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Posted By

tuffo19 on 09/17/10


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php html f0rm


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Mega form + php

 / Published in: PHP
 

258 campi da creare, validare, inserire.

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  1. <?php 
  2.  
  3. //imposto la modalita
  4. $debug = false;
  5.  
  6. //definisco l'error page per inoltrare potenziali errori
  7. function error_page($user, $error, $error_spec){
  8. 	global $filetxt;
  9. 	global $in;
  10. 	global $SRV;
  11. 	global $log_conn;
  12. 	global $service;
  13. 	global $remote_userid;
  14. 	global $session_number;
  15. 	$today = date("j/m/Y, H:m:s");
  16. 	if (is_array($error_spec)) foreach ($error_spec as $key => $val) $spec.="\n $key : $val";
  17. 	mail("", "Errore[".$in['remote_userid']."]","$today\n $error \n Specifiche errore: \n".$spec, "From: ERROR_".$service."@{$_SERVER['SERVER_NAME']}
  18. ");
  19. 	$body="<p align=center><font size=4><b>Si e' verificato un errore</b></p><br><br>$error_spec<br>$error";
  20. 	die($body);
  21. }
  22.  
  23.  
  24. //connessione al DB
  25. require_once("/http/lib/php_utils/database/oracle/db.inc");
  26. $conn=new dbconn();
  27. $query=new query($conn);
  28.  
  29. //autenticazione. 
  30. //1. Controllo che la variabile REMOTE_USER sia un numero
  31. if (preg_match('/^[0-9]+$/',($_SERVER['REMOTE_USER']))){
  32. 	$remote_user = $_SERVER['REMOTE_USER'];
  33. }
  34. else {
  35. 	$remote_user = -1;
  36. 	$error[] = "Errore nell'autenticazione. Si &egrave; verificato un problema con le variabili di sessione.";
  37. }
  38.  
  39.  
  40. //2. verifico che l'utente in questione sia abilitato alla compilazione della form
  41. //if ($remote_user == '<INSERIRE>')
  42. //	$error[] = "Errore nell'autenticazione. L'utente $remote_user non 
  43. //	dispone dell'autorizzazione per visualizzare questa pagina";
  44.  
  45.  
  46. ?>
  47. <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd">
  48. <html>
  49. <head>
  50. <meta http-equiv="Content-Type" content="text/html; charset=windows-1252">
  51. <STYLE type="text/css">
  52. A:link { text-decoration: none; color: #0000FF},
  53. A:visited { text-decoration: none; color: #0000FF}
  54. A:hover { text-decoration: none; color: #0000FF}
  55. div#qTip {
  56.  padding: 3px;
  57.  border: 1px solid #666;
  58.  border-right-width: 2px;
  59.  border-bottom-width: 2px;
  60.  display: none;
  61.  background: #999;
  62.  color: #FFF;
  63.  font: bold 9px Verdana, Arial, sans-serif;
  64.  text-align: left;
  65.  position: absolute;
  66.  z-index: 1000;
  67. }
  68. </style>
  69. <title>AIEOP-Banca Dati Centri</title>
  70. <script language="JavaScript1.2" src="/js/fmweb.js"></script>
  71. <script language="javascript1.2" src="/js/show_values.js"></script>
  72. <script language="javascript1.2" src="/js/bdcentri.js"></script>
  73. <script language="JavaScript" src="/js/qTip.js" type="text/JavaScript"></script>
  74. <SCRIPT LANGUAGE="JavaScript">
  75. <!-- Begin
  76. var ImgHome = new Image();
  77. var ImgCentri = new Image();
  78. var ImgMedici = new Image();
  79. var ImgBambini = new Image();
  80. var ImgBiblioteca = new Image();
  81. var ImgWeb = new Image();
  82.  
  83.  
  84. ImgHome.src = "/images/tasti-rollover-11401_08-sop.jpg";
  85. ImgCentri.src = "/images/bbcentrigiu.jpg";
  86. ImgMedici.src = "/images/bbmedicigiu.jpg";
  87. ImgBambini.src = "/images/bbbambinigiu.jpg";
  88. ImgBiblioteca.src = "/images/bbbiblotecagiu.jpg";
  89. ImgWeb.src = "/images/bbwebgiu.jpg";
  90.  
  91. function doButtons(imgName,picimage) {
  92.  
  93. document['centri'].src=picimage;
  94.  
  95. }
  96.  
  97. //  End -->
  98. </script>
  99. <!-- parte js nuova -->
  100. <title>Associazione Italiana Ematologia Oncologia Pediatrica</title>
  101.  
  102. 	<META http-equiv="content-type" content="text/html; charset=iso-8859-1">
  103. 	<META http-equiv="Content-Script-Type" content="text/javascript">
  104. 	<META http-equiv="Content-Style-Type" content="text/css">
  105.  
  106.  
  107. 	<SCRIPT LANGUAGE="JavaScript" TYPE="text/javascript">
  108. 		function checkbrowse(){
  109. 		 browsename = navigator.appName.charAt(0);
  110. 		 ver = window.navigator.appVersion.charAt(0);
  111. 		 if (browsename == "N"){
  112. 		  if (ver >= 5){
  113. 		  document.write("<LINK HREF='/stili/body_area_ns.css' REL='STYLESHEET' TYPE='text/css' CHARSET='iso-8859-1'>");
  114.  		  }
  115. 		  else {
  116. 		  document.write("<LINK HREF='/stili/body_area_ns4.css' REL='STYLESHEET' TYPE='text/css' 'CHARSET=iso-8859-1'>");
  117.  		  }
  118. 		 }
  119. 		 else {
  120. 		 document.write("<LINK HREF='/stili/body_area_ie.css' REL='STYLESHEET' TYPE='text/css' CHARSET='iso-8859-1'>");
  121. 		 }
  122.  
  123. 		}
  124. 		javascript:checkbrowse();
  125. 	</SCRIPT>
  126. 	<LINK rel="stylesheet" href="/stili/print.css" type="text/css" media="print"> 
  127.  
  128.  
  129.  
  130. 	<script language="JavaScript" TYPE="text/javascript" src="/script/rollover.js"></script>
  131. <!--  fine parte js nuova-->
  132.  
  133. </head>
  134. <body background="">
  135. <!-- prima tabella -->
  136.  
  137. <div id="testata">
  138. <table border="0" width="100%" height="75" cellpadding="0" cellspacing="0">
  139. <tr><td>
  140. <a href="/index.htm"><img src="/immagini/marchio_aieop1.jpg" width="347" height="75" border="0" alt="A.I.E.O.P. Associazione Italiana Ematologia Oncologia Pediatrica"></a></td>
  141. <td width="60%" background="/immagini/zona_rigata1.jpg">&nbsp;</td><td valign="top">
  142. <img src="/immagini/foto_bambini1.jpg" border="0" width="402" height="75"></td></tr></table>
  143. <!--FINE TESTATA-->
  144. </div>
  145. <!-- fine prima tabella -->
  146.  
  147. <!-- inizio parte nuova-->
  148.  
  149. <div id="menuC">
  150.  
  151. <table width="100%" border="0" cellspacing="0" cellpadding="0" class="bordoblu"><tr><td>
  152. <TABLE border="0" cellspacing="0" cellpadding="0">
  153. <tr><td><img src="/immagini/menu_c_laterale_sin1.gif" width="17" height="24"></td>
  154.  
  155. <TD>
  156. <A accesskey="1" HREF="mailto:">
  157. <IMG SRC="/stdoc/mail1.gif" ALT="Mail" NAME="MENU_C_liv1_mail" BORDER="0"></A><br />
  158. </TD>
  159. <TD></TD>
  160. <TD>
  161. <A accesskey="2" HREF="/area1/glossario.htm">
  162. <IMG SRC="/stdoc/glossario1.gif" ALT="Glossario" NAME="MENU_C_liv1_glossario" BORDER="0"></A>				
  163. </TD>
  164. <TD></TD>
  165. <TD>
  166. <A accesskey="3" HREF="/mappa/mappa.htm">
  167. <IMG SRC="/stdoc/mappa.gif" ALT="Mappa del sito" NAME="MENU_C_liv1_mappa" BORDER="0"></A><br />
  168.  
  169. </TD>
  170. <TD></TD>
  171. <TD>
  172. <A accesskey="4" HREF="/area1/sponsor.htm">
  173. <IMG SRC="/stdoc/spons2.gif" ALT="Sponsor" NAME="MENU_C_liv1_sponsor" BORDER="0"></A>				
  174. </TD>
  175. <TD></TD>
  176. </TABLE></td>
  177. <TD class="menuCsfondoblu" width="100%">&nbsp;</TD>
  178. <td>
  179.  
  180.  
  181. <TABLE border="0" cellspacing="0" cellpadding="0" width="50%"><tr>
  182. 	<TD><img src="/immagini/cerca3.gif" width="69" height="24" border="0"></TD>
  183. 	<TD background="/immagini/bianco.gif" width="151" height="24"><input name="KEYWORDS" type="text" class="input" maxlength="150" value=""></TD>
  184.  
  185. 	<TD><img src="/immagini/ok1.gif" width="67" height="24" border="0" alt="cerca" ></TD>
  186. 	<TD><img src="/immagini/agenda1.gif" width="122" height="24" border="0" usemap="#Map"><br />
  187. 	</TD>
  188. 	</tr>
  189. </TABLE>
  190.  
  191.  
  192. </td>
  193. </tr>
  194. <map name="Map">
  195.  <area shape="rect" coords="77,4,119,21" href="/area2/initiative_agenda.htm">
  196. </map>
  197.  
  198. </table>
  199. </div>
  200. <!-- fine parte nuova-->
  201. <div>
  202. <table border="2" class="bordoblu" height="15%" width="100%">
  203. <tr>
  204. <td width="80%">
  205.  
  206.  
