문진 작성 추가

src/main/java/com/lemon/lifecenter/controller/MobileMenuController.java

@@ -5,12 +5,15 @@ import javax.servlet.http.HttpServletResponse;
 
 import org.slf4j.Logger;
 import org.slf4j.LoggerFactory;
+import org.springframework.beans.factory.annotation.Autowired;
 import org.springframework.stereotype.Controller;
 import org.springframework.web.bind.annotation.RequestMapping;
 import org.springframework.web.servlet.ModelAndView;
 
 import com.lemon.lifecenter.common.LifeCenterController;
 import com.lemon.lifecenter.common.LifeCenterSessionController;
+import com.lemon.lifecenter.dto.PatientDTO;
+import com.lemon.lifecenter.service.MobilePatientService;
 
 @Controller
 @RequestMapping("/mobile")
@@ -18,17 +21,25 @@ public class MobileMenuController extends LifeCenterController {
     
     private final Logger logger = LoggerFactory.getLogger(this.getClass());
     
+    @Autowired
+    private MobilePatientService patientService;
+    
     @RequestMapping("/menu")
     public ModelAndView menu(
             HttpServletRequest request, HttpServletResponse response) {
         String patientId = LifeCenterSessionController.getSession(request, "sesMId");
         String roomId = LifeCenterSessionController.getSession(request, "sesMRoomNum");
         String patientName = LifeCenterSessionController.getSession(request, "sesMName");
+        String sesMpIdx  = LifeCenterSessionController.getSession( request, "sesMpIdx" );
+        PatientDTO dto = new PatientDTO();
+        dto.setPatientIdx(Integer.parseInt(sesMpIdx));
+        int cnt = patientService.selectMunJinCount(dto);
         
         ModelAndView mv = setMobileMV("menu/menu");
         mv.addObject("patientId", patientId);
         mv.addObject("roomId", roomId);
         mv.addObject("name", patientName);
+        mv.addObject("munjinCnt", cnt);
         return mv;
     }
     

src/main/java/com/lemon/lifecenter/controller/MobileServeyController.java

@@ -1,18 +1,51 @@
 package com.lemon.lifecenter.controller;
 
+import javax.servlet.http.HttpServletRequest;
+import javax.servlet.http.HttpServletResponse;
+
+import org.slf4j.Logger;
+import org.slf4j.LoggerFactory;
+import org.springframework.beans.factory.annotation.Autowired;
 import org.springframework.stereotype.Controller;
+import org.springframework.web.bind.annotation.ModelAttribute;
 import org.springframework.web.bind.annotation.RequestMapping;
 import org.springframework.web.servlet.ModelAndView;
 
 import com.lemon.lifecenter.common.LifeCenterController;
+import com.lemon.lifecenter.common.LifeCenterSessionController;
+import com.lemon.lifecenter.dto.PatientDTO;
+import com.lemon.lifecenter.service.MobilePatientService;
 
 @Controller
 @RequestMapping("/mobile")
 public class MobileServeyController extends LifeCenterController {
     
+    private final Logger logger = LoggerFactory.getLogger(this.getClass());
+    
+    @Autowired
+    private MobilePatientService patientService;
+    
     @RequestMapping("/servey")
-    public ModelAndView login() {
+    public ModelAndView servey(HttpServletRequest request,HttpServletResponse response) {
         ModelAndView mv = setMobileMV("servey/servey");
         return mv;
     }
+    
+    @RequestMapping("/servey/insert")
+    public String serveyInsert(
+            @ModelAttribute("dto") final PatientDTO dto,
+            HttpServletRequest request,HttpServletResponse response) {
+        String sesMpIdx  = LifeCenterSessionController.getSession( request, "sesMpIdx" );
+        String jumin = dto.getJumin().replace( "-" , "" );
+        dto.setPatientIdx(Integer.parseInt(sesMpIdx));
+        dto.setJumin(jumin);
+        
+        String bloodPressureLevelCon = dto.getBloodPressureLevelCon();
+        String bloodPressureLevelRel = dto.getBloodPressureLevelRel();
+        dto.setBloodPressureLevel(bloodPressureLevelCon + "|" + bloodPressureLevelRel);
+        
+        patientService.mobileInsertPatientMunjin(dto);
+        
+        return "redirect:/mobile/menu";
+    }
 }

src/main/java/com/lemon/lifecenter/mapper/MobilePatientMapper.java

@@ -10,4 +10,6 @@ import com.lemon.lifecenter.dto.PatientDTO;
 public interface MobilePatientMapper {
     public int selectMPatientCount(PatientDTO dto);
     public PatientDTO selectMPatientInfo(PatientDTO dto);
+    public void mobileInsertPatientMunjin(PatientDTO dto);
+    public int selectMunJinCount(PatientDTO dto);
 }

src/main/java/com/lemon/lifecenter/service/MobilePatientService.java

@@ -19,4 +19,12 @@ public class MobilePatientService {
     public PatientDTO selectMPatientInfo(PatientDTO dto) {
         return mapper.selectMPatientInfo(dto);
     }
+    
+    public void mobileInsertPatientMunjin(PatientDTO dto) {
+        mapper.mobileInsertPatientMunjin(dto);
+    }
+    
+    public int selectMunJinCount(PatientDTO dto) {
+        return mapper.selectMunJinCount(dto);
+    }
 }

