or
3 answers
302 views
Hi,
I have a grid with 4 visible columns. The problem I'm having is that the header for the last column ignores the font-size property that I've set (12px). All the other headers displayed correctly.
Any reason why?
Thanks.
I have a grid with 4 visible columns. The problem I'm having is that the header for the last column ignores the font-size property that I've set (12px). All the other headers displayed correctly.
Any reason why?
Thanks.
| <rad:RadGrid ID="RadGrid1" runat="server" AllowPaging="True" AllowSorting="True" |
| DataSourceID="dsSearch" ShowGroupPanel="True" |
| AllowCustomPaging="True" AutoGenerateColumns="False" |
| AllowMultiRowSelection="True"> |
| <HeaderStyle Font-Names="Verdana,Tahoma,Arial" Font-Size="12px" /> |
| <ClientSettings AllowDragToGroup="True"> |
| <Selecting AllowRowSelect="True" /> |
| </ClientSettings> |
| <MasterTableView DataSourceID="dsSearch"> |
| <RowIndicatorColumn Visible="False"> |
| <HeaderStyle Width="20px" /> |
| </RowIndicatorColumn> |
| <ExpandCollapseColumn Resizable="False" Visible="False"> |
| <HeaderStyle Width="20px" /> |
| </ExpandCollapseColumn> |
| <Columns> |
| <rad:GridBoundColumn DataField="ID" HeaderText="ID" UniqueName="colID" |
| Visible="False"> |
| </rad:GridBoundColumn> |
| <rad:GridTemplateColumn UniqueName="colSelect"> |
| <ItemTemplate> |
| <asp:CheckBox ID="chkSelect" runat="server" /> |
| </ItemTemplate> |
| </rad:GridTemplateColumn> |
| <rad:GridTemplateColumn HeaderText="Keywords" UniqueName="colKeywords"> |
| <ItemTemplate> |
| <asp:Label ID="Label12" runat="server" Text="Label"></asp:Label> |
| </ItemTemplate> |
| <ItemStyle Font-Names="Verdana,Tahoma,Arial" Font-Size="12px" /> |
| </rad:GridTemplateColumn> |
| <rad:GridHyperLinkColumn DataNavigateUrlField="ID" |
| DataNavigateUrlFormatString="~/bookinfo.aspx?BookID={0}" |
| DataTextField="Title" UniqueName="colTitle" HeaderText="Title"> |
| <ItemStyle Font-Names="Verdana,Tahoma,Arial" Font-Size="12px" /> |
| </rad:GridHyperLinkColumn> |
| <rad:GridBoundColumn DataField="CategoryTitle" HeaderText="Dewey Category" |
| UniqueName="colCategoryTitle"> |
| <HeaderStyle Font-Names="Verdana,Tahoma,Arial" Font-Size="12px" /> |
| <ItemStyle Font-Names="Verdana,Tahoma,Arial" Font-Size="12px" /> |
| </rad:GridBoundColumn> |
| </Columns> |
| </MasterTableView> |
| </rad:RadGrid> |
Travis Johnson
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Rank 1
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answered
on
09 Feb 2011
8 answers
150 views
I have created a web page in which I have placed a rad editor and in that I created a template for the editor. Now I insert that template in editor and save it when I opened the rad editor in edit mode then in firefox template is not allowing to edit but in IE browser it is allowing. Kindly reply me as soon as possible.
Rumen Jekov
Top achievements
Rank 1
Rank 1
answered
on
09 Feb 2011
4 answers
140 views
I would appreciate it if someone could point me in the right direction to solve my issue.
I have a radgrid that has returns all the media such as audio, video and other media etc associated with it that particular message. Then on edit I have a dropdown whose data source populates the dropdown with all the possible audio files. Now on edit if there was a audio file chosen, it will be displayed in the dropdown and the selected value is a guid.
My issue is that IF the audiofile gets deleted before it is removed from the message, it breaks. I want to verify that the audio file still exists. Hope it all makes sense.
<
telerik:RadGrid AutoGenerateColumns="False" ID="RadGrid1" DataSourceID="SqlDataSource1"
AllowFilteringByColumn="True" AllowPaging="True" AllowSorting="True" runat="server"
Skin="Telerik" AllowAutomaticDeletes="True" AllowAutomaticInserts="True" PageSize="10"
AllowAutomaticUpdates="True" OnItemUpdated="RadGrid1_ItemUpdated" OnItemDeleted="RadGrid1_ItemDeleted"
OnItemInserted="RadGrid1_ItemInserted" ShowStatusBar="true" Width="600px" OnItemCommand="RadGrid1_ItemCommand">
<PagerStyle Mode="NextPrevAndNumeric" />
<GroupingSettings CaseSensitive="false" />
<MasterTableView TableLayout="Fixed" DataKeyNames="episodeGuid" CommandItemDisplay="TopAndBottom">
<Columns>
<telerik:GridEditCommandColumn HeaderStyle-Width="40px" FilterControlWidth="30px"
ButtonType="ImageButton" UniqueName="EditCommandColumn">
<ItemStyle CssClass="MyImageButton" />
</telerik:GridEditCommandColumn>
<telerik:GridBoundColumn SortExpression="messageGuid" HeaderText="messageGuid" DataField="messageGuid"
UniqueName="messageGuid" Visible="false" ReadOnly="true">
</telerik:GridBoundColumn>
<telerik:GridBoundColumn SortExpression="episodeTitle" HeaderText="title" DataField="episodeTitle">
</telerik:GridBoundColumn>
<telerik:GridBoundColumn SortExpression="date" HeaderText="date" DataField="date">
</telerik:GridBoundColumn>
<telerik:GridButtonColumn ConfirmText="Delete this record?" ConfirmDialogType="RadWindow"
ConfirmTitle="Delete" ButtonType="ImageButton" CommandName="Delete" Text="Delete"
UniqueName="DeleteColumn">
<ItemStyle HorizontalAlign="Center" CssClass="MyImageButton" />
</telerik:GridButtonColumn>
</Columns>
<EditFormSettings ColumnNumber="1" CaptionDataField="Epsiode" CaptionFormatString="Edit properties ministry {0}"EditFormType="Template">
<FormTemplate><table cellpadding="5" cellspacing="0" border="0"><
tr><td class="formFieldNameGeneric">Episode Video File</td><td class="formField"><asp:DropDownList ID="dlVideos" runat="server" DataTextField="videoTitle" DataValueField="videoGuid"SelectedValue='<%# Bind( "videoGuid") %>' AppendDataBoundItems="true" CssClass="DropDown"DataSourceID="SqlDataSource2"><asp:ListItem Text="None" Value=""></asp:ListItem></asp:DropDownList></td></tr>
I was thinking something along these lines but I could never get it to work
protected
void RadGrid1_ItemCommand(object source, GridCommandEventArgs e)
{
GridEditCommandColumn
editColumn = (GridEditCommandColumn)RadGrid1.MasterTableView.GetColumn("EditCommandColumn");
try
{
//If the file exists then bind it to the dropdown
}
catch
{
//The file was deleted. Selected value is now NULL.
}
}
Thanks for the help!!!
0 answers
47 views
Hi there,
I am using RadTreeView Control and have come across this issue when validating CSS and Markup in validate.w3.org.
I get :
Here are the some of the errors:
Any suggestions please?
Thank you
I am using RadTreeView Control and have come across this issue when validating CSS and Markup in validate.w3.org.
I get :
id and name attributes must begin with a letter, not a digit. errorHere are the some of the errors:
# Error Line 820, Column 179: there is no attribute "runat"…lutions/Solutions-By-Need.aspx' runat='server' id='8c1836f8-fc8d-4842-817b-18b…?You have used the attribute named above in your document, but the document type you are using does not support that attribute for this element. This error is often caused by incorrect use of the "Strict" document type with a document that uses frames (e.g. you must use the "Transitional" document type to get the "target" attribute), or by using vendor proprietary extensions such as "marginheight" (this is usually fixed by using CSS to achieve the desired effect instead).This error may also result if the element itself is not supported in the document type you are using, as an undefined element will have no supported attributes; in this case, see the element-undefined error message for further information.How to fix: check the spelling and case of the element and attribute, (Remember XHTML is all lower-case) and/or check that they are both allowed in the chosen document type, and/or use CSS instead of this attribute. If you received this error when using the <embed> element to incorporate flash media in a Web page, see the FAQ item on valid flash.# Error Line 820, Column 192: value of attribute "id" invalid: "8" cannot start a name…ions-By-Need.aspx' runat='server' id='8c1836f8-fc8d-4842-817b-18b17d76c9b4'>So…?It is possible that you violated the naming convention for this attribute. For example, id and name attributes must begin with a letter, not a digit.# Error Line 820, Column 350: value of attribute "id" invalid: "8" cannot start a name…ions-By-Need.aspx' runat='server' id='8c1836f8-fc8d-4842-817b-18b17d76c9b4'>By…?It is possible that you violated the naming convention for this attribute. For example, id and name attributes must begin with a letter, not a digit.# Error Line 820, Column 350: ID "8c1836f8-fc8d-4842-817b-18b17d76c9b4" already defined…ions-By-Need.aspx' runat='server' id='8c1836f8-fc8d-4842-817b-18b17d76c9b4'>By…?An "id" is a unique identifier. Each time this attribute is used in a document it must have a different value. If you are using this attribute as a hook for style sheets it may be more appropriate to use classes (which group elements) than id (which are used to identify exactly one element).# Info Line 820, Column 192: ID "8c1836f8-fc8d-4842-817b-18b17d76c9b4" first defined here…ions-By-Need.aspx' runat='server' id='8c1836f8-fc8d-4842-817b-18b17d76c9b4'>So…# Error Line 820, Column 472: value of attribute "id" invalid: "8" cannot start a name…ons-By-State.aspx' runat='server' id='8c1836f8-fc8d-4842-817b-18b17d76c9b4'>By…?It is possible that you violated the naming convention for this attribute. For example, id and name attributes must begin with a letter, not a digit.# Error Line 820, Column 472: ID "8c1836f8-fc8d-4842-817b-18b17d76c9b4" already defined…ons-By-State.aspx' runat='server' id='8c1836f8-fc8d-4842-817b-18b17d76c9b4'>By…?An "id" is a unique identifier. Each time this attribute is used in a document it must have a different value. If you are using this attribute as a hook for style sheets it may be more appropriate to use classes (which group elements) than id (which are used to identify exactly one element).# Info Line 820, Column 192: ID "8c1836f8-fc8d-4842-817b-18b17d76c9b4" first defined here…ions-By-Need.aspx' runat='server' id='8c1836f8-fc8d-4842-817b-18b17d76c9b4'>So…# Error Line 820, Column 598: value of attribute "id" invalid: "8" cannot start a name…-By-Industry.aspx' runat='server' id='8c1836f8-fc8d-4842-817b-18b17d76c9b4'>By…?It is possible that you violated the naming convention for this attribute. For example, id and name attributes must begin with a letter, not a digit.# Error Line 820, Column 598: ID "8c1836f8-fc8d-4842-817b-18b17d76c9b4" already defined…-By-Industry.aspx' runat='server' id='8c1836f8-fc8d-4842-817b-18b17d76c9b4'>By…?An "id" is a unique identifier. Each time this attribute is used in a document it must have a different value. If you are using this attribute as a hook for style sheets it may be more appropriate to use classes (which group elements) than id (which are used to identify exactly one element).Any suggestions please?
Thank you
2 answers
236 views
I have a RadGrid using the standard command, "Add New Record". Clicking on this does post back (InitInsert) and places the first row (I'm using InPlace editing) into edit mode as well as performing the validations for fields in the row (using standrd Required Field Validators), but clicking on the Insert link does nothing, no postback at all!
The Edit/Update/Cancel (through an EditCommand column) works fine for all of these functions and I'm trying to capture the Insert (i.e. PerformInsert or InsertCommand) event as it bubbles to the InsertCommand event handler so I can pull values from the form and update the data repository.
Here's the grid definition (I've omitted the column definitions for brevity):
When I hover over the Insert link, the href for it is set to, "javascript:WebForm_DoPostBackWithOptions(new WebForm_PostBackOptions("StaffBreakout$RadGrid_StaffBreakout$ctl00$ctl02$ctl03$PerformInsertButton", "", true, "", "", false, true))". I tried searching in the source of the page for this ID and didn't find it, but I'm not sure how to get this to be inserted into the page (or how I managed to omitted this).
I tried setting breakpoints in both PageLoad and InsertCommand event handlers, but neither gets called after the form is initially set up (i.e. InitInsert) - no PeformInsert/InsertCommand is ever being called.
All help appreciated!
Jon
The Edit/Update/Cancel (through an EditCommand column) works fine for all of these functions and I'm trying to capture the Insert (i.e. PerformInsert or InsertCommand) event as it bubbles to the InsertCommand event handler so I can pull values from the form and update the data repository.
