Li Liu

Tuesday, 21 October 2014 at 5:30pm for 90 minutes

Jane Doe

678-399-3456 (mobile)

jane.doe@gmail.com Email sent

Last updated 11 Oct 2014, 11:10 AM

CANCEL APPOINTMENT

Reason

Feeling better

Condition worse

Sick

Away

Other

Notes

</td></tr>
	</table>
	</td>
	</tr>
	<tr><td style='padding:20px 0px 0px 25px'><font size="1" color="#D0D0D0"></font></td></tr>
	</table>
	-->

<div id="hidden">
	<form>
	<fieldset>
		<label>Practitioner</label>
        <select id="practitioner1a" style="width:430px;" >
        <option value="1" selected>Li Liu</option>
        <option value="2">Christie Peng</option>
        <option value="3">Richard Peng</option>
        <option value="4">Michael Peng</option>
        </select>

<label for="appType">Appointment type</label>
        <select id="appointmentType1a" name="appointmentType" style="width:430px;" >
        <option value="1">-Unavailable-</option>
        <option value="2">1st Consultation for Acupuncture and Treatment</option>
        <option value="3">1st Consultation for both Nutrition and Acupuncture</option>
        <option value="4">1st Consultation for Nutrition</option>
        <option value="5">1st Consultation for Nutrition with Acupuncture</option>
        <option value="6">1st Fertility Consultation for Acupuncture and Treatment</option>
        <option value="7">1st Fertility Consultation for both Acupuncture and Nutrition</option>
        <option value="8">Acupuncture</option>
        <option value="9">Acupuncture and Allergy Treatment</option>
        <option value="10">Acupuncture and Nutrition</option>
        <option value="11">Acupuncture, Nutrition and Allergy Testing/Treatment</option>
        <option value="12">Allergy Testing/Treatment</option>
        <option value="13">Ear Staples</option>
        <option value="14">Foot Detox</option>
        <option value="15">Jennifer ACU</option>
        <option value="16">Nutrition</option>
        <option value="17">Nutrition and Allergy</option>
        <option value="18">Report of Findings</option>
        <option value="19">Report of Findings with ACU</option>
        </select>

<label for="patient">Existing patient</label>
		<input id="patient1a" title="Please enter one or more characters" style="width:415px;" >

<h4>or <a href="javascript:;" onClick="myFunc2(); return false" style="color: #FF0099">Create new patient</a></h4>

<label for="repeat">Repeat ?</label>
        <select id="repeat1a" name="repeat" >
        <option value="None" selected>None</option>
        <option value="Daily">Daily</option>
        <option value="Weekly">Weekly</option>
        <option value="Monthly">Monthly</option>
        </select>

<label for="notes">Notes</label>
		<textarea id="notes1a" value="" style="overflow: hidden; word-wrap: break-word; resize: none; height: 84px;width: 415px" cols="63" data-enableautosize="true" rows="3" />
	</fieldset>
	</form>
	</div>
</div>

<div id="popup" title="NEW APPOINTMENT" class="ui-dialog" style="margin-top: -2px; margin-left: -3px; margin-right:
-3px; margin-bottom: -2px; display:none" >
	<form>	
	<fieldset>
		<table cellpadding="5px" >	
		<tr>
		<td>		
		<label>    Practitioner   </label>
		</td>
		<td>
        <select id="practitioner" style="width:300px;" >
		<option value="1">Li Liu</option>
        <option value="2">Christie Peng</option>
        <option value="3">Richard Peng</option>
		<option value="4">Michael Peng</option>
		</select>		
		</td>
		</tr>
		<tr>
		<td>		
		<label for="appType">    Type   </label>
		</td>
		<td>
        <select id="appointmentType" name="appointmentType" style="width:300px" >
       	<option value="1">-Unavailable-</option>
        <option value="2">1st Consultation for Acupuncture and Treatment</option>
        <option value="3">1st Consultation for both Nutrition and Acupuncture</option>
        <option value="4">1st Consultation for Nutrition</option>
        <option value="5">1st Consultation for Nutrition with Acupuncture</option>
        <option value="6">1st Fertility Consultation for Acupuncture and Treatment</option>
        <option value="7" selected>1st Fertility Consultation for both Acupuncture and Nutrition</option>
        <option value="8">Acupuncture</option>
        <option value="9">Acupuncture and Allergy Treatment</option>
        <option value="10">Acupuncture and Nutrition</option>
        <option value="11">Acupuncture, Nutrition and Allergy Testing/Treatment</option>
        <option value="12">Allergy Testing/Treatment</option>
        <option value="13">Ear Staples</option>
        <option value="14">Foot Detox</option>
        <option value="15">Jennifer ACU</option>
        <option value="16">Nutrition</option>
        <option value="17">Nutrition and Allergy</option>
        <option value="18">Report of Findings</option>
        <option value="19">Report of Findings with ACU</option>
        </select>
		</td>
		</tr>