src/main/resources/mybatis/mapper/mobile/munjin.xml

@@ -0,0 +1,38 @@
+<?xml version="1.0" encoding="UTF-8"?>
+<!DOCTYPE mapper PUBLIC "-//mybatis.org//DTD Mapper 3.0//EN" "http://mybatis.org/dtd/mybatis-3-mapper.dtd">
+
+<mapper namespace="com.lemon.lifecenter.mapper.MobilePatientMapper">
+
+    <select id="selectMunJinCount" parameterType="PatientDTO" resultType="int">
+        <![CDATA[
+            SELECT COUNT(*) CNT
+              FROM MUNJIN
+             WHERE PATIENT_IDX = #{patientIdx}
+        ]]>
+    </select>
+    <insert id="mobileInsertPatientMunjin" parameterType="PatientDTO">
+        <![CDATA[
+            INSERT INTO MUNJIN
+                        (patient_idx,        hospitalization_date,       cv_confirmation_date,         symptom_start_date,       gender,
+                         birthday,           basal_disease_yn,           high_blood_pressure_check,    low_blood_pressure_check, organ_transplant_check,
+                         diabetes_check,     respiratory_disease_check,  immunological_disease_check,  heart_disease,            liver_disease,
+                         `operation`,        allergy_check,              cancer_check,                 disease_etc,              disease_etc_content,
+                         fever_check,        cough_check,                colic,                        cold_fit_check,           sputum_check,
+                         ocin_check,         chest_pain,                 nose_check,                   vomiting_check,           muscle_pain_check,
+                         sore_throat_check,  diarrhea_check,             headache_check,               dyspnea_check,            fatigue_check,
+                         symptom_etc,        symptom_etc_content,        fever_right,                  fever_left,               pulse_rate,
+                         respiration_rate,   blood_pressure_level,       oxygen_saturation,            pregnancy_status,         pregnancy_week,
+                         create_date)
+                  VALUE (#{patientIdx},      #{hospitalizationDate},     #{confirmationDate},          #{symptomStartDate},      #{gender},
+                         #{jumin},           #{basalDiseaseYn},          #{highBloodPressureCheck},    #{lowBloodPressureCheck}, #{lowBloodPressureCheck},
+                         #{diabetesCheck},   #{respiratoryDiseaseCheck}, #{immunologicalDiseaseCheck}, #{heartDisease},          #{liverDisease},
+                         #{operation},       #{allergyCheck},            #{cancerCheck},               #{etcCheckDisease},       #{etcContentDisease},
+                         #{feverCheck},      #{coughCheck},              #{colic},                     #{coldFitCheck},          #{sputumCheck},
+                         #{ocinCheck},       #{chestPain},               #{noseCheck},                 #{vomitingCheck},         #{musclePainCheck},
+                         #{soreThroatCheck}, #{diarrheaCheck},           #{headacheCheck},             #{dyspneaCheck},          #{fatigueCheck},
+                         #{etcCheckSymptom}, #{etcContentSymptom},       #{feverRight},                #{feverLeft},             #{pulseRate},
+                         #{respirationRate}, #{bloodPressureLevel},      #{oxygenSaturation},          #{pregnancyStatus},       #{pregnancyWeek},
+                         NOW())
+        ]]>
+    </insert>
+</mapper>

src/main/webapp/WEB-INF/jsp/mobile/menu/menu.jsp

@@ -3,6 +3,11 @@
 <%@ page language="java" contentType="text/html; charset=UTF-8"
     pageEncoding="UTF-8"%>
 <jsp:include page="${data._INCLUDE}/header.jsp"></jsp:include>
+<script>
+function alreadyMunjin() {
+    alert("문진을 이미 작성하였습니다.");
+}
+</script>
 </head>
 <body>
     <div id="main">
@@ -26,7 +31,13 @@
                                 <a href="javascript:;">건강정보기록</a>
                             </li>
                             <li>
-                                <a href="./servey">문진</a>
+                                <c:if test="${munjinCnt > 0}">
+                                    <a onclick="alreadyMunjin();">문진</a>
+                                </c:if>
+                                <c:if test="${munjinCnt eq 0}">
+                                    <a href="./servey">문진</a>
+                                </c:if>
+                                
                             </li>
                             <li>
                                 <a href="javascript:;">건강 기기 관리</a>
@@ -83,9 +94,16 @@
                         </a>
                     </li>
                     <li>
-                        <a href="./servey">
+                        <c:if test="${munjinCnt > 0}">
+                            <a onclick="alreadyMunjin();">
+                        </c:if>
+                        <c:if test="${munjinCnt eq 0}">
+                            <a href="./servey">
+                        </c:if>
                             <div class="image">
-                                <div class="new_icon">NEW</div>
+                                <c:if test="${munjinCnt eq 0}">
+                                    <div class="new_icon">NEW</div>
+                                </c:if>
                                 <img src="/resources/images/mobile/quick_2.png" />
                             </div>
                             <div class="text">

src/main/webapp/WEB-INF/jsp/mobile/servey/servey.jsp

@@ -1,5 +1,6 @@
 <%@ taglib uri="http://java.sun.com/jsp/jstl/core" prefix="c"%>
 <%@ taglib prefix="fmt" uri="http://java.sun.com/jsp/jstl/fmt"%>
+<%@ taglib prefix="form" uri="http://www.springframework.org/tags/form"%>
 <%@ page language="java" contentType="text/html; charset=UTF-8"
     pageEncoding="UTF-8"%>
 <jsp:include page="${data._INCLUDE}/header.jsp"></jsp:include>
@@ -7,18 +8,9 @@
 <script type="text/javascript">
 
