Belajar Ngoding: Sistem Informasi Rawat Jalan Rumah Sakit Dengan PHP,Javascript,Bootstrap - Part 5 (Pembuatan Proses Pendaftaran menggunakan MODAL Bootsrap

Pada tahap ini kita akan beranjak ke menu "transaksi-daftar pasien rawat jalan". Pada page ini akan di buat proses pendaftaran terhadap pasien. mulai dari pendaftarn pasien baru hingga pasien yang sudah pernah terdaftar sebelumnya.
persiapan yang akan kita lakukan adalah sbb:

persiapan database :
tabel - tabel yang akan kita gunakan nantinya adalah : pasien, dokter, department, asuransi, perusahaan, tprosespendaftaranrj, tdetail_prosesdaftar_jp_um, tdetail_prosesdaftar_jp_um (untuk menyimpan data jika pasien menggunakan jaminan umum/bayar pribadi), tdetail_prosesdaftar_jp_pr(untuk menyimpan data jika pasien menggunakan jaminan perusahaan), tdetail_prosesdaftar_jp_as(untuk menyimpan data jika pasien menggunakan jaminan asuransi), untuk pembuatan database silhakan di cek atau di lihat kembali pada pembuatan database .
file yang akan di buat adalah : FProsesDaftarPxRJ.php, list_data_pasien_rj.php, FdaftarPxBaru.php, edit_data_pasien2.php, ftambahpoli.php, list_reg_px.php, proseshapuspoli.php, cetakstrkregister.php.
Bentuk Tampilan yang akan di buat

Page Pendaftaran(FProsesDaftarPxRJ.php)

page list data pasien lama/ telah terdaftar (list_data_pasien_rj.php) - kondisi jika tombol cari rekam medis di klik.

page entry data pasien baru (FdaftarPxBaru.php) - kondisi jika tombol rekam medis baru di klik

page pendaftran awal yang telah di isi dengan data pasien dan pemilihan department yg di pilih pasien

page edit data pasien(edit_data_pasien.php)-kondisi saat tombol edit data pasien di klik

kondisi saat tombol History pasien di klik

4. sytax program

FProsesDaftarPxRJ.php

list_data_pasien_rj.php

<!DOCTYPE html>
<html>
<head>
 <link rel="stylesheet" href="bootstrap-3.3.6/dist/css/bootstrap.min.css"/>
 <script src="bootstrap-3.3.6/dist/js/bootstrap.min.js"></script>
</head>
<body>
<fieldset>
 <legend>List Data Pasien</legend>

 <form action="" method="POST" class="navbar-form navbar-right">
 <div class="form-group">
  <input type="text" name="txtcari" placeholder='Cari MR/Nama Pasien' class='form-control input-sm'></input>
  <button type="submit" name="btncari" class='btn btn-sm btn-primary'><span class="glyphicon glyphicon-search"> Cari Data</span></button>

  <input type="date" name="datecaritgl" class='form-control input-sm'></input>
  <button type="submit" name="btncaritgl" class='btn btn-sm btn-primary'><span class="glyphicon glyphicon-search"> Cari Tgl Lahir</span></button>
 </div>
</form>
<table class="table table-striped table-bordered small">
<tr>
    <th bgcolor="yellow">Medical record</th>
    <th bgcolor="yellow">Panggilan</th>
    <th bgcolor="yellow">Nama Pasien</th>
    <th bgcolor="yellow">Jen.Kel</th>
    <th bgcolor="yellow">Tanggal Lahir</th>
    <th bgcolor="yellow">Alamat</th>
    <th bgcolor="yellow">No Telfon</th>
    <th bgcolor="yellow">Action</th>
</tr>
<?php
    include 'koneksi.php';
 $txtcari = @$_POST['txtcari'];
 $btncari = @$_POST['btncari'];
 $datecaritgl = @$_POST['datecaritgl'];
 $btncaritgl = @$_POST['btncaritgl'];

 $sql = mysqli_query($conn, "select * from pasien");

 if(isset($_POST['btncari'])){
    $sql = mysqli_query($conn, "select * from pasien where namapasien like '%$txtcari%' or medicalrecord like '%$txtcari%'") or die (mysqli_error()); 
 }elseif(isset($_POST['btncaritgl'])){
    $sql = mysqli_query($conn, "select * from pasien where tanggallahir like '%$datecaritgl%' ") or die (mysqli_error()); 
 }
 while ($data = mysqli_fetch_array($sql)) {
 ?>
<tr>
 <td><?php echo $data['medicalrecord']; ?></td>
 <td><?php echo $data['panggilan']; ?></td>
 <td><?php echo $data['namapasien']; ?></td>
 <td><?php echo $data['jeniskelamin']; ?></td>
 <td><?php echo $data['tanggallahir']; ?></td>
 <td><?php echo $data['alamat']; ?></td>
 <td><?php echo $data['notelfon']; ?></td>
 <td>
     <?php
  $statusregister = $data['statusregister'];
   if($statusregister == "PROSES"){
   echo "PROSES";
   }else{
   ?>
  <a href="?page=transaksi&action=pasienrj&medicalrecord=<?php echo $data['medicalrecord']; ?>&tgllahir=<?php echo $data['tanggallahir']; ?>">
  <button class='btn btn-sm btn-link'>Pilih</button>
  </a>
     <?php
  }
     ?>
 </td>
</tr>
<?php
   }
?>

</table>
</fieldset>
</body>
</html>

FdaftarPxBaru.php

<!DOCTYPE html>
<html>
<head>
 <title> Entry Data Pasien Baru</title>

  <link rel="stylesheet" href="bootstrap-3.3.6/dist/css/bootstrap.min.css"/>
  <script src="bootstrap-3.3.6/dist/js/bootstrap.min.js"></script>
  <link rel="stylesheet" href="bootstrap-3.3.6/dist/css/form.trans.pendaftaran.css"/>

</head>
<body>

<?php 
  include "koneksi.php";
   $carikode = mysqli_query($conn ,"select max(medicalrecord) from pasien") or die (mysql_error());
   $datakode = mysqli_fetch_array($carikode);
   if ($datakode) {
    $nilaikode = substr($datakode[0], 1);
    $kode = (int) $nilaikode;
    $kode = $kode + 1;
    $hasilkode = "0".str_pad($kode, 5, "0", STR_PAD_LEFT);
   } else {
    $hasilkode = "000001";
   }
?>