<tr>
		<td>		
		<label for="patient" id="existingpatient">    Patient   </label>
		</td>
		<td>

<tr><td>   </td><td><label for="appType" id="newpatient" ><h3>NEW PATIENT</h3></label></td></tr>	
				<tr><td><label for="appType">  Title   </label></td><td><select id="title" style="width:160px">
							<option value=""></option>
							<option value="Mr">Mr</option>
							<option value="Ms">Ms</option>
							<option value="Mrs">Mrs</option>
							<option value="Miss">Miss</option>
							<option value="Dr">Dr</option>
							<option value="Master">Master</option>
							<option value="Professor">Professor</option>
							<option value="Sir">Sir</option>
							<option value="Lord">Lord</option>
							<option value="Lady">Lady</option>
							<option value="Reverend">Reverend</option>
							<option value="Sister">Sister</option>
							<option value="Rabbi">Rabbi</option>
						</select></td></tr>	
				<tr><td><label for="appType">  First name   </label></td><td><input id="fname" style="width:287px;" /></td></tr>	
				<tr><td><label for="appType">  Last name   </label></td><td><input id="lname" style="width:287px;" /></td></tr>	
				<tr><td><label for="appType">  Date of birth</label></td><td><table cellpadding="1px"><tr><td><select id="dd1" style="width:90px;">
<option value="">Day</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
					</select></td><td><select id="dm1" style="width:90px;">
<option value="">Month</option>
<option value="1">Jan</option>
<option value="2">Feb</option>
<option value="3">Mar</option>
<option value="4">Apr</option>
<option value="5">May</option>
<option value="6">Jun</option>
<option value="7">Jul</option>
<option value="8">Aug</option>
<option value="9">Sep</option>
<option value="10">Oct</option>
<option value="11">Nov</option>
<option value="12">Dec</option>
					</select></td><td><select id="dy1" style="width:90px;">
<option value="">Year</option>
<option value="2014">2014</option>
<option value="2013">2013</option>
<option value="2012">2012</option>
<option value="2011">2011</option>
<option value="2010">2010</option>
<option value="2009">2009</option>
<option value="2008">2008</option>
<option value="2007">2007</option>
<option value="2006">2006</option>
<option value="2005">2005</option>
<option value="2004">2004</option>
<option value="2003">2003</option>
<option value="2002">2002</option>
<option value="2001">2001</option>
<option value="2000">2000</option>
<option value="1999">1999</option>
<option value="1998">1998</option>
<option value="1997">1997</option>
<option value="1996">1996</option>
<option value="1995">1995</option>
<option value="1994">1994</option>
<option value="1993">1993</option>
<option value="1992">1992</option>
<option value="1991">1991</option>
<option value="1990">1990</option>
<option value="1989">1989</option>
<option value="1988">1988</option>
<option value="1987">1987</option>
<option value="1986">1986</option>
<option value="1985">1985</option>
<option value="1984">1984</option>
<option value="1983">1983</option>
<option value="1982">1982</option>
<option value="1981">1981</option>
<option value="1980">1980</option>
<option value="1979">1979</option>
<option value="1978">1978</option>
<option value="1977">1977</option>
<option value="1976">1976</option>
<option value="1975">1975</option>
<option value="1974">1974</option>
<option value="1973">1973</option>
<option value="1972">1972</option>
<option value="1971">1971</option>
<option value="1970">1970</option>
<option value="1969">1969</option>
<option value="1968">1968</option>
<option value="1967">1967</option>
<option value="1966">1966</option>
<option value="1965">1965</option>