Here's the grid definition (I've omitted the column definitions for brevity):
<telerik:radgrid id="RadGrid_StaffBreakout" runat="server" autogeneratecolumns="False" allowsorting="True" gridlines="None" insertitempageindexaction="ShowItemOnFirstPage" width="400px" allowpaging="True" skin="Windows7" horizontalalign="Center"> <ItemStyle HorizontalAlign="Center" BorderWidth="0px" /> <MasterTableView HorizontalAlign="Center" GridLines="None" EditMode="InPlace" CommandItemDisplay="TopAndBottom"> <CommandItemSettings ExportToPdfText="Export to Pdf"></CommandItemSettings> <ItemStyle Font-Bold="False" Font-Italic="False" Font-Overline="False" Font-Strikeout="False" Font-Underline="False" HorizontalAlign="Center" Wrap="True" VerticalAlign="Middle" /> <AlternatingItemStyle Font-Bold="False" Font-Italic="False" Font-Overline="False" Font-Strikeout="False" Font-Underline="False" HorizontalAlign="Center" Wrap="True" VerticalAlign="Middle" /> <EditItemStyle Font-Bold="False" Font-Italic="False" Font-Overline="False" Font-Strikeout="False" Font-Underline="False" HorizontalAlign="Center" Wrap="True" VerticalAlign="Middle" /> <PagerStyle Font-Bold="False" Font-Italic="False" Font-Overline="False" Font-Strikeout="False" Font-Underline="False" HorizontalAlign="Center" VerticalAlign="Middle" Wrap="True" /> <HeaderStyle Font-Bold="False" Font-Italic="False" Font-Overline="False" Font-Strikeout="False" Font-Underline="False" HorizontalAlign="Center" Wrap="True" VerticalAlign="Bottom" /> </MasterTableView> <HeaderStyle BorderStyle="None" /> </telerik:RadGrid> When I hover over the Insert link, the href for it is set to, "javascript:WebForm_DoPostBackWithOptions(new WebForm_PostBackOptions("StaffBreakout$RadGrid_StaffBreakout$ctl00$ctl02$ctl03$PerformInsertButton", "", true, "", "", false, true))". I tried searching in the source of the page for this ID and didn't find it, but I'm not sure how to get this to be inserted into the page (or how I managed to omitted this).
I tried setting breakpoints in both PageLoad and InsertCommand event handlers, but neither gets called after the form is initially set up (i.e. InitInsert) - no PeformInsert/InsertCommand is ever being called.
All help appreciated!
Jon
1 answer
46 views
Hi,
I have a view created on the list with Edit type column (basically a hyperlink which would redirect the user when clicked) and a column which would denote the user the type of document it is ( ex Icon for Visio, pdf, word).
I can view the column if I browse the view, but when I bind the view to the grid I am not able to view the columns being rendered.
Can anyone please help on this.
Tsvetoslav
Telerik team
answered
on
09 Feb 2011
2 answers
122 views
I have a RadAjaxLoadingPanel at the bottom of my html in a user control and is not being displayed when the page is loading or posting back.
I have confirmed that the image exists in the proper path. I have a RadScriptManager on my Master page. Here is the full HTML. Scroll all the way down near the bottom in bold to see the control. I also have a RadAjaxManager in place (see bolding). Note that the page works absolutely fine; I just can't get the image to appear... What do I need to do in order for it to appear?
I have confirmed that the image exists in the proper path. I have a RadScriptManager on my Master page. Here is the full HTML. Scroll all the way down near the bottom in bold to see the control. I also have a RadAjaxManager in place (see bolding). Note that the page works absolutely fine; I just can't get the image to appear... What do I need to do in order for it to appear?
<%@ Page Language="C#" AutoEventWireup="true" CodeBehind="Demographics.aspx.cs" Inherits="GlobalNET.Patient.Demographics" %>
<%@ Register Assembly="Telerik.Web.UI" Namespace="Telerik.Web.UI" TagPrefix="telerik" %>
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head id="Head1" runat="server">
<link href="../CommonSecurity/CSS/Stylesheet1.css" rel="stylesheet" type="text/css" />
<script type="text/javascript" src="../Common/js/bulkscanmatch.js"></script>
<script type="text/javascript" src="../Common/js/CommonValidations.js"></script>
<script type="text/javascript" src="../Common/js/sortable.js"></script>
<script type="text/javascript" src="../Common/js/DemographicsCoding.js"></script>
<script language="javascript" type="text/javascript" event="OnPostTransfer" for="DynamicWebTwain1">
<!--
DynamicWebTwain1_OnPostTransfer();
//-->
</script>
<script language="javascript" type="text/javascript" event="OnMouseClick(index)"
for="DynamicWebTwain1">
<!--
logPage_DynamicWebTwain1_OnMouseClick(index);
//-->
</script>
<telerik:RadCodeBlock ID="RadCodeBlock1" runat="server">
<script language="javascript" type="text/javascript">
var td = document.getElementById('tdThumbNails');
// wyeager - 09/21/2010
// Tab to next tab depending on last field selected
// Once all required fields have been entered, enable the Save button
function CheckForCompletedReqFlds(currentTab) {
var tabStrip = $find("<%= tsPatientDemographics.ClientID %>");
if (currentTab == "Patient") {
var tab = tabStrip.findTabByText("Guarantor");
tab.select();
var GuarRelToPat = document.getElementById("GuarRelToPat");
GuarRelToPat.focus();
}
else if (currentTab == "Guarantor") {
var tab = tabStrip.findTabByText("Pri Ins");
tab.select();
var priInsCode = document.getElementById("priInsCode");
priInsCode.focus();
}
else if (currentTab == "Pri Ins") {
var tab = tabStrip.findTabByText("Sec Ins");
tab.enable();
tab.select();
var secInsCode = document.getElementById("secInsCode");
secInsCode.focus();
}
else if (currentTab == "Sec Ins") {
var tab = tabStrip.findTabByText("Ter Ins");
tab.enable();
tab.select();
var terInsCode = document.getElementById("terInsCode");
terInsCode.focus();
}
else if (currentTab == "Ter Ins") {
var tab = tabStrip.findTabByText("Patient");
tab.select();
var HospAcctno = document.getElementById("HospAcctno");
HospAcctno.focus();
}
if ((document.getElementById("HospAcctno").value != "") && (document.getElementById("MRN").value != "") && (document.getElementById("PatLName").value != "") && (document.getElementById("PatFName").value != "") && (document.getElementById("PatAddress1").value != "") && (document.getElementById("PatCity").value != "") && (document.getElementById("PatState").value != "Select") && (document.getElementById("PatDOB").value != "") && (document.getElementById("PatMaritalStatus").value != "Select") && (document.getElementById("PatSex").value != "Select") && (document.getElementById("GuarRelToPat").value != "Select") && (document.getElementById("GuarLName").value != "") && (document.getElementById("GuarFName").value != "") && (document.getElementById("GuarAddress1").value != "") && (document.getElementById("GuarCity").value != "") && (document.getElementById("GuarState").value != "Select") && (document.getElementById("ddlGuarArrivalMode").value != "Select") && (document.getElementById("radAdmitDate").value != "") && (document.getElementById("radAdmitTime").value != "") && (document.getElementById("GuarSex").value != "Select") && (document.getElementById("radDischargeDate").value != "") && (document.getElementById("radDischargeTime").value != "") && (document.getElementById("ddlGuarMaritalStatus").value != "Select") && (document.getElementById("radGuarDOB").value != "") && (document.getElementById("priInsCode").value != "") && (document.getElementById("priInsName").value != "") && (document.getElementById("priInsAddress1").value != "") && (document.getElementById("priInsCity").value != "") && (document.getElementById("priInsState").value != "") && (document.getElementById("priInsZip").value != "") && (document.getElementById("priInsPolicyNum").value != "") && (document.getElementById("priInsPolicyNumVer").value != "") && (document.getElementById("priInsGrpNum").value != ""))
document.getElementById("btnSaveLogEntry").disabled = false;
else
document.getElementById("btnSaveLogEntry").disabled = true;
}
</script>
<script language="javascript" type="text/javascript">
// wyeager - 10/06/2010
// Check if user has secondary or tertiary insurance as a reminder to fill in.
function CheckForOtherIns() {
var tabStrip = $find("<%= tsPatientDemographics.ClientID %>");
var selectedTab = tabStrip.get_selectedTab();
var hdnOtherIns = document.getElementById("hdnOtherIns");
var secInsCode = document.getElementById("secInsCode");
var terInsCode = document.getElementById("terInsCode");
hdnOtherIns.value = "0";
if (selectedTab != null) {
var selectedTabValue = selectedTab.get_text();
if (selectedTabValue == "Pri Ins") {
if (confirm("Is there Secondary or Tertiary Insurance information available?" + '\n' + "Press OK if Yes or CANCEL if No.")) {
selectSecTab();
hdnOtherIns.value = "1";
return false;
}
else {
return true;
}
}
else if ((selectedTabValue == "Sec Ins") && (secInsCode.value == ""))
if (confirm("Is there Secondary Insurance information available?" + '\n' + "Press OK if Yes or CANCEL if No.")) {
selectSecTab();
hdnOtherIns.value = "2";
return false;
}
else {
return true;
}
else if ((selectedTabValue == "Sec Ins") && (secInsCode.value != ""))
if (confirm("Is there Tertiary Insurance information available?" + '\n' + "Press OK if Yes or CANCEL if No.")) {
selectTerTab();
hdnOtherIns.value = "2";
return false;
}
else {
return true;
}
else if ((selectedTabValue == "Ter Ins") && (terInsCode.value == ""))
if (confirm("Is there Tertiary Insurance information available?" + '\n' + "Press OK if Yes or CANCEL if No.")) {
selectTerTab();
hdnOtherIns.value = "3";
return false;
}
else {
return true;
}
}
}
// wyeager - 10/13/2010
function selectSecTab() {
var tabStrip = $find("<%= tsPatientDemographics.ClientID %>");
var tab = tabStrip.findTabByText("Sec Ins");
tab.enable();
tab.select();
}
// wyeager - 10/13/2010
function selectTerTab() {
var tabStrip = $find("<%= tsPatientDemographics.ClientID %>");
var tab = tabStrip.findTabByText("Ter Ins");
tab.enable();
tab.select();
}
// wyeager - 10/13/2010
// Gets the Relation to Patient for the Guarantor.
function getGuarSelectedValue() {
var index = document.getElementById("GuarRelToPat").selectedIndex;
if (document.getElementById("GuarRelToPat").options[index].text == "Self") {
var GuarRelToPat = document.getElementById("GuarRelToPat");
GuarRelToPat.options[index].text = 'Self';
var GuarLName = document.getElementById("GuarLName");
var PatLName = document.getElementById("PatLName");
GuarLName.value = PatLName.value;
var GuarFName = document.getElementById("GuarFName");
var PatFName = document.getElementById("PatFName");
GuarFName.value = PatFName.value;
var GuarInitial = document.getElementById("GuarInitial");
var PatInitial = document.getElementById("PatInitial");
GuarInitial.value = PatInitial.value;
var GuarAddress1 = document.getElementById("GuarAddress1");
var PatAddress1 = document.getElementById("PatAddress1");
GuarAddress1.value = PatAddress1.value;
var GuarAddress2 = document.getElementById("GuarAddress2");
var PatAddress2 = document.getElementById("PatAddress2");
GuarAddress2.value = PatAddress2.value;
var GuarCity = document.getElementById("GuarCity");
var PatCity = document.getElementById("PatCity");
GuarCity.value = PatCity.value;
var GuarState = document.getElementById("GuarState");
var PatState = document.getElementById("PatState");
GuarState.value = PatState.value;
var GuarZip = $find("<%= GuarZip.ClientID %>");
var PatZip = $find("<%= PatZip.ClientID %>");
GuarZip.set_value(PatZip.get_value());
var GuarSex = document.getElementById("GuarSex");
var PatSex = document.getElementById("PatSex");
GuarSex.value = PatSex.value;
var GuarSSN = $find("<%= GuarSSN.ClientID %>");
var PatSSN = $find("<%= PatSSN.ClientID %>");
GuarSSN.set_value(PatSSN.get_value());
var radGuarDOB = $find("<%= radGuarDOB.ClientID %>");
var PatDOB = $find("<%= PatDOB.ClientID %>");
var PatDOBDate = PatDOB.get_selectedDate();
radGuarDOB.set_selectedDate(PatDOBDate);
var ddlGuarMaritalStatus = document.getElementById("ddlGuarMaritalStatus");
var PatMaritalStatus = document.getElementById("PatMaritalStatus");
ddlGuarMaritalStatus.value = PatMaritalStatus.value;
var GuarHomePhone = $find("<%= GuarHomePhone.ClientID %>");
var PatHomePhone = $find("<%= PatHomePhone.ClientID %>");
GuarHomePhone.set_value(PatHomePhone.get_value());
var GuarWorkPhone = $find("<%= GuarWorkPhone.ClientID %>");
var PatWorkPhone = $find("<%= PatWorkPhone.ClientID %>");
GuarWorkPhone.set_value(PatWorkPhone.get_value());
var GuarCellPhone = $find("<%= GuarCellPhone.ClientID %>");
var PatCellPhone = $find("<%= PatCellPhone.ClientID %>");
GuarCellPhone.set_value(PatCellPhone.get_value());
}
}
// wyeager - 10/13/2010
// Gets the Relation to Patient for the Primary Insurance.
