ESH/form/add_health_advice.php
2024-10-23 18:28:06 +05:30

44 lines
1.7 KiB
PHP

<script>
</script>
<style>
#modal-add-health_advice {
overflow-y: scroll;
}
</style>
<div class="modal fade" id="modal-add-health_advice" name="modal-add-health_advice" role="dialog" aria-hidden="true">
<form role="form" id="health_advice_form" name="health_advice_form" action="#" method="post">
<div class="modal-dialog">
<div class="modal-content">
<div class="widget-header">
<h5 class="widget-title">Health Advice</h5>
<div class="widget-toolbar">
<div class="widget-menu">
<a href="#" class="close" data-action="close" data-dismiss="modal">
<i class="ace-icon fa fa-times"></i>
</a>
</div>
</div>
</div>
<div class="modal-body">
<div class="form-group">
<label for="role">Health Advice Name</label>
<input type="hidden" class="form-control" name="health_advice_id" id="health_advice_id" />
<input type="text" class="form-control" name="health_advice_name" id="health_advice_name" maxlength="255" placeholder="Enter Health Advice Name" required />
</div>
<div class="form-group">
<label for="health_advice">Health Advice Category</label>
<input type="text" class="form-control" name="health_advice_cat" id="health_advice_cat" maxlength="255" placeholder="Enter Health Advice Category" required />
</div>
<div class="widget-toolbox padding-8 clearfix">
<button type="button" class="btn btn-info btn-sm save_button" onclick="validate();"><i class="ace-icon fa fa-floppy-o bigger-110"></i>Save </button>
<button type="button" class="btn btn-danger btn-sm" data-dismiss="modal"><i class="ace-icon fa fa-times bigger-110"></i>Cancel</button>
</div>
</div>
</div>
</form>
</div>