<fieldset>
   <legend class="col-sm-4">
   <a href="?page=transaksi&action=pasienrj">
 <button class='btn btn-block btn-warning'>Batal</button>
   </a>

<form action="" method="POST">
  <table width="100%">
 <th colspan="3"><center>
 Entry Data Pasien Baru  </center>
</th>
<tr>
 <td>No. Rekam Medis </td>
 <td colspan="2"><input type="text" name="txtmedicalrecord" value="<?php echo "$hasilkode"; ?>" class='form-control input-sm' readonly required></input> </td>
  </tr>
<tr>
 <td>Nama Pasien </td>
 <td style="width: 50px"><select name="slcpanggilan" class='form-control input-sm' required>
    <option value="Tn.">Tn</option>
    <option value="Ny.">Ny</option>
    <option value="An.">An</option>
    <option value="By.">By</option>
    </select>
 </td>
 <td><input type="text" name="txtnamapasien" class='form-control input-sm' required></input> </td>
  </tr>
<tr>
 <td>Jenis Kelamin </td>
 <td><input type="radio" name="genre" value="L"> Laki - Laki</input></td>
 <td><input type="radio" name="genre" value="P"> Perempuan</input> </td>
  </tr>
<tr>
 <td>Golongan Darah </td>
 <td><input type="text" name="txtgoldarah" class='form-control input-sm'></input> </td>
  </tr>
<tr>
 <td>Agama </td>
 <td><select name="slcagama" class='form-control input-sm'>
    <option value="Islam">Islam</option>
    <option value="Kristen">Kristen</option>
    <option value="Budha">Budha</option>
    <option value="Konghucu">Konghucu</option>
    <option value="Atheis">Atheis</option>
      </select></td>
  </tr>
<tr>
 <td>Suku Bangsa </td>
 <td colspan="2"><input type="text" name="txtsukubangsa" class='form-control input-sm' required></input> </td>
  </tr>
<tr>
 <td>Bahasa </td>
 <td colspan="2"><input type="text" name="txtbahasa" class='form-control input-sm' required></input> </td>
  </tr>
<tr>
 <td>Tempat Lahir </td>
 <td colspan="2"><input type="text" name="txttempatlahir" class='form-control input-sm' required></input> </td>
  </tr>
<tr>
 <td>Tanggal Lahir </td>
 <td><input type="date" name="datetanggallahir" class='form-control input-sm' required></input> </td>
  </tr>
<tr>
 <td>Status </td>
 <td><select name="slcstatus" class='form-control input-sm' required>
    <option value="Menikah">Menikah</option>
    <option value="Belum Menikah">Belum Menikah</option>
      </select></td>
  </tr>
<tr>
 <td>Type Identitas </td>
 <td><select name="slctypeidentitas" class='form-control input-sm' required>
    <option value="Kitas">Kitas</option>
    <option value="KTP">KTP</option>
    <option value="Passpor">Passpor</option>
    <option value="SIM">SIM</option>
      </select> 
 </td>
 <td><input type="text" name="txtnoidentitas" class='form-control input-sm' required></input></td>
  </tr>
<tr>
 <td>Kewarganegaraan </td>
 <td colspan="2"><input type="text" name="txtkewarganegaraan" class='form-control input-sm' required></input> </td> 
  </tr>
<tr>
 <td>Alamat </td>
 <td colspan="2"><ttextarea name="txtalamat" rows="2" cols="30" class='form-control input-sm' required></ttextarea> </div>
<br />
        Kota <br />
 <input class="form-control input-sm" name="txtkota" required="" type="text" /> <br />
 Provinsi <br />
 <input class="form-control input-sm" name="txtprovinsi" required="" type="text" /> <br />
 Negara <br />
 <input class="form-control input-sm" name="txtnegara" required="" type="text" /> <br />
 No Telfon <br />
 <input class="form-control input-sm" name="txtnotelfon" required="" type="text" /> <br />
 <input class="btn btn-block btn-info" name="btnsimpan" type="submit" value="Simpan" />
 <br />
 <input name="txtstatusregister" type="hidden" value="PULANG" />
 
if($simpan){ 
 $carikode = mysqli_query($conn ,"select max(medicalrecord) from pasien") or die (mysqli_error());
 $medicalrecord = mysqli_fetch_row($carikode);
 //echo "$medicalrecord[0]";
 ?>
 <script type="text/javascript">
 window.location.href="?page=transaksi&action=pasienrj&medicalrecord=<?php echo $medicalrecord[0]; ?>";
 </script>
 <?php
 }else{
 echo "Error Simpan  record: " . $conn->error;
 }
 }
 ?>

</body>
</html>

edit_data_pasien2.php

<!DOCTYPE html>
<html>
<head>
 <title>edit data pasien</title>

  <link rel="stylesheet" href="bootstrap-3.3.6/dist/css/bootstrap.min.css"/>
  <script src="bootstrap-3.3.6/dist/js/bootstrap.min.js"></script>
  <link rel="stylesheet" href="bootstrap-3.3.6/dist/css/form.trans.pendaftaran.css"/>

 <script>
  $( function() {
      $( "#datepicker" ).datepicker();
    } );
 </script>

</head>
<body>
<fieldset>
<legend>
<?php
 include 'koneksi.php';
 $noregistrasi = @$_GET['noregistrasi'];
 $medicalrecord = @$_GET['medicalrecord'];
 $sql = mysqli_query($conn, "select * from pasien where medicalrecord='$medicalrecord' ") or die(mysqli_error());
 $data = mysqli_fetch_array($sql);
?>