<option value="1964">1964</option>
<option value="1963">1963</option>
<option value="1962">1962</option>
<option value="1961">1961</option>
<option value="1960">1960</option>
<option value="1959">1959</option>
<option value="1958">1958</option>
<option value="1957">1957</option>
<option value="1956">1956</option>
<option value="1955">1955</option>
<option value="1954">1954</option>
<option value="1953">1953</option>
<option value="1952">1952</option>
<option value="1951">1951</option>
<option value="1950">1950</option>
<option value="1949">1949</option>
<option value="1948">1948</option>
<option value="1947">1947</option>
<option value="1946">1946</option>
<option value="1945">1945</option>
<option value="1944">1944</option>
<option value="1943">1943</option>
<option value="1942">1942</option>
<option value="1941">1941</option>
<option value="1940">1940</option>
<option value="1939">1939</option>
<option value="1938">1938</option>
<option value="1937">1937</option>
<option value="1936">1936</option>
<option value="1935">1935</option>
<option value="1934">1934</option>
<option value="1933">1933</option>
<option value="1932">1932</option>
<option value="1931">1931</option>
<option value="1930">1930</option>
<option value="1929">1929</option>
<option value="1928">1928</option>
<option value="1927">1927</option>
<option value="1926">1926</option>
<option value="1925">1925</option>
<option value="1924">1924</option>
<option value="1923">1923</option>
<option value="1922">1922</option>
<option value="1921">1921</option>
<option value="1920">1920</option>
<option value="1919">1919</option>
<option value="1918">1918</option>
<option value="1917">1917</option>
<option value="1916">1916</option>
<option value="1915">1915</option>
<option value="1914">1914</option>
<option value="1913">1913</option>
<option value="1912">1912</option>
<option value="1911">1911</option>
<option value="1910">1910</option>
<option value="1909">1909</option>
<option value="1908">1908</option>
<option value="1907">1907</option>
<option value="1906">1906</option>
<option value="1905">1905</option>
<option value="1904">1904</option>
					</select></td></tr></table></td></tr>	
				<tr><td><label for="appType">  Phone </label></td><td><table cellpadding="0px"><tr><td><input id="ph1" style="width:175px;" /></td><td><select id="pt1" style="width:112px;">
					<option value="0">Mobile</option>
					<option value="1">Home</option>
					<option value="2">Work</option>
					<option value="4">Fax</option>
					<option value="3">Other</option>
				</select></td></tr></table></td></tr>	
				<tr><td><label for="appType">  Email   </label></td><td><input id="em1" style="width:287px;" /></td></tr>	
				<tr><td><label for="appType">  Reminder   </label></td><td><select id="art1" style="width:302px" >
							<option value="0">None</option>
							<option value="10">SMS</option>
							<option value="20" selected="selected">Email</option>
							<option value="30">SMS & Email</option>
						</select></td></tr>

</table>	
		</div>

<div id="EXT_PATIENT">
		<select id="ext_patient" style="width:300px"  > 
				<option value="" ></option> 
				
				
		</select>
		</div>

</td>

<tr><td></td><td>		
				<h4 id="createpatient" style="font-weight: normal;">Or <a href="javascript:;" onClick="myFunc(); return false" style="color: #FF0099">Create new patient</a></h4>
				</td>		
				</tr>
				<tr><td></td><td>		
				<h4 id="choosepatient" style="font-weight: normal;">Or <a href="javascript:;" onClick="myFunc3(); return false" style="color: #FF0099">Choose existing patient</a></h4>
				</td>		
				</tr>
				<tr><td></td><td>
				<div id="hrline"><hr class="dotted" /></div>
				</td></tr>
		
