add.php

<?php
include_once('../_header.php');
// require '../_config/libs/vendor/autoload.php';
// require '../_config/libs/vendor/moontoast/math/src/Moontoast/Math/BigNumber.php';

?>
<div class="content-wrapper">
    <!-- Content Header (Page header) -->
    <section class="content-header">
      <h1>
        Tambah Data Rekam Medis
      </h1>
      <ol class="breadcrumb">
        <li><a href="#"><i class="fa fa-medkit"></i>Rumah Sakit</a></li>
        <li><a href="#">Tambah Rekam Medis</a></li>
        <li class="active">Rekam Medis</li>
      </ol>
    </section>
    <div class="pull-right" style="margin-right: 20px; margin-top: 15px;">
        <a href="data.php" class="btn btn-warning btn-xs"><i class="glyphicon glyphicon-chevron-left"></i>Kembali</a>&nbsp;
    </div>
    <section class="content">
        <div class="container-fluid" style="margin-right: 250px;">
            <div class="box" style="margin-top: 35px;">
                <div class="box-body clearfix">
                    <form id="form-rekammedis">
                        <div class="form-group">
                            <label for="pasien">Pasien</label>
                            <select name="pasien" id="pasien" class="form-control" required>
                                <option value="">-Pilih -</option>
                                <?php
                                    $sql_pasien = mysqli_query($koneksi, "SELECT * FROM tb_pasien") or die (mysqli_error($sql_pasien));
                                    while ($data_pasien = mysqli_fetch_array($sql_pasien)) {
                                        echo '<option value="'.$data_pasien['id_pasien'].'">'.$data_pasien['nama_pasien'].'</option>';
                                    }
                                ?>
                            </select>
                        </div>
                        <div class="form-group">
                            <label for="keluhan">Keluhan</label>
                            <textarea name="keluhan" id="keluhan" class="form-control" required></textarea>
                        </div>
                        <div class="form-group">
                            <label for="dokter">Dokter</label>
                            <select name="dokter" id="dokter" class="form-control" required>
                                <option value="">-Pilih -</option>
                                <?php
                                    $sql_dokter = mysqli_query($koneksi, "SELECT * FROM tb_dokter") or die (mysqli_error($sql_dokter));
                                    while ($data_dokter = mysqli_fetch_array($sql_dokter)) {
                                        echo '<option value="'.$data_dokter['id_dokter'].'">'.$data_dokter['nama_dokter'].'</option>';
                                    }
                                ?>
                            </select>
                        </div>
                        <div class="form-group">
                            <label for="diagnosa">Diagnosa</label>
                            <textarea name="diagnosa" id="diagnosa" class="form-control" required></textarea>
                        </div>
                        <div class="form-group">
                            <label for="poli">Poliklinik</label>
                            <select name="poli" id="poli" class="form-control" required>
                                <option value="">-Pilih -</option>
                                <?php
                                    $sql_poli = mysqli_query($koneksi, "SELECT * FROM tb_poli ORDER BY nama_poli ASC") or die (mysqli_error($sql_poli));
                                    while ($data_poli = mysqli_fetch_array($sql_poli)) {
                                        echo '<option value="'.$data_poli['id_poli'].'">'.$data_poli['nama_poli'].'</option>';
                                    }
                                ?>
                            </select>
                        </div>
                        <div class="form-group">
                            <label for="obat">Obat</label>
                            <select multiple name="obat[]" id="obat[]" class="form-control" size="7" required>
                                <?php
                                    $sql_obat = mysqli_query($koneksi, "SELECT * FROM tb_obat") or die (mysqli_error($sql_obat));
                                    while ($data_obat = mysqli_fetch_array($sql_obat)) {
                                        echo '<option value="'.$data_obat['id_obat'].'">'.$data_obat['nama_obat'].'</option>';
                                    }
                                ?>
                            </select>
                        </div>
                        <div class="form-group">
                            <label for="tgl">Tanggal Periksa</label>
                            <input type="date" name="tgl" id="tgl" value="<?=date('Y-m-d')?>" class="form-control" required autofocus>
                        </div>
                        <div class="form-group pull-right">
                            <input type="submit" name="add" value="Simpan" class="btn btn-success" id="tombol-simpan">
                        </div>
                    </form>
                </div>
            </div>
        </div>
    </section>
</div>
<script type="text/javascript">
    $('#form-rekammedis').submit(function(e){
        e.preventDefault();
        var pasien = $("#pasien").val();
        var keluhan = $("#keluhan").val();
        var dokter = $("#dokter").val();
        var diagnosa = $("#diagnosa").val();
        var poli = $("#poli").val();
        var obat = $("#obat").val();
        var tgl = $("#tgl").val();
        var obat = {};
        // $.each($())
        var data ={
            pasien:$("#pasien").val(),
            keluhan:$("#keluhan").val(),
            dokter:$("#dokter").val(),
            diagnosa:$("#diagnosa").val(),
            poli:$("#poli").val(),
            obat:$("#obat").val(),
            tgl:$("#tgl").val(),
            add:true
        }
        console.log(data);
        //      $.ajax({
        //       type: "post",
        //          url: "proses.php",
        //          data: data,  //post data
        //          success: function(){
        //          Swal.fire({
        //          title:"Tambah data dokter berhasil!",
        //          type:"success",
        //          confirmButtonText: 'OK'
        //       }).then((result) =>{
        //              console.log(result)
        //              if(result.value){
        //                  window.location="data.php"
        //              }
        //          }
        //      )
        //   }
        // })
    });

</script>

    <?php
        include_once('../_footer.php');
    ?>