<form action="" method="POST">
<table class="col-sm-4">
 <th colspan="3"><center>
 Edit Data Pasien </center>
</th>
<tr>
 <td>No. Rekam Medis </td>
 <td colspan="2"><input type="text" name="txtmedicalrecord" value="<?php echo $data['medicalrecord']; ?>" class='form-control input-sm' readonly required></input> </td>
</tr>
<tr>
 <td>Nama Pasien </td>
 <td><select name="slcpanggilan" class='form-control input-sm'>
  <option value="Tn." <?php if ($data['panggilan']=="Tn.") { echo "selected=\"selected\""; } ?>> Tn </option>
  <option value="Ny." <?php if ($data['panggilan']=="Ny.") { echo "selected=\"selected\""; } ?>> Ny </option>
  <option value="An." <?php if ($data['panggilan']=="An.") { echo "selected=\"selected\""; } ?>> An </option>
  <option value="By." <?php if ($data['panggilan']=="By.") { echo "selected=\"selected\""; } ?>> By </option>
 </select></td>
 <td>
 <input type="text" name="txtnamapasien" value="<?php echo $data['namapasien']; ?>" class='form-control input-sm'></input>
 </td>
</tr>
<tr>
 <td>Jenis Kelamin </td>
 <td><input type="radio" name="genre" value="L" <?php if($data['jeniskelamin']=='L'){echo 'checked';}?> >Laki - Laki</input></td>
 <td><input type="radio" name="genre" value="P" <?php if($data['jeniskelamin']=='P'){echo 'checked';}?> >Perempuan</input> </td>
</tr>
<tr>
 <td>Golongan Darah </td>
 <td colspan="2"><input type="text" name="txtgoldarah" value="<?php echo $data['goldarah']; ?>" class='form-control input-sm'></input> </td>
</tr>
<tr>
 <td>Agama </td>
 <td colspan="2"><select name="slcagama" class='form-control input-sm'>
 <option value="Islam" <?php if ($data['agama']=="Islam") { echo "selected=\"selected\""; } ?>>Islam</option>
 <option value="Kristen" <?php if ($data['agama']=="Kristen") { echo "selected=\"selected\""; } ?>>Kristen</option>
 <option value="Budha" <?php if ($data['agama']=="Budha") { echo "selected=\"selected\""; } ?>>Budha</option>
 <option value="Konghucu" <?php if ($data['agama']=="Konghucu") { echo "selected=\"selected\""; } ?>>Konghucu</option>
 <option value="Atheis" <?php if ($data['agama']=="Atheis") { echo "selected=\"selected\""; } ?>>Atheis</option>
   </select></td>
</tr>
<tr>
 <td>Suku Bangsa </td>
 <td colspan="2"><input type="text" name="txtsukubangsa" value=<?php echo $data['sukubangsa']; ?> class='form-control input-sm'></input> </td>
</tr>
<tr>
 <td>Bahasa </td>
 <td colspan="2"><input type="text" name="txtbahasa" value="<?php echo $data['bahasa']; ?>" class='form-control input-sm'></input> </td>
</tr>
<tr>
 <td>Tempat Lahir </td>
 <td colspan="2"><input type="text" name="txttempatlahir" value="<?php echo $data['tempatlahir']; ?>" class='form-control input-sm'></input> </td>
</tr>
<tr>
 <td>Tanggal Lahir </td>
 <td colspan="2"><input type="date" name="datetanggallahir" value="<?php echo $data['tanggallahir']; ?>" id="datepicker" class='form-control input-sm'></input> </td>
</tr>
<tr>
 <td>Status </td>
 <td colspan="2"><select name="slcstatus" class='form-control input-sm'>
  <option value="Menikah" <?php if ($data['status']=="Menikah") { echo "selected=\"selected\""; } ?>>Menikah</option>
  <option value="Belum Menikah" <?php if ($data['status']=="Belum Menikah") { echo "selected=\"selected\""; } ?>>Belum Menikah</option>
   </select></td>
</tr>
<tr>
 <td>Type Identitas </td>
 <td><select name="slctypeidentitas" class='form-control input-sm'>
 <option value="Kitas" <?php if ($data['typeidentitas']=="Kitas") { echo "selected=\"selected\""; } ?>>Kitas</option>
 <option value="KTP" <?php if ($data['typeidentitas']=="KTP") { echo "selected=\"selected\""; } ?>>KTP</option>
 <option value="Passpor" <?php if ($data['typeidentitas']=="Passpor") { echo "selected=\"selected\""; } ?>>Passpor</option>
 <option value="SIM" <?php if ($data['typeidentitas']=="SIM") { echo "selected=\"selected\""; } ?>>SIM</option>
 </select></td> 
 <td><input type="text" name="txtnoidentitas" value="<?php echo $data['noidentitas']; ?>" class='form-control input-sm'></input></td>
</tr>
<tr>
 <td>Kewarganegaraan </td>
 <td colspan="2"><input type="text" name="txtkewarganegaraan" value="<?php echo $data['kewarganegaraan']; ?>" class='form-control input-sm'></input> </td>
</tr>
<tr>
 <td>Alamat </td>
 <td colspan="2"><ttextarea name="txtalamat" rows="2" cols="30" class='form-control input-sm'> <?php echo $data['alamat']; ?> </ttextarea> </td>
</tr>
<tr>
 <td>Kota </td>
 <td colspan="2"><input type="text" name="txtkota" value="<?php echo $data['kota']; ?>" class='form-control input-sm'></input> </td>
</tr>
<tr>
 <td>Provinsi </td>
 <td colspan="2"><input type="text" name="txtprovinsi" value="<?php echo $data['provinsi']; ?>" class='form-control input-sm'></input> </td>
</tr>
<tr>
 <td>Negara </td>
 <td colspan="2"><input type="text" name="txtnegara" value="<?php echo $data['negara']; ?>" class='form-control input-sm'></input> </td>
</tr>
<tr>
 <td>No Telfon </td>
 <td colspan="2"><input type="text" name="txtnotelfon" value="<?php echo $data['notelfon']; ?>" class='form-control input-sm'></input> </td>
</tr>
<tr>
 <td> <input type="submit" name="btnedit" value="Edit" class='btn btn-block btn-info'></input></td>
 <td colspan="2"> <input type="submit" name="btnbatal" value="Batal" class='btn btn-block btn-warning'></input></td>
</tr>
</table>
</form>
</legend>
</fieldset>
<?php
  if(isset($_POST['btnedit'])){
    $datetanggallahir = $_POST['datetanggallahir'];
    //echo $date."<br>" ;
    $datetanggallahir = strtotime($datetanggallahir);
    $datetanggallahir = date ('Y-m-d', $datetanggallahir);
    //echo $date;

