12%">Nature of job/occupation</th> <th width="12%">Raw materials,products or by-products likely to be exposed to</th> <th width="12%">Date of joining</th> <th width="12%">Date of leaving/transfer other work</th> <th width="12%">Reason for discharge/transfer to other work</th> <!-- <th >Signs and symptoms observed during examination</th> <th >Nature of tests & thereof</th> <th >Result Fit/Unfit</th> <th >Period of temporary withdrawal from that work</th> <th>Reason for such withdrawal</th> <th>Date of declaring him unfit for that work</th> <th>Date of issuing fitness certificate</th> <th>Signature with data of the Factory Medical Officer/the Certifying Surgeon</th> --> </tr> <tr> <th>1</th> <th>2</th> <th>3</th> <th>4</th> <th>5</th> <th>6</th> <th>7</th> <th>8</th> <!-- <th>9</th> <th>10</th> <th>11</th> <th>12</th> <th>13</th> <th>14</th> <th>15</th> <th>16</th> --> </tr> <?php $count=1; while ($row1= mysqli_fetch_assoc($result)){ extract($row1); ?> <tr> <td><?php echo getFieldfromTable('dept_name','department','dept_id',$row1['dept_id'])?></td> <td><?php echo $row1['hazardous_operation']?></td> <td><?php echo $row1['dangerous_process']?></td> <td><?php echo getFieldfromTable('designation_name','designation','designation_id',$row1['designation_id']);?></td> <td><?php echo $row1['raw_materials_exposed']?></td> <td><?php echo date("d-M-Y",strtotime($row1['doj']))?></td> <td><?php echo $row1['date_leaving']?></td> <td><?php echo $row1['reason_for_discharge']?></td> <!-- <td><?php echo $row1['signs_symptoms']?></td> <td><?php echo $row1['nature_tests']?></td> <td><?php echo $row1['result']?></td> <td><?php echo $row1['period_temp_withdrawal']?></td> <td><?php echo $row1['reason_withdrawal']?></td> <td><?php echo $row1['date_unfit']?></td> <td><?php echo $row1['date_fitness']?></td> <td></td> --> </tr> <?php $count++; } ?> </table> <br/> <table border="1" width="100%" class="tbl2"> <tr> <td align="center">Medical examination and the results there of</td> </tr> <tr> <td align="center">Signs and symptoms observed during examination</td> </tr> <tr> <td align="center">9</td> </tr> <tr > <td rowspan="10" > <div> <b style="font-weight: 800;text-decoration: underline;">CLINICAL EXAMINATION</b> <b><span style="float: right;">Date:<?php echo date("d-M-Y",strtotime($row_1['medical_entry_date']))?></span></b> </div> <br> <div style="display: inline;"> <b>Height: <?php echo $row_1['height']?></b> cm <b>Weight: <?php echo $row_1['weight']?></b> Kgs <b>BMI: <?php echo $row_1['bmi']?></b> <b>Built & Nutrition: <?php echo $row_1['bn_findings']?></b> <b>Blood Pressure: <?php echo $row_1['bp']?></b> mmHg <b>Pulse: <?php echo $row_1['pulse']?> </b> /m </div> <br> <br> <div style="display: inline;"> <b>General Inspection</b> <b>A: <?php echo $row_1['a']?></b> <b>CY: <?php echo $row_1['cy']?></b> <b>I: <?php echo $row_1['i']?></b> <b>Cl: <?php echo $row_1['cl']?> </b> <b>E: <?php echo $row_1['e']?> </b> </div> <br> <br> <div style="display: inline;"> <b style="text-decoration: underline;">Respiratory System: </b> <b>Chest: <?php echo $row_1['chest']?></b> <b>Chest Inspiration: <?php echo $row_1['chest_in']?></b> <b>Expiration: <?php echo $row_1['chest_exp']?></b> cm (NA Female Candidate) </div> <br> <br> <div style="display: inline;"> <b>SKIN: <?php echo $row_1['skin']?> </b> <b>Muscular Skeletal: <?php echo $row_1['musculo_skeletal']?> </b> </div> <br> <br> <div style="display: inline;"> <b style="text-decoration: underline;">CNS: </b> <b>Speech: <?php echo $row_1['speech']?> </b> <b>Higher Function: <?php echo $row_1['higher_function']?> </b> <b>Motor Function: <?php echo $row_1['motor_function']?> </b> <b>Vertigo: <?php echo $row_1['vertigo']?> </b> </div> <br> <br> <div style="display: inline;"> <b>Reflexes(Superficial & Deep): <?php echo $row_1['reflexes']?