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Template for eForm with just a patient name

by David Chan last modified 2007-06-18 14:31

 

<html>

<head>

<!-- CSS Script that removes textarea and textbox borders when printing -->
<style type="text/css" media="print">
td.subjectline {
    display:none;
}
input.noborder {
    border : 0px;
    background: transparent;
}

textarea.noborder {
    scrollbar-3dlight-color: transparent;
    scrollbar-3dlight-color: transparent;
    scrollbar-arrow-color: transparent;
    scrollbar-base-color: transparent;
    scrollbar-darkshadow-color: transparent;
    scrollbar-face-color: transparent;
    scrollbar-highlight-color: transparent;
    scrollbar-shadow-color: transparent;
    scrollbar-track-color: transparent;
        background: transparent;
        overflow: hidden;

    //scrollbar : none;
    border : 0px;
}

</style>
<!-- ------------------------------------------------------------------ -->

</head>

<body width="750px">
<div style="position: absolute; left: 12; top: 16; z-index:'-1'"><IMG SRC="../../OscarDocument/oscar_sfhc/eform/images/WSIB_Form_26_Phy_Progress.gif"></div>

<form method="POST" action="">
<div style="position: absolute; left:270px; top:285px;">
    <input type="text" class="noborder" name="thisfield121" style="width: 289px; font-family: Arial; font-size: 12px;" oscarDB=patient_name tabindex="1">
</div>

 

<!-- --------------------------------------------------------------------- -->


<!-- The submit/print/reset buttons -->
<div style="position: absolute; top: 1550px; left: 27px;">
  <table>
     <tr>
        <td class="subjectline">
             Subject: <input type="text" name=subject size="40">&nbsp;
             <input type="submit" value="Submit" name="B1">
             <input type="reset" value="Reset" name="B2">
             <input type=button value=Print onclick="javascript:window.print()">
        </td>
     </tr>
  </table>
</div>
</form>
</body>

</html>