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cliente_ficha_rel.php
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<?php
include_once 'dao/dao.php';
$_POST['str_tela'] = 'cli';
$_POST['str_acao'] = 'lis';
?>
<style>
table, tr, td {
font-size: 12px;
}
.com_borda{
border: 1px solid;
}
</style>
<form id="formRel" name="formRel" action="main.php" enctype="multipart/form-data" method="post">
<input type="hidden" name="str_tela" value="cli" />
<input type="hidden" name="str_acao" value="lis" />
</form>
<table width="100%" border="0"
cellpadding="1" cellspacing="1"
style="margin-top: 0px; border: none">
<tr>
<td width="50%" style="border: none">
<table width="100%" border="0" style="border: none">
<tr>
<td colspan="2" class="com_borda">Nome: <strong><?php echo $_POST["nm_cliente"]; ?></strong></td>
</tr>
<tr>
<td width="50%" class="com_borda">D.N: <strong><?php echo $_POST["dt_nascimento"]; ?></strong></td>
<td width="50%" class="com_borda">Profissão:</td>
</tr>
<tr>
<td width="50%" class="com_borda">RG: <strong><?php echo $_POST["nr_rg"]; ?></strong></td>
<td width="50%" class="com_borda">CPF: <strong><?php echo $_POST["nr_cpf"]; ?></strong></td>
</tr>
<tr>
<td colspan="2" class="com_borda">Endereço: <strong><?php echo $_POST["ds_endereco"]; ?></strong></td>
</tr>
<tr>
<td colspan="2" class="com_borda">Telefone: <strong><?php echo $_POST["ds_telefone_residencial"]." / ".$_POST["ds_telefone_celular"]; ?></strong></td>
</tr>
<tr>
<td colspan="2" class="com_borda">Autorização quando menor de idade</td>
</tr>
<tr>
<td colspan="2" class="com_borda">Nome:</td>
</tr>
<tr>
<td colspan="2" class="com_borda">RG/CPF:</td>
</tr>
<tr>
<td colspan="2" class="com_borda">Assinat. Paciente/Responsável:</td>
</tr>
<tr>
<td colspan="2" align="center" class="com_borda">Controle Clínico</td>
</tr>
<tr>
<td colspan="2" align="center">
<div style="height: 174px">
<img src="img/control_clinico.png" width="270" height="160" />
</div>
</td>
</tr>
<tr>
<td class="com_borda" colspan="2" align="center"><strong>Plano de Tratamento</strong></td>
</tr>
<tr><td colspan="2" class="com_borda"> </td></tr>
<tr><td colspan="2" class="com_borda"> </td></tr>
<tr><td colspan="2" class="com_borda"> </td></tr>
</table>
</td>
<td style="vertical-align: top; border: none">
<table width="100%" border="0" style="border: none">
<tr>
<td class="com_borda" width="80%">Ficha de Anamnese</td>
<td class="com_borda">G: <strong><?php echo $_POST["ds_ficha"]; ?></strong></td>
</tr>
<tr>
<td class="com_borda" width="80%">Gravidez? ( )S ( )N Meses ____</td>
<td class="com_borda">O: <strong><?php echo $_POST["ds_ficha_orto"]; ?></strong></td>
</tr>
<tr>
<td class="com_borda" colspan="2">Sofre alguma doença? ( )S ( )N Qual: </td>
</tr>
<tr>
<td class="com_borda" colspan="2">Está em tratamento médico? ( )S ( )N</td>
</tr>
<tr>
<td class="com_borda" colspan="2">Faz uso medicação? ( )S ( )N Qual: </td>
</tr>
<tr>
<td class="com_borda" colspan="2">Alergia medicamentos/alimentos? ( )S ( )N</td>
</tr>
<tr>
<td class="com_borda" colspan="2">Problemas anestesia/hemorragia? ( )S ( )N</td>
</tr>
<tr>
<td class="com_borda" colspan="2">Hipertensão? ( )S ( )N Diabetes? ( )S ( )N</td>
</tr>
<tr>
<td class="com_borda" colspan="2">Médico Assistente:</td>
</tr>
<tr>
<td class="com_borda" colspan="2" align="center"><strong>Plano de Tratamento</strong></td>
</tr>
<tr><td colspan="2" class="com_borda"> </td></tr>
<tr><td colspan="2" class="com_borda"> </td></tr>
<tr><td colspan="2" class="com_borda"> </td></tr>
<tr><td colspan="2" class="com_borda"> </td></tr>
<tr><td colspan="2" class="com_borda"> </td></tr>
<tr><td colspan="2" class="com_borda"> </td></tr>
<tr><td colspan="2" class="com_borda"> </td></tr>
<tr><td colspan="2" class="com_borda"> </td></tr>
<tr><td colspan="2" class="com_borda"> </td></tr>
<tr><td colspan="2" class="com_borda"> </td></tr>
<tr><td colspan="2" class="com_borda"> </td></tr>
<tr><td colspan="2" class="com_borda"> </td></tr>
<tr><td colspan="2" class="com_borda"> </td></tr>
</table>
</td>
</tr>
</table>
<!--<br><br><br><br><br><br><br><br><br><br><br><br><br><br><br><br><br><br>
<br><br><br><br><br><br><br><br><br><br><br><br><br><br><br><br> -->
<table style="border: none; page-break-before: always" width="100%">
<tr>
<td width="100%" colspan="2" border="0">
<table width="100%" border="0" style="border: none">
<tr>
<td class="com_borda" width="8%"><strong>Data</strong></td>
<td class="com_borda" width="30%"><strong>Procedimento</strong></td>
<td class="com_borda"><strong>DR.</strong></td>
<td class="com_borda" width="8%"><strong>Valor</strong></td>
<td class="com_borda" width="10%"><strong>Ass. Pac.</td>
<td class="com_borda" width="8%"><strong>Data</strong></td>
<td class="com_borda" width="8%"><strong>Vl Pago</strong></td>
<td class="com_borda"><strong>FP</strong></td>
<td class="com_borda"><strong>Secr.</strong></td>
<td class="com_borda" width="10%"><strong>Ass. Pac.</strong></td>
</tr>
<tr><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td></tr>
<tr><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td></tr>
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<tr><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td></tr>
<tr><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td></tr>
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<tr><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td></tr>
<tr><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td></tr>
<tr><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td></tr>
<tr><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td></tr>
<tr><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td></tr>
<tr><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td></tr>
<tr><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td></tr>
<tr><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td></tr>
<tr><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td></tr>
<tr><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td></tr>
<tr><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td><td class="com_borda"> </td></tr>
</table>
</td>
</tr>
</table>
<?php
echo "<script type=\"text/javascript\">
document.getElementById('cabecalho').className = 'invisivel';
document.getElementById('menu_opcao').className = 'invisivel';
document.getElementById('menu_acao').className = 'invisivel';
window.onload = function imprimir(){ self.print(); setTimeout(reload_form, 1000); }
</script>";
?>