   $edit = mysqli_query($conn, "update  pasien set 
       panggilan = '".$_POST['slcpanggilan']."',
       namapasien = '".$_POST['txtnamapasien']."',  
       jeniskelamin = '".$_POST['genre']."',
       goldarah = '".$_POST['txtgoldarah']."',
       agama = '".$_POST['slcagama']."',
       sukubangsa = '".$_POST['txtsukubangsa']."',
       bahasa = '".$_POST['txtbahasa']."',
       tempatlahir = '".$_POST['txttempatlahir']."',
       tanggallahir = '".$datetanggallahir."',
       status = '".$_POST['slcstatus']."',
       typeidentitas = '".$_POST['slctypeidentitas']."',
       noidentitas = '".$_POST['txtnoidentitas']."',
       kewarganegaraan = '".$_POST['txtkewarganegaraan']."',
       alamat = '".$_POST['txtalamat']."',
       kota = '".$_POST['txtkota']."',
       provinsi = '".$_POST['txtprovinsi']."',
       negara = '".$_POST['txtnegara']."',
       notelfon = '".$_POST['txtnotelfon']."'
       WHERE medicalrecord = '".$_POST['txtmedicalrecord']."' "); // '".$_POST['txtid']."' ganti NULL jika type id user auto increament di database
   if($edit){
     ?>
      <script type="text/javascript">
       window.location.href="?page=transaksi&action=tambahpoli&noregistrasi=<?php echo $noregistrasi; ?>";
      </script>
     <?php
   }else{
    echo "Error updating record: " . $conn->error;
   }
  }
 ?>

 <?php
  if(isset($_POST['btnbatal'])){
   ?>
   <script type="text/javascript">
    window.location.href="?page=transaksi&action=tambahpoli&noregistrasi=<?php echo $noregistrasi; ?>";
   </script>
   <?php
  }else{

  }

 ?>

</body>
</html>

ftambahpoli.php

<!DOCTYPE html>
<html>
<head>
 <title> Pendaftran Rawat Jalan</title>
  
  <script type="text/javascript" src="jquery-1.12.4.min.js"></script> <!-- jquery-1.12.4.min.js untuk memanggil script autocomplete-->
  <link rel="stylesheet" href="jquery-ui-1.12.1//jquery-ui.css">
  <script type="text/javascript" src="jquery-ui-1.12.1/jquery-ui.min.js"></script>
 
  <link rel="stylesheet" href="bootstrap-3.3.6/dist/css/bootstrap.min.css"/>
  <script src="bootstrap-3.3.6/dist/js/bootstrap.min.js"></script>
  
  <link rel="stylesheet" href="bootstrap-3.3.6/dist/css/form.trans.pendaftaran.css"/>

 <?php 
  include "koneksi.php";
  include "scriptautofillnautocomplete.php";
 
  $noregistrasi = @$_GET['noregistrasi'];
  $sqllistdatareg = mysqli_query($conn, "SELECT tprosespendaftaranrj.noregistrasi, 
           tprosespendaftaranrj.tglregistrasi, 
           tprosespendaftaranrj.wktregister, 
           tprosespendaftaranrj.medicalrecord, 
           pasien.namapasien,
           pasien.tanggallahir,
           pasien.jeniskelamin, 
           pasien.alamat, 
           tprosespendaftaranrj.umur, 
           tprosespendaftaranrj.jenispasien,
           tprosespendaftaranrj.catatanmasuk,
           pasien.statusregister
           FROM tprosespendaftaranrj, pasien 
           WHERE tprosespendaftaranrj.medicalrecord=pasien.medicalrecord 
           AND tprosespendaftaranrj.noregistrasi = '$noregistrasi' ") or die(mysqli_error());
  $datareg = mysqli_fetch_array($sqllistdatareg);
 ?>

 <?php
  $slcjenispasien = $datareg['jenispasien'];
  if($slcjenispasien == 'asuransi'){
   $listdatajampxas = mysqli_query($conn, "SELECT tdetail_prosesdaftar_jp_as.noregistrasi,
              tdetail_prosesdaftar_jp_as.medicalrecord,
              tdetail_prosesdaftar_jp_as.idasuransi,
              asuransi.namaasuransi,
              asuransi.tarifcorporate,
              tdetail_prosesdaftar_jp_as.nopolis,
              tdetail_prosesdaftar_jp_as.namakaryawan
            FROM asuransi,tdetail_prosesdaftar_jp_as
            WHERE tdetail_prosesdaftar_jp_as.idasuransi = asuransi.idasuransi
            AND tdetail_prosesdaftar_jp_as.noregistrasi = '$noregistrasi'");
   $datajampxas = mysqli_fetch_array($listdatajampxas);
  }elseif($slcjenispasien = 'perusahaan'){
   $listdatajampxpr = mysqli_query($conn, "SELECT tdetail_prosesdaftar_jp_pr.noregistrasi,
               tdetail_prosesdaftar_jp_pr.medicalrecord,
               tdetail_prosesdaftar_jp_pr.idperusahaan,
               perusahaan.namaperusahaan,
               perusahaan.tarifcorporate,
               tdetail_prosesdaftar_jp_pr.nopolis,
               tdetail_prosesdaftar_jp_pr.namakaryawan
             FROM perusahaan,tdetail_prosesdaftar_jp_pr
             WHERE tdetail_prosesdaftar_jp_pr.idperusahaan = perusahaan.idperusahaan
             AND tdetail_prosesdaftar_jp_pr.noregistrasi = '$noregistrasi'");
   $datajampxpr = mysqli_fetch_array($listdatajampxpr);
  }else{
   $listdatajampxum = mysqli_query($conn, "select * from tdetail_prosesdaftar_jp_um");
   $datajampxum = mysqli_fetch_array($listdatajampxum);
   }
 ?>
 
 <?php 
  $jeniskelamin = $datareg['jeniskelamin'];
  if($jeniskelamin == "L"){
   $jeniskelamin =  "Laki-laki";
  }else if(($jeniskelamin == "P")){
   $jeniskelamin =  "Perempuan";
  }else{
   $jeniskelamin = "";
  }
 ?>

</head>
<body>

<fieldset>
<legend class="col-sm-6"> Pendaftaran Rawat Jalan
<div class="navbar-right">
 <a href="halamanutama.php?page=transaksi&action=editpasien2&noregistrasi=<?php echo $datareg['noregistrasi']; ?>&medicalrecord=<?php echo $datareg['medicalrecord']; ?>">
  <button name="btneditmedicalrecord" class='btn btn-sm btn-info'>Edit Rekam Medis</button>
 </a>
 <a href="halamanutama.php?page=transaksi&action=pasienrj"> 
  <button class='btn btn-sm btn-warning'>Daftar Baru</button>
 </a>