  207. <div align=" left">
  208.   <table border="0" cellspacing="0" width="100%" cellpadding="0" height="358px" align="left">
  209.    <tr>
  210.       <td width="751px" valign="top" align="left" height="15" colspan="3">
  211.         <div align="left">
  212.           <table border="0" cellpadding="0" cellspacing="0" width="794px">
  213.             <tr>
  214.               <td width="61%" nowrap>
  215.                 <p style="margin-left: 10"><b><font face="Arial" size="3">Anagrafica Centri AIEOP</font></b></p>
  216. 	</td>
  217.             </tr>
  218.             <tr>
  219.       <td width="100%" valign="top" height="27" colspan="3">
  220.         <p style="margin-left: 6"><img border="0" src="/images/redbar.jpg" width="720" height="5" align="left">
  221.         </p>
  222.       </td>
  223.     </tr>
  224.         </table>
  225.       </div>
  226. <?php 
  227. //se nell'intestazione si sono verificati errori, mostrali e poi ferma tutto
  228. if ($error){
  229. 	echo "<p align='center'><ul>";
  230. 	foreach ($error as $err){
  231. 		echo "<li>".$err."</li>";
  232. 	}
  233. 	echo "</ul>
  234. 	<a href=\"javascript:history.back()\"><b>Torna indietro</b></a></p>";
  235. 	die();
  236. }
  237.  
  238. //se ho inviato la form, e quindi ho tutti i dati belli pronti dentro POST, procedo!
  239. if ($_POST && $_POST['submit'] == 'Invia'){
  240. 	//print_r($_POST);
  241.  
  242. 	//elimino dal POST la variabile 'submit' => 'Invia'
  243. 	unset($_POST['submit']);
  244.  
  245. 	//invio al DB i dati
  246. 	$query=new query($conn);
  247. 	$query->insert($_POST,'CENTRI_ANA_NEW');
  248. 	$conn->commit();
  249.  
  250. }
  251.  
  252. //se invece POST non �¨ completato o se per qualche strano motivo lo �¨, ma non �¨ stato
  253. //creato cliccando sul Submit "Invia"... mostra la form!
  254. else{
  255. ?>
  256.  
  257. <form name="FORM_INSERT_CENTRI" method="post" action="<?= $_SERVER['REQUEST_URI']; ?>" 
  258. <?php if ($debug) echo 'onSubmit="show_values();return false'; ?>
  259. >
  260.  
  261. <table width="90%"  border="2" bordercolor="gray">
  262. <tr>
  263.           <td colspan="2" width="675px">
  264.           	<p style="margin-left: 6"><B><FONT face="Verdana" size="3"><br />
  265.           	Dati del Centro:</FONT></B></p>
  266.           </td>
  267. </tr>
  268. <tr>
  269. 	<td class="label">Codice Centro <font color="red">*</font> </td>
  270. 	<td class="field">
  271. 	<input size="5" type="text" name="CODICE_CENTRO" maxlength="4" value="" 
  272. 	onFocus="//valore=this.value" onBlur="//if (TYPE.value =='UPDATE'){ this.value=valore}" />
  273. 	</td>
  274. </tr>
  275. <tr>
  276. 	<td class="label">Regione <font color="red">*</font> </td>
  277. 	<td class="field">
  278. 	<select name="REGIONE">
  279. 	<option value=""></option>
  280. <?php 
  281. 	 $sql = "SELECT * FROM REGIONI ORDER BY NOME ASC";
  282.  
  283. $query->set_sql ( $sql );
  284. $query->exec ();
  285.  
  286. while($query->get_row ()){
  287. 	echo "<option value='".$query->row['ID']."'>".$query->row['NOME']."</option>";
  288. }
  289. ?>
  290. 	</select>
  291. 	</td>
  292. </tr>
  293. <tr>
  294. 	<td class="label">H &amp; S <font color="red">*</font> </td>
  295. 	<td class="field">
  296. 	<select name="HES" size="1">
  297.           <option value=""></option>
  298.           <option value="9">Non noto</option>
  299.           <option value="n">No</option>
  300.           <option value="s">S&igrave;</option>
  301.           <option value="1">CSPRRe</option>
  302.           <option value="2">CSPRRe  Thalass.</option>
  303.           <option value="3">COPRRe</option> 
  304.     </select>
  305. 	</td>
  306. </tr>
  307. <tr>
  308. 	<td class="label">Centro <font color="red">*</font> </td>
  309. 	<td class="field">
  310. 	<input size="50" type="text" name="NOME_CENTRO" maxlength="200" value="" />
  311. 	</td>
  312. </tr>
  313. <tr>
  314. 	<td class="label">Indirizzo <font color="red">*</font> </td>
  315. 	<td class="field">
  316. 	<input size="40" type="text" name="INDIRIZZO" maxlength="45" value="" />
  317. 	</td>
  318. </tr>
  319. <tr>
  320. 	<td class="label">C.A.P. </td>
  321. 	<td class="field">
  322. 	<input type="text" size="6" name="CAP" value="" maxlength="6" />
  323. 	</td>
  324. </tr>
  325. <tr>
  326. 	<td class="label">Citt&agrave; </td>
  327. 	<td class="field">
  328. 	<input type="text" size="30" name="CITTA" value="" maxlength="30" />
  329. 	</td>
  330. </tr>
  331. <tr>
  332. 	<td class="label">Provincia </td>
  333. 	<td class="field">
  334. 	<input type="text" size="2" name="PROVINCIA" value="" maxlength="2" />
  335. 	</td>
  336. </tr>
  337. <tr>
  338. 	<td class="label">Telefono </td>
  339. 	<td class="field">
  340. 	<input type="text" size="12" name="TEL" value="" maxlength="40" />
  341. 	</td>
  342. </tr>
  343. <tr>
  344. 	<td class="label">Fax </td>
  345. 	<td class="field">
  346. 	<input type="text" size="12" name="FAX" value="" maxlength="40" />
  347. 	</td>
  348. </tr>
  349. <tr>
  350. 	<td class="label">Email </td>
  351. 	<td class="field">
  352. 	<input type="text" size="40" name="EMAIL" value="" maxlength="100" />
  353. 	</td>
  354. </tr>
  355. <tr>
  356. <td colspan="2" width="675px">
  357.           	<p style="margin-left: 6"><B><FONT face="Verdana" size="3"><br />
  358.           	Responsabile:</FONT></B>
  359.           	</p>
  360. </td>
  361. </tr>
  362. <tr>
  363. 	<td class="label">Titolo <font color="red">*</font> </td>
  364. 	<td class="field">
  365. 	<select name="TITOLO_RESP">
  366.           <option value=""></option>
  367.           <option value="1">Dott.   </option>
  368.           <option value="2">Dott.ssa</option>
  369.           <option value="3">Prof.   </option>
  370.           <option value="4">Prof.ssa</option>
  371.           </select>
  372. 	</td>
  373. </tr>
  374. <tr>
  375. 	<td class="label">Cognome <font color="red">*</font> </td>
  376. 	<td class="field">
  377. 	<input size="40" type="text" name="COGNOME_RESP" maxlength="60" value="" />
  378. 	</td>
  379. </tr>
  380. <tr>
  381. 	<td class="label">Nome <font color="red">*</font> </td>
  382. 	<td class="field">
  383. 	<input size="40" type="text" name="NOME_RESP" maxlength="60" value="" />
  384. 	</td>
  385. </tr>
  386. <tr>
  387. 	<td class="label">Tipo di centro </td>
  388. 	<td class="field">
  389. 	<select name="AIEOP">
  390. 			<option value="0"></option>
  391. 			<option value="1">AIEOP</option>
  392. 			<option value="2">IMMUNODEFICIENZE</option>
  393. 			<option value="3">AIEOP+IMMUNODEFICIENZE</option>
  394. 	</select>
  395. 	</td>
  396. </tr>
  397.  
  398. <!-- Inizio SETTORE INTERESSE -->
  399.  
  400. <tr>
  401. <td colspan="2" width="675px">
  402.           	<p style="margin-left: 6"><B><FONT face="Verdana" size="3"><br />
  403.           	Settore di interesse:</FONT></B>
  404.           	</p>
  405. </td>
  406. </tr>
  407. <tr>
  408. 	<td class="label">Ematologia non oncologica </td>
  409. 	<td class="field">
  410. 	<select name="EMAT_NONONCO">
  411. 		<option value=""></option>
  412.                 <option value="n"> No</option>
  413.                 <option value="s"> S&igrave; </option>
  414.     </select>
  415. 	</td>
  416. </tr>
  417. <tr>
  418. 	<td class="label">Oncologia </td>
  419. 	<td class="field">
  420. 	<select name="ONCO">
  421. 		<option value=""></option>
  422.                 <option value="n"> No</option>
  423.                 <option value="s"> S&igrave; </option>
  424.     </select>
  425. 	</td>
  426. </tr>
  427. <tr>
  428. 	<td class="label">Ematologia oncologica </td>
  429. 	<td class="field">
  430. 	<select name="EMATONCO">
  431. 		<option value=""></option>
  432.                 <option value="n"> No</option>
  433.                 <option value="s"> S&igrave; </option>
  434.     </select>
  435. 	</td>
  436. </tr>
  437. <tr>
  438. 	<td class="label">Trapianto di Cellule Staminali Emopoietiche (TCSE) </td>
  439. 	<td class="field">
  440. 	<select name="TCSE">
  441. 		<option value=""></option>
  442.                 <option value="n"> No</option>
  443.                 <option value="s"> S�¯�¿�½ </option>
  444.                 <option value="sa"> S�¯�¿�½ auto</option>
  445.                 <option value="sal"> S�¯�¿�½ allo</option> 
  446. 		<option value="saal"> S�¯�¿�½ auto/allo</option>
  447. 		</select>
  448. 	</td>
  449. </tr>
  450. <tr>
  451. 	<td class="label">Immunologia </td>
  452. 	<td class="field">
  453. 	<select name="IMMUNO">
  454. 		<option value=""></option>
  455.                 <option value="n"> No</option>
  456.                 <option value="s"> S&igrave; </option>
  457.     </select>
  458. 	</td>
  459. </tr>
  460. <tr>
  461. 	<td class="label">Altro <i>(specificare)</i> </td>
  462. 	<td class="field">
  463. 	<select name="SETT_ALTRO">
  464. 		<option value=""></option>
  465.                 <option value="n"> No</option>
  466.                 <option value="s"> S&igrave; </option>
  467.     </select>
  468.    <input type="text" size="50" name="SETT_ALTRO_S" value="" maxlength="50" /> 
  469. 	</td>
  470. </tr>
  471.  
