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cdacbba | 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 | <!DOCTYPE html>
<html lang="th">
<head>
<meta charset="UTF-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<title>สร้างคำเบิกยาใหม่ | MedTrackRx</title>
<link rel="icon" type="image/x-icon" href="/static/favicon.ico">
<link rel="stylesheet" href="style.css">
<script src="https://cdn.tailwindcss.com"></script>
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</head>
<body class="bg-gray-50">
<custom-navbar></custom-navbar>
<main class="container mx-auto px-4 py-8">
<div class="flex items-center mb-6">
<a href="/" class="text-indigo-600 hover:text-indigo-800 mr-2">
<i data-feather="home"></i>
</a>
<i data-feather="chevron-right" class="text-gray-400 mx-2"></i>
<h1 class="text-2xl font-bold text-gray-800">สร้างคำเบิกยาใหม่</h1>
</div>
<div class="bg-white rounded-lg shadow-md p-6">
<form id="medRequestForm">
<div class="grid grid-cols-1 md:grid-cols-2 gap-6 mb-8">
<div>
<h2 class="text-xl font-semibold mb-4 text-gray-800">ข้อมูลผู้ป่วย</h2>
<div class="mb-4">
<label for="patientId" class="block text-sm font-medium text-gray-700 mb-1">เลขประจำตัวผู้ป่วย</label>
<input type="text" id="patientId" class="w-full px-3 py-2 border border-gray-300 rounded-md focus:outline-none focus:ring-2 focus:ring-indigo-500" required>
</div>
<div class="mb-4">
<label for="patientName" class="block text-sm font-medium text-gray-700 mb-1">ชื่อ-สกุลผู้ป่วย</label>
<input type="text" id="patientName" class="w-full px-3 py-2 border border-gray-300 rounded-md focus:outline-none focus:ring-2 focus:ring-indigo-500" required>
</div>
<div class="mb-4">
<label for="patientWard" class="block text-sm font-medium text-gray-700 mb-1">แผนก/หอผู้ป่วย</label>
<select id="patientWard" class="w-full px-3 py-2 border border-gray-300 rounded-md focus:outline-none focus:ring-2 focus:ring-indigo-500" required>
<option value="">เลือกแผนก</option>
<option value="ward1">หอผู้ป่วยศัลยกรรม</option>
<option value="ward2">หอผู้ป่วยอายุรกรรม</option>
<option value="ward3">หอผู้ป่วยกุมารเวชกรรม</option>
<option value="ward4">หอผู้ป่วย ICU</option>
</select>
</div>
</div>
<div>
<h2 class="text-xl font-semibold mb-4 text-gray-800">ข้อมูลแพทย์ผู้สั่งจ่าย</h2>
<div class="mb-4">
<label for="doctorId" class="block text-sm font-medium text-gray-700 mb-1">รหัสแพทย์</label>
<input type="text" id="doctorId" class="w-full px-3 py-2 border border-gray-300 rounded-md focus:outline-none focus:ring-2 focus:ring-indigo-500" required>
</div>
<div class="mb-4">
<label for="doctorName" class="block text-sm font-medium text-gray-700 mb-1">ชื่อแพทย์ผู้สั่งจ่าย</label>
<input type="text" id="doctorName" class="w-full px-3 py-2 border border-gray-300 rounded-md focus:outline-none focus:ring-2 focus:ring-indigo-500" required>
</div>
<div class="mb-4">
<label for="requestDate" class="block text-sm font-medium text-gray-700 mb-1">วันที่สั่งจ่าย</label>
<input type="date" id="requestDate" class="w-full px-3 py-2 border border-gray-300 rounded-md focus:outline-none focus:ring-2 focus:ring-indigo-500" required>
</div>
</div>
</div>
<div class="mb-8">
<h2 class="text-xl font-semibold mb-4 text-gray-800">รายการยา</h2>
<div id="medicationItems" class="space-y-4">
<!-- Medication items will be added here -->
<div class="medication-item bg-gray-50 p-4 rounded-lg border border-gray-200">
<div class="grid grid-cols-1 md:grid-cols-4 gap-4">
<div>
<label class="block text-sm font-medium text-gray-700 mb-1">ชื่อยา</label>
<select class="w-full px-3 py-2 border border-gray-300 rounded-md focus:outline-none focus:ring-2 focus:ring-indigo-500 medication-name" required>
<option value="">เลือกยา</option>
<option value="morphine">Morphine</option>
<option value="fentanyl">Fentanyl</option>
<option value="oxycodone">Oxycodone</option>
<option value="methadone">Methadone</option>
<option value="codeine">Codeine</option>
</select>
</div>
<div>
<label class="block text-sm font-medium text-gray-700 mb-1">ปริมาณ</label>
<input type="text" class="w-full px-3 py-2 border border-gray-300 rounded-md focus:outline-none focus:ring-2 focus:ring-indigo-500 medication-dose" required>
</div>
<div>
<label class="block text-sm font-medium text-gray-700 mb-1">หน่วย</label>
<select class="w-full px-3 py-2 border border-gray-300 rounded-md focus:outline-none focus:ring-2 focus:ring-indigo-500 medication-unit" required>
<option value="mg">mg</option>
<option value="ml">ml</option>
<option value="tablet">เม็ด</option>
<option value="ampoule">แอมพูล</option>
</select>
</div>
<{"ok":false,"message":"Request timeout: The AI model took too long to respond. Please try again with a simpler prompt or try a different model."}
</body>
</html> |