@extends('master')

@section('content')

	 <div class="row">
        <div class="large-12 columns">
            <div class="row">
                <div class="small-12 medium-12 large-12 columns">
                    <h4>Illness Exam</h4>
                </div>
            </div>

            <div class="row">
                <div class="small-6 medium-6 large-6 columns">
                    <h5>{{{ $patientData->fname . " " . $patientData->lname }}}</h5>
                </div>
            </div>

            <div class="row">
                <div class="small-4 medium-4 large-4 columns">
                    <h5>Employer: {{{ $employer->name }}}</h5>
                </div>
            </div>

            <div class="row">
                <div class="small-12 medium-12 large-12 columns">
                    <p>This screen for evaluation of illness following accidental exposure known at the time of the examination. </p>
                </div>
            </div>
        </div>
    </div>
    <div class="row">
    	<div class="small-12 medium-12 large-12  columns">
    		<div class="row">
    			<div class="small-12 medium-3 large-3  columns">
    				<hr>
    				<h5>Physical Exam Findings</h5>
			        <h6>Vital Signs</h6>

			        @foreach ($vitals as $value)

				    	<div class="row">
				            <div class="large-12 columns">

				            	@if($value->value != 'true' && $value->description != 'Prior work related injury or impairment') 

					            <label>{{{ $value->description }}}</label>
					            <input type="text" value="{{{ $value->value }}}" readonly   />

					            

					            @elseif($value->description == 'Prior work related injury or impairment')
									 <label>
									 	<input type="checkbox" checked onclick="return false" />
									 	{{{ $value->description }}}
									 </label>
					            	
					            	<textarea  readonly >{{{ $value->value }}}</textarea>
					            @endif
				            </div>
				        </div>

				    @endforeach

    			</div>
    			<div class="small-12 medium-8 large-8  columns">
    				<div class="row">
    					
    					<div class="small-12 medium-6 large-6  columns">
	    					<hr>
							<h5>Drug Allergy History</h5>

					        @foreach ($drugAllergy as $key => $value)

					        	<div class="row">
						            <div class="large-12 columns">
						            	<p>
						            		<label>
									            <input type="checkbox" checked onclick="return false" />
									            {{{ $value->description }}}
							            	</label>
							            </p>
							            @if($value->value != 'true')
								    		<textarea  readonly >{{{ $value->value }}}</textarea>
								    	@endif
						            </div>
					            
						        </div> 
					        	
					        @endforeach

					    </div>

					    <div class="small-12 medium-6 large-6 end columns">
					    	<hr>
					        <h6>Head and Neck</h6>

					        @foreach ($headNeck as $value)

						    	<div class="row">
						            <div class="large-12 columns">

						            	@if($value->value != 'true') 

							            <label>{{{ $value->description }}}</label>
							            <textarea  readonly >{{{ $value->value }}}</textarea>

							            @else
											<p>
							            		<label>
										            <input type="checkbox" checked onclick="return false" />
										            {{{ $value->description }}}
								            	</label>
								            </p>
							            @endif
						            </div>
						        </div>
						    @endforeach
					    </div>
					</div>
				    <div class="row">
						<div class="small-12 medium-6 large-6  columns">
	    					<hr>
							<h5>Review of Systems Related to ChE Inhibition</h5>
							<p>Positive answers suggest possible illness related to ChE inhibitor</p>
					        @foreach ($reviewSystems as $key => $value)
					        	<div class="row">
						            <div class="large-12 columns">
						            	<p>
						            		<label>
									            <input type="checkbox" checked onclick="return false" />
									            {{{ $value->description }}}
							            	</label>
							            </p>
						            </div>
						        </div> 
					        @endforeach
						</div>
						<div class="small-12 medium-6 large-6  columns">
							<hr>
					        <h6>Chest</h6>
					        @foreach ($chest as $value)
						    	<div class="row">
						            <div class="large-12 columns">
						            	@if($value->value != 'true') 
							            <label>{{{ $value->description }}}</label>
							            <textarea  readonly >{{{ $value->value }}}</textarea>
							            @else
											<p>
							            		<label>
										            <input type="checkbox" checked onclick="return false" />
										            {{{ $value->description }}}
								            	</label>
								            </p>
							            @endif
						            </div>
						        </div>
						    @endforeach
						</div>
					</div>
				</div>			
    		</div>
    	</div>
    </div>
    <div class="row">
    	<div class="small-12 medium-6 large-6  columns">
    		<hr>
	        <h5>Exposures</h5>
	        @foreach($exposures as $value)
	         <div class="row">
	            <div class="large-12 columns">
	            	<label>{{{ $value->description }}}</label>
		            <textarea rows="4" cols="20" readonly>{{{ $value->value }}}</textarea>
	            </div>
	        </div>
	        @endforeach
    	</div>
    	<div class="small-12 medium-6 large-6  end columns">
    		<hr>
			<h5>illnesses</h5>
	         @foreach($illnesses as $value)
	         <div class="row">
	            <div class="large-12 columns">
	            	<label>{{{ $value->description }}}</label>
		            <textarea rows="4" cols="20" readonly>{{{ $value->value }}}</textarea>
	            </div>
	        </div>
	        @endforeach
    	</div>
		@if($poisoning)
    	<div class="small-12 medium-12 large-12  columns">
    		<hr>
	        <h5>Poisoning</h5>
    		<label> {{{ $poisoning->description }}} </label>
    	</div>
		@endif
    </div>

    
    <div class="row">
    	<hr>
    	<div class="small-6 medium-6 large-4 end columns">
    		<a href="{{{ URL::to('hl7Manager') }}}" class="button digital-signature">Send To Lab</a>
    	</div>
    	<div class="small-6 large-4 columns">
			<a class="button expand" href=" {{{ URL::to('patients/' . $patientData->pid . '/notification') }}} ">Notification</a>
		</div>
        <div class="small-6 medium-6 large-4 end columns">
            <a href="{{{ URL::to('patients/'.$patientData->pid) }}}" class="button expand">Return</a>
        </div>
    </div>

     <div id="myModal" class="reveal-modal" data-reveal aria-labelledby="modalTitle" aria-hidden="true" role="dialog">
        <form id="actionForm" action="" method="POST">
			<input hidden name="pid" value="{{{$patientData->pid}}}" />
			<input hidden name="examType" value="followUp" />
        </form>
        <form id="signForm" action="" method="GET">
            <div class="row">
              <div class="large-6 columns">
                <label for="password">Please type your digital signature password</label>
                <input type="password" name="password">
                <button class="button">Sign</button>
              </div>
            </div>
        </form>
      <a class="close-reveal-modal" aria-label="Close">&#215;</a>
    </div>

	<script>

	$(document).ready(function(){
		$('#signForm').submit(function(e) {
	        e.preventDefault();
	        var url = '{{ URL::to("sign") }}';
	        var passvalue = $("#signForm").find( "input[name='password']" ).val();
	        $.ajax({
	          type: "POST",
	          url: url,
	          contentType: "application/json",
	          data: {password: passvalue}
	        }).done(function(response) {
	          if(response==='false'){
	              $("#actionForm").attr("action", $('a.digital-signature').attr("href"));
	              $("#actionForm").submit();
	          }
	        });
      	});
      	$('a.digital-signature').on('click', function(e) {
        	e.preventDefault();
        	$('#myModal').foundation('reveal','open');
      	});

	   $('#close').foundation('reveal', 'close');
	});

	</script>
    
@stop