function getPriSelectedValue() {
var index = document.getElementById("priSubRelToPat").selectedIndex;
if (document.getElementById("priSubRelToPat").options[index].text == "Self") {
var priSubRelToPat = document.getElementById("priSubRelToPat");
priSubRelToPat.options[index].text = 'Self';
var priSubLName = document.getElementById("priSubLName");
var PatLName = document.getElementById("PatLName");
priSubLName.value = PatLName.value;
var priSubFName = document.getElementById("priSubFName");
var PatFName = document.getElementById("PatFName");
priSubFName.value = PatFName.value;
var priSubInitial = document.getElementById("priSubInitial");
var PatInitial = document.getElementById("PatInitial");
priSubInitial.value = PatInitial.value;
var priSubAddress1 = document.getElementById("priSubAddress1");
var PatAddress1 = document.getElementById("PatAddress1");
priSubAddress1.value = PatAddress1.value;
var priSubAddress2 = document.getElementById("priSubAddress2");
var PatAddress2 = document.getElementById("PatAddress2");
priSubAddress2.value = PatAddress2.value;
var priSubCity = document.getElementById("priSubCity");
var PatCity = document.getElementById("PatCity");
priSubCity.value = PatCity.value;
var priSubState = document.getElementById("priSubState");
var PatState = document.getElementById("PatState");
priSubState.value = PatState.value;
var priSubZip = $find("<%= priSubZip.ClientID %>");
var PatZip = $find("<%= PatZip.ClientID %>");
priSubZip.set_value(PatZip.get_value());
var priSubSex = document.getElementById("priSubSex");
var PatSex = document.getElementById("PatSex");
priSubSex.value = PatSex.value;
var priSubSSN = $find("<%= priSubSSN.ClientID %>");
var PatSSN = $find("<%= PatSSN.ClientID %>");
priSubSSN.set_value(PatSSN.get_value());
var priSubDOB = $find("<%= priSubDOB.ClientID %>");
var PatDOB = $find("<%= PatDOB.ClientID %>");
var PatDOBDate = PatDOB.get_selectedDate();
priSubDOB.set_selectedDate(PatDOBDate);
}
}
// wyeager - 10/13/2010
// Gets the Relation to Patient for the Secondary Insurance.
function getSecSelectedValue() {
var index = document.getElementById("secSubRelToPat").selectedIndex;
if (document.getElementById("secSubRelToPat").options[index].text == "Self") {
var secSubRelToPat = document.getElementById("secSubRelToPat");
secSubRelToPat.options[index].text = 'Self';
var secSubLName = document.getElementById("secSubLName");
var PatLName = document.getElementById("PatLName");
secSubLName.value = PatLName.value;
var secSubFName = document.getElementById("secSubFName");
var PatFName = document.getElementById("PatFName");
secSubFName.value = PatFName.value;
var secSubInitial = document.getElementById("secSubInitial");
var PatInitial = document.getElementById("PatInitial");
secSubInitial.value = PatInitial.value;
var secSubAddress1 = document.getElementById("secSubAddress1");
var PatAddress1 = document.getElementById("PatAddress1");
secSubAddress1.value = PatAddress1.value;
var secSubAddress2 = document.getElementById("secSubAddress2");
var PatAddress2 = document.getElementById("PatAddress2");
secSubAddress2.value = PatAddress2.value;
var secSubCity = document.getElementById("secSubCity");
var PatCity = document.getElementById("PatCity");
secSubCity.value = PatCity.value;
var secSubState = document.getElementById("secSubState");
var PatState = document.getElementById("PatState");
secSubState.value = PatState.value;
var secSubZip = $find("<%= secSubZip.ClientID %>");
var PatZip = $find("<%= PatZip.ClientID %>");
secSubZip.set_value(PatZip.get_value());
var secSubSex = document.getElementById("secSubSex");
var PatSex = document.getElementById("PatSex");
secSubSex.value = PatSex.value;
var secSubSSN = $find("<%= secSubSSN.ClientID %>");
var PatSSN = $find("<%= PatSSN.ClientID %>");
secSubSSN.set_value(PatSSN.get_value());
var secSubDOB = $find("<%= secSubDOB.ClientID %>");
var PatDOB = $find("<%= PatDOB.ClientID %>");
var PatDOBDate = PatDOB.get_selectedDate();
secSubDOB.set_selectedDate(PatDOBDate);
}
}
// wyeager - 10/13/2010
// Gets the Relation to Patient for the Tertiary Insurance.
function getTerSelectedValue() {
var index = document.getElementById("terSubRelToPat").selectedIndex;
if (document.getElementById("terSubRelToPat").options[index].text == "Self") {
var terSubRelToPat = document.getElementById("terSubRelToPat");
terSubRelToPat.options[index].text = 'Self';
var terSubLName = document.getElementById("terSubLName");
var PatLName = document.getElementById("PatLName");
terSubLName.value = PatLName.value;
var terSubFName = document.getElementById("terSubFName");
var PatFName = document.getElementById("PatFName");
terSubFName.value = PatFName.value;
var terSubInitial = document.getElementById("terSubInitial");
var PatInitial = document.getElementById("PatInitial");
terSubInitial.value = PatInitial.value;
var terSubAddress1 = document.getElementById("terSubAddress1");
var PatAddress1 = document.getElementById("PatAddress1");
terSubAddress1.value = PatAddress1.value;
var terSubAddress2 = document.getElementById("terSubAddress2");
var PatAddress2 = document.getElementById("PatAddress2");
terSubAddress2.value = PatAddress2.value;
var terSubCity = document.getElementById("terSubCity");
var PatCity = document.getElementById("PatCity");
terSubCity.value = PatCity.value;
var terSubState = document.getElementById("terSubState");
var PatState = document.getElementById("PatState");
terSubState.value = PatState.value;
var terSubZip = $find("<%= terSubZip.ClientID %>");
var PatZip = $find("<%= PatZip.ClientID %>");
terSubZip.set_value(PatZip.get_value());
var terSubSex = document.getElementById("terSubSex");
var PatSex = document.getElementById("PatSex");
terSubSex.value = PatSex.value;
var terSubSSN = $find("<%= terSubSSN.ClientID %>");
var PatSSN = $find("<%= PatSSN.ClientID %>");
terSubSSN.set_value(PatSSN.get_value());
var terSubDOB = $find("<%= terSubDOB.ClientID %>");
var PatDOB = $find("<%= PatDOB.ClientID %>");
var PatDOBDate = PatDOB.get_selectedDate();
terSubDOB.set_selectedDate(PatDOBDate);
}
}
</script>
</telerik:RadCodeBlock>
</head>
<body onkeydown="checkImage_onclick(event);" text="#000000" link="#165492" bgcolor="#ffffff"
leftmargin="0" topmargin="0" marginheight="0" marginwidth="0">
<form id="frmPatientDemo" runat="server">
<telerik:RadScriptManager ID="RadScriptManager1" runat="server">
</telerik:RadScriptManager>
<telerik:RadWindowManager ID="RadWindowManager1" ShowContentDuringLoad="false" VisibleStatusbar="false"
ReloadOnShow="true" runat="server">
<Windows>
<telerik:RadWindow ID="RadWindow1" Behaviors="Close" Title="Primary Institution Search"
Modal="true" runat="server" OnClientClose="OnPriClientClose">
</telerik:RadWindow>
<telerik:RadWindow ID="RadWindow2" Behaviors="Close" Title="Secondary Institution Search"
Modal="true" runat="server" OnClientClose="OnSecClientClose">
</telerik:RadWindow>
<telerik:RadWindow ID="RadWindow3" Behaviors="Close" Title="Tertiary Institution Search"
Modal="true" runat="server" OnClientClose="OnTerClientClose">
</telerik:RadWindow>
</Windows>
</telerik:RadWindowManager>
<div>
<input type="hidden" id="hdnImageURL" name="hdnImageURL" value="" runat="server" />
<input type="hidden" id="hdnImageName" name="hdnImageName" value="" runat="server" />
<input type="hidden" id="hdnPendFlag" name="hdnPendFlag" value="" runat="server" />
<input type="hidden" id="hdnVoidFlag" name="hdnVoidFlag" value="" runat="server" />
<input type="hidden" id="hdnDefFlag" name="hdnDefFlag" value="" runat="server" />
<input type="hidden" id="hdnbfiPriCount" name="hdnbfiPriCount" value="" runat="server" />
<input type="hidden" id="hdnbfiSecCount" name="hdnbfiSecCount" value="" runat="server" />
<input type="hidden" id="hdnbfiTerCount" name="hdnbfiTerCount" value="" runat="server" />
<input type="hidden" id="hdnpriInsID" name="hdnpriInsID" value="" runat="server" />
<input type="hidden" id="hdnsecInsID" name="hdnsecInsID" value="" runat="server" />
<input type="hidden" id="hdnterInsID" name="hdnterInsID" value="" runat="server" />
<input type="hidden" id="hdnPageName" name="hdnPageName" value="Demographics" runat="server" />
<input type="hidden" id="hdnOtherIns" name="hdnOtherIns" value="0" runat="server" />
<telerik:RadAjaxManager ID="RadAjaxManager1" runat="server">
<AjaxSettings>
<telerik:AjaxSetting AjaxControlID="btnPriSearch">
<UpdatedControls>
<telerik:AjaxUpdatedControl ControlID="priInsCode" />
<telerik:AjaxUpdatedControl ControlID="priInsName" />
<telerik:AjaxUpdatedControl ControlID="priInsAddress1" />
<telerik:AjaxUpdatedControl ControlID="priInsAddress2" />
<telerik:AjaxUpdatedControl ControlID="priInsCity" />
<telerik:AjaxUpdatedControl ControlID="priInsState" />
<telerik:AjaxUpdatedControl ControlID="priInsZip" />
</UpdatedControls>
</telerik:AjaxSetting>
<telerik:AjaxSetting AjaxControlID="btnSecSearch">
<UpdatedControls>
<telerik:AjaxUpdatedControl ControlID="secInsCode" />
<telerik:AjaxUpdatedControl ControlID="secInsName" />
<telerik:AjaxUpdatedControl ControlID="secInsAddress1" />
<telerik:AjaxUpdatedControl ControlID="secInsAddress2" />
<telerik:AjaxUpdatedControl ControlID="secInsCity" />
<telerik:AjaxUpdatedControl ControlID="secInsState" />
<telerik:AjaxUpdatedControl ControlID="secInsZip" />
</UpdatedControls>
</telerik:AjaxSetting>
<telerik:AjaxSetting AjaxControlID="btnTerSearch">
<UpdatedControls>
<telerik:AjaxUpdatedControl ControlID="terInsCode" />
<telerik:AjaxUpdatedControl ControlID="terInsName" />
<telerik:AjaxUpdatedControl ControlID="terInsAddress1" />
<telerik:AjaxUpdatedControl ControlID="terInsAddress2" />
<telerik:AjaxUpdatedControl ControlID="terInsCity" />
<telerik:AjaxUpdatedControl ControlID="terInsState" />
<telerik:AjaxUpdatedControl ControlID="terInsZip" />
</UpdatedControls>
</telerik:AjaxSetting>
<telerik:AjaxSetting AjaxControlID="btnSaveLogEntry">
<UpdatedControls>
<telerik:AjaxUpdatedControl ControlID="tsPatientDemographics" />
<telerik:AjaxUpdatedControl ControlID="RadMultiPage1" />
<telerik:AjaxUpdatedControl ControlID="hdnImageName" />
<telerik:AjaxUpdatedControl ControlID="hdnImageURL" />
</UpdatedControls>
</telerik:AjaxSetting>
<telerik:AjaxSetting AjaxControlID="btnVoid">
<UpdatedControls>
<telerik:AjaxUpdatedControl ControlID="tsPatientDemographics" />
<telerik:AjaxUpdatedControl ControlID="RadMultiPage1" />
<telerik:AjaxUpdatedControl ControlID="hdnVoidFlag" />
<telerik:AjaxUpdatedControl ControlID="hdnImageName" />
<telerik:AjaxUpdatedControl ControlID="hdnImageURL" />
</UpdatedControls>
</telerik:AjaxSetting>
<telerik:AjaxSetting AjaxControlID="btnPend">
<UpdatedControls>
<telerik:AjaxUpdatedControl ControlID="tsPatientDemographics" />
<telerik:AjaxUpdatedControl ControlID="RadMultiPage1" />
<telerik:AjaxUpdatedControl ControlID="hdnPendFlag" />
<telerik:AjaxUpdatedControl ControlID="hdnImageName" />
<telerik:AjaxUpdatedControl ControlID="hdnImageURL" />
</UpdatedControls>
</telerik:AjaxSetting>
<telerik:AjaxSetting AjaxControlID="btnDEF">
<UpdatedControls>
<telerik:AjaxUpdatedControl ControlID="tsPatientDemographics" />
<telerik:AjaxUpdatedControl ControlID="RadMultiPage1" />
<telerik:AjaxUpdatedControl ControlID="hdnDefFlag" />
<telerik:AjaxUpdatedControl ControlID="hdnImageName" />
<telerik:AjaxUpdatedControl ControlID="hdnImageURL" />
</UpdatedControls>
</telerik:AjaxSetting>
<telerik:AjaxSetting AjaxControlID="priInsCode">
<UpdatedControls>
<telerik:AjaxUpdatedControl ControlID="priInsName" />
<telerik:AjaxUpdatedControl ControlID="priInsAddress1" />
<telerik:AjaxUpdatedControl ControlID="priInsAddress2" />
<telerik:AjaxUpdatedControl ControlID="priInsCity" />
<telerik:AjaxUpdatedControl ControlID="priInsState" />
<telerik:AjaxUpdatedControl ControlID="priInsZip" />
<telerik:AjaxUpdatedControl ControlID="hdnpriInsID" />
</UpdatedControls>
</telerik:AjaxSetting>
<telerik:AjaxSetting AjaxControlID="secInsCode">
<UpdatedControls>
<telerik:AjaxUpdatedControl ControlID="secInsName" />
<telerik:AjaxUpdatedControl ControlID="secInsAddress1" />
<telerik:AjaxUpdatedControl ControlID="secInsAddress2" />
<telerik:AjaxUpdatedControl ControlID="secInsCity" />
<telerik:AjaxUpdatedControl ControlID="secInsState" />