  472.  
  473. <!-- Fine SETTORE INTERESSE -->
  474.  
  475. <!-- Inizio SERVIZI -->
  476.  
  477. <tr>
  478. <td colspan="2" width="675px">
  479.           	<p style="margin-left: 6"><B><FONT face="Verdana" size="3"><br />
  480.           	Servizi:</FONT></B>
  481.           	</p>
  482. </td>
  483. </tr>
  484.  
  485.  <!-- Chirurgia -->
  486. <tr>
  487. 	<td colspan="2" class="label2" >1. Chirurgia (<a href="#" onclick="javascript:return false;">?</a>)</td>
  488. </tr>
  489. <tr>
  490. 	<td class="label">Generale </td>
  491. 	<td class="field">
  492. 	<select name="CHIR_GENERALE">
  493. 		<option value=""></option>
  494.                 <option value="0"> No</option>
  495.                 <option value="1"> S&igrave; nella Struttura </option>
  496.                 <option value="2"> S&igrave; nell' Azienda </option>
  497.                 <option value="3"> S&igrave;, altre strutture </option>
  498.     </select>
  499. 	</td>
  500. </tr>
  501. <tr>
  502. 	<td class="label">Generale con competenze pediatriche </td>
  503. 	<td class="field">
  504. 	<select name="CHIR_GENERALE_PEDIATR">
  505. 		<option value=""></option>
  506.                 <option value="0"> No</option>
  507.                 <option value="1"> S&igrave; nella Struttura </option>
  508.                 <option value="2"> S&igrave; nell' Azienda </option>
  509.                 <option value="3"> S&igrave;, altre strutture </option>
  510.     </select>
  511. 	</td>
  512. </tr>
  513. <tr>
  514. 	<td class="label">Pediatrica </td>
  515. 	<td class="field">
  516. 	<select name="CHIR_PEDIATR">
  517. 		<option value=""></option>
  518.                 <option value="0"> No</option>
  519.                 <option value="1"> S&igrave; nella Struttura </option>
  520.                 <option value="2"> S&igrave; nell' Azienda </option>
  521.                 <option value="3"> S&igrave;, altre strutture </option>
  522.     </select>
  523. 	</td>
  524. </tr>
  525. <tr>
  526. 	<td class="label">Pediatrica ad indirizzo oncologico </td>
  527. 	<td class="field">
  528. 	<select name="CHIR_PEDIATR_ONCO">
  529. 		<option value=""></option>
  530.                 <option value="0"> No</option>
  531.                 <option value="1"> S&igrave; nella Struttura </option>
  532.                 <option value="2"> S&igrave; nell' Azienda </option>
  533.                 <option value="3"> S&igrave;, altre strutture </option>
  534.     </select>
  535. 	</td>
  536. </tr>
  537. <tr>
  538. 	<td class="label">Trapianto d'organo </td>
  539. 	<td class="field">
  540. 	<select name="CHIR_TRAPIANTO">
  541. 		<option value=""></option>
  542.                 <option value="0"> No</option>
  543.                 <option value="1"> S&igrave; nella Struttura </option>
  544.                 <option value="2"> S&igrave; nell' Azienda </option>
  545.                 <option value="3"> S&igrave;, altre strutture </option>
  546.     </select>
  547. 	</td>
  548. </tr>
  549.  
  550. <!-- /Chirurgia -->
  551.  
  552. <!-- Neurochirurgia -->
  553. <tr>
  554. 	<td colspan="2" class="label2" >2. Neurochirurgia (<a href="#" onclick="javascript:return false;">?</a>)</td>
  555. </tr>
  556. <tr>
  557. 	<td class="label">Neurochirurgia </td>
  558. 	<td class="field">
  559. 	<select name="NEUROCHIR_NEUROCHIR">
  560. 		<option value=""></option>
  561.                 <option value="0"> No</option>
  562.                 <option value="1"> S&igrave; nella Struttura </option>
  563.                 <option value="2"> S&igrave; nell' Azienda </option>
  564.                 <option value="3"> S&igrave;, altre strutture </option>
  565.     </select>
  566. 	</td>
  567. </tr>
  568. <tr>
  569. 	<td class="label">Neurochirurgia ad indirizzo pediatrico </td>
  570. 	<td class="field">
  571. 	<select name="NEUROCHIR_PEDIATR">
  572. 		<option value=""></option>
  573.                 <option value="0"> No</option>
  574.                 <option value="1"> S&igrave; nella Struttura </option>
  575.                 <option value="2"> S&igrave; nell' Azienda </option>
  576.                 <option value="3"> S&igrave;, altre strutture </option>
  577.     </select>
  578. 	</td>
  579. </tr>
  580.  
  581. <!-- /Neurochirurgia -->
  582.  
  583. <!-- Terapia intensiva -->
  584. <tr>
  585. 	<td colspan="2" class="label2" >3. Terapia intensiva e Rianimazione (<a href="#" onclick="javascript:return false;">?</a>)</td>
  586. </tr>
  587.  
  588. <tr>
  589. 	<td class="label">Non pediatrica </td>
  590. 	<td class="field">
  591. 	<select name="TERINT_NOPEDIATR">
  592. 		<option value=""></option>
  593.                 <option value="0"> No</option>
  594.                 <option value="1"> S&igrave; nella Struttura </option>
  595.                 <option value="2"> S&igrave; nell' Azienda </option>
  596.                 <option value="3"> S&igrave;, altre strutture </option>
  597.     </select>
  598. 	</td>
  599. </tr>
  600. <tr>
  601. 	<td class="label">Non pediatrica con competenze pediatriche</td>
  602. 	<td class="field">
  603. 	<select name="TERINT_NOPEDIATR_PEDIATR">
  604. 		<option value=""></option>
  605.                 <option value="0"> No</option>
  606.                 <option value="1"> S&igrave; nella Struttura </option>
  607.                 <option value="2"> S&igrave; nell' Azienda </option>
  608.                 <option value="3"> S&igrave;, altre strutture </option>
  609.     </select>
  610. 	</td>
  611. </tr>
  612. <tr>
  613. 	<td class="label">Pediatrica </td>
  614. 	<td class="field">
  615. 	<select name="TERINT_PEDIATR">
  616. 		<option value=""></option>
  617.                 <option value="0"> No</option>
  618.                 <option value="1"> S&igrave; nella Struttura </option>
  619.                 <option value="2"> S&igrave; nell' Azienda </option>
  620.                 <option value="3"> S&igrave;, altre strutture </option>
  621.     </select>
  622. 	</td>
  623. </tr>
  624.  
  625. <!-- /Terapia intensiva -->
  626.  
  627. <!-- Terapia dolore -->
  628. <tr>
  629. 	<td colspan="2" class="label2" >4. Terapia del dolore (<a href="#" onclick="javascript:return false;">?</a>)</td>
  630. </tr>
  631.  
  632. <tr>
  633. 	<td class="label">Con personale finalizzato a questo settore </td>
  634. 	<td class="field">
  635. 	<select name="TERDOL_CONPERSON">
  636. 		<option value=""></option>
  637.                 <option value="0"> No</option>
  638.                 <option value="1"> S&igrave; nella Struttura </option>
  639.                 <option value="2"> S&igrave; nell' Azienda </option>
  640.                 <option value="3"> S&igrave;, altre strutture </option>
  641.     </select>
  642. 	</td>
  643. </tr>
  644. <tr>
  645. 	<td class="label">Senza personale finalizzato a questo settore </td>
  646. 	<td class="field">
  647. 	<select name="TERDOL_SENZAPERSON">
  648. 		<option value=""></option>
  649.                 <option value="0"> No</option>
  650.                 <option value="1"> S&igrave; nella Struttura </option>
  651.                 <option value="2"> S&igrave; nell' Azienda </option>
  652.                 <option value="3"> S&igrave;, altre strutture </option>
  653.     </select>
  654. 	</td>
  655. </tr>
  656.  
  657. <!-- /Terapia dolore -->
  658.  
  659. <!-- Diagnostica immagini -->
  660. <tr>
  661. 	<td colspan="2" class="label2" >5. Diagnostica per immagini (<a href="#" onclick="javascript:return false;">?</a>)</td>
  662. </tr>
  663.  
