21 Des 2009

form penting

RIFAI said :

Index

<?php
echo '<head>';
echo '<meta http-equiv="refresh" name="keywords" content="STMIK Kharisma">';
echo '<title>Pelatihan Pemrograman WEB,STMIK Kharisma Karawang</title>';
echo '<frameset rows="20%,*" border= "1">';

echo '<frame name="frame_judul" src= "judul.php" scrolling = "no">';

echo '<frameset cols="25%,60%,15%" border= "1" scrolling ="no">';
echo '<frame name="frame_menu" src= "menu.php" scrolling = "no">';
echo '<frame name="frame_isi" src= "profil.php" scrolling = "yes">';
echo '<frame name="frame_plk" src= "plk.php" scrolling = "yes">';
echo '</frameset>';
echo '</frameset>';
echo '</head>';
?>



Koneksi

<?php
$namaserver="localhost";
$username="root";
$password="";

$koneksi=mysql_connect($namaserver,$username,$password);
if (!$koneksi)
{
die('Koneksi Gagal !!:'.mysql_error());
}
?>

Entri Pasien


<html>
<head>
<title>Entri Data Pasien</title>
<meta http-equiv="content-type" content="text/html; charset=iso-8859-1">


<script language="JavaScript">
function trim(str)
{
return str.replace(/^\s+|\s+$/g,'');
}

function validasipasien()
{
var cpasien,cnama,calamat,cgol_darah,ckelamin,ctempat,ctanggal,ctelp;
with(window.document.formpasien)
{
cpasien = textpasien;
cnama = textnama;
calamat = textalamat;
cgol_darah = combodarah;
ckelamin = combojk;
ctempat = texttempat;
ctanggal = texttgl_lahir;
ctelp = texttelp;
}

if(trim(cpasien.value) == '')
{
alert('Silahkan isi dulu kode dengan lengkap');
cpasien.focus();
return false;
}
else
if(trim(cnama.value) == '')
{
alert('Silahkan isi dulu nama dengan lengkap');
cnama.focus();
return false;
}
else
if(trim(calamat.value)== '')
{
alert('Alamat jangan kosong!!');
calamat.focus();
return false;
}
else
if(trim(cgol_darah.value) == '')
{
alert('Isi dulu golongan darah pasien');
cgol_darah.focus();
return false;
}
else
if(trim(ckelamin.value) == '')
{
alert('Silahkan isi dulu jenis kelamin');
ckelamin.focus();
return false;
}
else
if(trim(ctempat.value) == '')
{
alert('Silahkan isi dulu tempat lahir pasien');
ctempat.focus();
return false;
}
else
if(trim(ctanggal.value) == '')
{
alert('Silahkan isi tanggal lahir pasien');
ctanggal.focus();
return false;
}
else
if(trim(ctelp.value) == '')
{
alert('Silahkan isi dulu nomor telephon !!');
ctelp.focus();
return false;
}
else
{
cpasien.value = trim(cpasien.value);
cnama.value = trim(cnama.value);
calamat.value = trim(calamat.value);
cgol_darah.value= trim(cgol_darah.value);
ckelamin.value = trim(ckelamin.value);
ctempat.value = trim(ctempat.value);
ctanggal.value = trim(ctanggal.value);
ctelp.value = trim(ctelp.value);
return true;
}

}
</script>
</head>

<body>
<FORM action = "simpanpasien.php" onsubmit = "return validasipasien();"
METHOD = "POST" name="formpasien" ENCTYPE="MULTIPART/FORM-DATA">

<font color="blue"><h3>ENTRI DATA PASIEN </h3>
<HR>
<table>
<tr><td align="right"> Kode Pasien : </td>
<td><input id="textpasien" name="textpasien"
type ="text" maxlength="8" size="8">
</td>
</tr>

<tr><td align="right"> Nama Pasien : </td>
<td><input id="textnama" name="textnama"
type ="text" maxlength="25" size="15">
</td>
</tr>

<tr><td align="right"> Alamat : </td>
<td><input id="textalamat" name="textalamat"
type ="text" maxlength="40" size="20">
</td>
</tr>

<tr><td align="right">Golongan Darah : </td>
<td>
<select id="combodarah" name="combodarah">
<option value="A" selected>A</option>
<option value="B">B</option>
<option value="AB">AB</option>
<option value="O">O</option>
</select>
</td>
</tr>