<telerik:AjaxUpdatedControl ControlID="secInsZip" />
<telerik:AjaxUpdatedControl ControlID="hdnsecInsID" />
</UpdatedControls>
</telerik:AjaxSetting>
<telerik:AjaxSetting AjaxControlID="terInsCode">
<UpdatedControls>
<telerik:AjaxUpdatedControl ControlID="terInsName" />
<telerik:AjaxUpdatedControl ControlID="terInsAddress1" />
<telerik:AjaxUpdatedControl ControlID="terInsAddress2" />
<telerik:AjaxUpdatedControl ControlID="terInsCity" />
<telerik:AjaxUpdatedControl ControlID="terInsState" />
<telerik:AjaxUpdatedControl ControlID="terInsZip" />
<telerik:AjaxUpdatedControl ControlID="hdnterInsID" />
</UpdatedControls>
</telerik:AjaxSetting>
</AjaxSettings>
</telerik:RadAjaxManager>
</div>
<table cellpadding="0" cellspacing="0" border="1" style="border: thin solid #004990;
width: 100%; height: 100%" frame="box">
<tr valign="top" style="height: 100%">
<td width="100%">
<fieldset>
<legend><font color="blue" size="1"><b>Patient Demographics ==> Data Entry</b></font></legend>
<table cellpadding="0" cellspacing="0" border="0" width="100%">
<tr valign="top">
<td width="100%">
<input onclick="rd_onclick();" type="hidden" value=".bmp" name="ImageType">
<object classid="clsid:5220cb21-c88d-11cf-b347-00aa00a28331">
<param name="LPKPath" value="../DynamicWebTwain.lpk" />
</object>
<table cellspacing="1" cellpadding="1" width="100%" border="0">
<tbody>
<tr height="300">
<td valign="top" width="10%" height="280" align="center" bgcolor="f0f0f0" id="tdThumbNails">
<table cellpadding="1" cellspacing="1" width="100%">
<tr>
<td height="300">
<div align="left">
<font color="darkblue"><b> Thumbnails<br>
</b></font>
</div>
<object classid="clsid:E7DA7F8D-27AB-4EE9-8FC0-3FEC9ECFE758" id="DynamicWebTwain1"
height="70%" width="90%" codebase="../DynamicWebTWAIN.cab#version=5,2">
<param name="_cx" value="847" />
<param name="_cy" value="847" />
<param name="JpgQuality" value="80" />
<param name="Manufacturer" value="Dynamsoft Corporation" />
<param name="ProductFamily" value="Dynamic Web TWAIN" />
<param name="ProductName" value="Dynamic Web TWAIN" />
<param name="VersionInfo" value="Dynamic Web TWAIN 5.2" />
<param name="TransferMode" value="0" />
<param name="BorderStyle" value="0" />
<param name="FTPUserName" value="" />
<param name="FTPPassword" value="" />
<param name="FTPPort" value="21" />
<param name="HTTPUserName" value="" />
<param name="HTTPPassword" value="" />
<param name="HTTPPort" value="80" />
<param name="ProxyServer" value="" />
<param name="IfDisableSourceAfterAcquire" value="0" />
<param name="IfShowUI" value="1" />
<param name="IfModalUI" value="1" />
<param name="IfTiffMultiPage" value="0" />
<param name="IfThrowException" value="0" />
<param name="MaxImagesInBuffer" value="1" />
<param name="TIFFCompressionType" value="0" />
</object>
</td>
</tr>
<tr>
<td>
<table cellpadding="1" cellspacing="1" width="100%">
<tr>
<td colspan="2" bgcolor="#f0f0f0" align="left">
<font color="darkblue"><b>Edit Image</b></font>
</td>
</tr>
<tr>
<td bgcolor="#f0f0f0" colspan="2" align="left">
<input id="btnRotateRight" onclick="return btnRotateRight_onclick()" style="font-size: xx-small;
font-weight: bold; width: 90px;" type="button" value="Rotate Right">
<input id="btnRotateLeft" onclick="return btnRotateLeft_onclick()" type="button"
style="font-size: xx-small; font-weight: bold; width: 80px;" value="Rotate Left">
</td>
</tr>
<tr>
<td bgcolor="#f0f0f0" colspan="2" align="left">
<input id="btnFirstImage" onclick="return btnFirstImage_onclick()" type="button"
style="font-size: xx-small; font-weight: bold; width: 25px;" value="|<">
<input id="btnPreImage" onclick="return btnPreImage_onclick()" style="font-size: xx-small;
font-weight: bold; width: 25px;" type="button" value="<">
<input id="CurrentImage" readonly size="2" name="CurrentImage" style="font-size: xx-small;
font-weight: bold; width: 25px;">/
<input id="TotalImage" readonly size="2" value="0" name="TotalImage" style="font-size: xx-small;
font-weight: bold; width: 25px;">
<input id="btnNextImage" onclick="return btnNextImage_onclick()" style="font-size: xx-small;
font-weight: bold; width: 25px;" type="button" value=">">
<input id="btnLastImage" onclick="return btnLastImage_onclick()" style="font-size: xx-small;
font-weight: bold; width: 25px;" type="button" value=">|">
</td>
</tr>
<tr>
<td bgcolor="#f0f0f0" colspan="2" align="left">
<input id="btnFit" onclick="return btnFit_onclick()" type="button" value="Fit Window"
style="font-size: xx-small; font-weight: bold; width: 80px;" />
<input id="btnFact" onclick="return btnFact_onclick()" type="button" value="1:1"
style="font-size: xx-small; font-weight: bold; width: 25px;" />
<input id="btnZoomIn" onclick="return btnZoomIn_onclick()" type="button" value="+"
style="font-size: xx-small; font-weight: bold; width: 25px;">
<input id="btnZoomOut" onclick="return btnZoomOut_onclick()" type="button" value="-"
style="font-size: xx-small; font-weight: bold; width: 25px;">
</td>
</tr>
<tr>
<td bgcolor="#f0f0f0" colspan="2" align="left">
<input id="btnPointer" onclick="return btnPointer_onclick()" type="button" value="Pointer"
style="font-size: xx-small; font-weight: bold; width: 90px;" />
<input id="btnHand" onclick="return btnHand_onclick()" type="button" value="Hand"
style="font-size: xx-small; font-weight: bold; width: 90px;" />
<br />
<br />
<div align="left">
Message:<br />
</div>
<center>
<textarea name="emessage" rows="4" readonly cols="10"></textarea></center>
</td>
</tr>
</table>
</td>
</tr>
</table>
</td>
<td valign="top" width="65%">
<object classid="clsid:E7DA7F8D-27AB-4EE9-8FC0-3FEC9ECFE758" id="DynamicWebTwain2"
width="100%" height="900px" codebase="../DynamicWebTWAIN.cab#version=5,1" style="z-index: -10000">
<param name="_cx" value="847" />
<param name="_cy" value="847" />
<param name="JpgQuality" value="80" />
<param name="Manufacturer" value="Dynamsoft Corporation" />
<param name="ProductFamily" value="Dynamic Web TWAIN" />
<param name="ProductName" value="Dynamic Web TWAIN" />
<param name="VersionInfo" value="Dynamic Web TWAIN 5.1" />
<param name="TransferMode" value="0" />
<param name="BorderStyle" value="0" />
<param name="FTPUserName" value="" />
<param name="FTPPassword" value="" />
<param name="FTPPort" value="21" />
<param name="HTTPUserName" value="" />
<param name="HTTPPassword" value="" />
<param name="HTTPPort" value="80" />
<param name="ProxyServer" value="" />
<param name="IfDisableSourceAfterAcquire" value="0" />
<param name="IfShowUI" value="1" />
<param name="IfModalUI" value="1" />
<param name="IfTiffMultiPage" value="0" />
<param name="IfThrowException" value="0" />
<param name="MaxImagesInBuffer" value="1" />
<param name="TIFFCompressionType" value="0" />
</object>
</td>
<td valign="top" width="25%">
<table cellspacing="0" cellpadding="0" width="100%" border="0">
<tbody style="font-size: 8pt;">
<tr>
<td colspan="3">
<table cellpadding="0" cellspacing="0" width="100%">
<tr>
<td class="td_AEVNoBold">
<b>FACILITY: </b>
<asp:Label ID="lblFacility" runat="server" Font-Bold="true" ForeColor="Blue"></asp:Label>
<b>DOS: </b>
<asp:Label ID="lblDOS" runat="server" Font-Bold="true" ForeColor="Blue"></asp:Label>
</td>
</tr>
<tr>
<td>
<div>
<telerik:RadTabStrip ID="tsPatientDemographics" runat="server" AutoPostBack="false"
ScrollButtonsPosition="Right" MultiPageID="RadMultiPage1" BackColor="Gray" CausesValidation="False"
Align="Left" Width="100%">
<Tabs>
<telerik:RadTab Text="P<u>a</u>tient" AccessKey="A" Width="60px">
</telerik:RadTab>
<telerik:RadTab Text="G<u>u</u>arantor" AccessKey="U" Width="80px">
</telerik:RadTab>
<telerik:RadTab Text="<u>P</u>ri Ins" AccessKey="P" Width="60px">
</telerik:RadTab>
<telerik:RadTab Text="<u>S</u>ec Ins" AccessKey="S" Value="Sec Ins" Width="60px"
Enabled="false">
</telerik:RadTab>
<telerik:RadTab Text="<u>T</u>er Ins" AccessKey="T" Value="Ter Ins" Width="70px"
Enabled="false">
</telerik:RadTab>
</Tabs>
</telerik:RadTabStrip>
<telerik:RadMultiPage ID="RadMultiPage1" runat="server" SelectedIndex="0" ScrollBars="None">
<telerik:RadPageView ID="RadPatientInfoView" runat="server" Width="100%" BackColor="LightGray">
<table width="100%" bgcolor="#F6F6F6" cellpadding="0" cellspacing="0">
<tr>
<td>
<fieldset>
<legend><b><font style="font-size: x-small;">Patient Info</font></b></legend>
<table width="100%" bordercolor="white" border="1" cellpadding="0" cellspacing="0">
<tr>
<td class="td_AEV" width="35%">
Hosp Acct# *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="HospAcctno" runat="server" onblur="CheckForCompletedReqFlds();"
MaxLength="25"></asp:TextBox>
<asp:RequiredFieldValidator ID="RequiredFieldValidator1" ControlToValidate="HospAcctno"
Display="Dynamic" ErrorMessage="Patient Info: Hosp Acct#" Text="*" runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
MRN # *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="MRN" runat="server" onblur="CheckForCompletedReqFlds();" MaxLength="25"></asp:TextBox>
<asp:RequiredFieldValidator ID="RequiredFieldValidator2" ControlToValidate="MRN"
Display="Dynamic" ErrorMessage="Patient Info: MRN #" Text="*" runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
Admit Date *:
</td>
<td class="td_AEVNoBold">
<telerik:RadDatePicker ID="radAdmitDate" runat="server" onblur="CheckForCompletedReqFlds();"
Font-Size="8pt">
<Calendar UseColumnHeadersAsSelectors="False" UseRowHeadersAsSelectors="False" ViewSelectorText="x">
</Calendar>
<DatePopupButton HoverImageUrl="" ImageUrl="" />
<DateInput ID="DateInput4" DateFormat="M/d/yyyy" DisplayDateFormat="M/d/yyyy" runat="server">
</DateInput>
</telerik:RadDatePicker>
<asp:RequiredFieldValidator ID="RequiredFieldValidator17" ControlToValidate="radAdmitDate"
Display="Dynamic" ErrorMessage="Patient Info: Admit Date" Text="*" runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
Admit Time *:
</td>
<td class="td_AEVNoBold">
<telerik:RadTimePicker ID="radAdmitTime" runat="server" onblur="CheckForCompletedReqFlds();"
Font-Size="8pt">
<Calendar UseColumnHeadersAsSelectors="False" UseRowHeadersAsSelectors="False" ViewSelectorText="x">
</Calendar>
<TimeView CellSpacing="-1">
</TimeView>
<TimePopupButton CssClass="" HoverImageUrl="" ImageUrl="" />
<DatePopupButton CssClass="" HoverImageUrl="" ImageUrl="" Visible="False" />
<DateInput ID="DateInput5" DateFormat="h:mm tt" DisplayDateFormat="h:mm tt" runat="server">
</DateInput>
</telerik:RadTimePicker>
<asp:RequiredFieldValidator ID="RequiredFieldValidator18" ControlToValidate="radAdmitTime"
Display="Dynamic" ErrorMessage="Patient Info: Admit Time" Text="*" runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
Discharge Date *:
</td>
<td class="td_AEVNoBold">
<telerik:RadDatePicker ID="radDischargeDate" runat="server" onblur="CheckForCompletedReqFlds();"
Font-Size="8pt">
<Calendar UseColumnHeadersAsSelectors="False" UseRowHeadersAsSelectors="False" ViewSelectorText="x">
</Calendar>
<DatePopupButton HoverImageUrl="" ImageUrl="" />
<DateInput ID="DateInput6" DateFormat="M/d/yyyy" DisplayDateFormat="M/d/yyyy" runat="server">
</DateInput>
</telerik:RadDatePicker>
<asp:CompareValidator ID="cvAdmitDischargeDates" runat="server" ErrorMessage="Patient Info: Discharge Date cannot be less than Admit Date!"
Display="Dynamic" Text="*" ControlToValidate="radAdmitDate" ControlToCompare="radDischargeDate"
Operator="LessThanEqual" Type="Date"></asp:CompareValidator>
</td>
</tr>
<tr>
<td class="td_AEV">
Discharge Time *:
</td>
<td class="td_AEVNoBold">
<telerik:RadTimePicker ID="radDischargeTime" runat="server" onblur="CheckForCompletedReqFlds();"
Font-Size="8pt">
<Calendar UseColumnHeadersAsSelectors="False" UseRowHeadersAsSelectors="False" ViewSelectorText="x">
</Calendar>
<TimeView CellSpacing="-1">
</TimeView>
<TimePopupButton CssClass="" HoverImageUrl="" ImageUrl="" />
<DatePopupButton CssClass="" HoverImageUrl="" ImageUrl="" Visible="False" />
<DateInput ID="DateInput7" DateFormat="h:mm tt" DisplayDateFormat="h:mm tt" runat="server">
</DateInput>
</telerik:RadTimePicker>
<asp:CustomValidator ID="cvDischargeDateTime" runat="server" ErrorMessage="Patient Info: Discharge Date & Time cannot be less than Admit Date & Time!"