  664. <tr>
  665. 	<td class="label">Radiologia tradizionale </td>
  666. 	<td class="field">
  667. 	<select name="DIAIMM_RADTRAD">
  668. 		<option value=""></option>
  669.                 <option value="0"> No</option>
  670.                 <option value="1"> S&igrave; nella Struttura </option>
  671.                 <option value="2"> S&igrave; nell' Azienda </option>
  672.                 <option value="3"> S&igrave;, altre strutture </option>
  673.     </select>
  674. 	</td>
  675. </tr>
  676. <tr>
  677. 	<td class="label">Radiologia ad indirizzo pediatrico </td>
  678. 	<td class="field">
  679. 	<select name="DIAIMM_RADPEDIATR">
  680. 		<option value=""></option>
  681.                 <option value="0"> No</option>
  682.                 <option value="1"> S&igrave; nella Struttura </option>
  683.                 <option value="2"> S&igrave; nell' Azienda </option>
  684.                 <option value="3"> S&igrave;, altre strutture </option>
  685.     </select>
  686. 	</td>
  687. </tr>
  688. <tr>
  689. 	<td class="label">ECO </td>
  690. 	<td class="field">
  691. 	<select name="DIAIMM_ECO">
  692. 		<option value=""></option>
  693.                 <option value="0"> No</option>
  694.                 <option value="1"> S&igrave; nella Struttura </option>
  695.                 <option value="2"> S&igrave; nell' Azienda </option>
  696.                 <option value="3"> S&igrave;, altre strutture </option>
  697.     </select>
  698. 	</td>
  699. </tr>
  700. <tr>
  701. 	<td class="label">TAC </td>
  702. 	<td class="field">
  703. 	<select name="DIAIMM_TAC">
  704. 		<option value=""></option>
  705.                 <option value="0"> No</option>
  706.                 <option value="1"> S&igrave; nella Struttura </option>
  707.                 <option value="2"> S&igrave; nell' Azienda </option>
  708.                 <option value="3"> S&igrave;, altre strutture </option>
  709.     </select>
  710. 	</td>
  711. </tr>
  712. <tr>
  713. 	<td class="label">RMN </td>
  714. 	<td class="field">
  715. 	<select name="DIAIMM_RMN">
  716. 		<option value=""></option>
  717.                 <option value="0"> No</option>
  718.                 <option value="1"> S&igrave; nella Struttura </option>
  719.                 <option value="2"> S&igrave; nell' Azienda </option>
  720.                 <option value="3"> S&igrave;, altre strutture </option>
  721.     </select>
  722. 	</td>
  723. </tr>
  724.  
  725. <!-- /Diagnostica immagini -->
  726.  
  727. <!-- Lab Micro -->
  728. <tr>
  729. 	<td colspan="2" class="label2" >6. Laboratorio Microbiologico (<a href="#" onclick="javascript:return false;">?</a>)</td>
  730. </tr>
  731.  
  732. <tr>
  733. 	<td class="label">Batteriologia </td>
  734. 	<td class="field">
  735. 	<select name="LABMICRO_BATTER">
  736. 		<option value=""></option>
  737.                 <option value="0"> No</option>
  738.                 <option value="1"> S&igrave; nella Struttura </option>
  739.                 <option value="2"> S&igrave; nell' Azienda </option>
  740.                 <option value="3"> S&igrave;, altre strutture </option>
  741.     </select>
  742. 	</td>
  743. </tr>
  744. <tr>
  745. 	<td class="label">Virologia </td>
  746. 	<td class="field">
  747. 	<select name="LABMICRO_VIRO">
  748. 		<option value=""></option>
  749.                 <option value="0"> No</option>
  750.                 <option value="1"> S&igrave; nella Struttura </option>
  751.                 <option value="2"> S&igrave; nell' Azienda </option>
  752.                 <option value="3"> S&igrave;, altre strutture </option>
  753.     </select>
  754. 	</td>
  755. </tr>
  756. <tr>
  757. 	<td class="label">Micologia </td>
  758. 	<td class="field">
  759. 	<select name="LABMICRO_MICOL">
  760. 		<option value=""></option>
  761.                 <option value="0"> No</option>
  762.                 <option value="1"> S&igrave; nella Struttura </option>
  763.                 <option value="2"> S&igrave; nell' Azienda </option>
  764.                 <option value="3"> S&igrave;, altre strutture </option>
  765.     </select>
  766. 	</td>
  767. </tr>
  768. <tr>
  769. 	<td class="label">Parassitologia </td>
  770. 	<td class="field">
  771. 	<select name="LABMICRO_PARASS">
  772. 		<option value=""></option>
  773.                 <option value="0"> No</option>
  774.                 <option value="1"> S&igrave; nella Struttura </option>
  775.                 <option value="2"> S&igrave; nell' Azienda </option>
  776.                 <option value="3"> S&igrave;, altre strutture </option>
  777.     </select>
  778. 	</td>
  779. </tr>
  780.  
  781. <!-- /Lab Micro -->
  782.  
  783. <!-- Farmacia -->
  784.  
  785. <tr>
  786. 	<td colspan="2" class="label2" >7. Farmacia (<a href="#" onclick="javascript:return false;">?</a>)</td>
  787. </tr>
  788. <tr>
  789. 	<td class="label">Preparazione centralizzata antiblastici </td>
  790. 	<td class="field">
  791. 	<select name="FARMA_ANTIBLAST">
  792. 		<option value=""></option>
  793.                 <option value="0"> No</option>
  794.                 <option value="1"> S&igrave; nella Struttura </option>
  795.                 <option value="2"> S&igrave; nell' Azienda </option>
  796.                 <option value="3"> S&igrave;, altre strutture </option>
  797.     </select>
  798. 	</td>
  799. </tr>
  800. <tr>
  801. 	<td class="label">Preparazione centralizzata antibiotici </td>
  802. 	<td class="field">
  803. 	<select name="FARMA_ANTIBIOT">
  804. 		<option value=""></option>
  805.                 <option value="0"> No</option>
  806.                 <option value="1"> S&igrave; nella Struttura </option>
  807.                 <option value="2"> S&igrave; nell' Azienda </option>
  808.                 <option value="3"> S&igrave;, altre strutture </option>
  809.     </select>
  810. 	</td>
  811. </tr>
  812. <tr>
  813. 	<td class="label">Preparazione centralizzata soluzioni nutrizionali parentali </td>
  814. 	<td class="field">
  815. 	<select name="FARMA_SOLNUTPAR">
  816. 		<option value=""></option>
  817.                 <option value="0"> No</option>
  818.                 <option value="1"> S&igrave; nella Struttura </option>
  819.                 <option value="2"> S&igrave; nell' Azienda </option>
  820.                 <option value="3"> S&igrave;, altre strutture </option>
  821.     </select>
  822. 	</td>
  823. </tr>
  824. <tr>
  825. 	<td class="label">Preparazione centralizzata altro <i>(specificare)</i> </td>
  826. 	<td class="field">
  827. 	<select name="FARMA_PREPALTRO">
  828. 		<option value=""></option>
  829.                 <option value="0"> No</option>
  830.                 <option value="1"> S&igrave; nella Struttura </option>
  831.                 <option value="2"> S&igrave; nell' Azienda </option>
  832.                 <option value="3"> S&igrave;, altre strutture </option>
  833.     </select>
  834.    <input type="text" size="50" name="FARMA_PREPALTRO_S" value="" maxlength="50" />
  835. 	</td>
  836. </tr>
  837.  
  838.  
  839. <!-- /Farmacia -->
  840.  
  841. <!-- Centro Trasfusionale -->
  842.  
  843. <tr>
  844. 	<td colspan="2" class="label2" >8. Centro trasfusionale (<a href="#" onclick="javascript:return false;">?</a>)</td>
  845. </tr>
  846. <tr>
  847. 	<td class="label">Guardia <b>24</b>/24h e 7/7g </td>
  848. 	<td class="field">
  849. 	<select name="TRASF_GUARDIA_COMPLETA">
  850. 		<option value=""></option>
  851.                 <option value="0"> No</option>
  852.                 <option value="1"> S&igrave; nella Struttura </option>
  853.                 <option value="2"> S&igrave; nell' Azienda </option>
  854.                 <option value="3"> S&igrave;, altre strutture </option>
  855.     </select>
  856. 	</td>
  857. </tr>
  858. <tr>
  859. 	<td class="label">Guardia <b>12</b>/24h e 7/7g </td>
  860. 	<td class="field">
  861. 	<select name="TRASF_GUARDIA_MEZZA">
  862. 		<option value=""></option>
  863.                 <option value="0"> No</option>
  864.                 <option value="1"> S&igrave; nella Struttura </option>
  865.                 <option value="2"> S&igrave; nell' Azienda </option>
  866.                 <option value="3"> S&igrave;, altre strutture </option>
  867.     </select>
  868. 	</td>
  869. </tr>
  870. <tr>
  871. 	<td class="label">Altro <i>(specificare)</i> </td>
  872. 	<td class="field">
  873. 	<select name="TRASF_ALTRO">
  874. 		<option value=""></option>
  875.                 <option value="0"> No</option>
  876.                 <option value="1"> S&igrave; nella Struttura </option>
  877.                 <option value="2"> S&igrave; nell' Azienda </option>
  878.                 <option value="3"> S&igrave;, altre strutture </option>
  879.     </select>
  880.     <input type="text" size="50" name="TRASF_ALTRO_S" value="" maxlength="50" />
  881. 	</td>
  882. </tr>
  883.  
  884. <!-- /Centro Trasfusionale -->
  885.  
  886. <!-- Medicina nucleare -->
  887.  
  888. <tr>
  889. 	<td colspan="2" class="label2" >9. Medicina nucleare (<a href="#" onclick="javascript:return false;">?</a>)</td>
  890. </tr>
  891. <tr>
  892. 	<td class="label">Scintigrafia </td>
  893. 	<td class="field">
  894. 	<select name="NUCL_SCINT">
  895. 		<option value=""></option>
  896.                 <option value="0"> No</option>
  897.                 <option value="1"> S&igrave; nella Struttura </option>
  898.                 <option value="2"> S&igrave; nell' Azienda </option>
  899.                 <option value="3"> S&igrave;, altre strutture </option>
  900.     </select>
  901. 	</td>
  902. </tr>
  903. <tr>
  904. 	<td class="label">PET </td>
  905. 	<td class="field">
  906. 	<select name="NUCL_PET">
  907. 		<option value=""></option>
  908.                 <option value="0"> No</option>
  909.                 <option value="1"> S&igrave; nella Struttura </option>
  910.                 <option value="2"> S&igrave; nell' Azienda </option>
  911.                 <option value="3"> S&igrave;, altre strutture </option>
  912.     </select>
  913. 	</td>
  914. </tr>
  915. <tr>
  916. 	<td class="label">Terapeutica </td>
  917. 	<td class="field">
  918. 	<select name="NUCL_TERAP">
  919. 		<option value=""></option>
  920.                 <option value="0"> No</option>
  921.                 <option value="1"> S&igrave; nella Struttura </option>
  922.                 <option value="2"> S&igrave; nell' Azienda </option>
  923.                 <option value="3"> S&igrave;, altre strutture </option>
  924.     </select>
  925. 	</td>
  926. </tr>
  927.  