 $( function(){
-    $( "select.ymd-date" ).on( "change", function(){
-        var hYear  = $( "#hYear" ).val();
-        var hMonth = $( "#hMonth" ).val();
-        var hDay   = $( "#hDay" ).val();
-
-        hMonth = Number(hMonth) < 10 ? "0" + hMonth : hMonth;
-        hDay   = Number(hDay) < 10   ? "0" + hDay   : hDay;
-
-        $("#hYmd").val( hYear  + "-" + hMonth  + "-" + hDay );
-
-    });
-
+    patientNewInit()
+    setEventHandler()
+    
     $( ".select-date" ).on( "change", function(){
         var $this = $( this );
         var wrap  = $this.closest( "div.date" );
@@ -34,6 +26,49 @@ $( function(){
     });
 });
 
+function patientNewInit() {
+    $( "ul.basalDisease input" ).prop( "disabled", true );
+    
+    $( "div.label-readonly-check" ).each( function( i, v ){
+        var $this = $(v);
+        var checkbox = $this.find( "input[type='checkbox']" );
+        var textbox  = $this.find( "input[type='text']" );
+        
+        if( !checkbox.is(":checked") ){
+            textbox.prop( "readonly", true );
+        }
+    });
+};
+
+function setEventHandler() {
+
+    //체크yes시 content입력 처리
+    $( "li.full input[type='checkbox']" ).on( "click", function(){
+        var $this = $( this );
+        console.log("!!!!!!!!!!!!!!");
+        
+        $this.closest( "div" ).find( "input[type='text']" ).prop( "readonly", $this.is( ":checked" ) === false );
+        
+        if( $this.is( ":checked" ) === false ) {
+            $this.closest( "div" ).find( "input[type='text']" ).val( "" );
+        } else {
+            $this.closest( "div" ).find( "input[type='text']" ).focus();
+        };
+    }); 
+    
+    //기저질환유무 처리
+    $( "input[name='basalDiseaseYn']" ).on( "click", function(){
+        var $this = $( this );
+        if( $this.val() == "Y" ){
+            patientNewInit();
+            $( ".basalDisease input" ).prop( "disabled", false );
+        } else {
+            $( "ul.basalDisease input" ).prop( "disabled", true );
+            $( "ul.basalDisease input[type='checkbox']" ).prop( "checked", false );
+            $( "ul.basalDisease input[type='text']" ).val( "" );
+        }
+    });
+}
 