Display="Dynamic" EnableClientScript="true" Text="Patient Info: Discharge Date & Time cannot be less than Admit Date & Time!"
ControlToValidate="radDischargeTime" OnServerValidate="cvAdmitDischargeDateTime_OnServerValidate"></asp:CustomValidator>
</td>
</tr>
<tr>
<td class="td_AEV">
Last Name *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="PatLName" runat="server" onblur="CheckForCompletedReqFlds();" MaxLength="50"></asp:TextBox>
<asp:RequiredFieldValidator ID="RequiredFieldValidator3" ControlToValidate="PatLName"
Display="Dynamic" ErrorMessage="Patient Info: Last Name" Text="*" runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
First Name *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="PatFName" runat="server" onblur="CheckForCompletedReqFlds();" MaxLength="50"></asp:TextBox>
<asp:RequiredFieldValidator ID="RequiredFieldValidator4" ControlToValidate="PatFName"
Display="Dynamic" ErrorMessage="Patient Info: First Name" Text="*" runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
Initial:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="PatInitial" runat="server" MaxLength="25"></asp:TextBox>
</td>
</tr>
<tr>
<td class="td_AEV">
Address1 *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="PatAddress1" runat="server" onblur="CheckForCompletedReqFlds();"
MaxLength="50"></asp:TextBox>
<asp:RequiredFieldValidator ID="RequiredFieldValidator5" ControlToValidate="PatAddress1"
Display="Dynamic" ErrorMessage="Patient Info: Address1" Text="*" runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
Address2:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="PatAddress2" runat="server" MaxLength="50"></asp:TextBox>
</td>
</tr>
<tr>
<td class="td_AEV">
City *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="PatCity" runat="server" onblur="CheckForCompletedReqFlds();" MaxLength="50"></asp:TextBox>
<asp:RequiredFieldValidator ID="RequiredFieldValidator6" ControlToValidate="PatCity"
Display="Dynamic" ErrorMessage="Patient Info: City" Text="*" runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
State *:
</td>
<td class="td_AEVNoBold">
<asp:DropDownList ID="PatState" runat="server" Font-Size="8pt" />
<asp:RequiredFieldValidator ID="RequiredFieldValidator7" ControlToValidate="PatState"
Display="Dynamic" ErrorMessage="Patient Info: State" Text="*" runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
Zip:
</td>
<td class="td_AEVNoBold">
<telerik:RadMaskedTextBox ID="PatZip" runat="server" Mask="#####-####" Width="70px"
Font-Size="8pt">
</telerik:RadMaskedTextBox>
<asp:RegularExpressionValidator ID="RegularExpressionValidator5" runat="server" ErrorMessage="Patient Info: Zip Invalid!"
Display="Dynamic" ValidationExpression="^((\d{5}-_{0,4})|(|(\d{5}-\d{4})))$"
ControlToValidate="PatZip"></asp:RegularExpressionValidator>
</td>
</tr>
<tr>
<td class="td_AEV">
SSN:
</td>
<td class="td_AEVNoBold">
<telerik:RadMaskedTextBox ID="PatSSN" runat="server" Mask="###-##-####" Width="92px"
Font-Size="8pt">
</telerik:RadMaskedTextBox>
<asp:RegularExpressionValidator ID="RegularExpressionValidator6" runat="server" ErrorMessage="Patient Info: SSN Invalid!"
Display="Dynamic" ValidationExpression="^\d{3}-\d{2}-\d{4}$" ControlToValidate="PatSSN"></asp:RegularExpressionValidator>
</td>
</tr>
<tr>
<td class="td_AEV">
DOB *:
</td>
<td class="td_AEVNoBold">
<telerik:RadDatePicker ID="PatDOB" runat="server" onblur="CheckForCompletedReqFlds();"
Font-Size="8pt">
<Calendar UseColumnHeadersAsSelectors="False" UseRowHeadersAsSelectors="False" ViewSelectorText="x">
</Calendar>
<DatePopupButton HoverImageUrl="" ImageUrl="" />
<DateInput ID="DateInput0" DateFormat="M/d/yyyy" DisplayDateFormat="M/d/yyyy" runat="server">
</DateInput>
</telerik:RadDatePicker>
<asp:RequiredFieldValidator ID="RequiredFieldValidator8" ControlToValidate="PatDOB"
Display="Dynamic" ErrorMessage="Patient Info: DOB" Text="*" runat="server" />
<asp:CompareValidator ID="cvPatDOB" runat="server" ErrorMessage="Admit Date cannot be less than Patient DOB!"
ControlToValidate="PatDOB" ControlToCompare="radAdmitDate" Operator="LessThanEqual"
Display="Dynamic" Type="Date"></asp:CompareValidator>
<asp:CompareValidator ID="cvDOB2" runat="server" ErrorMessage="Discharge Date cannot be less than Patient DOB!"
Display="Dynamic" ControlToValidate="PatDOB" ControlToCompare="radDischargeDate"
Operator="LessThanEqual" Type="Date"></asp:CompareValidator>
</td>
</tr>
<tr>
<td class="td_AEV">
Home Phone:
</td>
<td class="td_AEVNoBold">
<telerik:RadMaskedTextBox ID="PatHomePhone" runat="server" Mask="(###) ###-####"
Width="80px" Font-Size="8pt">
</telerik:RadMaskedTextBox>
<asp:RegularExpressionValidator ID="RegularExpressionValidator8" runat="server" ErrorMessage="Patient Info: Home Phone Invalid!"
Display="Dynamic" ControlToValidate="PatHomePhone" ValidationExpression="^([\(]{1}[0-9]{3}[\)]{1}[ ]{1}[0-9]{3}[\-]{1}[0-9]{4})$"></asp:RegularExpressionValidator>
</td>
</tr>
<tr>
<td class="td_AEV">
Work Phone:
</td>
<td class="td_AEVNoBold">
<telerik:RadMaskedTextBox ID="PatWorkPhone" runat="server" Mask="(###) ###-####"
Width="80px" Font-Size="8pt">
</telerik:RadMaskedTextBox>
<asp:RegularExpressionValidator ID="RegularExpressionValidator9" runat="server" ErrorMessage="Patient Info: Work Phone Invalid!"
Display="Dynamic" ControlToValidate="PatWorkPhone" ValidationExpression="^([\(]{1}[0-9]{3}[\)]{1}[ ]{1}[0-9]{3}[\-]{1}[0-9]{4})$"></asp:RegularExpressionValidator>
</td>
</tr>
<tr>
<td class="td_AEV">
Cell Phone:
</td>
<td class="td_AEVNoBold">
<telerik:RadMaskedTextBox ID="PatCellPhone" runat="server" Mask="(###) ###-####"
Width="80px" Font-Size="8pt">
</telerik:RadMaskedTextBox>
<asp:RegularExpressionValidator ID="RegularExpressionValidator10" runat="server"
Display="Dynamic" ErrorMessage="Patient Info: Cell Phone Invalid!" ControlToValidate="PatCellPhone"
ValidationExpression="^([\(]{1}[0-9]{3}[\)]{1}[ ]{1}[0-9]{3}[\-]{1}[0-9]{4})$"></asp:RegularExpressionValidator>
</td>
</tr>
<tr>
<td class="td_AEV">
Marital status *:
</td>
<td class="td_AEVNoBold">
<asp:DropDownList ID="PatMaritalStatus" runat="server" onblur="CheckForCompletedReqFlds();"
Font-Size="8pt" />
<asp:RequiredFieldValidator ID="RequiredFieldValidator9" ControlToValidate="PatMaritalStatus"
Display="Dynamic" ErrorMessage="Patient Info: Marital status" Text="*" runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
Sex *:
</td>
<td class="td_AEVNoBold">
<asp:DropDownList ID="PatSex" runat="server" onblur="CheckForCompletedReqFlds('Patient');"
Font-Size="8pt">
<asp:ListItem Selected="True" Text="Select" Value=""></asp:ListItem>
<asp:ListItem Text="Male" Value="M"></asp:ListItem>
<asp:ListItem Text="Female" Value="F"></asp:ListItem>
</asp:DropDownList>
<asp:RequiredFieldValidator ID="RequiredFieldValidator10" ControlToValidate="PatSex"
Display="Dynamic" ErrorMessage="Patient Info: Sex" Text="*" runat="server" />
</td>
</tr>
</table>
</fieldset>
</td>
</tr>
</table>
</telerik:RadPageView>
<telerik:RadPageView ID="RadGuarView" runat="server" Width="100%">
<table width="100%" bgcolor="#F6F6F6" cellpadding="0" cellspacing="0">
<tr>
<td>
<fieldset>
<legend><b><font style="font-size: x-small;">Guarantor Info</font></b></legend>
<table width="100%" bordercolor="white" border="1" cellpadding="0" cellspacing="0">
<tr>
<td class="td_AEV">
Rel to Patient *:
</td>
<td class="td_AEVNoBold">
<asp:DropDownList ID="GuarRelToPat" runat="server" onblur="CheckForCompletedReqFlds();"
onchange="getGuarSelectedValue();" Font-Size="8pt" />
<asp:RequiredFieldValidator ID="RequiredFieldValidator11" ControlToValidate="GuarRelToPat"
Display="Dynamic" ErrorMessage="Guarantor Info: Rel to Patient" Text="*" runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
Last Name *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="GuarLName" runat="server" onblur="CheckForCompletedReqFlds();" MaxLength="50"></asp:TextBox>
<asp:RequiredFieldValidator ID="RequiredFieldValidator12" ControlToValidate="GuarLName"
Display="Dynamic" ErrorMessage="Guarantor Info: Last Name" Text="*" runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
First Name *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="GuarFName" runat="server" onblur="CheckForCompletedReqFlds();" MaxLength="50"></asp:TextBox>
<asp:RequiredFieldValidator ID="RequiredFieldValidator13" ControlToValidate="GuarFName"
Display="Dynamic" ErrorMessage="Guarantor Info: First Name" Text="*" runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
Initial:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="GuarInitial" runat="server" MaxLength="25"></asp:TextBox>
</td>
</tr>
<tr>
<td class="td_AEV">
Address1 *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="GuarAddress1" runat="server" onblur="CheckForCompletedReqFlds();"
MaxLength="50"></asp:TextBox>
<asp:RequiredFieldValidator ID="RequiredFieldValidator14" ControlToValidate="GuarAddress1"
Display="Dynamic" ErrorMessage="Guarantor Info: Address1" Text="*" runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
Address2:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="GuarAddress2" runat="server" MaxLength="50"></asp:TextBox>
</td>
</tr>
<tr>
<td class="td_AEV">
City *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="GuarCity" runat="server" onblur="CheckForCompletedReqFlds();" MaxLength="50"></asp:TextBox>
<asp:RequiredFieldValidator ID="RequiredFieldValidator15" ControlToValidate="GuarCity"
Display="Dynamic" ErrorMessage="Guarantor Info: City" Text="*" runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
State *:
</td>
<td class="td_AEVNoBold">
<asp:DropDownList ID="GuarState" runat="server" Font-Size="8pt" />
<asp:RequiredFieldValidator ID="RequiredFieldValidator16" ControlToValidate="GuarState"
Display="Dynamic" ErrorMessage="Guarantor Info: State" Text="*" runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
Zip:
</td>
<td class="td_AEVNoBold">
<telerik:RadMaskedTextBox ID="GuarZip" runat="server" Mask="#####-####" Width="70px">
</telerik:RadMaskedTextBox>
<asp:RegularExpressionValidator ID="RegularExpressionValidator11" runat="server"
ErrorMessage="Guarantor Info: Home Phone Invalid!" ControlToValidate="GuarZip"
Display="Dynamic" ValidationExpression="^((\d{5}-_{0,4})|(|(\d{5}-\d{4})))$"></asp:RegularExpressionValidator>
</td>
</tr>
<tr>
<td class="td_AEV">
Home Phone:
</td>
<td class="td_AEVNoBold">
<telerik:RadMaskedTextBox ID="GuarHomePhone" runat="server" Mask="(###) ###-####"
Width="80px" Font-Size="8pt">
</telerik:RadMaskedTextBox>
<asp:RegularExpressionValidator ID="RegularExpressionValidator12" runat="server"
ErrorMessage="Guarantor Info: Home Phone Invalid!" ControlToValidate="GuarHomePhone"
Display="Dynamic" ValidationExpression="^([\(]{1}[0-9]{3}[\)]{1}[ ]{1}[0-9]{3}[\-]{1}[0-9]{4})$"></asp:RegularExpressionValidator>
</td>
</tr>
<tr>
<td class="td_AEV">
Work Phone:
</td>
<td class="td_AEVNoBold">
<telerik:RadMaskedTextBox ID="GuarWorkPhone" runat="server" Mask="(###) ###-####"
Width="80px" Font-Size="8pt">
</telerik:RadMaskedTextBox>
<asp:RegularExpressionValidator ID="RegularExpressionValidator13" runat="server"
ErrorMessage="Guarantor Info: Work Phone Invalid!" ControlToValidate="GuarWorkPhone"
Display="Dynamic" ValidationExpression="^([\(]{1}[0-9]{3}[\)]{1}[ ]{1}[0-9]{3}[\-]{1}[0-9]{4})$"></asp:RegularExpressionValidator>
</td>
</tr>
<tr>
<td class="td_AEV">
Cell Phone:
</td>
<td class="td_AEVNoBold">
<telerik:RadMaskedTextBox ID="GuarCellPhone" runat="server" Mask="(###) ###-####"
Width="80px" Font-Size="8pt">
</telerik:RadMaskedTextBox>
<asp:RegularExpressionValidator ID="RegularExpressionValidator14" runat="server"
ErrorMessage="Guarantor Info: Cell Phone Invalid!" ControlToValidate="GuarCellPhone"
Display="Dynamic" ValidationExpression="^([\(]{1}[0-9]{3}[\)]{1}[ ]{1}[0-9]{3}[\-]{1}[0-9]{4})$"></asp:RegularExpressionValidator>
</td>
</tr>
<tr>
<td class="td_AEV">
SSN:
</td>
<td class="td_AEVNoBold">
<telerik:RadMaskedTextBox ID="GuarSSN" runat="server" Mask="###-##-####" Width="92px"
Font-Size="8pt">
</telerik:RadMaskedTextBox>
<asp:RegularExpressionValidator ID="RegularExpressionValidator15" runat="server"
ErrorMessage="Guarantor Info: SSN Invalid!" ValidationExpression="^\d{3}-\d{2}-\d{4}$"
Display="Dynamic" ControlToValidate="GuarSSN"></asp:RegularExpressionValidator>
</td>
</tr>
<tr>
<td class="td_AEV">
Sex *:
</td>
<td class="td_AEVNoBold">
<asp:DropDownList ID="GuarSex" runat="server" onblur="CheckForCompletedReqFlds();"
Font-Size="8pt">
<asp:ListItem Selected="True" Text="Select" Value=""></asp:ListItem>
<asp:ListItem Text="Male" Value="M"></asp:ListItem>
<asp:ListItem Text="Female" Value="F"></asp:ListItem>
</asp:DropDownList>
<asp:RequiredFieldValidator ID="RequiredFieldValidator22" ControlToValidate="GuarSex"
Display="Dynamic" ErrorMessage="Guarantor Info: Sex" Text="*" runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
Marital status *:
</td>
<td class="td_AEVNoBold">
<asp:DropDownList ID="ddlGuarMaritalStatus" runat="server" onblur="CheckForCompletedReqFlds();"
Font-Size="8pt" />
<asp:RequiredFieldValidator ID="RequiredFieldValidator21" ControlToValidate="ddlGuarMaritalStatus"
Display="Dynamic" ErrorMessage="Guarantor Info: Marital status" Text="*" runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV" valign="top">
DOB *:
</td>
<td class="td_AEVNoBold">
<telerik:RadDatePicker ID="radGuarDOB" runat="server" onblur="CheckForCompletedReqFlds();"
Font-Size="8pt">
<Calendar UseColumnHeadersAsSelectors="False" UseRowHeadersAsSelectors="False" ViewSelectorText="x">
</Calendar>
<DatePopupButton HoverImageUrl="" ImageUrl="" />
<DateInput ID="DateInput8" DateFormat="M/d/yyyy" DisplayDateFormat="M/d/yyyy" runat="server">
</DateInput>
</telerik:RadDatePicker>
<asp:RequiredFieldValidator ID="RequiredFieldValidator23" ControlToValidate="radGuarDOB"
Display="Dynamic" ErrorMessage="Guarantor Info: DOB" Text="*" runat="server" />
<asp:CompareValidator ID="CompareValidator1" runat="server" ErrorMessage="Admit Date cannot be less than Guarantor DOB!"