  928. <!-- /Medicina nucleare -->
  929.  
  930. <!-- Lab Biologia Cell -->
  931.  
  932. <tr>
  933. 	<td colspan="2" class="label2" >10. Laboratorio Biologia Cellulare e Molecolare (<a href="#" onclick="javascript:return false;">?</a>)</td>
  934. </tr>
  935. <tr>
  936. 	<td class="label">Citogenetica </td>
  937. 	<td class="field">
  938. 	<select name="LABBIO_CITOGEN">
  939. 		<option value=""></option>
  940.                 <option value="0"> No</option>
  941.                 <option value="1"> S&igrave; nella Struttura </option>
  942.                 <option value="2"> S&igrave; nell' Azienda </option>
  943.                 <option value="3"> S&igrave;, altre strutture </option>
  944.     </select>
  945. 	</td>
  946. </tr>
  947. <tr>
  948. 	<td class="label">Citofluorimetria </td>
  949. 	<td class="field">
  950. 	<select name="LABBIO_CITOFLUO">
  951. 		<option value=""></option>
  952.                 <option value="0"> No</option>
  953.                 <option value="1"> S&igrave; nella Struttura </option>
  954.                 <option value="2"> S&igrave; nell' Azienda </option>
  955.                 <option value="3"> S&igrave;, altre strutture </option>
  956.     </select>
  957. 	</td>
  958. </tr>
  959. <tr>
  960. 	<td class="label">Biologia molecolare </td>
  961. 	<td class="field">
  962. 	<select name="LABBIO_BIOMOL">
  963. 		<option value=""></option>
  964.                 <option value="0"> No</option>
  965.                 <option value="1"> S&igrave; nella Struttura </option>
  966.                 <option value="2"> S&igrave; nell' Azienda </option>
  967.                 <option value="3"> S&igrave;, altre strutture </option>
  968.     </select>
  969. 	</td>
  970. </tr>
  971. <tr>
  972. 	<td class="label">Colture cellulari </td>
  973. 	<td class="field">
  974. 	<select name="LABBIO_COLTCELL">
  975. 		<option value=""></option>
  976.                 <option value="0"> No</option>
  977.                 <option value="1"> S&igrave; nella Struttura </option>
  978.                 <option value="2"> S&igrave; nell' Azienda </option>
  979.                 <option value="3"> S&igrave;, altre strutture </option>
  980.     </select>
  981. 	</td>
  982. </tr>
  983.  
  984. <!-- /Lab Biologia Cell -->
  985.  
  986. <!-- Lab prestazioni diagnostica -->
  987.  
  988. <tr>
  989. 	<td colspan="2" class="label2" >11. Laboratorio per prestazioni di diagnostica e terapia specifica
  990. 	per le competenze dichiarate dal Centro (specificare nella sezione finale '<em>Descrizione del centro</em>' (<a href="#" onclick="javascript:return false;">?</a>)</td>
  991. </tr>
  992. <tr>
  993. 	<td class="label">Emato-oncologico </td>
  994. 	<td class="field">
  995. 	<select name="LABPREST_EMATONCO">
  996. 		<option value=""></option>
  997.                 <option value="0"> No</option>
  998.                 <option value="1"> S&igrave; nella Struttura </option>
  999.                 <option value="2"> S&igrave; nell' Azienda </option>
  1000.                 <option value="3"> S&igrave;, altre strutture </option>
  1001.     </select>
  1002. 	</td>
  1003. </tr>
  1004. <tr>
  1005. 	<td class="label">Oncologico </td>
  1006. 	<td class="field">
  1007. 	<select name="LABPREST_ONCO">
  1008. 		<option value=""></option>
  1009.                 <option value="0"> No</option>
  1010.                 <option value="1"> S&igrave; nella Struttura </option>
  1011.                 <option value="2"> S&igrave; nell' Azienda </option>
  1012.                 <option value="3"> S&igrave;, altre strutture </option>
  1013.     </select>
  1014. 	</td>
  1015. </tr>
  1016. <tr>
  1017. 	<td class="label">Ematologico </td>
  1018. 	<td class="field">
  1019. 	<select name="LABPREST_EMAT">
  1020. 		<option value=""></option>
  1021.                 <option value="0"> No</option>
  1022.                 <option value="1"> S&igrave; nella Struttura </option>
  1023.                 <option value="2"> S&igrave; nell' Azienda </option>
  1024.                 <option value="3"> S&igrave;, altre strutture </option>
  1025.     </select>
  1026. 	</td>
  1027. </tr>
  1028. <tr>
  1029. 	<td class="label">TCSE </td>
  1030. 	<td class="field">
  1031. 	<select name="LABPREST_TCSE">
  1032. 		<option value=""></option>
  1033.                 <option value="0"> No</option>
  1034.                 <option value="1"> S&igrave; nella Struttura </option>
  1035.                 <option value="2"> S&igrave; nell' Azienda </option>
  1036.                 <option value="3"> S&igrave;, altre strutture </option>
  1037.     </select>
  1038. 	</td>
  1039. </tr>
  1040. <tr>
  1041. 	<td class="label">Immunologia </td>
  1042. 	<td class="field">
  1043. 	<select name="LABPREST_IMMUNO">
  1044. 		<option value=""></option>
  1045.                 <option value="0"> No</option>
  1046.                 <option value="1"> S&igrave; nella Struttura </option>
  1047.                 <option value="2"> S&igrave; nell' Azienda </option>
  1048.                 <option value="3"> S&igrave;, altre strutture </option>
  1049.     </select>
  1050. 	</td>
  1051. </tr>
  1052. <tr>
  1053. 	<td class="label">Altro <i>(specificare)</i></td>
  1054. 	<td class="field">
  1055. 	<select name="LABPREST_ALTRO">
  1056. 		<option value=""></option>
  1057.                 <option value="0"> No</option>
  1058.                 <option value="1"> S&igrave; nella Struttura </option>
  1059.                 <option value="2"> S&igrave; nell' Azienda </option>
  1060.                 <option value="3"> S&igrave;, altre strutture </option>
  1061.     </select>
  1062.     <input type="text" size="50" name="LABPREST_ALTRO_S" value="" maxlength="50" /> 
  1063. 	</td>
  1064. </tr>
  1065.  
  1066. <!-- /Lab prestazioni diagnostica -->
  1067.  
  1068. <!-- Anatomia patologica -->
  1069.  
  1070. <tr>
  1071. 	<td colspan="2" class="label2" >12. Anatomia patologica (<a href="#" onclick="javascript:return false;">?</a>)</td>
  1072. </tr>
  1073. <tr>
  1074. 	<td class="label">Anatomia patologica con esperienza pediatrica </td>
  1075. 	<td class="field">
  1076. 	<select name="ANATPAT_PEDIAT">
  1077. 		<option value=""></option>
  1078.                 <option value="0"> No</option>
  1079.                 <option value="1"> S&igrave; nella Struttura </option>
  1080.                 <option value="2"> S&igrave; nell' Azienda </option>
  1081.                 <option value="3"> S&igrave;, altre strutture </option>
  1082.     </select>
  1083. 	</td>
  1084. </tr>
  1085.  
  1086. <!-- /Anatomia patologica -->
  1087.  
  1088. <!-- Radioterapia -->
  1089.  
  1090. <tr>
  1091. 	<td colspan="2" class="label2" >13. Radioterapia (<a href="#" onclick="javascript:return false;">?</a>)</td>
  1092. </tr>
  1093. <tr>
  1094. 	<td class="label">Non pediatrica </td>
  1095. 	<td class="field">
  1096. 	<select name="RADIOT_NOPEDIAT">
  1097. 		<option value=""></option>
  1098.                 <option value="0"> No</option>
  1099.                 <option value="1"> S&igrave; nella Struttura </option>
  1100.                 <option value="2"> S&igrave; nell' Azienda </option>
  1101.                 <option value="3"> S&igrave;, altre strutture </option>
  1102.     </select>
  1103. 	</td>
  1104. </tr>
  1105. <tr>
  1106. 	<td class="label">Con competenze specifiche pediatriche </td>
  1107. 	<td class="field">
  1108. 	<select name="RADIOT_COMPPEDIATR">
  1109. 		<option value=""></option>
  1110.                 <option value="0"> No</option>
  1111.                 <option value="1"> S&igrave; nella Struttura </option>
  1112.                 <option value="2"> S&igrave; nell' Azienda </option>
  1113.                 <option value="3"> S&igrave;, altre strutture </option>
  1114.     </select>
  1115. 	</td>
  1116. </tr>
  1117. <tr>
  1118. 	<td class="label">Pediatrica con possibilit&agrave; di sedazione </td>
  1119. 	<td class="field">
  1120. 	<select name="RADIOT_CONSEDAZPEDIAT">
  1121. 		<option value=""></option>
  1122.                 <option value="0"> No</option>
  1123.                 <option value="1"> S&igrave; nella Struttura </option>
  1124.                 <option value="2"> S&igrave; nell' Azienda </option>
  1125.                 <option value="3"> S&igrave;, altre strutture </option>
  1126.     </select>
  1127. 	</td>
  1128. </tr>
  1129. <tr>
  1130. 	<td class="label">Pediatrica senza possibilt&agrave; di sedazione </td>
  1131. 	<td class="field">
  1132. 	<select name="RADIOT_SENZASEDAZPEDIAT">
  1133. 		<option value=""></option>
  1134.                 <option value="0"> No</option>
  1135.                 <option value="1"> S&igrave; nella Struttura </option>
  1136.                 <option value="2"> S&igrave; nell' Azienda </option>
  1137.                 <option value="3"> S&igrave;, altre strutture </option>
  1138.     </select>
  1139. 	</td>
  1140. </tr>
  1141.  
  1142. <!-- /Radioterapia -->
  1143.  