 </script>
 </head>
@@ -53,407 +88,441 @@ $( function(){
             </div>
             <c:set var="now" value="<%=new java.util.Date()%>" />
             <c:set var="sysYear"><fmt:formatDate value="${now}" pattern="yyyy" /></c:set>
-            <div class="check_list" id="check_list1">
-                <div class="part">
-                    <div class="title">
-                        1. 입원일을 입력 하세요.
-                    </div>
-                    <div class="date">
-                        <div class="year">
-                            <select class="custom-select select-date date-year">
-                                  <option value="" selected="">년</option>
-                                  <c:forEach var="y" begin="1940" end="${sysYear}" step="1">
-                                      <option value="${y}">${y} 년</option>
-                                  </c:forEach>
-                            </select>
-<!--                             <select> -->
-<!--                                 <option>1900</option> -->
-<!--                             </select> 년 -->
-                        </div>
-                        <div class="month">
-<!--                             <input type="text" name=""> 월 -->
-                            <select class="custom-select select-date date-month">
-                                  <option value="" selected="">월</option>
-                                  <c:forEach var="m" begin="1" end="12" step="1">
-                                      <option value="${m}">${m} 월</option>
-                                  </c:forEach>
-                            </select>
-                        </div>
-                        <div class="day">
-<!--                             <input type="text" name=""> 일 -->
-                            <select class="custom-select select-date date-day">
-                                  <option value="" selected="">일</option>
-                                  <c:forEach var="d" begin="1" end="31" step="1">
-                                      <option value="${d}">${d} 일</option>
-                                  </c:forEach>
-                            </select>
-                        </div>
-                    <input type="text" class="error-box" id="hYmd" name="hYmd" required>
-                    </div>
-                </div>
-                <div class="part">
-                    <div class="title">
-                        2. 코로나 19 확진일을 입력 하세요
-                    </div>
-                    <div class="date">
-                        <div class="year">
-                            <select class="custom-select " id="cvYear">
-                                  <option value="" selected="">년</option>
-                                  <c:forEach var="y" begin="1940" end="${sysYear}" step="1">
-                                      <option value="${y}">${y} 년</option>
-                                  </c:forEach>
-                            </select>
-                        </div>
-                        <div class="month">
-<!--                             <input type="text" name=""> 월 -->
-                            <select class="custom-select" id="cvMonth" >
-                                  <option value="" selected="">월</option>
-                                  <c:forEach var="m" begin="1" end="12" step="1">
-                                      <option value="${m}">${m} 월</option>
-                                  </c:forEach>
-                            </select>
-                        </div>
-                        <div class="day">
-<!--                             <input type="text" name=""> 일 -->
-                            <select class="custom-select" id="cvDay">
-                                  <option value="" selected="">일</option>
-                                  <c:forEach var="d" begin="1" end="31" step="1">
-                                      <option value="${d}">${d} 일</option>
-                                  </c:forEach>
-                            </select>
-                        </div>
-                        <input type="text" class="error-box" id="cvYmd" name="cvYmd" required>
-                    </div>
-                </div>
-                <div class="part">
-                    <div class="title">
-                        3. 증상 시작일을 입력 하세요.
-                    </div>
-                    <div class="date">
-                        <div class="year">
-                            <select>
-                                <option>1900</option>
-                            </select> 년
-                        </div>
-                        <div class="month">
-                            <input type="text" name=""> 월
+            <c:set var="action" value="/mobile/servey/insert" />
+            
+            <form id="patientForm" action="${action}" method="post">
+                <div class="check_list" id="check_list1">
+                    <div class="part">
+                        <div class="title">
+                            1. 입원일을 입력 하세요.
                         </div>
-                        <div class="day">
-                            <input type="text" name=""> 일
+                        <div class="date">
+                            <div class="year">
+                                <select class="custom-select select-date date-year">
+                                      <option value="" selected="">년</option>
+                                      <c:forEach var="y" begin="1940" end="${sysYear}" step="1">
+                                          <option value="${y}">${y} 년</option>
+                                      </c:forEach>
+                                </select>
+    <!--                             <select> -->
+    <!--                                 <option>1900</option> -->
+    <!--                             </select> 년 -->
+                            </div>
+                            <div class="month">
+    <!--                             <input type="text" name=""> 월 -->
+                                <select class="custom-select select-date date-month">
+                                      <option value="" selected="">월</option>
+                                      <c:forEach var="m" begin="1" end="12" step="1">
+                                          <option value="${m}">${m} 월</option>
+                                      </c:forEach>
+                                </select>
+                            </div>
+                            <div class="day">
+    <!--                             <input type="text" name=""> 일 -->
+                                <select class="custom-select select-date date-day">
+                                      <option value="" selected="">일</option>
+                                      <c:forEach var="d" begin="1" end="31" step="1">
+                                          <option value="${d}">${d} 일</option>
+                                      </c:forEach>
+                                </select>
+                            </div>
+                        <input type="text" class="error-box" name="hospitalizationDate" required>
                         </div>
                     </div>
-                </div>
-                <div class="part">
-                    <div class="title">
-                        4. 성별을 입력하세요.
-                    </div>
-                    <div class="list">
-                        <ul class="circle half">
-                            <li>
-                                <input type="radio" id="a1" name="aa" />
-                                <label for="a1"><span></span>남</label>
-                            </li>
-                            <li>
-                                <input type="radio" id="a2" name="aa" />
-                                <label for="a2"><span></span>여</label>
-                            </li>
-                        </ul>
-                    </div>
-                </div>
-                <div class="part">
-                    <div class="title">
-                        5. 생년월일을 입력 하세요
-                    </div>
-                    <div class="date">
-                        <div class="year">
-                            <select>
-                                <option>1900</option>
-                            </select> 년
-                        </div>
-                        <div class="month">
-                            <input type="text" name=""> 월
+                    <div class="part">
+                        <div class="title">
+                            2. 코로나 19 확진일을 입력 하세요
                         </div>
-                        <div class="day">