ControlToValidate="radGuarDOB" ControlToCompare="radAdmitDate" Operator="LessThanEqual"
Display="Dynamic" Type="Date"></asp:CompareValidator>
<asp:CompareValidator ID="CompareValidator2" runat="server" ErrorMessage="Discharge Date cannot be less than Guarantor DOB!"
ControlToValidate="radGuarDOB" ControlToCompare="radDischargeDate" Operator="LessThanEqual"
Display="Dynamic" Type="Date"></asp:CompareValidator>
</td>
</tr>
<tr>
<td class="td_AEV">
Arrival Mode *:
</td>
<td class="td_AEVNoBold">
<asp:DropDownList ID="ddlGuarArrivalMode" runat="server" onblur="CheckForCompletedReqFlds();"
Font-Size="8pt" />
<asp:RequiredFieldValidator ID="RequiredFieldValidator25" ControlToValidate="ddlGuarArrivalMode"
Display="Dynamic" ErrorMessage="Guarantor Info: Arrival Mode" Text="*" runat="server" />
</td>
</tr>
</table>
</fieldset>
</td>
</tr>
<tr>
<td>
<fieldset>
<legend><b><font style="font-size: x-small;">Employer Info</font></b></legend>
<table width="100%" bordercolor="white" border="1" cellpadding="0" cellspacing="0">
<tr>
<td class="td_AEV" width="35%">
Employer:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="GuarEmployer" runat="server" MaxLength="100"></asp:TextBox>
</td>
</tr>
<tr>
<td class="td_AEV">
Address1:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="GuarEmpAddress1" runat="server" MaxLength="50"></asp:TextBox>
</td>
</tr>
<tr>
<td class="td_AEV">
Address2:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="GuarEmpAddress2" runat="server" MaxLength="50"></asp:TextBox>
</td>
</tr>
<tr>
<td class="td_AEV">
City:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="GuarEmpCity" runat="server" MaxLength="50"></asp:TextBox>
</td>
</tr>
<tr>
<td class="td_AEV">
State:
</td>
<td class="td_AEVNoBold">
<asp:DropDownList ID="GuarEmpState" runat="server" Font-Size="8pt" />
</td>
</tr>
<tr>
<td class="td_AEV">
Zip:
</td>
<td class="td_AEVNoBold">
<telerik:RadMaskedTextBox ID="GuarEmpZip" runat="server" Mask="#####-####" Width="70px"
Font-Size="8pt">
</telerik:RadMaskedTextBox>
<asp:RegularExpressionValidator ID="RegularExpressionValidator17" runat="server"
ErrorMessage="Guarantor Employer Info: Zip Invalid!" ControlToValidate="GuarEmpZip"
Display="Dynamic" ValidationExpression="^((\d{5}-_{0,4})|(|(\d{5}-\d{4})))$"></asp:RegularExpressionValidator>
</td>
</tr>
<tr>
<td class="td_AEV">
Phone:
</td>
<td class="td_AEVNoBold">
<telerik:RadMaskedTextBox ID="GuarEmpPhone" runat="server" Mask="(###) ###-####"
Width="80px" onblur="CheckForCompletedReqFlds('Guarantor');" Font-Size="8pt">
</telerik:RadMaskedTextBox>
<asp:RegularExpressionValidator ID="RegularExpressionValidator18" runat="server"
ErrorMessage="Guarantor Employer Info: Phone Invalid!" ControlToValidate="GuarEmpPhone"
Display="Dynamic" ValidationExpression="^([\(]{1}[0-9]{3}[\)]{1}[ ]{1}[0-9]{3}[\-]{1}[0-9]{4})$"></asp:RegularExpressionValidator>
</td>
</tr>
</table>
</fieldset>
</td>
</tr>
</table>
</telerik:RadPageView>
<telerik:RadPageView ID="RadPriView" runat="server" Width="100%">
<table width="100%" bgcolor="#F6F6F6" cellpadding="0" cellspacing="0">
<tr>
<td>
<fieldset>
<legend><b><font style="font-size: x-small;">Primary Insurance</font></b></legend>
<table width="100%" bordercolor="white" border="1" cellpadding="0" cellspacing="0">
<tr>
<td class="td_AEV" width="30%">
Ins Code *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="priInsCode" runat="server" AutoPostBack="true" OnTextChanged="priInsCode_OnTextChanged"
MaxLength="10"></asp:TextBox>
<asp:Button ID="btnPriSearch" runat="server" Text="Search" CausesValidation="false"
AccessKey="1" />
<asp:RequiredFieldValidator ID="rfvpriInsCode" ControlToValidate="priInsCode" ErrorMessage="Primary Insurance: Pri Ins Code"
Display="Dynamic" Text="*" runat="server" Enabled="false" />
</td>
</tr>
<tr>
<td class="td_AEV">
Ins Name *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="priInsName" runat="server" ReadOnly="true" Width="225px"></asp:TextBox>
</td>
</tr>
<tr>
<td class="td_AEV">
Ins Address1 *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="priInsAddress1" runat="server" ReadOnly="true"></asp:TextBox>
</td>
</tr>
<tr>
<td class="td_AEV">
Ins Address2:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="priInsAddress2" runat="server" ReadOnly="true"></asp:TextBox>
</td>
</tr>
<tr>
<td class="td_AEV">
City *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="priInsCity" runat="server" ReadOnly="true"></asp:TextBox>
</td>
</tr>
<tr>
<td class="td_AEV">
State *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="priInsState" runat="server" onblur="CheckForCompletedReqFlds();"
ReadOnly="true"></asp:TextBox>
</td>
</tr>
<tr>
<td class="td_AEV">
Zip *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="priInsZip" runat="server" ReadOnly="true" Width="70px">
</asp:TextBox>
</td>
</tr>
<tr>
<td>
</td>
</tr>
<tr>
<td class="td_AEV">
Policy # *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="priInsPolicyNum" runat="server" MaxLength="50" onblur="CheckForCompletedReqFlds();"></asp:TextBox>
<asp:RequiredFieldValidator ID="rfvpriInsPolicyNum" ControlToValidate="priInsPolicyNum"
Display="Dynamic" ErrorMessage="Primary Insurance: Policy #" Text="*" runat="server"
Enabled="false" />
</td>
</tr>
<tr>
<td class="td_AEV" valign="top">
Retype Policy #:
</td>
<td>
<asp:TextBox ID="priInsPolicyNumVer" runat="server" MaxLength="50" onblur="CheckForCompletedReqFlds();"></asp:TextBox>
<asp:CompareValidator ID="CompareValidator9" runat="server" ErrorMessage="Primary Insurance: Confirmation Primary Policy Numbers NOT equal!"
ControlToValidate="priInsPolicyNumVer" ControlToCompare="priInsPolicyNum" Operator="Equal"
Display="Dynamic" Type="String"></asp:CompareValidator>
</td>
</tr>
<tr>
<td class="td_AEV">
Group # *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="priInsGrpNum" runat="server" MaxLength="25" onblur="CheckForCompletedReqFlds();"></asp:TextBox>
<asp:RequiredFieldValidator ID="rfvpriInsGrpNum" ControlToValidate="priInsGrpNum"
Display="Dynamic" ErrorMessage="Primary Insurance: Group #" Text="*" runat="server"
Enabled="false" />
</td>
</tr>
</table>
</fieldset>
</td>
</tr>
<tr>
<td>
<fieldset>
<legend><b><font style="font-size: x-small;">Primary Subscriber Info</font></b></legend>
<table width="100%" bordercolor="white" border="1" cellpadding="0" cellspacing="0">
<tr>
<td class="td_AEV" width="30%">
Rel to Patient *:
</td>
<td class="td_AEVNoBold">
<asp:DropDownList ID="priSubRelToPat" runat="server" onchange="getPriSelectedValue();"
Font-Size="8pt" />
<asp:RequiredFieldValidator ID="rfvpriSubRelToPat" ControlToValidate="priSubRelToPat"
Enabled="false" Display="Dynamic" ErrorMessage="Primary Subscriber Info: Rel to Patient"
Text="*" runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
Last Name *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="priSubLName" runat="server" MaxLength="100"></asp:TextBox>
<asp:RequiredFieldValidator ID="rfvpriSubLName" ControlToValidate="priSubLName" Enabled="false"
Display="Dynamic" ErrorMessage="Primary Subscriber Info: Last Name" Text="*"
runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
First Name *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="priSubFName" runat="server" MaxLength="100"></asp:TextBox>
<asp:RequiredFieldValidator ID="rfvpriSubFName" ControlToValidate="priSubFName" Enabled="false"
Display="Dynamic" ErrorMessage="Primary Subscriber Info: First Name" Text="*"
runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
Initial:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="priSubInitial" runat="server" MaxLength="50"></asp:TextBox>
</td>
</tr>
<tr>
<td class="td_AEV">
Address1 *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="priSubAddress1" runat="server" MaxLength="100"></asp:TextBox>
<asp:RequiredFieldValidator ID="rfvpriSubAddress1" ControlToValidate="priSubAddress1"
Enabled="false" Display="Dynamic" ErrorMessage="Primary Subscriber Info: Address1"
Text="*" runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
Address2:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="priSubAddress2" runat="server" MaxLength="100"></asp:TextBox>
</td>
</tr>
<tr>
<td class="td_AEV">
City *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="priSubCity" runat="server" MaxLength="100"></asp:TextBox>
<asp:RequiredFieldValidator ID="rfvpriSubCity" ControlToValidate="priSubCity" Enabled="false"
Display="Dynamic" ErrorMessage="Primary Subscriber Info: City" Text="*" runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
State *:
</td>
<td class="td_AEVNoBold">
<asp:DropDownList ID="priSubState" runat="server" Font-Size="8pt" />
<asp:RequiredFieldValidator ID="rfvpriSubState" ControlToValidate="priSubState" Enabled="false"
Display="Dynamic" ErrorMessage="Primary Subscriber Info: State" Text="*" runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
Zip:
</td>
<td class="td_AEVNoBold">
<telerik:RadMaskedTextBox ID="priSubZip" runat="server" Mask="#####-####" Width="70px"
Font-Size="8pt">
</telerik:RadMaskedTextBox>
<asp:RegularExpressionValidator ID="RegularExpressionValidator19" runat="server"
ErrorMessage="Primary Insurance: Zip Invalid!" ControlToValidate="priSubZip"
Display="Dynamic" ValidationExpression="^((\d{5}-_{0,4})|(|(\d{5}-\d{4})))$"></asp:RegularExpressionValidator>
</td>
</tr>
<tr>
<td class="td_AEV">
SSN:
</td>
<td class="td_AEVNoBold">
<telerik:RadMaskedTextBox ID="priSubSSN" runat="server" Mask="###-##-####" Width="92px"
Font-Size="8pt">
</telerik:RadMaskedTextBox>
<asp:RegularExpressionValidator ID="RegularExpressionValidator20" runat="server"
ErrorMessage="Primary Insurance: SSN Invalid!" ValidationExpression="^\d{3}-\d{2}-\d{4}$"
Display="Dynamic" ControlToValidate="priSubSSN"></asp:RegularExpressionValidator>
</td>
</tr>
<tr>
<td class="td_AEV" valign="top">
DOB:
</td>
<td class="td_AEVNoBold">
<telerik:RadDatePicker ID="priSubDOB" runat="server" Font-Size="8pt">
<Calendar UseColumnHeadersAsSelectors="False" UseRowHeadersAsSelectors="False" ViewSelectorText="x">
</Calendar>
<DatePopupButton HoverImageUrl="" ImageUrl="" />
<DateInput ID="DateInput1" DateFormat="M/d/yyyy" DisplayDateFormat="M/d/yyyy" runat="server">
</DateInput>
</telerik:RadDatePicker>
<asp:CompareValidator ID="CompareValidator3" runat="server" ErrorMessage="Admit Date cannot be less than Primary Subscriber DOB!"