  1144. <tr>
  1145.           <td colspan="2" width="675px">
  1146.           	<p style="margin-left: 6"><B><FONT face="Verdana" size="3"><br />
  1147.           	Ambulatorio Off Therapy:</FONT></B></p>
  1148.           </td>
  1149. </tr>
  1150.  
  1151. <tr>
  1152. <td colspan="2" class="minitable">
  1153. 	<table style="padding: 2px; text-align:center; " border="1" width="100%" bordercolor="black" >
  1154. 	<tr>
  1155. 	<td class="label">Disponibile nella struttura </td>
  1156. 	<td class="label">Funzionante 12 mesi/anno </td>
  1157. 	<td class="label">Personale dedicato </td>
  1158. 	<td class="label">Esistenza di <br /> limite d'et&agrave; per FUP </td>
  1159. 	</tr>
  1160. <?php 
  1161. 	$spazi = array("Con spazi disponibili" => "CON", "Senza spazi dedicati" => "SENZA");
  1162.  
  1163. 	$disponib = array("FUNZ12MESI", "PERSDED", "LIMITFUP");
  1164.  
  1165. 	foreach ($spazi as $desc => $short):	
  1166. 	?>
  1167. 	<tr>
  1168. 	<td class="label"><?=$desc;?> </td>
  1169. 	<?php 
  1170. 	foreach ($disponib as $disp):
  1171. 	?>
  1172. 	<td class="field">
  1173. 	<select name="AMB_OFFTHER_<?=$short;?>_<?=$disp;?>">
  1174. 		<option value=""></option>
  1175.                 <option value="0"> No</option>
  1176.                 <option value="1"> S&igrave; </option>
  1177.     </select> 
  1178. </td>
  1179. 	<?php endforeach; ?>
  1180. 	</tr>
  1181. 	<?php endforeach; ?>
  1182. </table>
  1183. 	</td>
  1184. </tr>
  1185. <tr>
  1186.           <td colspan="2" width="675px">
  1187.           	<p style="margin-left: 6"><B><FONT face="Verdana" size="3"><br />
  1188.           	Personale dedicato:</FONT></B></p>
  1189.           </td>
  1190. </tr>
  1191. <tr>
  1192. 	<td colspan="2" class="minitable">
  1193. 	<table style="padding: 2px; text-align:center; " border="1" width="100%" bordercolor="black" >
  1194. 	<tr>
  1195. 	<td>&nbsp;</td>
  1196. 	<td class="label" colspan="2">Strutturato (<a href="#" onclick="javascript:return false;" title="Se in convenzione 
  1197. 	con l'azienda<br /> considerarlo strutturato">?</a>) </td>
  1198. 	<td class="label" colspan="2">Contrattista </td>
  1199. 	<td class="label" colspan="2">Borsista </td>
  1200. 	</tr>
  1201. 	<tr>
  1202. 	<td>&nbsp;</td>
  1203. 	<td class="label">Full time </td>
  1204. 	<td class="label">Part time </td>
  1205.  
  1206. 	<td class="label">Full time </td>
  1207. 	<td class="label">Part time </td>
  1208.  
  1209. 	<td class="label">Full time </td>
  1210. 	<td class="label">Part time </td>
  1211. 	</tr>
  1212. 	<?php 
  1213. 	$ruoli = array("Medici" => "MED", "Biologi" => "BIOLOGI","Psicologi" => "PSI",
  1214. 				 "Infermieri professionali" => "INPR", "Infermieri di ricerca" => "INRI",
  1215. 					"Tecnici" => "TEC", "Assistenti socio-sanitari" => "ASS",
  1216. 				 "Mediatori culturali" => "MECU", "Fisioterapisti" => "FIS",
  1217. 					"Amministrativi" => "AMM", "Data manager" => "DM");
  1218.  
  1219. 	$orario = array("FULL", "PART");
  1220.  
  1221. 	$tipo = array("STRU", "CONT", "BORS");
  1222.  
  1223. 	foreach ($ruoli as $desc => $short):	
  1224. 	?>
  1225. 	<tr>
  1226. 	<td class="label"><?=$desc;?> </td>
  1227. 	<?php 
  1228. 	foreach ($tipo as $tip):
  1229. 		foreach($orario as $orar):
  1230. 	?>
  1231. 	<td class="field"><input size="3" type="text" name="PERS_DED_<?=$short;?>_<?=$tip;?>_<?=$orar;?>" 
  1232. 	maxlength="3" value="" /> </td>
  1233.  
  1234. 	<?php endforeach; endforeach; ?>
  1235. 	</tr>
  1236. 	<?php endforeach;?>
  1237.  
  1238.  
  1239. 	</table>
  1240. 	</td>
  1241. </tr>
  1242.  
  1243. <tr>
  1244.           <td colspan="2" width="675px">
  1245.           	<p style="margin-left: 6"><B><FONT face="Verdana" size="3"><br />
  1246.           	Guardia: (<a href="#" onclick="javascript:return false;" title="">?</a>)</FONT></B></p>
  1247.           </td>
  1248. </tr>
  1249.  
  1250. <tr>
  1251. <td colspan="2" class="minitable">
  1252. 	<table style="padding: 2px; text-align:center; " border="1" width="100%" bordercolor="black" >
  1253. 	<tr>
  1254. 	<td class="label" colspan="2">&nbsp; </td>
  1255. 	<td class="label">Pediatra Emato-Oncologo </td>
  1256. 	<td class="label">Pediatra </td>
  1257. 	<td class="label">Oncologo </td>
  1258. 	<td class="label">Ematologo </td>
  1259. 	<td class="label">Trapiantologo </td>
  1260. 	</tr>
  1261.  
  1262. 	<tr>
  1263. 	<td class="label" colspan="2">Guardia attiva / 24 ore </td>
  1264. 	<td class="field"><select name="GUARDIA_PEDEMATONCO">
  1265. 		<option value=""></option>
  1266.                 <option value="0"> No</option>
  1267.                 <option value="1"> S&igrave; </option>
  1268.     </select>  </td>
  1269. 	<td class="field"><select name="GUARDIA_PED">
  1270. 		<option value=""></option>
  1271.                 <option value="0"> No</option>
  1272.                 <option value="1"> S&igrave; </option>
  1273.     </select>  </td>
  1274. 	<td class="field"><select name="GUARDIA_ONCO">
  1275. 		<option value=""></option>
  1276.                 <option value="0"> No</option>
  1277.                 <option value="1"> S&igrave; </option>
  1278.     </select></td>
  1279. 	<td class="field"><select name="GUARDIA_EMAT">
  1280. 		<option value=""></option>
  1281.                 <option value="0"> No</option>
  1282.                 <option value="1"> S&igrave; </option>
  1283.     </select> </td>
  1284. 	<td class="field"> --- </td>
  1285. 	</tr>
  1286.  
  1287. 	<tr>
  1288. 	<td class="label" colspan="2">PRONTA REPERIBILITA'</td>
  1289. 	<td class="label">&nbsp; </td>
  1290. 	<td class="label">&nbsp; </td>
  1291. 	<td class="label">&nbsp; </td>
  1292. 	<td class="label">&nbsp; </td>
  1293. 	<td class="label">&nbsp; </td>
  1294. 	</tr>
  1295.  
  1296. 	<tr>
  1297. 	<td class="label" rowspan="2">Una sola unit&agrave;<br /> per tutti i settori</td>
  1298. 	<td class="label">festiva </td>
  1299. 	<td class="field"><select name="UNICA_FEST_PEDEMATONCO">
  1300. 		<option value=""></option>
  1301.                 <option value="0"> No</option>
  1302.                 <option value="1"> S&igrave; </option>
  1303.     </select> </td>
  1304. 	<td class="field"><select name="UNICA_FEST_PED">
  1305. 		<option value=""></option>
  1306.                 <option value="0"> No</option>
  1307.                 <option value="1"> S&igrave; </option>
  1308.     </select> </td>
  1309. 	<td class="field"><select name="UNICA_FEST_ONCO">
  1310. 		<option value=""></option>
  1311.                 <option value="0"> No</option>
  1312.                 <option value="1"> S&igrave; </option>
  1313.     </select> </td>
  1314. 	<td class="field"><select name="UNICA_FEST_EMAT">
  1315. 		<option value=""></option>
  1316.                 <option value="0"> No</option>
  1317.                 <option value="1"> S&igrave; </option>
  1318.     </select> </td>
  1319.     <td class="field"><select name="UNICA_FEST_TRAPIANT">
  1320. 		<option value=""></option>
  1321.                 <option value="0"> No</option>
  1322.                 <option value="1"> S&igrave; </option>
  1323.     </select> </td>
  1324. 	</tr>
  1325.  
  1326. 	<tr>
  1327.  
  1328. 	<td class="label">notturna </td>
  1329. 	<td class="field"><select name="UNICA_NOTT_PEDEMATONCO">
  1330. 		<option value=""></option>
  1331.                 <option value="0"> No</option>
  1332.                 <option value="1"> S&igrave; </option>
  1333.     </select> </td>
  1334. 	<td class="field"><select name="UNICA_NOTT_PED">
  1335. 		<option value=""></option>
  1336.                 <option value="0"> No</option>
  1337.                 <option value="1"> S&igrave; </option>
  1338.     </select> </td>
  1339. 	<td class="field"><select name="UNICA_NOTT_ONCO">
  1340. 		<option value=""></option>
  1341.                 <option value="0"> No</option>
  1342.                 <option value="1"> S&igrave; </option>
  1343.     </select> </td>
  1344. 	<td class="field"><select name="UNICA_NOTT_EMAT">
  1345. 		<option value=""></option>
  1346.                 <option value="0"> No</option>
  1347.                 <option value="1"> S&igrave; </option>
  1348.     </select> </td>
  1349.     <td class="field"><select name="UNICA_NOTT_TRAPIANT">
  1350. 		<option value=""></option>
  1351.                 <option value="0"> No</option>
  1352.                 <option value="1"> S&igrave; </option>
  1353.     </select> </td>
  1354. 	</tr>
  1355. 	<tr>
  1356. 	<td class="label" rowspan="2">Una unit&agrave;<br /> per ogni settore</td>
  1357. 	<td class="label">festiva </td>
  1358. 	<td class="field"><select name="OGNI_FEST_PEDEMATONCO">
  1359. 		<option value=""></option>
  1360.                 <option value="0"> No</option>
  1361.                 <option value="1"> S&igrave; </option>
  1362.     </select> </td>
  1363. 	<td class="field"><select name="OGNI_FEST_PED">
  1364. 		<option value=""></option>
  1365.                 <option value="0"> No</option>
  1366.                 <option value="1"> S&igrave; </option>
  1367.     </select> </td>
  1368. 	<td class="field"><select name="OGNI_FEST_ONCO">
  1369. 		<option value=""></option>
  1370.                 <option value="0"> No</option>
  1371.                 <option value="1"> S&igrave; </option>
  1372.     </select> </td>
  1373. 	<td class="field"><select name="OGNI_FEST_EMAT">
  1374. 		<option value=""></option>
  1375.                 <option value="0"> No</option>
  1376.                 <option value="1"> S&igrave; </option>
  1377.     </select> </td>
  1378.     <td class="field"><select name="OGNI_FEST_TRAPIANT">
  1379. 		<option value=""></option>
  1380.                 <option value="0"> No</option>
  1381.                 <option value="1"> S&igrave; </option>
  1382.     </select> </td>
  1383. 	</tr>
  1384.  