 <button name="btnhistorymedicalrecord" class='btn btn-sm btn-info' data-toggle="modal" data-target="#HistoryPasien"> History Pasien </button>
 <font color="white">...</font>
   <!-- Modal History Pasien -->
  <div class="modal fade" id="HistoryPasien" tabindex="-1" role="dialog" aria-labelledby="HistoryPasien">
    <div class="modal-dialog" role="document">
      <div class="modal-content">
        <div class="modal-header">
          <button type="button" class="close" data-dismiss="modal" aria-label="Close"><span aria-hidden="true">×</span></button>
          <h4 class="modal-title" id="HistoryPasien">
History Pasien</h4>
</div>
<div class="modal-body">
          <form action="" method="POST" role="form">
           <div class="form-group">
            <table width="100%">
<tr>
              <th>No Registrasi</th>
              <th>Tgl Berobat</th>
              <th>Department</th>
              <th>Nama Dokter</th>
              <th>Jaminan</th>
             </tr>
<?php
             $hmedicalrecord = $datareg['medicalrecord'];
             $sqlhistory = mysqli_query($conn, "SELECT tprosespendaftaranrj.noregistrasi, 
           tprosespendaftaranrj.tglregistrasi,
           tprosespendaftaranrj.medicalrecord, 
           pasien.namapasien,
           tprosespendaftaranrj.jenispasien,
           tdetailprosespendaftaranrj.iddepartment,
           department.namadepartment,
           tdetailprosespendaftaranrj.id_dokter,
           dokter.namadokter,
           tprosespendaftaranrj.catatanmasuk
           FROM tprosespendaftaranrj, pasien, tdetailprosespendaftaranrj, dokter, department
           WHERE tprosespendaftaranrj.medicalrecord=pasien.medicalrecord
           AND tprosespendaftaranrj.noregistrasi = tdetailprosespendaftaranrj.noregistrasi 
           AND tdetailprosespendaftaranrj.iddepartment=department.iddepartment
           AND tdetailprosespendaftaranrj.id_dokter=dokter.id_dokter
           AND tprosespendaftaranrj.medicalrecord = '$hmedicalrecord' ");
     while ($datasqlhistory = mysqli_fetch_array($sqlhistory)) {
     ?>
<tr>
              <td><?php echo $datasqlhistory['noregistrasi']; ?></td>
              <td><?php echo $datasqlhistory['tglregistrasi']; ?></td>
              <td><?php echo $datasqlhistory['namadepartment']; ?></td>
              <td><?php echo $datasqlhistory['namadokter']; ?></td>
              <td><?php echo $datasqlhistory['jenispasien']; ?></td>
             </tr>
<?php
      }
     ?>
            </table>
</div>
</div>
<div class="modal-footer">
          <button type="button" class="btn btn-default" data-dismiss="modal">Close</button>
         </form>
</div>
</div>
</div>
</div>
</div>
</legend>
</fieldset>
<form action="" method="POST" name="ftambahpoli">
<!--PROSES UNTUK MEMBUAT FORM PENDAFTARAN  -->
<fieldset>
<legend class="col-sm-6">
 <table width="100%">
<tr>
   <td>No Registrasi</td>
   <td><input type="text" name="txtnoregistrasi" value="<?php echo $datareg['noregistrasi']; ?>" readonly class='form-control input-sm'></input></td>
   <td><input type="text" name="txtstatusregister"  value="PROSES" readonly class='form-control input-sm'></input></td>
  </tr>
<tr>
   <td>Tanggal</td>
   <td><input type="text" name="datetglregistrasi" value="<?php echo $datareg['tglregistrasi']; ?>" class='form-control input-sm' readonly></input></td>
   <td><input type="text" name="timetglregistrasi" value="<?php echo $datareg['wktregister']; ?>" class='form-control input-sm' readonly></input></td>
  </tr>
<tr>
   <td>No Rekam Medis</td>
   <td><input type="text" name="txtmedicalrecord"  value="<?php echo $datareg['medicalrecord']; ?>" class='form-control input-sm' readonly></input></td>
  </tr>
<tr>
   <td>Nama Pasien</td>
   <td><input type="text" name="txtnamapasien" value="<?php echo $datareg['namapasien']; ?>" class='form-control input-sm' readonly></input></td>
  </tr>
<tr>
   <td style="width: 180px">Tanggal Lahir/umur/Jen.Kel</td>
   <td>
    <input type="date" name="datetgllahir" value="<?php echo $datareg['tanggallahir']; ?>" readonly class='form-control input-sm'></input>
   </td>
   <td>
    <input type="text" name="txtumur" value="<?php echo $datareg['umur']; ?>" readonly class='form-control input-sm'></input>
   </td>
   <td>
    <input type="text" name="txtjenkel" value="<?php echo $jeniskelamin; ?>" readonly class='form-control input-sm'></input>
   </td>
  </tr>
<tr>
   <td>Alamat</td>
   <td colspan="3"><input type="text" name="txtalamat" value="<?php echo $datareg['alamat']; ?>" readonly class='form-control input-sm'></input></td>
  </tr>
<tr>
   <td>Jenis Pasien</td>
   <td><select name="slcjenispasien" id="slcjenispasien" class='form-control input-sm'>
    <option value="umum" onclick="tampil(0);" <?php if ($datareg['jenispasien']=="umum") { echo "selected=\"selected\""; } ?> > umum </option>
    <option value="asuransi" onclick="tampil(1);" <?php if ($datareg['jenispasien']=="asuransi") { echo "selected=\"selected\""; } ?> > asuransi </option>
    <option  value="perusahaan" onclick="tampil(2);" <?php if ($datareg['jenispasien']=="perusahaan") { echo "selected=\"selected\""; } ?>> perusahaan </option>
    </select></td>
  </tr>
</table>
<fieldset id="templateasuransi" style="display:none;">
  <legend>  <center>
 Data Asuransi </center>
<table width="100%">
<tr>
    <td>Nama ASuransi </td>
    <td><input type="text" name="txtnamaasuransi" id="namaasuransi" value="<?php echo $datajampxas['namaasuransi']; ?>" class='form-control input-sm' readonly></input></td>
   </tr>
<tr>
    <td style="width: 150px">Tarif Corporate </td>
    <td><input type="text" name="txttarifcorporate" id="tarifcorporate" value="<?php echo $datajampxas['tarifcorporate']; ?>" class='form-control input-sm' readonly></input></td>
   </tr>
<tr>
    <td>No Polis </td>
    <td><input type="text" name="txtnopolisasuransi" value="<?php echo $datajampxas['nopolis']; ?>" class='form-control input-sm' readonly></input></td>
   </tr>
<tr>
    <td>Nama Karyawan </td>
    <td><input type="text" name="txtnamakaryawanas" value="<?php echo $datajampxas['namakaryawan']; ?>" class='form-control input-sm' readonly></input></td>
   </tr>
</table>
</legend>
 </fieldset>
<fieldset id="templateperusahaan" style="display:none;">
  <legend> <center>
 Data perusahaan </center>
<table width="100%">
<tr>
    <td>Nama perusahaan </td>
    <td><input type="text" name="txtnamaperusahaan" id="namaperusahaan" value="<?php echo $datajampxpr['namaperusahaan']; ?>" class='form-control input-sm' readonly></input></td>
   </tr>
<tr>
    <td style="width: 150px">Tarif Corporate</td>
    <td><input type="text" name="txttarifcorporate" disabled="disabled" id="tarifcorporateP" value="<?php echo $datajampxpr['tarifcorporate']; ?>" readonly class='form-control input-sm'></input></td>
   </tr>
<tr>
    <td>NIK Karyawan</td>
    <td><input type="text" name="txtnik" value="<?php echo $datajampxpr['nopolis']; ?>" class='form-control input-sm' readonly></input></td>
   </tr>
<tr>
    <td>Nama Karyawan</td>
    <td><input type="text" name="txtnamakaryawanpr" value="<?php echo $datajampxpr['namakaryawan']; ?>" class='form-control input-sm' readonly></input></td>
   </tr>
</table>
</legend>
 </fieldset>
<table width="100%" class="table-sm">
<tr>
   <td style="width: 180px">Catatan Masuk</td>
   <td colspan="4">
    <ttextarea name="txtcatatanmasuk" disabled="disabled" class='form-control input-sm'> 
     <?php echo $datareg['catatanmasuk']; ?> 
    </ttextarea>
   </td>
  </tr>
<tr>
   <td>Departement/Poli</td>
   <td><input type="text" name="txtnamadepartment" id="namadepartment" onkeyup="autofilldepartment()" class='form-control input-sm' required></input>
    <input type="text" name="txtiddepartment" id="iddepartment" style="display: none;"></input></td>
   <td style="width: 50px"><center>
Dokter</center>
</td>
   <td><input type="text" name="txtnamadokter" id="namadokter" onkeyup="autofilldokter()" class='form-control input-sm' required></input>
       <input type="text" name="txtiddokter" id="id_dokter" style="display: none;"></input></td>
   <td>Antrian</td>
   <td style="width: 60px"><input type="number" name="txtantrian" class='form-control input-sm' required></input></td>
   <td><input type="submit" name="btntambah" value="Tambah" class='btn btn-sm btn-info'></input></td>
  </tr>
</table>
<!-- ---------------------------------------------- Tambah Data Poli Pasien --------------------------------------------------- -->
   <?php
    $medicalrecord = $datareg['medicalrecord'];    
    if(isset($_POST['btntambah'])){
     $tambahpoli = mysqli_query($conn, "insert into tdetailprosespendaftaranrj values 
           ('$noregistrasi',
           '$medicalrecord',
           '".$_POST['txtiddepartment']."',
           '".$_POST['txtiddokter']."',
           '".$_POST['txtantrian']."')");
    }
   ?>

