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<?php
ob_start();
session_start();
$mainBody='
<!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>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<title>ePortal | Biodata</title>
<link href="css.css" rel="stylesheet" type="text/css" />
</head>
<body size="7" >
';
$matNo=$_SESSION['matNo'];
$semester = $_SESSION['asemester']='First Semester';
require_once('../../connect.php');
$db=db_connect();
$biodataSQL="select * from realdata where matNo='$matNo'";
$biodataResult=$db->query($biodataSQL);
$biodataNum=$biodataResult->rowCount();
$biodataResult_fetch=$biodataResult->fetch(PDO::FETCH_BOTH);
$formNo=$biodataResult_fetch['formNo'];
$dept=$biodataResult_fetch['course'];
$title=$biodataResult_fetch['sex'];
if ($title=='Male') {
$title1 = 'Mr';
$title2 = 'his';
}else if ($title=='Female'){
$title1 = 'Miss';
$title2 = 'her';
}else{
$title1 = '';
}
//$title1=$biodataResult_fetch['status']
$mainBody.='
<table width="95%" align="center" cellpadding="3" cellspacing="5">
<tr>
<td><table width="100%" cellspacing="1" cellpadding="1">
<tr>
<td valign="top"><table width="100%" cellspacing="1" cellpadding="1">
<tr>
<td align="center" valign="top"><p><img src="../../images/siwesHead.png" width="731" height="95" /><br />
</p></td>
</tr>
<tr>
<td align="center" bgcolor="#CCCCCC"><strong id="cen"><h2>MEDICAL REGISTRATION FORM</h2></strong></td>
</tr>
</table></td>
</tr>
<tr><td align="center"> <i>(candidates are to complete Part 2 ONLY)</i></td></tr>
<tr>
<td>
<table width="100%" cellpadding="0" cellspacing="3">
<tr><td colspan="6" bgcolor="#dcdcdc"><strong>1. BIO-DATA</strong></td></tr>
<tr>
<td width="22%" colspan="1" id="lab"><b>Matric Number</b></td>
<td width="1%"> </td>
<td colspan="3">'. $matNo.'</td>
<td width="31%" rowspan="4"><img src="../../passport/Reg'. $matNo.'.jpg" alt="" width="105" height="115" /></td>
</tr>
<tr>
<td colspan="1" id="lab"><b>Full Name</b></td>
<td> </td>
<td colspan="3"><b><H4>'. strtoupper($_SESSION['names']).'</H4></b></td>
</tr>
<tr>
<td colspan="1" id="lab"><b>Date of Birth</b></td>
<td> </td>
<td colspan="1">'.$dob=$biodataResult_fetch['dob'];$mainBody.='</td><td><b>Sex: </b>'.$biodataResult_fetch['sex'].' </td>
</tr>
<tr>
<td colspan="1" id="lab"><b>Name of Parents/Guardian:</b></td>
<td> </td>
<td colspan="3">'.$biodataResult_fetch['gNames']; $mainBody.='</td>
</tr>
<tr>
<td colspan="1" id="lab"><b>Address of parents/Guardian:</b></td>
<td> </td>
<td colspan="3">'.$biodataResult_fetch['gAddress']; $mainBody.='</td>
</tr>
<tr>
<td id="lab"><b>Parents\' Current Phone No(s)</b></td>
<td> </td>
<td width="26%">'. $biodataResult_fetch['gGSM'].'</td>
<td width="18%" id="lab"><b>Candidates\' Phone No(s)</b></td>
<td width="2%"> </td>
<td>';
$mainBody.= $biodataResult_fetch['gsm'];
$mainBody.='
</td>
</tr>
<tr><td style="color: #ffffff">a</td></tr>
<tr><td colspan="6" bgcolor="#dcdcdc"><strong>2. ANY FAMILY HISTORY OF : (Please tick as appropriate)</strong></td></tr>
<tr>
<td id="lab"><b>Hypertension</b></td>
<td> </td>
<td>Yes/No</td>
<td id="lab"><strong>Diabetes Mellitus</strong></td>
<td> </td>
<td>Yes/No</td>
</tr>
<tr>
<td id="lab"><b>Asthma</b></td>
<td> </td>
<td>Yes/No</td>
<td id="lab"><b>Sickle Cell Disease</b></td>
<td> </td>
<td>Yes/No</td>
</tr>
<tr>
<td id="lab"><b>Mental Illiness</b></td>
<td> </td>
<td>Yes/No</td>
<td id="lab"><b>Epilepsy</b></td>
<td> </td>
<td>Yes/No</td>
</tr>
<tr><td style="color: #ffffff">a</td></tr>
<tr><td colspan="6" bgcolor="#dcdcdc"><strong>3. BASIC MEASUREMENTS :</strong></td></tr>