> </b> <b>Vibration syndrome: <?php echo $row_1['vibration_syndrome']?></b> </div> <br> <br> <div style="display: inline;"> <b style="text-decoration: underline;">ENT: </b> <b>Conversational Hearing: <?php echo $row_1['conversational_hearing']?> </b> <b>EAC: <?php echo $row_1['eac']?></b> <b>Nose: <?php echo $row_1['nose']?> </b> <b>Throat: <?php echo $row_1['throat']?></b> </div> <br> <br> <div style="display: inline;"> <b style="text-decoration: underline;">Dental: </b> <b>Teeth & Gum: <?php echo $row_1['teeth_n_gum']?> </b> </div> <br> <br> <div style="display: inline;"> <b style="text-decoration: underline;">CVS: </b> <b>S1 & S2: <?php echo $row_1['s1']?> </b> <b>Any other sound: <?php echo $row_1['any_other_sound']?> </b> </div> <br> <br> <div style="display: inline;"> <b style="text-decoration: underline;">ABDOMEN: </b> <b>Liver: <?php echo $row_1['liver']?></b> <b>Spleen: <?php echo $row_1['speen']?> </b> <b>Tenderness: <?php echo $row_1['tenderness']?> </b> </div> <br> <br> <div style="display: inline;"> <b>Any Other Abnormality: <?php echo $row_1['any_other_abnormality']?> </b> </div> </td> </tr> </table> <br> <table border="1" width="100%" class="tbl2"> <tr> <td width="100%" align="center">Medical examination and the results thereof</td> <td>11</td> </tr> <tr> <td align="center">Nature of tests & results thereof</td> <td>Result Fit/Unfit</td> </tr> <tr> <td align="center" >10</td> </tr> <tr > <td > <div> <b style="font-weight: 800;text-decoration: underline;">BLOOD ROUTINE EXAMINATION</b> <b><span style="float: right;">Date:<?php echo date("d-M-Y",strtotime($row_1['medical_entry_date']))?></span></b> </div> <br> <div style="display: inline;"> <b>Hemoglobin: <?php echo $row_1['hb']?></b> % gm/dl <b>Total Leucocyte Count: <?php echo $row_1['tlc']?> </b> cu. /mm </div> <br> <br> <div style="display: inline;"> <b>Differential Leucocyte Count</b> <b>Neutrophils: <?php echo $row_1['dlc_n']?></b> % <b> Lymphocytes: <?php echo $row_1['dlc_l']?></b> % <b>Monocytes: <?php echo $row_1['dlc_m']?></b> % <b>Eosinophil: <?php echo $row_1['dlc_e']?></b> % <b>Basophils: <?php echo $row_1['dlc_b']?> </b> % </div> <br> <br> <div style="display: inline;"> <b>Total Cholesterol: <?php echo $row_1['total_cholestrol']?></b> mg/dl <b>(LDL) Cholesterol: <?php echo $row_1['ldl']?></b> mg/dl <b>(VLDL) Cholesterol : <?php echo $row_1['vldl']?></b> mg/dl </div> <br> <br> <div style="display: inline;"> <b>Blood Sugar: </b> <b>RBS: <?php echo $row_1['blood_sugar_rbs']?></b> mg/dl <b>FBS: <?php echo $row_1['blood_sugar_fbs']?> </b> mg/dl <b>PPBS: <?php echo $row_1['blood_sugar_ppbs']?> </b> mg/dl </div> <br> <br> <div style="display: inline;"> <b style="font-weight: 800;text-decoration: underline;">RENAL FUNCTION TEST</b> <b style="font-weight: 800;text-decoration: underline;">LIVER FUNCTION TEST</b> </div> <br> <br> <div style="display: inline;"> <b >Uric Acid: </b> <span style="margin-left: 137px"><?php echo $row_1['uric_acid']?> mg/dl</span> <b>Total Bilirubin </b> <span style="margin-left: 122px"><?php echo $row_1['total_bilirubin']?> mg/dl</span> </div> <br> <br> <div style="display: inline;"> <b >Urea: </b><span style="margin-left: 165px"><?php echo $row_1['s_urea']?> mg/dl</span> <b>Conj. </b> <span style="margin-left: 175px"><?php echo $row_1['conj']?> mg/dl</span> </div> <br> <br> <div style="display: inline;"> <b>Creatinine: </b><span style="margin-left: 131px"><?php echo $row_1['s_creatinine']?> mg/dl</span> <b>Unconj. </b> <span style="margin-left: 160px"><?php echo $row_1['uniconj']?> mg/dl</span> </div> <br> <br> <div style="display: inline;"> <b>Sodium (Na+): </b> <span style="margin-left: 112px"><?php echo $row_1['sodium']?> mg/dl</span> <b>SGOT </b> <span style="margin-left: 170px"><?php echo $row_1['sgop']?