?? addoutpatient.jsp
字號:
<%@ page language="java" import="java.util.*" import="bean.Staff" pageEncoding="gbk"%>
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.1//EN"
"http://www.w3.org/TR/xhtml11/DTD/xhtml11.dtd">
<html>
<head>
<link href="style.css" rel="Stylesheet" type="text/css" />
<meta content="text/html; charset=utf-8" http-equiv="Content-Type" />
<title>Hospital</title>
<!--
<link rel="stylesheet" type="text/css" href="styles.css">
-->
</head>
<body>
<form action="/hopitalAdmin/addOutPatient.do" method="post">
<div id="Page">
<div id="Header">
</div>
<div id="Main">
<h1>
ADD Allocation Form
</h1>
<div style="text-align: center">
<table>
<caption>
Patient Details
</caption>
<tr>
<td>
<b>Frist name</b>
</td>
<td>
<input class="txt" name="f_name" />
</td>
<td>
<b>Last name</b>
</td>
<td>
<input class="txt" name="l_name" />
</td>
</tr>
<tr>
<td>
<b>Address</b>
</td>
<td>
<input class="txt" name="address" />
</td>
<td>
<b>Birthday</b>
</td>
<td>
<input class="txt" name="birthday" />
</td>
</tr>
<tr>
<td>
<b>Tele</b>
</td>
<td>
<input class="txt" name="tele" />
</td>
<td>
<b>Marital Status</b>
</td>
<td>
<input class="txt" name="marital_status" />
</td>
</tr>
<tr>
<td>
<b>ClinicNum</b>
</td>
<td>
<input class="txt" name="clinicNum" />
</td>
<td>
<b>Register_date</b>
</td>
<td>
<input class="txt" name="register_date" />
</td>
</tr>
<tr>
<td>
<b>See Date</b>
</td>
<td>
<input class="txt" name="seeDate" />
</td>
<td></td><td><input type="submit" class="submit" value="確認(rèn)"></td>
</tr>
</table>
</div>
</div>
<A href="mainPage.jsp">返回</A>
</div>
</form>
</body>
</html>
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