ControlToValidate="priSubDOB" ControlToCompare="radAdmitDate" Operator="LessThanEqual"
Display="Dynamic" Type="Date"></asp:CompareValidator>
<asp:CompareValidator ID="CompareValidator4" runat="server" ErrorMessage="Discharge Date cannot be less than Primary Subscriber DOB!"
ControlToValidate="priSubDOB" ControlToCompare="radDischargeDate" Operator="LessThanEqual"
Display="Dynamic" Type="Date"></asp:CompareValidator>
</td>
</tr>
<tr>
<td class="td_AEV">
Sex:
</td>
<td class="td_AEVNoBold">
<asp:DropDownList ID="priSubSex" runat="server" Font-Size="8pt">
<asp:ListItem Selected="True" Text="Select" Value=""></asp:ListItem>
<asp:ListItem Text="Male" Value="M"></asp:ListItem>
<asp:ListItem Text="Female" Value="F"></asp:ListItem>
</asp:DropDownList>
</td>
</tr>
<tr>
<td class="td_AEV">
Authorization:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="priAuthorization" runat="server" MaxLength="50" onblur="CheckForCompletedReqFlds('Pri Ins');"></asp:TextBox>
</td>
</tr>
</table>
</fieldset>
</td>
</tr>
</table>
</telerik:RadPageView>
<telerik:RadPageView ID="RadSecView" runat="server" Width="100%">
<table width="100%" bgcolor="#F6F6F6" cellpadding="0" cellspacing="0">
<tr>
<td>
<fieldset>
<legend><b><font style="font-size: x-small;">Secondary Insurance</font></b></legend>
<table width="100%" bordercolor="white" border="1" cellpadding="0" cellspacing="0">
<tr>
<td class="td_AEV" width="35%">
Ins Code *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="secInsCode" runat="server" AutoPostBack="true" OnTextChanged="secInsCode_OnTextChanged"
MaxLength="10"></asp:TextBox>
<asp:RequiredFieldValidator ID="rfvsecInsCode" ControlToValidate="secInsCode" ErrorMessage="Secondary Insurance: Sec Ins Code"
Display="Dynamic" Text="*" runat="server" Enabled="false" />
<asp:Button ID="btnSecSearch" runat="server" Text="Search" CausesValidation="false"
AccessKey="2" />
</td>
</tr>
<tr>
<td class="td_AEV">
Ins Name *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="secInsName" runat="server" ReadOnly="true" Width="225px"></asp:TextBox>
</td>
</tr>
<tr>
<td class="td_AEV">
Ins Address1 *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="secInsAddress1" runat="server" ReadOnly="true"></asp:TextBox>
</td>
</tr>
<tr>
<td class="td_AEV">
Ins Address2:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="secInsAddress2" runat="server" ReadOnly="true" MaxLength="100"></asp:TextBox>
</td>
</tr>
<tr>
<td class="td_AEV">
City *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="secInsCity" runat="server" ReadOnly="true"></asp:TextBox>
</td>
</tr>
<tr>
<td class="td_AEV">
State *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="secInsState" runat="server" ReadOnly="true"></asp:TextBox>
</td>
</tr>
<tr>
<td class="td_AEV">
Zip *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="secInsZip" runat="server" Height="21px" ReadOnly="true" Width="70px">
</asp:TextBox>
</td>
</tr>
<tr>
<td>
</td>
</tr>
<tr>
<td class="td_AEV">
Policy # *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="secInsPolicyNum" runat="server" MaxLength="50"></asp:TextBox>
<asp:RequiredFieldValidator ID="rfvsecInsPolicyNum" ControlToValidate="secInsPolicyNum"
Display="Dynamic" ErrorMessage="Secondary Insurance: Policy #" Text="*" runat="server"
Enabled="false" />
</td>
</tr>
<tr>
<td class="td_AEV" valign="top">
Retype Policy #:
</td>
<td>
<asp:TextBox ID="secInsPolicyNumVer" runat="server" MaxLength="50"></asp:TextBox>
<asp:CompareValidator ID="CompareValidator10" runat="server" ErrorMessage="Secondary Insurance: Confirmation Secondary Policy Numbers NOT equal!"
Display="Dynamic" ControlToValidate="secInsPolicyNumVer" ControlToCompare="secInsPolicyNum"
Operator="Equal" Type="String"></asp:CompareValidator>
</td>
</tr>
<tr>
<td class="td_AEV">
Group # *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="secInsGrpNum" runat="server" MaxLength="25"></asp:TextBox>
<asp:RequiredFieldValidator ID="rfvsecInsGrpNum" ControlToValidate="secInsGrpNum"
Display="Dynamic" ErrorMessage="Secondary Insurance: Group #" Text="*" runat="server"
Enabled="false" />
</td>
</tr>
</table>
</fieldset>
</td>
</tr>
<tr>
<td>
<fieldset>
<legend><b><font style="font-size: x-small;">Secondary Subscriber Info</font></b></legend>
<table width="100%" bordercolor="white" border="1" cellpadding="0" cellspacing="0">
<tr>
<td class="td_AEV" width="35%">
Rel to Patient *:
</td>
<td class="td_AEVNoBold">
<asp:DropDownList ID="secSubRelToPat" runat="server" onchange="getSecSelectedValue();"
Font-Size="8pt" />
<asp:RequiredFieldValidator ID="rfvsecSubRelToPat" ControlToValidate="secSubRelToPat"
Enabled="false" Display="Dynamic" ErrorMessage="Secondary Subscriber Info: Rel to Patient"
Text="*" runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
Last Name *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="secSubLName" runat="server" MaxLength="100"></asp:TextBox>
<asp:RequiredFieldValidator ID="rfvsecSubLName" ControlToValidate="secSubLName" Enabled="false"
Display="Dynamic" ErrorMessage="Secondary Subscriber Info: Last Name" Text="*"
runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
First Name *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="secSubFName" runat="server" MaxLength="100"></asp:TextBox>
<asp:RequiredFieldValidator ID="rfvsecSubFName" ControlToValidate="secSubFName" Enabled="false"
Display="Dynamic" ErrorMessage="Secondary Subscriber Info: First Name" Text="*"
runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
Initial:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="secSubInitial" runat="server" MaxLength="50"></asp:TextBox>
</td>
</tr>
<tr>
<td class="td_AEV">
Address1 *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="secSubAddress1" runat="server" MaxLength="100"></asp:TextBox>
<asp:RequiredFieldValidator ID="rfvsecSubAddress1" ControlToValidate="secSubAddress1"
Enabled="false" Display="Dynamic" ErrorMessage="Secondary Subscriber Info: Address1"
Text="*" runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
Address2:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="secSubAddress2" runat="server" MaxLength="100"></asp:TextBox>
</td>
</tr>
<tr>
<td class="td_AEV">
City *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="secSubCity" runat="server" MaxLength="100"></asp:TextBox>
<asp:RequiredFieldValidator ID="rfvsecSubCity" ControlToValidate="secSubCity" Enabled="false"
Display="Dynamic" ErrorMessage="Secondary Subscriber Info: City" Text="*" runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
State *:
</td>
<td class="td_AEVNoBold">
<asp:DropDownList ID="secSubState" runat="server" />
<asp:RequiredFieldValidator ID="rfvsecSubState" ControlToValidate="secSubState" Enabled="false"
Display="Dynamic" ErrorMessage="Secondary Subscriber Info: State" Text="*" runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
Zip:
</td>
<td class="td_AEVNoBold">
<telerik:RadMaskedTextBox ID="secSubZip" runat="server" Height="21px" Mask="#####-####"
Width="70px">
</telerik:RadMaskedTextBox>
<asp:RegularExpressionValidator ID="RegularExpressionValidator22" runat="server"
ErrorMessage="Secondary Insurance: Zip Invalid!" ControlToValidate="secSubZip"
Display="Dynamic" ValidationExpression="^((\d{5}-_{0,4})|(|(\d{5}-\d{4})))$"></asp:RegularExpressionValidator>
</td>
</tr>
<tr>
<td class="td_AEV">
SSN:
</td>
<td class="td_AEVNoBold">
<telerik:RadMaskedTextBox ID="secSubSSN" runat="server" Height="20px" Mask="###-##-####"
Width="92px">
</telerik:RadMaskedTextBox>
<asp:RegularExpressionValidator ID="RegularExpressionValidator23" runat="server"
Display="Dynamic" ErrorMessage="Secondary Insurance: SSN Invalid!" ValidationExpression="^\d{3}-\d{2}-\d{4}$"
ControlToValidate="secSubSSN"></asp:RegularExpressionValidator>
</td>
</tr>
<tr>
<td class="td_AEV" valign="top">
DOB:
</td>
<td class="td_AEVNoBold">
<telerik:RadDatePicker ID="secSubDOB" runat="server">
<DateInput ID="DateInput2" DateFormat="M/d/yyyy" DisplayDateFormat="M/d/yyyy" runat="server">
</DateInput>
</telerik:RadDatePicker>
<asp:CompareValidator ID="CompareValidator5" runat="server" ErrorMessage="Admit Date cannot be less than Secondary Subscriber DOB!"
ControlToValidate="secSubDOB" ControlToCompare="radAdmitDate" Operator="LessThanEqual"
Display="Dynamic" Type="Date"></asp:CompareValidator>
<asp:CompareValidator ID="CompareValidator6" runat="server" ErrorMessage="Discharge Date cannot be less than Secondary Subscriber DOB!"
ControlToValidate="secSubDOB" ControlToCompare="radDischargeDate" Operator="LessThanEqual"
Display="Dynamic" Type="Date"></asp:CompareValidator>
</td>
</tr>
<tr>
<td class="td_AEV">
Sex:
</td>
<td class="td_AEVNoBold">
<asp:DropDownList ID="secSubSex" runat="server">
<asp:ListItem Selected="True" Text="Select" Value=""></asp:ListItem>
<asp:ListItem Text="Male" Value="M"></asp:ListItem>
<asp:ListItem Text="Female" Value="F"></asp:ListItem>
</asp:DropDownList>
</td>
</tr>
<tr>
<td class="td_AEV">
Authorization:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="secAuthorization" runat="server" MaxLength="50" onblur="CheckForCompletedReqFlds('Sec Ins');"></asp:TextBox>
</td>
</tr>
</table>
</fieldset>
</td>
</tr>
</table>
</telerik:RadPageView>
<telerik:RadPageView ID="RadTerView" runat="server" Width="100%">
<table width="100%" bgcolor="#F6F6F6" cellpadding="0" cellspacing="0">
<tr>
<td>
<fieldset>
<legend><b><font style="font-size: x-small;">Tertiary Insurance</font></b></legend>
<table width="100%" bordercolor="white" border="1" cellpadding="0" cellspacing="0">
<tr>
<td class="td_AEV" width="35%">
Ins Code *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="terInsCode" runat="server" AutoPostBack="true" OnTextChanged="terInsCode_OnTextChanged"
MaxLength="10"></asp:TextBox>
<asp:RequiredFieldValidator ID="rfvterInsCode" ControlToValidate="terInsCode" ErrorMessage="Tertiary Insurance: Ter Ins Code"
Display="Dynamic" Text="*" runat="server" Enabled="false" />
<asp:Button ID="btnTerSearch" runat="server" Text="Search" CausesValidation="false"
AccessKey="3" />
</td>
</tr>
<tr>
<td class="td_AEV">
Ins Name *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="terInsName" runat="server" ReadOnly="true" Width="225px"></asp:TextBox>
</td>
</tr>
<tr>
<td class="td_AEV">
Ins Address1 *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="terInsAddress1" runat="server" ReadOnly="true"></asp:TextBox>
</td>
</tr>
<tr>
<td class="td_AEV">
Ins Address2:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="terInsAddress2" runat="server" ReadOnly="true"></asp:TextBox>
</td>
</tr>
<tr>
<td class="td_AEV">
City *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="terInsCity" runat="server" ReadOnly="true"></asp:TextBox>
</td>
</tr>
<tr>
<td class="td_AEV">
State *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="terInsState" runat="server" ReadOnly="true"></asp:TextBox>
</td>
</tr>
<tr>
<td class="td_AEV">
Zip *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="terInsZip" runat="server" Height="21px" ReadOnly="true" Width="70px">
</asp:TextBox>
</td>
</tr>
<tr>
<td>
</td>
</tr>
<tr>
<td class="td_AEV">
Policy # *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="terInsPolicyNum" runat="server" MaxLength="50"></asp:TextBox>
<asp:RequiredFieldValidator ID="rfvterInsPolicyNum" ControlToValidate="terInsPolicyNum"
Display="Dynamic" ErrorMessage="Tertiary Insurance: Policy #" Text="*" runat="server"
Enabled="false" />
</td>
</tr>
<tr>
<td class="td_AEV" valign="top">
Retype Policy #:
</td>
<td>
<asp:TextBox ID="terInsPolicyNumVer" runat="server" MaxLength="50"></asp:TextBox>
<asp:CompareValidator ID="CompareValidator11" runat="server" ErrorMessage="Tertiary Insurance: Confirmation Tertiary Policy Numbers NOT equal!"