  1385. 	<tr>
  1386.  
  1387. 	<td class="label">notturna </td>
  1388. 	<td class="field"><select name="OGNI_NOTT_PEDEMATONCO">
  1389. 		<option value=""></option>
  1390.                 <option value="0"> No</option>
  1391.                 <option value="1"> S&igrave; </option>
  1392.     </select> </td>
  1393. 	<td class="field"><select name="OGNI_NOTT_PED">
  1394. 		<option value=""></option>
  1395.                 <option value="0"> No</option>
  1396.                 <option value="1"> S&igrave; </option>
  1397.     </select> </td>
  1398. 	<td class="field"><select name="OGNI_NOTT_ONCO">
  1399. 		<option value=""></option>
  1400.                 <option value="0"> No</option>
  1401.                 <option value="1"> S&igrave; </option>
  1402.     </select> </td>
  1403. 	<td class="field"><select name="OGNI_NOTT_EMAT">
  1404. 		<option value=""></option>
  1405.                 <option value="0"> No</option>
  1406.                 <option value="1"> S&igrave; </option>
  1407.     </select> </td>
  1408.     <td class="field"><select name="OGNI_NOTT_TRAPIANT">
  1409. 		<option value=""></option>
  1410.                 <option value="0"> No</option>
  1411.                 <option value="1"> S&igrave; </option>
  1412.     </select> </td>
  1413. 	</tr>
  1414. </table>
  1415. 	</td>
  1416. </tr>
  1417.  
  1418. <tr>
  1419.           <td colspan="2" width="675px">
  1420.           	<p style="margin-left: 6"><B><FONT face="Verdana" size="3"><br />
  1421.           	Risorse dedicate: (<a href="#" onclick="javascript:return false;" title="">?</a>)</FONT></B></p>
  1422.           </td>
  1423. </tr>
  1424.  
  1425. <tr>
  1426. <td colspan="2" class="minitable">
  1427. 	<table style="padding: 2px; text-align:center; " border="1" width="100%" bordercolor="black" >
  1428. 	<tr>
  1429. 	<td class="label">&nbsp; </td>
  1430. 	<td class="label">A ciclo continuo </td>
  1431. 	<td class="label">Day Hospital<br />(n. posti letto x2)  (<a href="#" onclick="javascript:return false;" title="">?</a>)</td>
  1432. 	</tr>
  1433. <?php 
  1434. 	$ruoli = array("Pediatria" => "PED", "Oncologia" => "ONCO", "Ematologia" => "EMAT",
  1435. 					"Trapianto" => "TRAPIANT", "Oncoematologia" => "ONCOEMAT");
  1436.  
  1437. 	$tipologia = array("CONT", "DHOS");
  1438.  
  1439. 	foreach ($ruoli as $desc => $short):	
  1440. 	?>
  1441. 	<tr>
  1442. 	<td class="label"><?=$desc;?> </td>
  1443. 	<?php 
  1444. 	foreach ($tipologia as $tipo):
  1445. 	?>
  1446. 	<td class="field">
  1447. 	<input size="30" type="text" name="RIS_DED_<?=$short;?>_<?=$tipo;?>" 
  1448. 	maxlength="30" value="" />
  1449. </td>
  1450. 	<?php endforeach; ?>
  1451. 	</tr>
  1452. 	<?php endforeach; ?>
  1453. </table>
  1454. 	</td>
  1455. </tr>
  1456.  
  1457. <tr>
  1458.           <td colspan="2" width="675px">
  1459.           	<p style="margin-left: 6"><B><FONT face="Verdana" size="3"><br />
  1460.           	Scuole in ospedale: </FONT></B></p>
  1461.           </td>
  1462. </tr>
  1463.  
  1464. <tr>
  1465. 	<td class="label">Materna </td>
  1466. 	<td class="field">
  1467. 	<select name="MATERNA">
  1468. 	<option value=""></option>
  1469.         <option value="0"> No</option>
  1470.         <option value="1"> S&igrave; </option>
  1471.     </select>
  1472. 	</td>
  1473. </tr>
  1474.  
  1475. <tr>
  1476. 	<td class="label">Elementare </td>
  1477. 	<td class="field">
  1478. 	<select name="ELEMENTARE">
  1479. 	<option value=""></option>
  1480.         <option value="0"> No</option>
  1481.         <option value="1"> S&igrave; </option>
  1482.     </select>
  1483. 	</td>
  1484. </tr>
  1485.  
  1486. <tr>
  1487. 	<td class="label">Media inferiore </td>
  1488. 	<td class="field">
  1489. 	<select name="MEDIA_INF">
  1490. 	<option value=""></option>
  1491.         <option value="0"> No</option>
  1492.         <option value="1"> S&igrave; </option>
  1493.     </select>
  1494. 	</td>
  1495. </tr>
  1496.  
  1497. <tr>
  1498. 	<td class="label">Media superiore </td>
  1499. 	<td class="field">
  1500. 	<select name="MEDIA_SUP">
  1501. 	<option value=""></option>
  1502.         <option value="0"> No</option>
  1503.         <option value="1"> S&igrave; </option>
  1504.     </select>
  1505. 	</td>
  1506. </tr>
  1507.  
  1508. <tr>
  1509.           <td colspan="2" width="675px">
  1510.           	<p style="margin-left: 6"><B><FONT face="Verdana" size="3"><br />
  1511.           	Servizio di assistenza domiciliare:</FONT></B></p>
  1512.           </td>
  1513. </tr>
  1514. <tr>
  1515. 	<td class="label">E' presente un servizio di assistenza domicilare? </td>
  1516. 	<td class="field">
  1517. 	<select name="ASSIST_DOMIC" onchange="cf();">
  1518. 		<option value=""></option>
  1519.                 <option value="0"> No</option>
  1520.                 <option value="1"> S&igrave; altra struttura/servizio </option>
  1521.                 <option value="2"> S&igrave; a carico della struttura </option>
  1522.     </select>
  1523. 	</td>
  1524. </tr>
  1525.  
  1526. <tr id="tr_ASS_DOMIC" style="display: none;">
  1527. 	<td colspan="2" class="minitable">Se selezionato "A carico della struttura" compilare la tabella sottostante 
  1528. 	<table style="padding: 2px; text-align:center; " border="1" width="100%" bordercolor="black" >
  1529.  
  1530. 	<tr>
  1531. 	<td>&nbsp; </td>
  1532. 	<td class="label" colspan="2">Strutturato (<a href="#" onclick="javascript:return false;" title="Se in convenzione 
  1533. 	con l'azienda<br /> considerarlo strutturato">?</a>) </td>
  1534. 	<td class="label" colspan="2">Contrattista </td>
  1535. 	<td class="label" colspan="2">Borsista </td>
  1536. 	</tr>
  1537.  
  1538. 	<tr>
  1539. 	<td>&nbsp;</td>
  1540. 	<td class="label">Full time </td>
  1541. 	<td class="label">Part time </td>
  1542.  
  1543. 	<td class="label">Full time </td>
  1544. 	<td class="label">Part time </td>
  1545.  
  1546. 	<td class="label">Full time </td>
  1547. 	<td class="label">Part time </td>
  1548. 	</tr>
  1549. 	<?php 
  1550. 	$ruoli = array("Medici" => "MED", "Infermieri professionali" => "INPR",
  1551. 					"Fisioterapisti" => "FIS" ,"Psicologi" => "PSI","Altro..." => "ALTRO");
  1552.  
  1553. 	$orario = array("FULL", "PART");
  1554.  
  1555. 	$tipo = array("STRU", "CONTR", "BORS");
  1556.  
  1557. 	foreach ($ruoli as $desc => $short):	
  1558. 	?>
  1559. 	<tr>
  1560. 	<td class="label"><?=$desc;?> </td>
  1561. 	<?php 
  1562. 	foreach ($tipo as $tip):
  1563. 		foreach($orario as $orar):
  1564. 	?>
  1565. 	<td class="field"><input size="3" type="text" name="ASS_DOM_<?=$short;?>_<?=$tip;?>_<?=$orar;?>" 
  1566. 	maxlength="3" value="" /> </td>
  1567.  
  1568. 	<?php endforeach; endforeach; ?>
  1569. 	</tr>
  1570. 	<?php endforeach;?>
  1571.  
  1572.  
  1573. 	</table>
  1574. 	</td>
  1575. </tr>
  1576. <script language="JavaScript" type="text/JavaScript"> 
  1577. //viene eseguito cf() in questo punto perch�© se ho in cache il valore "2" per ASSIST_DOMIC
  1578. //la tabella verrebbe nascosta, e non deve.