<tr><td align="right">Jenis Kelamin : </td>
<td>
<select id="combojk" name="combojk">
<option value="L" selected>L</option>
<option value="P">P</option>
</select>
</td>
</tr>

<tr><td align="right">
<font size="2"color="blue">Tempat lahir :</font>
</td>
<td>
<input id="texttempat" name="texttempat" type="text" maxlength="15" size="15">
</td>
</tr>

<tr><td align="right">
<font size="2"color="blue">Tanggal lahir :</font>
</td>
<td>
<input id="texttgl_lahir" name="texttgl_lahir" type="text" maxlength="15" size="15">
</td>
</tr>

<tr><td align="right">
<font size="2"color="blue">Nomor Telepon :</font>
</td>
<td>
<input id="texttelp" name="texttelp" type="text" maxlength="15" size="15">
</td>
</tr>

</table>
<hr>
<input name="tombolsimpan" type="submit" value="Simpan">
<hr>

</form>
</body>
</html>


Simpan Pasien


<?php
include ("koneksi.php");

mysql_select_db("DB_KLINIKDUTA", $koneksi);
$cari="select*from pasien where kode_pasien='$_POST[textpasien]'";
$query=mysql_query($cari);
$periksa_data = mysql_num_rows($query);

if ($periksa_data != 0)
{
echo "Data sudah ada, silakan periksa lagi";
echo '<a href ="entripasien.php"> kembali ke Form Entri Data </a>';
return;
}

$sql="INSERT INTO pasien (kode_pasien,nama,alamat,gol_darah,jen_kel,tp_lahir,tgl_lahir,tlp)
VALUES ('$_POST[textpasien]','$_POST[textnama]','$_POST[textalamat]','$_POST[combodarah]','$_POST[combojk]',
'$_POST[texttempat]','$_POST[texttgl_lahir]','$_POST[texttelp]')";

if (!mysql_query($sql,$koneksi))
{
die('Error:'.mysql_error());
}

echo "satu record/data BERHASIL ditambahkan ke dalam tabel";
mysql_close($koneksi);
echo '<a href = "entripasien.php"> Kembali ke Entri Data </a>';
echo '</form>';
?>


Lihat pasien

<?php

include("denmase.css");
include("koneksi.php");
mysql_select_db("DB_KLINIKDUTA");
$query = mysql_query("select * from pasien") or die(mysql_error());

echo "<tr>";
echo "<td width=950 valign=top><h3 align=center>DATA PASIEN</h3>";

$jmlpasien = mysql_num_rows($query);

echo "<table border=1 align=center>";
echo "<tr bgcolor=green align=center>";
echo "<th><b>Nomor</font></b>";
echo "<th><b>Kode Pasien</font></b>";
echo "<th><b>Nama Pasien</font></b>";
echo "<th><b>Alamat</font></b>";
echo "<th><b>Golongan darah</font></b>";
echo "<th><b>Jenis Kelamin</font></b>";
echo "<th><b>Tempat Lahir</font></b>";
echo "<th><b>Tanggal Lahir</font></b>";
echo "<th><b>Nomor Telp.</font></b>";
echo "</tr>";

for ($i = 1; $i <= $jmlpasien; $i++)
{
$baris_data = mysql_fetch_array($query);

echo "<tr>";
echo "<td><font color=blue size=2>".$i. ".</td>";
echo "<td> $baris_data[kode_pasien]</td>";
echo "<td> $baris_data[nama]</td>";
echo "<td> $baris_data[alamat]</td>";
echo "<td> $baris_data[gol_darah]</td>";
echo "<td> $baris_data[jen_kel]</td>";
echo "<td> $baris_data[tp_lahir]</td>";
echo "<td> $baris_data[tgl_lahir]</td>";
echo "<td> $baris_data[tlp]</td>";
echo "</tr>";
}

echo "</table>";
echo "<br>";

echo "<table>";
echo "<tr align=center>";
echo "<td bgcolor=white colspan=3> Jumlah Total Pasien = </font>" ;

$total = $jmlpasien;
echo "<td bgcolor=white width=20 align=left> $total </td>";


echo "</table>";
echo "<br >";
echo"<form>";
echo "<input type ='button' value='Print' onClick='window.print()'>";
echo"<br><br><br>";
echo '<a href ="entripasien.php"><font size=2>Kembali Ke Form Entri Data</font> </a>';
echo "</form>";

?>

IN THE NAME ALLOH MOST GRACIOUS AND MOST MERCIFUL

  • segala puji bagi ALLOH tuhan semesta alam