97 lines
4.0 KiB
Plaintext
97 lines
4.0 KiB
Plaintext
<!DOCTYPE html>
|
|
<html lang="de">
|
|
<head>
|
|
<meta charset="UTF-8">
|
|
<title>Patient bearbeiten</title>
|
|
<meta name="viewport" content="width=device-width, initial-scale=1">
|
|
<link rel="stylesheet" href="/css/bootstrap.min.css">
|
|
</head>
|
|
<body class="bg-light">
|
|
|
|
<nav class="navbar navbar-dark bg-dark px-3">
|
|
<span class="navbar-brand">Patient bearbeiten</span>
|
|
<a href="<%= returnTo === 'overview'
|
|
? `/patients/${patient.id}/overview`
|
|
: '/patients' %>" class="btn btn-outline-light btn-sm">
|
|
Zurück
|
|
</a>
|
|
</nav>
|
|
|
|
<div class="container mt-4">
|
|
<%- include("partials/flash") %>
|
|
<div class="card shadow mx-auto" style="max-width: 700px;">
|
|
<div class="card-body">
|
|
|
|
<h4 class="mb-3">
|
|
<%= patient.firstname %> <%= patient.lastname %>
|
|
</h4>
|
|
|
|
<% if (error) { %>
|
|
<div class="alert alert-danger"><%= error %></div>
|
|
<% } %>
|
|
|
|
<form method="POST" action="/patients/edit/<%= patient.id %>?returnTo=<%= returnTo || '' %>">
|
|
|
|
<div class="row">
|
|
<div class="col-md-6 mb-2">
|
|
<input class="form-control"
|
|
name="firstname"
|
|
value="<%= patient.firstname %>"
|
|
placeholder="Vorname"
|
|
required>
|
|
</div>
|
|
|
|
<div class="col-md-6 mb-2">
|
|
<input class="form-control"
|
|
name="lastname"
|
|
value="<%= patient.lastname %>"
|
|
placeholder="Nachname"
|
|
required>
|
|
</div>
|
|
</div>
|
|
|
|
<div class="row">
|
|
<div class="col-md-4 mb-2">
|
|
<select class="form-select" name="gender">
|
|
<option value="">Geschlecht</option>
|
|
<option value="m" <%= patient.gender === 'm' ? 'selected' : '' %>>Männlich</option>
|
|
<option value="w" <%= patient.gender === 'w' ? 'selected' : '' %>>Weiblich</option>
|
|
<option value="d" <%= patient.gender === 'd' ? 'selected' : '' %>>Divers</option>
|
|
</select>
|
|
</div>
|
|
|
|
<div class="col-md-8 mb-2">
|
|
<input class="form-control"
|
|
type="date"
|
|
name="birthdate"
|
|
value="<%= patient.birthdate ? new Date(patient.birthdate).toISOString().split('T')[0] : '' %>"
|
|
required>
|
|
</div>
|
|
</div>
|
|
|
|
<input class="form-control mb-2" name="email" value="<%= patient.email || '' %>" placeholder="E-Mail">
|
|
<input class="form-control mb-2" name="phone" value="<%= patient.phone || '' %>" placeholder="Telefon">
|
|
|
|
<input class="form-control mb-2" name="street" value="<%= patient.street || '' %>" placeholder="Straße">
|
|
<input class="form-control mb-2" name="house_number" value="<%= patient.house_number || '' %>" placeholder="Hausnummer">
|
|
<input class="form-control mb-2" name="postal_code" value="<%= patient.postal_code || '' %>" placeholder="PLZ">
|
|
<input class="form-control mb-2" name="city" value="<%= patient.city || '' %>" placeholder="Ort">
|
|
<input class="form-control mb-2" name="country" value="<%= patient.country || '' %>" placeholder="Land">
|
|
|
|
<textarea class="form-control mb-3"
|
|
name="notes"
|
|
rows="4"
|
|
placeholder="Notizen"><%= patient.notes || '' %></textarea>
|
|
|
|
<button class="btn btn-primary w-100">
|
|
Änderungen speichern
|
|
</button>
|
|
</form>
|
|
|
|
</div>
|
|
</div>
|
|
</div>
|
|
|
|
</body>
|
|
</html>
|