Latihan Form dengan Percabangan
Script:
<!DOCTYPE HTML>
<head>
<title>Review Latihan Web</title>
</head>
<body bgcolor="yellow">
<form action="bukti_daftar.php" method="post">
<h2><p align="center">Pendaftaran Pasien Rawat Jalan - PMI Bogor</p></h2>
<hr />
<?php
//date("F j, Y")-hasilnya April 27, 2013; date("j-F -Y")
$hari = date("j-F-Y");
echo "Hari ini Tanggal: $hari";
?>
<br />
<table bgcolor="white">
<tr>
<td>No.Pendaftaran Pasien</td>
<td>:</td>
<td><input type="text" size="3" name="nopas" /></td>
</tr>
<tr>
<td>Nama Pasien</td>
<td>:</td>
<td><input type="text" size="25" name="napas" /></td>
</tr>
<tr>
<td>Daftar ke Poli</td>
<td>:</td>
<td><select name="dp">
<option value="1">UMUM</option>
<option value="2">ANAK</option>
<option value="3">KEBIDANAN</option>
<option value="4">INTERNIS</option>
<option value="5">THT</option>
</select></td>
</tr>
<tr>
<td>Keluhan Pasien</td>
<td>:</td>
<td><textarea cols="30" rows="6" name="keluhan"></textarea></td>
</tr>
<tr>
<td>Status Pasien</td>
<td>:</td>
<td><input type="radio" value="a" name="sp" />Baru
<input type="radio" value="b" name="sp"/>Lama</td>
</tr>
<tr>
<td colspan="3"><p align="center"><input type="submit" value="PROSES" />
<input type="reset" value="BATALKAN" /></p></td>
</tr>
</table>
</form>
</body>
</html>
Hasil Outputnya:
Scriptnya:
<!DOCTYPE HTML>
<head>
<title>Review Latihan Web</title>
</head>
<body bgcolor="yellow">
<?php
//date("F j, Y")-hasilnya April 27, 2013; date("j-F -Y")
echo"<h2>Bukti Pendaftaran Pasien Rawat Jalan - PMI Bogor</h2>";
echo"<hr>";
$hari = date("j-F-Y");
echo "Hari ini Tanggal: $hari";
//instansiasi variablenya dulu!!
$no =$_POST['nopas'];
$nama =$_POST['napas'];
$poli =$_POST['dp'];
$kp =$_POST['keluhan'];
$status=$_POST['sp'];
//Menentukan Poli dan Biaya Dokternya
if ($poli==1)
{
$nmpoli ="POLI UMUM";
$bdokter=30000;
}
else if ($poli==2)
{
$nmpoli ="POLI ANAK";
$bdokter=80000;
}
else if ($poli==3)
{
$nmpoli ="POLI KEBIDANAN";
$bdokter=110000;
}
else if ($poli==4)
{
$nmpoli ="POLI INTERNIS";
$bdokter=125000;
}
else
{
$nmpoli ="POLI THT";
$bdokter=50000;
}
//Menentukan biaya administrasinya
if($status=='a')
{
$ket_status="Pasien Baru";
$badmin =30000;
}
else
{
$ket_status="Pasien Lama";
$badmin =15000;
}
//Proses hitung biaya daftar
$bdaftar = $bdokter + $badmin;
echo"
<table bgcolor=aqua>
<tr>
<td>No Pendaftaran Pasien</td>
<td>:</td>
<td>$no</td>
</tr>
<tr>
<td>Nama Pasien</td>
<td>:</td>
<td>$nama</td>
</tr>
<tr>
<td>Daftar Ke Poli</td>
<td>:</td>
<td>$nmpoli</td>
</tr>
<tr>
<td>Biaya Dokter</td>
<td>:</td>
<td><strong><font color=red>Rp. $bdokter</font></strong></td>
</tr>
<tr>
<td>Keluhan</td>
<td>:</td>
<td>$kp</td>
</tr>
<tr>
<td>Status Pasien</td>
<td>:</td>
<td>$ket_status</td>
</tr>
<tr>
<td>Biaya Administrasi</td>
<td>:</td>
<td><strong><font color=red>Rp. $badmin</font></strong></td>
</tr>
<tr>
<td colspan=3><h2>Total Biaya Rawat Jalan <strong><font color=red>Rp. $bdaftar</font></strong></h2></td>
</tr>
</table>
";
?>
<a href="daftar_pasien.php">Menu Utama</a>
</body>
</html>
