| Select Client | "this.enteredText='';", 'onkeydown' => "return handleKey();", 'onkeyup' => "event.cancelbubble=true;return false;", 'onkeypress' => "return selectItem();") );?> |
| Client ID: | '30')); ?> |
| Client Name: | '30')); ?> |
| Address: | '30')); ?> |
| '30')); ?> | |
| City: | '30')); ?> |
| State: | 'Please Select...', 'AL' => 'Alabama', 'AK' => 'Alaska', 'AZ' => 'Arizona', 'AR' => 'Arkansas', 'CA' => 'California', 'CO' => 'Colorado', 'CT' => 'Connecticut', 'DE' => 'Deleware', 'DC' => 'District of Columbia', 'FL' => 'Florida', 'GA' => 'Georgia', 'HI' => 'Hawaii', 'ID' => 'Idaho', 'IL' => 'Illinois', 'IN' => 'Indiana', 'IA' => 'Iowa', 'KS' => 'Kansas', 'KY' => 'Kentucky', 'LA' => 'Louisiana', 'ME' => 'Maine', 'MD' => 'Maryland', 'MA' => 'Massachusetts', 'MI' => 'Michigan', 'MN' => 'Minnesota', 'MS' => 'Mississippi', 'MO' => 'Missouri', 'MT' => 'Montana', 'NE' => 'Nebraska', 'NV' => 'Nevada', 'NH' => 'New Hampshire', 'NJ' => 'New Jersey', 'NM' => 'New Mexico', 'NY' => 'New York', 'NC' => 'North Carolina', 'ND' => 'North Dakota', 'OH' => 'Ohio', 'OK' => 'Oklahoma', 'OR' => 'Oregon', 'PA' => 'Pennsylvania', 'RI' => 'Rhode Island', 'SC' => 'South Carolina', 'SD' => 'South Dakota', 'TN' => 'Tennessee', 'TX' => 'Texas', 'UT' => 'Utah', 'VT' => 'Vermont', 'VA' => 'Virginia', 'WA' => 'Washington', 'WV' => 'West Virginia', 'WI' => 'Wisconsin', 'WY' => 'Wyoming'), $stateValue)); ?> |
| Zip: | '5')); ?> |
| Attn: | '30')); ?> |
| Email: | '30')); ?> |
| Phone: | |
| Category: | 'Please Select...', 'orthopedics' => 'Orthopedics', 'pediatrics' => 'Pediatrics', 'radiology' => 'Radiology'), $categoryValue)); ?> |
| Notes: | '30')); ?> |
| Device ID | Device | Manufacturer | Model # | Serial # | Loc. | Frequency | Status |
| getDevice()->getId().'][identification]', $device->getIdentification(), 'size=8'); echo input_hidden_tag('device_update['.$device->getDevice()->getId().'][specification_id]', $device->getSpecification()->getId()); ?> | getDevice()->getId().'_name', $device->getSpecification()->getDeviceName()); ?> | getDevice()->getId().'][manufacturer]', $device->getSpecification()->getManufacturer()); ?> | getDevice()->getId().'][model_number]', $device->getSpecification()->getModelNumber(), 'size=4'); //$device->getModelNumber()); ?> | getDevice()->getId().'][serial_number]', $device->getDevice()->getSerialNumber(), 'size=4'); ?> | getDevice()->getId().'][location]', $device->getDevice()->getLocation(),'size=4'); ?> | getDevice()->getId().'][frequency]', options_for_select(array( '' => 'Please Select...', 'annual' => 'Annually', 'monthly' => 'Monthly', 'biannually' => 'Bi-annually', 'bimonthly' => 'Bi-monthly', 'twice_annually'=> 'Twice Annually', 'twice_monthly' => 'Twice Montly'),$device->getDevice()->getFrequency())); ?> | getDevice()->getId().'][status]', options_for_select(array( '' => 'Please Select...', 'active' => 'Active', 'retired' => 'Retired'), $device->getDevice()->getStatus())); ?> |
| 'Please Select...', 'annually' => 'Annually', 'monthly' => 'Monthly', 'biannually' => 'Bi-annually', 'bimonthly' => 'Bi-monthly', 'twice_annually'=> 'Twice Annually', 'twice_monthly' => 'Twice Montly'))); ?> | 'Please Select...', 'active' => 'Active', 'retired' => 'Retired'))); ?> |