-                            <input type="text" name=""> 일
+                        <div class="date">
+                            <div class="year">
+                                <select class="custom-select select-date date-year">
+                                      <option value="" selected="">년</option>
+                                      <c:forEach var="y" begin="1940" end="${sysYear}" step="1">
+                                          <option value="${y}">${y} 년</option>
+                                      </c:forEach>
+                                </select>
+                            </div>
+                            <div class="month">
+    <!--                             <input type="text" name=""> 월 -->
+                                <select class="custom-select select-date date-month">
+                                      <option value="" selected="">월</option>
+                                      <c:forEach var="m" begin="1" end="12" step="1">
+                                          <option value="${m}">${m} 월</option>
+                                      </c:forEach>
+                                </select>
+                            </div>
+                            <div class="day">
+    <!--                             <input type="text" name=""> 일 -->
+                                <select class="custom-select select-date date-day">
+                                      <option value="" selected="">일</option>
+                                      <c:forEach var="d" begin="1" end="31" step="1">
+                                          <option value="${d}">${d} 일</option>
+                                      </c:forEach>
+                                </select>
+                            </div>
+                            <input type="text" class="error-box" name="confirmationDate" required>
                         </div>
                     </div>
-                </div>
-                <div class="part">
-                    <div class="title">
-                        6. 기저질환 여부를 체크하세요.
-                    </div>
-                    <div class="list">
-                        <ul class="circle half">
-                            <li>
-                                <input type="radio" id="b1" name="bb" />
-                                <label for="b1"><span></span>예</label>
-                            </li>
-                            <li>
-                                <input type="radio" id="b2" name="bb" />
-                                <label for="b2"><span></span>아니오</label>
-                            </li>
-                        </ul>
-                    </div>
-                </div>
-                <div class="part">
-                    <div class="title">
-                        7. 6번의 ”예“인 경우 해당되는 기저질환을 모두 체크해주세요
-                        <span class="mini">(만일 ”아니오“ 경우에는 입력하지 마세요)</span>
-                    </div>
-                    <div class="list">
-                        <ul class="circle half">
-                            <li>
-                                <input type="radio" id="c1" name="cc" />
-                                <label for="c1"><span></span>고혈압</label>
-                            </li>
-                            <li>
-                                <input type="radio" id="c2" name="cc" />
-                                <label for="c2"><span></span>저혈압</label>
-                            </li>
-                            <li>
-                                <input type="radio" id="c3" name="cc" />
-                                <label for="c3"><span></span>장기이식(신장,간등)</label>
-                            </li>
-                            <li>
-                                <input type="radio" id="c4" name="cc" />
-                                <label for="c4"><span></span>당뇨병</label>
-                            </li>
-                            <li>
-                                <input type="radio" id="c5" name="cc" />
-                                <label for="c5"><span></span>호흡기질환</label>
-                            </li>
-                            <li>
-                                <input type="radio" id="c6" name="cc" />
-                                <label for="c6"><span></span>면역질환(류마티스 등)</label>
-                            </li>
-                            <li>
-                                <input type="radio" id="c7" name="cc" />
-                                <label for="c8"><span></span>심장질환</label>
-                            </li>
-                            <li>
-                                <input type="radio" id="c9" name="cc" />
-                                <label for="c9"><span></span>간질환</label>
-                            </li>
-                            <li>
-                                <input type="radio" id="c10" name="cc" />
-                                <label for="c10"><span></span>수술</label>
-                            </li>
-                            <li>
-                                <input type="radio" id="c11" name="cc" />
-                                <label for="c11"><span></span>알레르기</label>
-                            </li>
-                            <li>
-                                <input type="radio" id="c11" name="cc" />
-                                <label for="c11"><span></span>암</label>
-                            </li>
-                            <li class="full">
-                                <input type="radio" id="c12" name="cc" />
-                                <label for="c12"><span></span>기타</label>
-                                <div class="comment">
-                                    <input type="text" placeholder="기타 증상 및 암명/수술명을 입력하세요.">
-                                </div>
-                            </li>
-                        </ul>
-                    </div>
-                </div>
-                <div class="part">
-                    <div class="title">
-                        8. 현재 증상을 체크하세요 
-                        <span class="mini">(모두 체크하세요)</span>
-                    </div>
-                    <div class="list">
-                        <ul class="circle half">
-                            <li>
-                                <input type="checkbox" id="d1" name="dd" />
-                                <label for="d1"><span></span>열감(열나는 느낌)</label>
-                            </li>
-                            <li>
-                                <input type="checkbox" id="d2" name="dd" />
-                                <label for="d2"><span></span>기침</label>
-                            </li>
-                            <li>
-                                <input type="checkbox" id="d3" name="dd" />
-                                <label for="d3"><span></span>복통(배아픔)</label>
-                            </li>
-                            <li>
-                                <input type="checkbox" id="d4" name="dd" />
-                                <label for="d4"><span></span>오한(추운 느낌)</label>
-                            </li>
-                            <li>
-                                <input type="checkbox" id="d5" name="dd" />
-                                <label for="d5"><span></span>가래</label>
-                            </li>
-                            <li>
-                                <input type="checkbox" id="d6" name="dd" />
-                                <label for="d6"><span></span>오심(구역질)</label>
-                            </li>
-                            <li>
-                                <input type="checkbox" id="d7" name="dd" />
-                                <label for="d7"><span></span>흉통(가슴 통증)</label>
-                            </li>
-                            <li>
-                                <input type="checkbox" id="d8" name="dd" />
-                                <label for="d8"><span></span>콧물 또는 코 막힘</label>
-                            </li>
-                            <li>
-                                <input type="checkbox" id="d9" name="dd" />
-                                <label for="d9"><span></span>구토</label>
-                            </li>
-                            <li>
-                                <input type="checkbox" id="d10" name="dd" />
-                                <label for="d10"><span></span>근육통(몸살)</label>
-                            </li>
-                            <li>
-                                <input type="checkbox" id="d11" name="dd" />
-                                <label for="d11"><span></span>인후통(목 아픔)</label>
-                            </li>
-                            <li>