				<tr><td>
				<label for="day1">    Date</label>
				</td><td>
				<input type="date" name="day1" id="day1" readonly style="width:285px;" >
				</td>		
				</tr>
				<tr>
				<td>
				<label for="day1">    Time</label>
				</td>		
				<td>
				<table cellpadding="0px"><tr>
								<td>				
        <select id="time1t" name="time1t" style="width:60px;" >
        <option value="00" selected>00</option>
        <option value="01">01</option>
        <option value="02">02</option>
        <option value="03">03</option>
        <option value="04">04</option>
        <option value="05">05</option>
        <option value="06">06</option>
        <option value="07">07</option>
        <option value="08">08</option>
        <option value="09">09</option>
        <option value="10">10</option>
        <option value="11">11</option>
        <option value="12">12</option>
        <option value="13">13</option>
        <option value="14">14</option>
        <option value="15">15</option>
        <option value="16">16</option>
        <option value="17">17</option>
        <option value="18">18</option>
        <option value="19">19</option>
        <option value="20">20</option>
        <option value="21">21</option>
        <option value="22">22</option>
        <option value="23">23</option>
        </select>
				</td>
				<td>
        <select id="time1s" name="time1s" style="width:60px;" >
        <option value="00" selected>00</option>
        <option value="05">05</option>
        <option value="10">10</option>
        <option value="15">15</option>
        <option value="20">20</option>
        <option value="25">25</option>
        <option value="30">30</option>
        <option value="35">35</option>
        <option value="40">40</option>
        <option value="45">45</option>
        <option value="50">50</option>
        <option value="55">55</option>
        </select>
				</td>
				<td> to </td>
				<td>
        <select id="time2t" name="time2t" style="width:60px;">
        <option value="01">01</option>
        <option value="02">02</option>
        <option value="03">03</option>
        <option value="04">04</option>
        <option value="05">05</option>
        <option value="06">06</option>
        <option value="07">07</option>
        <option value="08">08</option>
        <option value="09">09</option>
        <option value="10">10</option>
        <option value="11">11</option>
        <option value="12">12</option>
        <option value="13">13</option>
        <option value="14">14</option>
        <option value="15">15</option>
        <option value="16">16</option>
        <option value="17">17</option>
        <option value="18">18</option>
        <option value="19">19</option>
        <option value="20">20</option>
        <option value="21">21</option>
        <option value="22">22</option>
        <option value="23">23</option>
        </select>
				</td>
				<td>
        <select id="time2s" name="time2s" style="width:60px;">
        <option value="00" selected>00</option>
        <option value="05">05</option>
        <option value="10">10</option>
        <option value="15">15</option>
        <option value="20">20</option>
        <option value="25">25</option>
        <option value="30">30</option>
        <option value="35">35</option>
        <option value="40">40</option>
        <option value="45">45</option>
        <option value="50">50</option>
        <option value="55">55</option>
        </select>
				</td>
				</tr>
				</table>		
				</td>

</tr>
				<tr>
				<td>		
		<label for="repeat">    Repeat</label>
				</td>
				<td>
        <select id="repeat" name="repeat" style="width:300px"  >
        <option value="None" selected>None</option>
        <option value="Daily">Daily</option>
        <option value="Weekly">Weekly</option>
        <option value="Monthly">Monthly</option>
        </select>
				</td>
				</tr>
				<tr>
				<td>		
		<label for="notes">    Notes</label>
				</td>
				<td>
		<textarea id="notes" value="" style="overflow: hidden; word-wrap: break-word; resize: none; height: 84px;width: 287px" cols="63" data-enableautosize="true" rows="3" />
				</td>
				</tr>
				
				</table>		
	</fieldset>
	</form>
</div>

<div id="confirmWindow" class="ui-dialog" style="margin-top: -5px; margin-left: -5px; margin-right: -5px; margin-bottom: -5px; display:none" >Appointment was successfully rescheduled to May 4, 2014, 2:30PM.</div>