<tr>
<td id="lab"><b> (a) Height :</b></td>
<td> </td>
<td>______________ (m)</td>
<td id="lab"><strong>(b) Weight : </strong></td>
<td> </td>
<td>_______________ (Kg)</td>
</tr>
<tr>
<td id="lab"><b>(c) Blood Pressure :</b></td>
<td> </td>
<td>______________ (mmHg)</td>
</tr>
<tr><td style="color: #ffffff">a</td></tr>
<tr><td colspan="6" bgcolor="#dcdcdc"><strong>4. RECORD OF SYSTEMATIC FINDINGS :</strong></td></tr>
<tr>
<td id="lab" colspan="6" width="100%">
<table border="1" width="100%" cellpadding="0" cellspacing="0">
<tr><td style="color: #ffffff"> a</td></tr>
<tr><td style="color: #ffffff"> a</td></tr>
</table>
</td>
</tr>
</tr>
<tr><td style="color: #ffffff">a</td></tr>
<tr><td colspan="6" bgcolor="#dcdcdc"><strong>5. INVESTIGATIONS :</strong></td></tr>
<tr><td colspan="6"><strong>I. Urine Test :</strong></td></tr>
<tr>
<tr>
<td id="lab" colspan="6" width="100%">
<table border="1" width="100%" cellpadding="0" cellspacing="0">
<tr>
<th > S/N</td>
<th > ITEM</td>
<th > PRESENT</td>
<th > NOT PRESENT</td>
<th > COMMENT</td>
</tr>
<tr>
<td style="color: #ffffff"> a</td>
<td style="color: #ffffff"> a</td>
<td style="color: #ffffff"> a</td>
<td style="color: #ffffff"> a</td>
<td style="color: #ffffff"> a</td>
</tr>
<tr>
<td style="color: #ffffff"> a</td>
<td style="color: #ffffff"> a</td>
<td style="color: #ffffff"> a</td>
<td style="color: #ffffff"> a</td>
<td style="color: #ffffff"> a</td>
</tr>
</table>
</td>
</tr>
<tr><td colspan="6"><strong>II. Blood Test :</strong></td></tr>
<tr>
<tr>
<td id="lab" colspan="6" width="100%">
<table border="1" width="100%" cellpadding="0" cellspacing="0">
<tr>
<th colspan="1"> S/N</td>
<th> ITEM</td>
<th colspan="4"> RESULT/COMMENT</td>
</tr>
<tr>
<td colspan="1"> (a)</td>
<td colspan="1"> Haematocrit/PCV</td>
<td colspan="4"> </td>
</tr>
<tr>
<td colspan="1"> (b)</td>
<td colspan="1"> WBC</td>
<td colspan="4"> </td>
</tr>
<tr>
<td colspan="1"> (c)</td>
<td colspan="1"> Differential</td>
<td colspan="4"> </td>
</tr>
<tr>
<td colspan="1"> (d)</td>
<td colspan="1"> Blood Group</td>
<td colspan="4"> </td>
</tr>
<tr>
<td colspan="1">(e)</td>
<td colspan="1">Genetype</td>
<td colspan="4"></td>
</tr>
<tr>
<td colspan="1"> (f)</td>
<td colspan="1"> HBsAg</td>
<td colspan="4"> </td>
</tr>
<tr>
<td colspan="1"> (g)</td>
<td colspan="1"> Malaria Parasite</td>
<td colspan="4"> </td>
</tr>
<tr>
<td colspan="1"> (h)</td>
<td colspan="1"> VDRL</td></td>
<td colspan="4"> </td>
</tr>
<tr>
<td colspan="1"> (i)</td>
<td colspan="1"> Retroviral Test (Optional)</td>
<td colspan="4"> </td>
</tr>
</table>
</td>
</tr>';
$mainBody2=' <table> <tr><td style="color: #ffffff">a</td></tr>
<tr><td colspan="6" bgcolor="#dcdcdc"><strong>6. VISUAL ACUITY :</strong></td></tr>
<tr>
<td id="lab"><b> (a) With Glasses : </b></td>
<td> </td>
<td> R 6/L 6 </td>
<td id="lab"><strong>(b) Without : </strong></td>
<td> </td>
<td>R 6/L 6 </td>
</tr>
<tr><td style="color: #ffffff">a</td></tr>
<tr>
<td colspan="6" bgcolor="#dcdcdc"><strong>7. DENTAL (TEETH) PROBLEM :</strong></td></tr>
<tr>
<td id="lab" colspan="6" width="100%">
<table border="1" width="100%" cellpadding="0" cellspacing="0">
<tr><td style="color: #ffffff"> a</td></tr>
<tr><td style="color: #ffffff"> a</td></tr>
</table>
</td>
</tr>
<tr><td style="color: #ffffff">a</td></tr>
<tr>
<td colspan="6" bgcolor="#dcdcdc"><strong>8. CHEST X-RAY :</strong></td></tr>
<tr>
<td id="lab" colspan="6" width="100%">
<table border="1" width="100%" cellpadding="0" cellspacing="0">