 </table>
</form>
<!-- ---------------------------------------------- Tampil Data Poli Pasien --------------------------------------------------- -->
<legend>
<table width="100%" class="table-sm table-bordered">
<tr>
   <th bgcolor="#07d1ca"><center>
Nama Department</center>
</th>
   <th bgcolor="#07d1ca"><center>
Nama Dokter</center>
</th>
   <th bgcolor="#07d1ca"><center>
Antrian</center>
</th>
   <th bgcolor="#07d1ca" colspan="2"><center>
Action</center>
</th>
  </tr>
<?php

    $listpolipasien = mysqli_query($conn, 
     "select tdetailprosespendaftaranrj.antrian, department.iddepartment, department.namadepartment, dokter.id_dokter, dokter.namadokter
     from department, dokter, tdetailprosespendaftaranrj
     where department.iddepartment=tdetailprosespendaftaranrj.iddepartment 
     and dokter.id_dokter=tdetailprosespendaftaranrj.id_dokter
     and tdetailprosespendaftaranrj.noregistrasi = '$noregistrasi' ") or die (mysqli_error());
     while ($datalistpasien = mysqli_fetch_array($listpolipasien)) {
      ?>
<tr>
       <td><?php echo $datalistpasien['namadepartment']; ?></td>
       <td><?php echo $datalistpasien['namadokter']; ?></td>
       <td><center>
<?php echo $datalistpasien['antrian']; ?> </center>
</td>
       <td><center>
        <a href="?page=transaksi&action=hapuspoli&noregistrasi=<?php echo $datareg['noregistrasi']; ?>&iddepartment=<?php echo $datalistpasien['iddepartment']; ?>&id_dokter=<?php echo $datalistpasien['id_dokter']; ?>">
        <button name="btnhapus" class='btn btn-sm btn-danger btn-block'>Hapus</button></a>
       </center>
</td>
       <td><center>
        <a href="?page=transaksi&action=cetakstrukregister&noregistrasi=<?php echo $datareg['noregistrasi']; ?>&iddepartment=<?php echo $datalistpasien['iddepartment']; ?>&id_dokter=<?php echo $datalistpasien['id_dokter']; ?>" target="_blank">
        <button name="btncetak" class='btn btn-sm btn-info btn-block'>Cetak</button></a>
       </center>
</td>
      </tr>
<?php
     }
   ?>
</table>
</legend>
</fieldset>
</body>
</html>

list_reg_px.php

<!DOCTYPE html>
<html>
<head>
 <link rel="stylesheet" href="bootstrap-3.3.6/dist/css/bootstrap.min.css"/>
 <script src="bootstrap-3.3.6/dist/js/bootstrap.min.js"></script>
</head>
<body>
<fieldset>
 <legend>List Data Registrasi</legend>