-                                <input type="checkbox" id="d12" name="dd" />
-                                <label for="d12"><span></span>설사</label>
-                            </li>
-                            <li>
-                                <input type="checkbox" id="d13" name="dd" />
-                                <label for="d13"><span></span>두통(머리아픔)</label>
-                            </li>
-                            <li>
-                                <input type="checkbox" id="d14" name="dd" />
-                                <label for="d14"><span></span>호흡곤란(숨 가쁨)</label>
-                            </li>
-                            <li>
-                                <input type="checkbox" id="d15" name="dd" />
-                                <label for="d15"><span></span>권태감(피곤함)</label>
-                            </li>
-                            <li class="full">
-                                <input type="checkbox" id="d16" name="dd" />
-                                <label for="d16"><span></span>기타</label>
-                                <div class="comment">
-                                    <input type="text" placeholder="기타 증상 및 암명/수술명을 입력하세요.">
-                                </div>
-                            </li>
-                        </ul>
-                    </div>
-                </div>
-                <div class="part">
-                    <div class="title">
-                        9. 체온을 입력하세요.
-                    </div>
-                    <div class="data">
-                        <label class="inline">
-                            우측 ( <input type="text" name=""> ) ℃
-                        </label>
-                        <label class="inline">
-                            좌측 ( <input type="text" name=""> ) ℃
-                        </label>
-                    </div>
-                </div>
-                <div class="part">
-                    <div class="title">
-                        10. 맥박수를 입력하세요.
-                    </div>
-                    <div class="data">
-                        <label class="inline">
-                            ( <input type="text" name=""> ) 회/분
-                        </label>
+                    <div class="part">
+                        <div class="title">
+                            3. 증상 시작일을 입력 하세요.
+                        </div>
+                        <div class="date">
+                            <div class="year">
+                                <select class="custom-select select-date date-year">
+                                      <option value="" selected="">년</option>
+                                      <c:forEach var="y" begin="1940" end="${sysYear}" step="1">
+                                          <option value="${y}">${y} 년</option>
+                                      </c:forEach>
+                                </select>
+                            </div>
+                            <div class="month">
+                                <select class="custom-select select-date date-month">
+                                      <option value="" selected="">월</option>
+                                      <c:forEach var="m" begin="1" end="12" step="1">
+                                          <option value="${m}">${m} 월</option>
+                                      </c:forEach>
+                                </select>
+                            </div>
+                            <div class="day">
+                                <select class="custom-select select-date date-day">
+                                      <option value="" selected="">일</option>
+                                      <c:forEach var="d" begin="1" end="31" step="1">
+                                          <option value="${d}">${d} 일</option>
+                                      </c:forEach>
+                                </select>
+                            </div>
+                            <input type="text" class="error-box" name="symptomStartDate" required>
+                        </div>
                     </div>
-                </div>
-                <div class="part">
-                    <div class="title">
-                        11. 호흡수를 입력하세요.
+                    <div class="part">
+                        <div class="title">
+                            4. 성별을 입력하세요.
+                        </div>
+                        <div class="list">
+                            <ul class="circle half">
+                                <li>
+                                    <input type="radio" id="gender1" name="gender" value="M" />
+                                    <label for="gender1"><span></span>남</label>
+                                </li>
+                                <li>
+                                    <input type="radio" id="gender2" name="gender" value="F" />
+                                    <label for="gender2"><span></span>여</label>
+                                </li>
+                            </ul>
+                        </div>
                     </div>
-                    <div class="data">
-                        <label class="inline">
-                            ( <input type="text" name=""> ) 회/분
-                        </label>
+                    <div class="part">
+                        <div class="title">
+                            5. 생년월일을 입력 하세요
+                        </div>
+                        <div class="date">
+                            <div class="year">
+                                <select class="custom-select select-date date-year">
+                                      <option value="" selected="">년</option>
+                                      <c:forEach var="y" begin="1940" end="${sysYear}" step="1">
+                                          <option value="${y}">${y} 년</option>
+                                      </c:forEach>
+                                </select>
+                            </div>
+                            <div class="month">
+                                <select class="custom-select select-date date-month">
+                                      <option value="" selected="">월</option>
+                                      <c:forEach var="m" begin="1" end="12" step="1">
+                                          <option value="${m}">${m} 월</option>
+                                      </c:forEach>
+                                </select>
+                            </div>
+                            <div class="day">
+                                <select class="custom-select select-date date-day">
+                                      <option value="" selected="">일</option>
+                                      <c:forEach var="d" begin="1" end="31" step="1">
+                                          <option value="${d}">${d} 일</option>
+                                      </c:forEach>
+                                </select>
+                            </div>
+                            <input type="text" class="error-box" name="jumin" required>
+                        </div>
                     </div>
-                </div>
-                <div class="part">
-                    <div class="title">
-                        12. 혈압을 입력하세요.
+                    <div class="part">
+                        <div class="title">
+                            6. 기저질환 여부를 체크하세요.
+                        </div>
+                        <div class="list">
+                            <ul class="circle half">
+                                <li>
+                                    <input type="radio" id="diseaseY" name="basalDiseaseYn" value="Y" />
+                                    <label for="diseaseY"><span></span>예</label>
+                                </li>
+                                <li>
+                                    <input type="radio" id="diseaseN" name="basalDiseaseYn" value="N" />
+                                    <label for="diseaseN"><span></span>아니오</label>
+                                </li>
+                            </ul>
+                        </div>
                     </div>
-                    <div class="data">
-                        <label class="inline">
-                            수축기( <input type="text" name=""> )mmHg
-                        </label>
-                        <label class="inline">
-                            이완기( <input type="text" name=""> )mmHg
-                        </label>
+                    <div class="part">
+                        <div class="title">
+                            7. 6번의 ”예“인 경우 해당되는 기저질환을 모두 체크해주세요
