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- <!DOCTYPE html>
- <html lang="zh" xmlns:th="http://www.thymeleaf.org" >
- <head>
- <th:block th:include="include :: header('随访统计表新增')" />
- <th:block th:include="include :: ztree-css" />
- </head>
- <body class="white-bg">
- <div class="wrapper wrapper-content animated fadeInRight ibox-content">
- <form id="form-SDtpSjdcFollowUpStatistics-add" class="customize-search-form">
- <div class="customize-form-group-container">
- <div class="customize-form-group">
- <label>跟进人:</label>
- <input name="follower" placeholder="跟进人" id="follower" class="styled-input" type="text">
- </div>
- <div class="customize-form-group">
- <label>年龄:</label>
- <input name="age" placeholder="年龄" id="age" class="styled-input" type="text">
- </div>
- <div class="customize-form-group">
- <label>性别:</label>
- <input name="gender" placeholder="性别" id="gender" class="styled-input" type="text">
- </div>
- <div class="customize-form-group">
- <label>适应症:</label>
- <input name="indication" placeholder="适应症" id="indication" class="styled-input" type="text">
- </div>
- <div class="customize-form-group">
- <label>不良反应:</label>
- <input name="adverseReaction" placeholder="不良反应" id="adverseReaction" class="styled-input" type="text">
- </div>
- <div class="customize-form-group">
- <label>用药状态:</label>
- <input name="medicationStatus" placeholder="用药状态" id="medicationStatus" class="styled-input" type="text">
- </div>
- <div class="customize-form-group">
- <label>配合度:</label>
- <input name="cooperationLevel" placeholder="配合度" id="cooperationLevel" class="styled-input" type="text">
- </div>
- <div class="customize-form-group">
- <label>永久停药:</label>
- <input name="permanentDiscontinuation" placeholder="永久停药" id="permanentDiscontinuation" class="styled-input" type="text">
- </div>
- <div class="customize-form-group">
- <label>暂停用药:</label>
- <input name="temporarySuspension" placeholder="暂停用药" id="temporarySuspension" class="styled-input" type="text">
- </div>
- <div class="customize-form-group">
- <label>既往治疗方案:</label>
- <input name="previousTreatmentPlan" placeholder="既往治疗方案" id="previousTreatmentPlan" class="styled-input" type="text">
- </div>
- <div class="customize-form-group">
- <label>目前治疗方案:</label>
- <input name="currentTreatmentPlan" placeholder="目前治疗方案" id="currentTreatmentPlan" class="styled-input" type="text">
- </div>
- <div class="customize-form-group">
- <label>生存期(天):</label>
- <input name="survivalPeriod" placeholder="生存期(天)" id="survivalPeriod" class="styled-input" type="text">
- </div>
- <div class="customize-form-group">
- <label>药品通用名:</label>
- <input name="genericName" placeholder="药品通用名" id="genericName" class="styled-input" type="text">
- </div>
- <div class="customize-form-group">
- <label>患者数:</label>
- <input name="patientCount" placeholder="患者数" id="patientCount" class="styled-input" type="text">
- </div>
- <div class="customize-form-group">
- <label>任务数:</label>
- <input name="taskCount" placeholder="任务数" id="taskCount" class="styled-input" type="text">
- </div>
- </div>
- </form>
- </div>
- <th:block th:include="include :: footer" />
- <th:block th:include="include :: ztree-js" />
- <script type="text/javascript">
- function submitHandler() {
- if ($.validate.form()) {
- add();
- }
- }
- function add() {
- var data = $("#form-SDtpSjdcFollowUpStatistics-add").serializeArray();
- $.ajax({
- cache : true,
- type : "POST",
- url : ctx + "dtp/sdtpsjdcfollowupstatistics/sDtpSjdcFollowUpStatisticsAdd",
- data : data,
- async : false,
- error : function(request) {
- $.modal.alertError("系统错误");
- },
- success : function(data) {
- $.operate.successCallback(data);
- }
- });
- }
- </script>
- </body>
- </html>
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