<input type="date" name="datecaritgl" class='form-control input-sm'></input>
  <button type="submit" name="btncaritgl" class='btn btn-sm btn-primary'><span class="glyphicon glyphicon-search"> Cari Tgl Lahir</span></button>
 </div>
</form>
<table class="table table-striped table-bordered small">
<tr>
   <th bgcolor="yellow">noregistrasi</th>
   <th bgcolor="yellow">status</th>
   <th bgcolor="yellow">Tanggal</th>
   <th bgcolor="yellow">waktu</th>
   <th bgcolor="yellow">medicalrecord</th>
   <th bgcolor="yellow">nama</th>
   <th bgcolor="yellow">Tanggal Lahir</th>
   <th bgcolor="yellow">JenKel</th>
   <th bgcolor="yellow">alamat</th>
   <th bgcolor="yellow">umur</th>
   <th bgcolor="yellow">jenis pasien</th>
   <th bgcolor="yellow">catatan masuk</th>
   <th bgcolor="yellow">Action</th>
  </tr>
<?php
    include 'koneksi.php';
    $txtcarimr = @$_POST['txtcarimr'];
    $btncarimr = @$_POST['btncarimr'];
    $txtcarinm = @$_POST['txtcarinm'];
    $btncarinm = @$_POST['btncarinm'];
    $datecaritgl = @$_POST['datecaritgl'];
    $btncaritgl = @$_POST['btncaritgl'];

$sql = mysqli_query($conn, "SELECT tprosespendaftaranrj.noregistrasi, 
           tprosespendaftaranrj.tglregistrasi, 
           tprosespendaftaranrj.wktregister, 
           tprosespendaftaranrj.medicalrecord, 
           pasien.namapasien,
           pasien.tanggallahir,
           pasien.jeniskelamin, 
           pasien.alamat, 
           tprosespendaftaranrj.umur, 
           tprosespendaftaranrj.jenispasien,
           tprosespendaftaranrj.catatanmasuk,
           pasien.statusregister
           FROM tprosespendaftaranrj, pasien 
           WHERE tprosespendaftaranrj.medicalrecord=pasien.medicalrecord ORDER BY noregistrasi DESC");

if(isset($_POST['btncarimr'])){
    $sql = mysqli_query($conn, "SELECT tprosespendaftaranrj.noregistrasi, 
           tprosespendaftaranrj.tglregistrasi, 
           tprosespendaftaranrj.wktregister, 
           tprosespendaftaranrj.medicalrecord, 
           pasien.namapasien,
           pasien.tanggallahir,
           pasien.jeniskelamin, 
           pasien.alamat, 
           tprosespendaftaranrj.umur, 
           tprosespendaftaranrj.jenispasien,
           tprosespendaftaranrj.catatanmasuk,
           pasien.statusregister
           FROM tprosespendaftaranrj, pasien 
           WHERE tprosespendaftaranrj.medicalrecord=pasien.medicalrecord
           AND tprosespendaftaranrj.medicalrecord LIKE '%$txtcarimr%' ") or die (mysqli_error()); 
    }elseif(isset($_POST['btncarinm'])){
    $sql = mysqli_query($conn, "SELECT tprosespendaftaranrj.noregistrasi, 
           tprosespendaftaranrj.tglregistrasi, 
           tprosespendaftaranrj.wktregister, 
           tprosespendaftaranrj.medicalrecord, 
           pasien.namapasien,
           pasien.tanggallahir,
           pasien.jeniskelamin, 
           pasien.alamat, 
           tprosespendaftaranrj.umur, 
           tprosespendaftaranrj.jenispasien,
           tprosespendaftaranrj.catatanmasuk,
           pasien.statusregister
           FROM tprosespendaftaranrj, pasien 
           WHERE tprosespendaftaranrj.medicalrecord=pasien.medicalrecord
           AND namapasien LIKE '%$txtcarinm%' ") or die (mysqli_error()); 
    }elseif(isset($_POST['btncaritgl'])){
    $sql = mysqli_query($conn, "SELECT tprosespendaftaranrj.noregistrasi, 
           tprosespendaftaranrj.tglregistrasi, 
           tprosespendaftaranrj.wktregister, 
           tprosespendaftaranrj.medicalrecord, 
           pasien.namapasien,
           pasien.tanggallahir,
           pasien.jeniskelamin, 
           pasien.alamat, 
           tprosespendaftaranrj.umur, 
           tprosespendaftaranrj.jenispasien,
           tprosespendaftaranrj.catatanmasuk,
           pasien.statusregister
           FROM tprosespendaftaranrj, pasien 
           WHERE tprosespendaftaranrj.medicalrecord=pasien.medicalrecord
           AND tanggallahir LIKE '%$datecaritgl%' ") or die (mysqli_error()); 
    }
    while ($datareg = mysqli_fetch_array($sql)) {
    ?>
<tr>
     <td><?php echo $datareg['noregistrasi']; ?></td>
     <td><?php echo $datareg['statusregister']; ?></td>
     <td><?php echo $datareg['tglregistrasi']; ?></td>
     <td><?php echo $datareg['wktregister']; ?></td>
     <td><?php echo $datareg['medicalrecord']; ?></td>
     <td><?php echo $datareg['namapasien']; ?></td>
     <td><?php echo $datareg['tanggallahir']; ?></td>
     <td><?php echo $datareg['jeniskelamin']; ?></td>
     <td><?php echo $datareg['alamat']; ?></td>
     <td><?php echo $datareg['umur']; ?></td>
     <td><?php echo $datareg['jenispasien']; ?></td>
     <td><?php echo $datareg['catatanmasuk']; ?></td>
     <td>
     <?php
      $statusregister = $datareg['statusregister'];
      if($statusregister == "PULANG"){
       echo "*****";
      }else{
       ?>
       <a href="?page=transaksi&action=tambahpoli&noregistrasi=<?php echo $datareg["noregistrasi"]; ?>">
       <button class='btn btn-sm btn-link'>Pilih</button>
       </a>
       <?php
      }
     ?>
     </td>
    </tr>
<?php
   }
  ?>

</table>
</form>
</form>
</fieldset>
</body>
</html>

proseshapuspoli.php

<?php
 include_once "koneksi.php";
 $iddepartmenth = $_GET['iddepartment'];
 $id_dokterh = $_GET['id_dokter'];
 $noregistrasi = $_GET['noregistrasi'];