+                            <span class="mini">(만일 ”아니오“ 경우에는 입력하지 마세요)</span>
+                        </div>
+                        <div class="list">
+                            <ul class="circle half basalDisease">
+                                <li>
+                                    <input type="checkbox" id="highBlood" name="highBloodPressureCheck" value="Y" />
+                                    <label for="highBlood"><span></span>고혈압</label>
+                                </li>
+                                <li>
+                                    <input type="checkbox" id="lowBlood" name="lowBloodPressureCheck" value="Y" />
+                                    <label for="lowBlood"><span></span>저혈압</label>
+                                </li>
+                                <li>
+                                    <input type="checkbox" id="organTransplant" name="organTransplantCheck" value="Y" />
+                                    <label for="organTransplant"><span></span>장기이식(신장,간등)</label>
+                                </li>
+                                <li>
+                                    <input type="checkbox" id="diabetes" name="diabetesCheck" value="Y" />
+                                    <label for="diabetes"><span></span>당뇨병</label>
+                                </li>
+                                <li>
+                                    <input type="checkbox" id="respiratoryDisease" name="respiratoryDiseaseCheck" value="Y" />
+                                    <label for="respiratoryDisease"><span></span>호흡기질환</label>
+                                </li>
+                                <li>
+                                    <input type="checkbox" id="immunologicalDisease" name="immunologicalDiseaseCheck" value="Y" />
+                                    <label for="immunologicalDisease"><span></span>면역질환(류마티스 등)</label>
+                                </li>
+                                <li>
+                                    <input type="checkbox" id="heartDisease" name="heartDisease" value="Y" />
+                                    <label for="heartDisease"><span></span>심장질환</label>
+                                </li>
+                                <li>
+                                    <input type="checkbox" id="liverDisease" name="liverDisease" value="Y" />
+                                    <label for="liverDisease"><span></span>간질환</label>
+                                </li>
+                                <li>
+                                    <input type="checkbox" id="operation" name="operation" value="Y" />
+                                    <label for="operation"><span></span>수술</label>
+                                </li>
+                                <li>
+                                    <input type="checkbox" id="allergy" name="allergyCheck" value="Y" />
+                                    <label for="allergy"><span></span>알레르기</label>
+                                </li>
+                                <li>
+                                    <input type="checkbox" id="cancer" name="cancerCheck" value="Y" />
+                                    <label for="cancer"><span></span>암</label>
+                                </li>
+                                <li class="full">
+                                    <input type="checkbox" id="diseaseEtc" name="etcCheckDisease" value="Y" />
+                                    <label for="diseaseEtc"><span></span>기타</label>
+                                    <div class="comment label-readonly-check">
+                                        <input type="text" name="etcContentDisease" placeholder="기타 증상 및 암명/수술명을 입력하세요.">
+                                    </div>
+                                </li>
+                            </ul>
+                        </div>
                     </div>
-                </div>
-                <div class="part">
-                    <div class="title">
-                        13. 산소포화도를 입력하세요.
+                    <div class="part">
+                        <div class="title">
+                            8. 현재 증상을 체크하세요 
+                            <span class="mini">(모두 체크하세요)</span>
+                        </div>
+                        <div class="list">
+                            <ul class="circle half">
+                                <li>
+                                    <input type="checkbox" id="fever" name="feverCheck" value="Y" />
+                                    <label for="fever"><span></span>열감(열나는 느낌)</label>
+                                </li>
+                                <li>
+                                    <input type="checkbox" id="cough" name="coughCheck" value="Y" />
+                                    <label for="cough"><span></span>기침</label>
+                                </li>
+                                <li>
+                                    <input type="checkbox" id="colic" name="colic" value="Y" />
+                                    <label for="colic"><span></span>복통(배아픔)</label>
+                                </li>
+                                <li>
+                                    <input type="checkbox" id="coldFit" name="coldFitCheck" value="Y" />
+                                    <label for="coldFit"><span></span>오한(추운 느낌)</label>
+                                </li>
+                                <li>
+                                    <input type="checkbox" id="sputum" name="sputumCheck" value="Y" />
+                                    <label for="sputum"><span></span>가래</label>
+                                </li>
+                                <li>
+                                    <input type="checkbox" id="ocin" name="ocinCheck" value="Y" />
+                                    <label for="ocin"><span></span>오심(구역질)</label>
+                                </li>
+                                <li>
+                                    <input type="checkbox" id="chestPain" name="chestPain" value="Y" />
+                                    <label for="chestPain"><span></span>흉통(가슴 통증)</label>
+                                </li>
+                                <li>
+                                    <input type="checkbox" id="nose" name="noseCheck" value="Y" />
+                                    <label for="nose"><span></span>콧물 또는 코 막힘</label>
+                                </li>
+                                <li>
+                                    <input type="checkbox" id="vomiting" name="vomitingCheck" value="Y" />
+                                    <label for="vomiting"><span></span>구토</label>
+                                </li>
+                                <li>
+                                    <input type="checkbox" id="musclePain" name="musclePainCheck" value="Y" />
+                                    <label for="musclePain"><span></span>근육통(몸살)</label>
+                                </li>
+                                <li>
+                                    <input type="checkbox" id="soreThroat" name="soreThroatCheck" value="Y" />
+                                    <label for="soreThroat"><span></span>인후통(목 아픔)</label>
+                                </li>
+                                <li>
+                                    <input type="checkbox" id="diarrhea" name="diarrheaCheck" value="Y" />
+                                    <label for="diarrhea"><span></span>설사</label>
+                                </li>
+                                <li>
+                                    <input type="checkbox" id="headache" name="headacheCheck" value="Y" />
+                                    <label for="headache"><span></span>두통(머리아픔)</label>
+                                </li>
+                                <li>
+                                    <input type="checkbox" id="dyspnea" name="dyspneaCheck" value="Y" />
+                                    <label for="dyspnea"><span></span>호흡곤란(숨 가쁨)</label>
+                                </li>
+                                <li>
+                                    <input type="checkbox" id="fatigue" name="fatigueCheck" value="Y" />
+                                    <label for="fatigue"><span></span>권태감(피곤함)</label>
+                                </li>
+                                <li class="full">
+                                    <input type="checkbox" id="symptomEtc" name="etcCheckSymptom" value="Y" />
+                                    <label for="symptomEtc"><span></span>기타</label>
+                                    <div class="comment">
+                                        <input type="text" name="etcContentSymptom" placeholder="기타 증상 및 암명/수술명을 입력하세요.">