<tr><td> (a)</td><td>X-Ray No.</td><td style="color: #ffffff" >jkhik iugiugiugiubgiubibib</td></tr>
<tr><td > (b)</td><td>Date Taken</td><td></td></tr>
<tr><td rowspan="5" height="20"> (c)<br></td><td>X-Ray Reading</td><td style="color: #ffffff">jkhhk <br> hbhbjhjh<br><br> hbhbjhjh<br> hbhbjhjh<br> hbhbjhjh<br> hbhbjhjh</td></tr>
</table>
</td>
</tr>
<tr><td style="color: #ffffff">a</td></tr>
<tr><td colspan="6" bgcolor="#dcdcdc"><strong>9. CERTIFICATION BY EXAMINING PHYSICIAN :</strong></td></tr>
<tr>
<td id="lab" colspan="6" width="100%">
<div style="color: #ffffff">a</div>
I certify that I have this date ...................................... examined '.$title1. '..........................................................................................................
<div style="color: #ffffff">a</div>
<br>................................................................................................... and found '.$title2. '
<br>
(a) IN GOOD HEALTH
<br>
<div style="color: #ffffff">a</div>
(b) HAVING THE FOLLOWING MEDICAL ISSUES (Please Specify) ........................................................................................
<br>
<div style="color: #ffffff">a</div>
(c) UNDERGOING TREATMENT FOR (Please Specify) ............................................................................................................
<br>
<div style="color: #ffffff">a</div>
10. NAME OF DOCTOR : ............................................................... SIGNATURE/STAMP : ..........................................................
<br>
<div style="color: #ffffff">a</div>
11. DATE : ......................................................................
</td>
</tr>
</tr>
</table></td>
</tr></table>';
$mainBody.='
</table>
</td>
</tr>
</table></td>
</tr>
</table>
</body>
</html>';
$mainBody2.='
</table>
</td>
</tr>
</table></td>
</tr>
</table>
</body>
</html>';
$mainBody3='<table width="95%" align="center" cellpadding="3" cellspacing="5">
<tr>
<td><table width="100%" cellspacing="1" cellpadding="1">
<tr>
<td valign="top"><table width="100%" cellspacing="1" cellpadding="1">
<tr>
<td align="center" valign="top"><p><img src="../../images/siwesHead.png" width="731" height="95" /><br />
</p></td>
</tr>
<tr>
<td align="center" bgcolor="#CCCCCC"><strong id="cen"><h2>MEDICAL CLEARANCE SLIP</h2></strong></td>
</tr>
</table></td>
</tr>
</table>
</td>
</tr>
<tr><td style="font-size: 20px">'.strtoupper($title1).' '.strtoupper($_SESSION['names']).' with Matric Number '.$matNo.'
in the department of '.strtoupper($dept).' has successfully completed '.$title2.' medical examination.</td></tr>
<tr><td><br>------------------------------------<br>Medical Officer Signature & Date<br> <i><br>This slip is to be kept in the student\'s file</i></td></tr>
</table></td>
</tr>
</table>
</body>
</html>';
//echo $mainBody;
if ($matNo=='MK20220S102641'){
echo $mainBody3;
die();
}
include("../../mpdf/mpdf.php");
$filename='medForm-'.$matNo.'.pdf';
$mpdf=new mPDF('c');
$mpdf->SetWatermarkImage('../../images/logoBack.png');
$mpdf->showWatermarkImage = true;
$dat=date('l, M d, o, h:i:s a');
$customizedFooter='<img src="../../images/siwesfooter.png"><br><div align="right">'. $dat.'</div>';
$mpdf->WriteHTML($mainBody);
$mpdf->WriteHTML('<pagebreak resetpagenum="0" pagenumstyle="A" />',2);
$mpdf->WriteHTML($mainBody2);
$mpdf->setFooter($customizedFooter) ;
$mpdf->WriteHTML('<pagebreak resetpagenum="0" pagenumstyle="A" />',2);
$mpdf->WriteHTML($mainBody3);
$mpdf->setFooter($customizedFooter) ;
$mpdf->Output($filename,'D');
exit;
ob_end_flush();
?>