 $sqlceklayanan = mysqli_query($conn, "SELECT * FROM tdetail_layanan_px WHERE iddepartment='$iddepartmenth' AND id_dokter='$id_dokterh' ");

   if(mysqli_num_rows($sqlceklayanan)>0)
   { 
      ?>
   <script type="text/javascript">
    alert("Pasien Telah Mendapat Layanan Dari Dokter Ini ");
    window.location.href="?page=transaksi&action=tambahpoli&noregistrasi=<?php echo $noregistrasi; ?>";
   </script>
  <?php
   }
   else
   {
    $sqlhapus= mysqli_query($conn, "DELETE FROM tdetailprosespendaftaranrj WHERE iddepartment='$iddepartmenth' AND id_dokter='$id_dokterh' ")or die(mysqli_error());
     ?>
   <script type="text/javascript">
    alert("DAta Telah Di HApus");
    window.location.href="?page=transaksi&action=tambahpoli&noregistrasi=<?php echo $noregistrasi; ?>"; 
   </script>
  <?php
      //Simpan data
   }
?>

cetakstrkregister.php

<?php
ob_start();
// memanggil library FPDF
require_once('fpdf181/fpdf.php');

//memanggil data di databse
include 'koneksi.php';
$noregistrasi = $_GET['noregistrasi'];
$iddepartment = $_GET['iddepartment'];
$id_dokter = $_GET['id_dokter'];

$sqlpendaftaran = mysqli_query($conn, "SELECT tprosespendaftaranrj.noregistrasi, 
           tprosespendaftaranrj.tglregistrasi, 
           tprosespendaftaranrj.wktregister, 
           tprosespendaftaranrj.medicalrecord, 
           pasien.panggilan,
           pasien.namapasien,
           pasien.tanggallahir,
           pasien.jeniskelamin, 
           pasien.alamat, 
           tprosespendaftaranrj.umur, 
           tprosespendaftaranrj.jenispasien,
           tprosespendaftaranrj.catatanmasuk,
           pasien.statusregister,
           tdetailprosespendaftaranrj.id_dokter,
           dokter.namadokter,
           tdetailprosespendaftaranrj.iddepartment,
           department.namadepartment,
           tdetailprosespendaftaranrj.antrian
           FROM tprosespendaftaranrj, tdetailprosespendaftaranrj, pasien, dokter, department 
           WHERE tprosespendaftaranrj.noregistrasi = tdetailprosespendaftaranrj.noregistrasi
           AND tdetailprosespendaftaranrj.id_dokter = dokter.id_dokter
           AND tdetailprosespendaftaranrj.iddepartment = department.iddepartment
           AND tprosespendaftaranrj.medicalrecord=pasien.medicalrecord 
           AND tprosespendaftaranrj.noregistrasi = '$noregistrasi'
           AND tdetailprosespendaftaranrj.iddepartment='$iddepartment'
           AND tdetailprosespendaftaranrj.id_dokter='$id_dokter' ") or die(mysqli_error());
$datareg = mysqli_fetch_array($sqlpendaftaran);

$jeniskelamin = $datareg['jeniskelamin'];
 if($jeniskelamin == "L"){
  $jeniskelamin =  "Laki-laki";
 }else if(($jeniskelamin == "P")){
  $jeniskelamin =  "Perempuan";
 }else{
  $jeniskelamin = "";
 }

// intance object dan memberikan pengaturan halaman PDF
$pdf = new FPDF('l','mm','A5');
// membuat halaman baru
$pdf->AddPage();
// setting jenis font yang akan digunakan
$pdf->SetFont('Arial','B',16);
// mencetak string 
$pdf->Cell(80,7,'RUMAH SAKIT ANGAN ANGAN',0,1,'C');
$pdf->SetFont('Arial','B',12);
$pdf->Cell(80,4,'STRUK PENDAFTARAN',0,1,'C');
 
// Memberikan space kebawah agar tidak terlalu rapat
$pdf->Cell(10,5,'------------------------------------------------------',0,1);

//menampilkan data
$pdf->SetFont('Arial','B',11); 
$pdf->Cell(80,5,'Department : '.$datareg['namadepartment'],0,1,'C');
$pdf->Cell(80,5,'No Antrian : '.$datareg['antrian'],0,1,'C');

$pdf->SetFont('Arial','',10);
$pdf->Cell(30,5,'No Registrasi',0,0); 
$pdf->Cell(30,5,': '.$datareg['noregistrasi'],0,1);

$pdf->Cell(30,5,'Tanggal Reg',0,0);
$pdf->Cell(20,5,': '.$datareg['tglregistrasi'],0,0);
$pdf->Cell(30,5,$datareg['wktregister'],0,1,'R');

$pdf->Cell(30,5,'Medrec',0,0); 
$pdf->Cell(30,5,': '.$datareg['medicalrecord'],0,1);//kode 0,1 -> untuk membuat label setelahnya di baris baru,

$pdf->Cell(30,5,'Nama',0,0);
$pdf->Cell(30,5,': '.$datareg['panggilan'].$datareg['namapasien'],0,1);

$pdf->Cell(30,5,'Tanggal Lahir',0,0);
$pdf->Cell(30,5,': '.$datareg['tanggallahir'],0,1);

$pdf->Cell(30,5,'Umur',0,0);// jika 1,0 -> maka label menjadi 1 baris, atau bersambung
$pdf->Cell(30,5,': '.$datareg['umur'],0,1);

$pdf->Cell(30,5,'jenkel',0,0); // jika 1,1-> maka label di beri border penuh.
$pdf->Cell(30,5,': '.$jeniskelamin,0,1);

$pdf->Cell(30,5,'Dokter Pemeriksa',0,0);
$pdf->Cell(30,5,': '.$datareg['namadokter'],0,1);

$pdf->Cell(30,5,'Jenis Pasien',0,0);
$pdf->Cell(30,5,': '.$datareg['jenispasien'],0,1);

$pdf->Cell(30,5,'catatan',0,0);
$pdf->Cell(30,5,': '.$datareg['catatanmasuk'],0,1);

$pdf->Cell(30,5,'Pemeriksaan',0,0);
$pdf->Cell(50,5,' _______________________',0,1,'R');
$pdf->Cell(80,5,' _______________________',0,1,'R');

$pdf->Cell(80,5,'',0,1,'R');

$pdf->Cell(40,5,'Ttd Pendaftar',0,0);
$pdf->Cell(40,5,'Ttd Dokter',0,1,'R');

$pdf->SetFont('Arial','',10);

$pdf->Output();
ob_end_flush(); 
?>

Thursday, 22 March 2018

Sistem Informasi Rawat Jalan Rumah Sakit Dengan PHP,Javascript,Bootstrap - Part 5 (Pembuatan Proses Pendaftaran menggunakan MODAL Bootsrap

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