dylanglenister
Merge branch 'main' of hf.co:spaces/MedAI-COS30018/MedicalDiagnosisSystem into hf_main
11ccbbe
| <html lang="en"> | |
| <head> | |
| <meta charset="UTF-8"> | |
| <meta name="viewport" content="width=device-width, initial-scale=1.0"> | |
| <title>Create Patient</title> | |
| <link rel="stylesheet" href="/static/css/patient.css"> | |
| <link rel="icon" type="image/svg+xml" href="/static/icon.svg"> | |
| <link href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/6.0.0/css/all.min.css" rel="stylesheet"> | |
| </head> | |
| <body> | |
| <div class="container"> | |
| <a href="/" class="back-link"><i class="fas fa-arrow-left"></i> Back to Assistant</a> | |
| <h1>Create Patient</h1> | |
| <form id="patientForm"> | |
| <div class="grid"> | |
| <!-- Row 1: Name and Age --> | |
| <div class="row"> | |
| <label>Name<input type="text" id="name" required></label> | |
| <label>Age<input type="number" id="age" min="0" max="130" required></label> | |
| </div> | |
| <!-- Row 2: Sex and Ethnicity --> | |
| <div class="row"> | |
| <label>Sex | |
| <select id="sex" required> | |
| <option value="Male">Male</option> | |
| <option value="Female">Female</option> | |
| <option value="Intersex">Intersex</option> | |
| </select> | |
| </label> | |
| <label>Ethnicity<input type="text" id="ethnicity"></label> | |
| </div> | |
| <!-- Row 3: Contact Information --> | |
| <div class="row contact-info"> | |
| <label>Phone<input type="tel" id="phone"></label> | |
| <label>Email<input type="email" id="email"></label> | |
| <label>Address<input type="text" id="address"></label> | |
| </div> | |
| <!-- Row 4: Medical Information --> | |
| <div class="row"> | |
| <label>Active Medications<textarea id="medications" placeholder="One per line"></textarea></label> | |
| <label>Past Assessment Summary<textarea id="summary"></textarea></label> | |
| </div> | |
| </div> | |
| <div class="actions"> | |
| <button type="button" id="cancelBtn" class="secondary">Cancel</button> | |
| <button type="submit" class="primary">Create</button> | |
| </div> | |
| </form> | |
| <div id="result" class="result"></div> | |
| </div> | |
| <!-- Success Modal --> | |
| <div class="modal" id="patientSuccessModal"> | |
| <div class="modal-content"> | |
| <div class="modal-header"> | |
| <h3>Patient Created</h3> | |
| <button class="modal-close" id="patientSuccessClose">×</button> | |
| </div> | |
| <div class="modal-body"> | |
| <p>Your new Patient ID is:</p> | |
| <div id="createdPatientId" class="big-id"></div> | |
| </div> | |
| <div class="modal-footer"> | |
| <button class="secondary" id="patientSuccessReturn">Return to main page</button> | |
| <button class="primary" id="patientSuccessEdit">Edit patient profile</button> | |
| </div> | |
| </div> | |
| </div> | |
| <script src="/static/js/patient.js"></script> | |
| </body> | |
| </html> | |