> mg/dl</span> </div> <br> <br> <div style="display: inline;"> <b >Potassium (K+): </b> <span style="margin-left: 102px"><?php echo $row_1['potassium']?> mg/dl</span> <b>SGPT </b> <span style="margin-left: 170px"><?php echo $row_1['sgpt']?> mg/dl</span> </div> <br> <br> <div style="display: inline;"> <b >Phosphate: </b> <span style="margin-left: 128px"><?php echo $row_1['rft_phosphate']?> mg/dl</span> <b>Alkaline Phosphatase </b> <span style="margin-left: 78px"><?php echo $row_1['alk_phosphatase']?> mg/dl</span> </div> <br> <br> <div style="display: inline;"> <b>Bi-Carbonate (Hco3): </b> <span style="margin-left: 72px"><?php echo $row_1['hco3']?> mmol/l</span> <b>Total Protein: </b> <span style="margin-left: 128px"><?php echo $row_1['total_protein']?> g/dl</span> </div> <br> <br> <div style="display: inline;"> <b style="margin-left: 292px">Globulin: </b> <span style="margin-left: 150px"><?php echo $row_1['globulin']?> g/dl</span> </div> <br> <br> <div style="display: inline;"> <b style="margin-left: 292px">Albumin: </b> <span style="margin-left: 150px"><?php echo $row_1['albumin']?> g/dl</span> </div> <br> <br> <div style="display: inline;"> <b style="text-decoration: underline;">URINE RE & ME: </b> <?php echo $row_1['urine_re_me']?> </div> <br> <br> <div style="display: inline;"> <b style="text-decoration: underline;">Pulmonary Function Test (Spirometry) : </b> <?php echo $row_1['spirometry_remarks']?> </div> <br> <br> <div style="display: inline;"> <b style="text-decoration: underline;">Audiometry : </b> <?php echo $row_1['audio_findings']?> </div> <br> <br> <div style="display: inline;"> <b style="text-decoration: underline;">Chest X-Ray: </b> <?php echo $row_1['xray_findings']?> </div> <br> <br> <div style="display: inline;"> <b style="text-decoration: underline;">ECG : </b> <?php echo $row_1['ecg_findings']?> </div> <br> <br> <div style="display: inline;"> <b style="text-decoration: underline;">Others: </b> <?php echo $row_1['others']?> </div> </td> <td> <?php echo $row_1['physical_status']?> </td> </tr> </table> <br> <table border="1" width="100%" class="tbl2"> <tr> <td colspan="4" align="center">If declared unfit for work</td> <th width="12%" rowspan="2">Signature with date of the Factory Medical Officer/ the Certifying Surgeon</th> </tr> <tr> <th width="12%" height="12%">Period of Temporary withdrawal from that work</th> <th width="12%">Reason for such withdrawal</th> <th width="12%">Date of declaring him unfit for that work</th> <th width="12%">Date of issuing fitness Certificate</th> </tr> <tr> <th>12</th> <th>13</th> <th>14</th> <th>15</th> <th>16</th> </tr> <?php $sql_17 = "select * from form_17 where checkup_id = '".$_REQUEST['checkup_id']."'"; $result_17 = mysqli_query($conn,$sql_17); $num = mysqli_num_rows($result_17); error_log("NUMBER OF ROWS::".$num); if($num > 0){ $sql="SELECT a.*,c.* FROM form_17 a left join medical_examination c on a.checkup_id = c.checkup_id WHERE a.checkup_id = '".$_REQUEST['checkup_id']."'"; } else{ $sql="SELECT * from medical_examination WHERE checkup_id = '".$_REQUEST['checkup_id']."'"; } error_log("FORM17".$sql); $result = mysqli_query($conn,$sql); $count=1; while ($row1= mysqli_fetch_assoc($result)){ extract($row1); ?> <tr> <td><?php echo $row1['period_temp_withdrawal']?></td> <td><?php echo $row1['reason_withdrawal']?></td> <td><?php echo $row1['date_unfit']?></td> <td><?php echo $row1['date_fitness']?></td> <td><img src="data:<?php echo $row1['doc_sign_image_type']?>;base64,<?php echo base64_encode( $row1['approving_doc_sign_img'])?>" style="width: 200px; height: 61px;" /></td> </tr> <?php $count++; } ?> </table> <?php //include('pdf_footer.php'); ?> <div align="center" > <button align ="center" id="printPageButton" class="btn btn-success" onClick="window.print();">Print</button> </div> <script> $(document).ready(function(){ window.print(); }); </script>