ControlToValidate="terInsPolicyNumVer" ControlToCompare="terInsPolicyNum" Operator="Equal"
Display="Dynamic" Type="String"></asp:CompareValidator>
</td>
</tr>
<tr>
<td class="td_AEV">
Group # *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="terInsGrpNum" runat="server" MaxLength="25"></asp:TextBox>
<asp:RequiredFieldValidator ID="rfvterInsGrpNum" ControlToValidate="terInsGrpNum"
Display="Dynamic" ErrorMessage="Tertiary Insurance: Group #" Text="*" runat="server"
Enabled="false" />
</td>
</tr>
</table>
</fieldset>
</td>
</tr>
<tr>
<td>
<fieldset>
<legend><b><font style="font-size: x-small;">Tertiary Subscriber Info</font></b></legend>
<table width="100%" bordercolor="white" border="1">
<tr>
<td class="td_AEV" width="35%">
Rel to Patient *:
</td>
<td class="td_AEVNoBold">
<asp:DropDownList ID="terSubRelToPat" runat="server" onchange="getTerSelectedValue();"
Font-Size="8pt" />
<asp:RequiredFieldValidator ID="rfvterSubRelToPat" ControlToValidate="terSubRelToPat"
Enabled="false" Display="Dynamic" ErrorMessage="Tertiary Subscriber Info: Rel to Patient"
Text="*" runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
Last Name *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="terSubLName" runat="server" MaxLength="100"></asp:TextBox>
<asp:RequiredFieldValidator ID="rfvterSubLName" ControlToValidate="terSubLName" Enabled="false"
Display="Dynamic" ErrorMessage="Tertiary Subscriber Info: Last Name" Text="*"
runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
First Name *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="terSubFName" runat="server" MaxLength="100"></asp:TextBox>
<asp:RequiredFieldValidator ID="rfvterSubFName" ControlToValidate="terSubFName" Enabled="false"
Display="Dynamic" ErrorMessage="Tertiary Subscriber Info: First Name" Text="*"
runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
Initial:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="terSubInitial" runat="server" MaxLength="50"></asp:TextBox>
</td>
</tr>
<tr>
<td class="td_AEV">
Address1 *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="terSubAddress1" runat="server" MaxLength="100"></asp:TextBox>
<asp:RequiredFieldValidator ID="rfvterSubAddress1" ControlToValidate="terSubAddress1"
Enabled="false" Display="Dynamic" ErrorMessage="Tertiary Subscriber Info: Address1"
Text="*" runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
Address2:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="terSubAddress2" runat="server" MaxLength="100"></asp:TextBox>
</td>
</tr>
<tr>
<td class="td_AEV">
City *:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="terSubCity" runat="server" MaxLength="100"></asp:TextBox>
<asp:RequiredFieldValidator ID="rfvterSubCity" ControlToValidate="terSubCity" Enabled="false"
Display="Dynamic" ErrorMessage="Tertiary Subscriber Info: City" Text="*" runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
State *:
</td>
<td class="td_AEVNoBold">
<asp:DropDownList ID="terSubState" runat="server" />
<asp:RequiredFieldValidator ID="rfvterSubState" ControlToValidate="terSubState" Enabled="false"
Display="Dynamic" ErrorMessage="Tertiary Subscriber Info: State" Text="*" runat="server" />
</td>
</tr>
<tr>
<td class="td_AEV">
Zip:
</td>
<td class="td_AEVNoBold">
<telerik:RadMaskedTextBox ID="terSubZip" runat="server" Height="21px" Mask="#####-####"
Width="70px">
</telerik:RadMaskedTextBox>
<asp:RegularExpressionValidator ID="RegularExpressionValidator25" runat="server"
ErrorMessage="Tertiary Insurance: Zip Invalid!" ControlToValidate="terSubZip"
Display="Dynamic" ValidationExpression="^((\d{5}-_{0,4})|(|(\d{5}-\d{4})))$"></asp:RegularExpressionValidator>
</td>
</tr>
<tr>
<td class="td_AEV">
SSN:
</td>
<td class="td_AEVNoBold">
<telerik:RadMaskedTextBox ID="terSubSSN" runat="server" Height="20px" Mask="###-##-####"
Width="92px">
</telerik:RadMaskedTextBox>
<asp:RegularExpressionValidator ID="RegularExpressionValidator26" runat="server"
Display="Dynamic" ErrorMessage="Tertiary Insurance: SSN Invalid!" ValidationExpression="^\d{3}-\d{2}-\d{4}$"
ControlToValidate="terSubSSN"></asp:RegularExpressionValidator>
</td>
</tr>
<tr>
<td class="td_AEV" valign="top">
DOB:
</td>
<td class="td_AEVNoBold">
<telerik:RadDatePicker ID="terSubDOB" runat="server">
<DateInput ID="DateInput3" DateFormat="M/d/yyyy" DisplayDateFormat="M/d/yyyy" runat="server">
</DateInput>
</telerik:RadDatePicker>
<asp:CompareValidator ID="CompareValidator7" runat="server" ErrorMessage="Admit Date cannot be less than Tertiary Subscriber DOB!"
ControlToValidate="terSubDOB" ControlToCompare="radAdmitDate" Operator="LessThanEqual"
Display="Dynamic" Type="Date"></asp:CompareValidator>
<asp:CompareValidator ID="CompareValidator8" runat="server" ErrorMessage="Discharge Date cannot be less than Tertiary Subscriber DOB!"
ControlToValidate="terSubDOB" ControlToCompare="radDischargeDate" Operator="LessThanEqual"
Display="Dynamic" Type="Date"></asp:CompareValidator>
</td>
</tr>
<tr>
<td class="td_AEV">
Sex:
</td>
<td class="td_AEVNoBold">
<asp:DropDownList ID="terSubSex" runat="server">
<asp:ListItem Selected="True" Text="Select" Value=""></asp:ListItem>
<asp:ListItem Text="Male" Value="M"></asp:ListItem>
<asp:ListItem Text="Female" Value="F"></asp:ListItem>
</asp:DropDownList>
</td>
</tr>
<tr>
<td class="td_AEV">
Authorization:
</td>
<td class="td_AEVNoBold">
<asp:TextBox ID="terAuthorization" runat="server" MaxLength="50" onblur="CheckForCompletedReqFlds('Ter Ins');"></asp:TextBox>
</td>
</tr>
</table>
</fieldset>
</td>
</tr>
</table>
</telerik:RadPageView>
</telerik:RadMultiPage>
</div>
</td>
</tr>
</table>
</td>
</tr>
<tr bgcolor="#ffffff">
<td colspan="3" align="center">
<div id="msg">
</div>
</td>
</tr>
<tr>
<td colspan="3">
<table cellpadding="1" cellspacing="1" width="100%" id="tblEntry">
<tr>
<td bgcolor="#f0f0f0" colspan="2" align="center">
<asp:Button ID="btnSaveLogEntry" runat="server" Text="Save Log Entry" Enabled="true"
AccessKey="L" Style="width: 150px; font-size: x-smaller; color: #fe8e14; font-style: italic;
font-family: Arial Black; font-weight: bold;" OnClick="btnSaveLogEntry_Click"
OnClientClick="CheckForOtherIns();" />
<asp:Button ID="btnVoid" runat="server" Text="VOID" AccessKey="V" CausesValidation="false"
Style="width: 150px; font-size: x-smaller; color: #fe8e14; font-style: italic;
font-family: Arial Black; font-weight: bold;" />
<asp:Button ID="btnPend" runat="server" Text="PEND" AccessKey="N" CausesValidation="false"
Style="width: 150px; font-size: x-smaller; color: #fe8e14; font-style: italic;
font-family: Arial Black; font-weight: bold;" />
<asp:Button ID="btnDEF" runat="server" Text="DEF" AccessKey="F" CausesValidation="false"
Style="width: 150px; font-size: x-smaller; color: #fe8e14; font-style: italic;
font-family: Arial Black; font-weight: bold;" />
<br />
<div id="testBlock" runat="server">
<input type="button" id="doIT" onclick="PatientLoad();" style="width: 1px; height: 1px" />
</div>
<asp:ValidationSummary ID="ValidationSummary1" runat="server" DisplayMode="BulletList"
ShowMessageBox="true" ShowSummary="false" EnableClientScript="true" HeaderText="You must enter a value in the following fields:" />
</td>
</tr>
</table>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
</table>
</fieldset>
</td>
</tr>
<telerik:RadAjaxLoadingPanel ID="LoadingPanel1" runat="server" BackgroundPosition="Center"
Skin="Windows7">
<asp:Image ID="Image1" runat="server" ImageUrl="~/Images/Windows7.gif"></asp:Image>
</telerik:RadAjaxLoadingPanel>
</table>
<telerik:RadCodeBlock ID="RadCodeBlock2" runat="server">
<script language="javascript">
var frmScan = document.forms['frmPatientDemo'];
document.getElementById("btnSaveLogEntry").disabled = true;
var td = document.getElementById("tdThumbNails");
var hdnImageName = document.getElementById("<%= hdnImageName.ClientID %>");
var hdnImageURL = document.getElementById("<%= hdnImageURL.ClientID %>");
function waitForPageLoad() {
while ((typeof document.getElementById("DynamicWebTwain1") == 'undefined') &&
(typeof document.getElementById("hdnImageURL") == 'undefined') &&
(typeof document.getElementById("hdnImageName") == 'undefined')) { }
document.getElementById("doIT").click();
}
setTimeout("waitForPageLoad()", 1000);
</script>
</telerik:RadCodeBlock>
</form>
</body>
</html>
8 answers
230 views
We've specified a number of CssClasses for our website's RadGrids' various styles, (specified via a .skin and .css file, so end-users can customise them easier), and have just upgraded to Q1 2009 - and so these settings have now been overridden by the Skin. Because of this, we've disabled the skin, (i.e. Skin=""), but this means the grid's pager appears on four lines as in;
{first} {prev}
{page numbers}
{next} {last}
Displaying page {num} of {count}, {first} to {last}
How can we put this content onto one line without having to return to the default skin?
Thanks,
Paul
{first} {prev}
{page numbers}
{next} {last}
Displaying page {num} of {count}, {first} to {last}
How can we put this content onto one line without having to return to the default skin?
Thanks,
Paul
2 answers
60 views
Hi,
it took me some while to figure out what was wrong.
Scenario:
RadTabStrip with RadMultiPage, one tab dynamically loads a usercontrol which contains a TreeList.
Important to note here is that the property ClientIdMode of the TreeList is set to Static!
When I expand one column in the TreeList, the loading panel is shown (AjaxManager is on the same page with RadTabStrip).
The second action on the treelist though, refreshes the whole page.
I tried to contain the problem and created a new web site project, but it worked as I expected, until I referenced the AjaxControlKit, without using any controls though.
If I change the ClientIdMode of the TreeList to AutoId, it works as expected. This problem might even occur without loading the usercontrol dynamically
I created a sample project, where can I upload it?
Forgot to add the version info:
Cheers Deval
it took me some while to figure out what was wrong.
Scenario:
RadTabStrip with RadMultiPage, one tab dynamically loads a usercontrol which contains a TreeList.
Important to note here is that the property ClientIdMode of the TreeList is set to Static!
When I expand one column in the TreeList, the loading panel is shown (AjaxManager is on the same page with RadTabStrip).
The second action on the treelist though, refreshes the whole page.
I tried to contain the problem and created a new web site project, but it worked as I expected, until I referenced the AjaxControlKit, without using any controls though.
If I change the ClientIdMode of the TreeList to AutoId, it works as expected. This problem might even occur without loading the usercontrol dynamically
I created a sample project, where can I upload it?
Forgot to add the version info:
- AjaxControlKit 4.1.40412.0
- Telerik.Web.UI 2010.3.1317.40
Cheers Deval
Maria Ilieva
Telerik team
answered
on
09 Feb 2011
1 answer
31 views
Dear All,
If we trun the grid into edit all mode, and move the cursor through tabbing, the horizontal scrollbar dont move. If I move the scroll bar then it do scroll. I dont know why on tabbing, horizontal scroll isnt working. Can you please give me a demo application about this issue.
Similarly, if we use fixed column and above senario is repeated, the serious issues are encontered. We are unable to scroll, dont know why.
Thanks
Nabeel
If we trun the grid into edit all mode, and move the cursor through tabbing, the horizontal scrollbar dont move. If I move the scroll bar then it do scroll. I dont know why on tabbing, horizontal scroll isnt working. Can you please give me a demo application about this issue.
Similarly, if we use fixed column and above senario is repeated, the serious issues are encontered. We are unable to scroll, dont know why.
Thanks
Nabeel
Pavlina
Telerik team
answered
on
09 Feb 2011