+                                    </div>
+                                </li>
+                            </ul>
+                        </div>
                     </div>
-                    <div class="data">
-                        <label class="inline">
-                            ( <input type="text" name=""> )%
-                        </label>
+                    <div class="part">
+                        <div class="title">
+                            9. 체온을 입력하세요.
+                        </div>
+                        <div class="data">
+                            <label class="inline">
+                                우측 ( <input type="text" name="feverRight"> ) ℃
+                            </label>
+                            <label class="inline">
+                                좌측 ( <input type="text" name="feverLeft"> ) ℃
+                            </label>
+                        </div>
                     </div>
-                </div>
-                <div class="part">
-                    <div class="title">
-                        14. 최근 24시간 이내 약 복용 여부를 체크하세요.
+                    <div class="part">
+                        <div class="title">
+                            10. 맥박수를 입력하세요.
+                        </div>
+                        <div class="data">
+                            <label class="inline">
+                                ( <input type="text" name="pulseRate"> ) 회/분
+                            </label>
+                        </div>
                     </div>
-                    <div class="list">
-                        <ul class="circle half">
-                            <li>
-                                <input type="radio" id="e1" name="ee" />
-                                <label for="e1"><span></span>예</label>
-                            </li>
-                            <li>
-                                <input type="radio" id="e2" name="ee" />
-                                <label for="e2"><span></span>아니오</label>
-                            </li>
-                        </ul>
+                    <div class="part">
+                        <div class="title">
+                            11. 호흡수를 입력하세요.
+                        </div>
+                        <div class="data">
+                            <label class="inline">
+                                ( <input type="text" name="respirationRate"> ) 회/분
+                            </label>
+                        </div>
                     </div>
-                </div>
-                <div class="part">
-                    <div class="title">
-                        15. 14번의 ”예“인 경우 약명을 입력 하세요
-                        <span class="mini">(만일 ”아니오“ 경우에는 입력하지 마세요)</span>
+                    <div class="part">
+                        <div class="title">
+                            12. 혈압을 입력하세요.
+                        </div>
+                        <div class="data">
+                            <label class="inline">
+                                수축기( <input type="text" name="bloodPressureLevelCon"> )mmHg
+                            </label>
+                            <label class="inline">
+                                이완기( <input type="text" name="bloodPressureLevelRel"> )mmHg
+                            </label>
+                        </div>
                     </div>
-                    <div class="data">
-                        <label class="inline">
-                            약명 ( <input type="text" name=""> )
-                        </label>
+                    <div class="part">
+                        <div class="title">
+                            13. 산소포화도를 입력하세요.
+                        </div>
+                        <div class="data">
+                            <label class="inline">
+                                ( <input type="text" name="oxygenSaturation"> )%
+                            </label>
+                        </div>
                     </div>
-                </div>
-                <div class="part">
-                    <div class="title">
-                        16. 임신 여부를 체크하세요.
+                    <div class="part">
+                        <div class="title">
+                            14. 최근 24시간 이내 약 복용 여부를 체크하세요.
+                        </div>
+                        <div class="list">
+                            <ul class="circle half">
+                                <li>
+                                    <input type="radio" id="drugYn1" name="drugYn" value="Y" />
+                                    <label for="drugYn1"><span></span>예</label>
+                                </li>
+                                <li>
+                                    <input type="radio" id="drugYn2" name="drugYn" value="N" />
+                                    <label for="drugYn2"><span></span>아니오</label>
+                                </li>
+                            </ul>
+                        </div>
                     </div>
-                    <div class="list">
-                        <ul class="circle half">
-                            <li>
-                                <input type="radio" id="f1" name="ff" />
-                                <label for="f1"><span></span>예</label>
-                            </li>
-                            <li>
-                                <input type="radio" id="f2" name="ff" />
-                                <label for="f2"><span></span>아니오</label>
-                            </li>
-                        </ul>
+                    <div class="part">
+                        <div class="title">
+                            15. 14번의 ”예“인 경우 약명을 입력 하세요
+                            <span class="mini">(만일 ”아니오“ 경우에는 입력하지 마세요)</span>
+                        </div>
+                        <div class="data">
+                            <label class="inline">
+                                약명 ( <input type="text" name="drugContent"> )
+                            </label>
+                        </div>
                     </div>
-                </div>
-                <div class="part">
-                    <div class="title">
-                        17. 16번의 ”예“인 경우 임신 주차를 입력 하세요
-                        <span class="mini">(만일 ”아니오“ 경우에는 입력하지 마세요)</span>
+                    <div class="part">
+                        <div class="title">
+                            16. 임신 여부를 체크하세요.
+                        </div>
+                        <div class="list">
+                            <ul class="circle half">
+                                <li>
+                                    <input type="radio" id="pregnancyStatus1" name="pregnancyStatus" value="Y" />
+                                    <label for="pregnancyStatus1"><span></span>예</label>
+                                </li>
+                                <li>
+                                    <input type="radio" id="pregnancyStatus2" name="pregnancyStatus" value="N" />
+                                    <label for="pregnancyStatus2"><span></span>아니오</label>
+                                </li>
+                            </ul>
+                        </div>
                     </div>
-                    <div class="data">
-                        <label class="inline">
-                            임신 주차 ( <input type="text" name=""> ) 주
-                        </label>
+                    <div class="part">
+                        <div class="title">
+                            17. 16번의 ”예“인 경우 임신 주차를 입력 하세요
+                            <span class="mini">(만일 ”아니오“ 경우에는 입력하지 마세요)</span>
+                        </div>
+                        <div class="data">
+                            <label class="inline">
+                                임신 주차 ( <input type="text" name="pregnancyWeek"> ) 주
+                            </label>
+                        </div>
                     </div>
                 </div>
-            </div>
             
-            <div class="btn_group">
-                <ul>
-                    <li>
-                        <a href="javascript:;" class="confirm">제출</a>
-                    </li>
-                </ul>
-            </div>
+            
+                <div class="btn_group">
+                    <ul>
+                        <li>
+<!--                             <a href="javascript:;" class="confirm">제출</a> -->
+                            <button type="submit" class="confirm">제출</button>
+                        </li>
+                    </ul>
+                </div>
+            </form>
         </div>
     </div>
 </body>