  1579. cf();
  1580. </script>
  1581. <tr>
  1582.           <td colspan="2" width="675px">
  1583.           	<p style="margin-left: 6"><B><FONT face="Verdana" size="3"><br />
  1584.           	Certificazioni qualit&agrave;: (<a href="#" onclick="javascript:return false;" title="">?</a>)</FONT></B></p>
  1585.           </td>
  1586. </tr>
  1587.  
  1588. <tr>
  1589. <td colspan="2" class="minitable">
  1590. 	<table style="padding: 2px; text-align:center; " border="1" width="100%" bordercolor="black" >
  1591. 	<tr>
  1592. 	<td class="label" rowspan="3">&nbsp; </td>
  1593. 	<td class="label" colspan="6"> SI </td>
  1594. 	<td class="label" rowspan="3"> NO </td>
  1595. 	</tr>
  1596.  
  1597. 	<tr>
  1598.  
  1599. 	<td class="label" colspan="2"> Della struttura</td>
  1600. 	<td class="label" colspan="3"> Del Dipartimento </td>
  1601.  
  1602. 	<td class="label" rowspan="2"> Dell'Azienda </td>
  1603. 	</tr>
  1604.  
  1605. 	<tr>
  1606.  
  1607. 	<td class="label">OEP </td>
  1608. 	<td class="label">TCSE </td>
  1609. 	<td class="label">Pediatria </td>
  1610. 	<td class="label">Laboratorio</td>
  1611. 	<td class="label">Trasfusionale </td>
  1612.  
  1613.  
  1614. 	</tr>
  1615.  
  1616. 	<tr>
  1617. 	<td class="label">ISO 9001 </td>
  1618. 		<td class="field"><input type="checkbox" name="ISO_OEP" /></td>
  1619. 		<td class="field"><input type="checkbox" name="ISO_TCSE" /></td>
  1620. 		<td class="field"><input type="checkbox" name="ISO_PED" /></td>
  1621. 		<td class="field"><input type="checkbox" name="ISO_LAB" /></td>
  1622. 		<td class="field"><input type="checkbox" name="ISO_TRASF" /></td>
  1623. 		<td class="field"><input type="checkbox" name="ISO_AZIENDA" /></td>
  1624. 		<td class="field"><input type="checkbox" name="ISO_NO" /></td>
  1625. 		</tr>
  1626.  
  1627. 		<tr>
  1628. 	<td class="label">Regionale </td>
  1629. 		<td class="field"><input type="checkbox" name="REGION_OEP" /></td>
  1630. 		<td class="field"><input type="checkbox" name="REGION_TCSE" /></td>
  1631. 		<td class="field"><input type="checkbox" name="REGION_PED" /></td>
  1632. 		<td class="field"><input type="checkbox" name="REGION_LAB" /></td>
  1633. 		<td class="field"><input type="checkbox" name="REGION_TRASF" /></td>
  1634. 		<td class="field"><input type="checkbox" name="REGION_AZIENDA" /></td>
  1635. 		<td class="field">	<input type="checkbox" name="REGION_NO" /></td>
  1636. 		</tr>
  1637.  
  1638. 		<tr>
  1639. 	<td class="label">Joint Commission International </td>
  1640. 		<td class="field"><input type="checkbox" name="JOINT_OEP" /></td>
  1641. 		<td class="field"><input type="checkbox" name="JOINT_TCSE" /></td>
  1642. 		<td class="field"><input type="checkbox" name="JOINT_PED" /></td>
  1643. 		<td class="field"><input type="checkbox" name="JOINT_LAB" /></td>
  1644. 		<td class="field"><input type="checkbox" name="JOINT_TRASF" /></td>
  1645. 		<td class="field"><input type="checkbox" name="JOINT_AZIENDA" /></td>
  1646. 		<td class="field"><input type="checkbox" name="JOINT_NO" /></td>
  1647. 		</tr>
  1648.  
  1649. 		<tr>
  1650. 	<td class="label">JACIE (fino al 31/12/2008) </td>
  1651. 		<td class="field"> --- </td>
  1652. 		<td class="field"><input type="checkbox" name="JACIE_TCSE" /></td>
  1653. 		<td class="field"> --- </td>
  1654. 		<td class="field"> --- </td>
  1655. 		<td class="field"><input type="checkbox" name="JACIE_TRASF" /></td>
  1656. 		<td class="field"> --- </td>
  1657. 		<td class="field"><input type="checkbox" name="JACIE_NO" /></td>
  1658. 		</tr>
  1659.  
  1660. 		<tr>
  1661. 	<td class="label">JACIE / FACHT (dal 1/1/2009) </td>
  1662. 		<td class="field"> --- </td>
  1663. 		<td class="field"><input type="checkbox" name="FACHT_TCSE" /></td>
  1664. 		<td class="field"> --- </td>
  1665. 		<td class="field"> --- </td>
  1666. 		<td class="field"><input type="checkbox" name="FACHT_TRASF" /></td>
  1667. 		<td class="field"> --- </td>
  1668. 		<td class="field"><input type="checkbox" name="FACHT_NO" /></td>
  1669. 		</tr>
  1670.  
  1671. 		<tr>
  1672. 	<td class="label">CNT </td>
  1673. 		<td class="field"> --- </td>
  1674. 		<td class="field"><input type="checkbox" name="CNT_TCSE" /></td>
  1675. 		<td class="field"> --- </td>
  1676. 		<td class="field"> --- </td>
  1677. 		<td class="field"><input type="checkbox" name="CNT_TRASF" /></td>
  1678. 		<td class="field"> --- </td>
  1679. 		<td class="field"><input type="checkbox" name="CNT_NO" /></td>
  1680. 		</tr>
  1681.  
  1682. 		<tr>
  1683. 	<td class="label">Altre </td>
  1684. 	<td class="label" colspan="7">&nbsp; </td>
  1685. 	</tr>
  1686. 	<tr>
  1687. 	<td class="label">&gt; <input type="text" value="" maxlength="30" name="ALTRE_LABEL" size="30" /> </td>
  1688. 		<td class="field" colspan="2"><input type="checkbox" name="ALTRE_STRUTT" /></td>
  1689.  
  1690. 		<td class="field"><input type="checkbox" name="ALTRE_PED" /></td>
  1691. 		<td class="field"><input type="checkbox" name="ALTRE_LAB" /></td>
  1692. 		<td class="field"><input type="checkbox" name="ALTRE_TRASF" /></td>
  1693. 		<td class="field"><input type="checkbox" name="ALTRE_AZIENDA" /></td>
  1694. 		<td class="field"><input type="checkbox" name="ALTRE_NO" /></td>
  1695. 	</tr>
  1696. 	<tr>
  1697. 	<td class="label">&gt; <input type="text" value="" maxlength="30" name="ALTRE2_LABEL" size="30" /> </td>
  1698. 		<td class="field" colspan="2"><input type="checkbox" name="ALTRE2_STRUTT" /></td>
  1699.  
  1700. 		<td class="field"><input type="checkbox" name="ALTRE2_PED" /></td>
  1701. 		<td class="field"><input type="checkbox" name="ALTRE2_LAB" /></td>
  1702. 		<td class="field"><input type="checkbox" name="ALTRE2_TRASF" /></td>
  1703. 		<td class="field"><input type="checkbox" name="ALTRE2_AZIENDA" /></td>
  1704. 		<td class="field"><input type="checkbox" name="ALTRE2_NO" /></td>
  1705. 	</tr>
  1706. 	</table>
  1707. 	</td>
  1708. </tr>
  1709.  
  1710. <tr>
  1711.           <td colspan="2" width="675px">
  1712.           	<p style="margin-left: 6"><B><FONT face="Verdana" size="3"><br />
  1713.           	Descrizione del centro: </FONT></B></p>
  1714.           </td>
  1715. </tr>
  1716. <tr>
  1717. 	<td class="label">Il responsabile pu&ograve; mettere in evidenza eventuali punti di forza o carenze che non emergono
  1718. 	dal presente questionario; quali attivit&agrave; centralizzate effettua e le attivit&agrave; per le quali 
  1719. 	il centro &egrave; a disposizione di altri centri (es. terapia cellulare...) (max 10 righe). </td>
  1720. 	<td class="field">
  1721. 	<textarea  rows="11" cols="100" name="DESCR_LUNGA" id="DESCR_LUNGA"></textarea>
  1722. 	</td>
  1723. </tr>
  1724. <tr>
  1725. 	<td class="label">Autorizzo la pubblicazione dell'intero questionario nel sito AIEOP nell'area
  1726. 	pubblica dedicata ai centri AIEOP? </td>
  1727. 	<td class="field">
  1728. 	<select name="AUTOR_PUBBLIC">
  1729. 	<option value=""></option>
  1730.         <option value="0"> No</option>
  1731.         <option value="1"> S&igrave; </option>
  1732.     </select>
  1733. 	</td>
  1734. </tr>
  1735. <tr>&nbsp;</tr>
  1736.  
  1737. </table>
  1738. </p>
  1739. <p align="center">
  1740. <input type="hidden" name="TYPE" value="CENTRI" />
  1741. <input type="hidden" name="ACTION" value="INSERT" />
  1742. <input type="submit" name="submit" value="Invia" />
  1743. <input type="reset" value="Reimposta" />
  1744. </p>
  1745.  
  1746. </form>
  1747. <?php 
  1748. }//endif mostra form
  1749. ?>
  1750. </td>
  1751. </tr>
  1752. </table></div></td></tr></table>
  1753. </div>
  1754. <table width=100% border=0><tr>
  1755. <td width=33%>
  1756. <a href="javascript:history.back()"><b>Previous Page</b></a></td>
  1757. <td width=33% align=center>
  1758. <a href='/'><b>Home Page</b></a></td>
  1759.  
  1760. <td align=right>
  1761. <a href="/cgi-bin/centri/index_gen" title="Torna alla home"><b>Index</b></a>
  1762. </td></tr>
  1763. </table>
  1764.  
  1765. </body>
  1766. </html>

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