49 lines
1.7 KiB
PHP
49 lines
1.7 KiB
PHP
<script>
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</script>
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<style>
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#modal-add-health_risk{
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overflow-y:scroll;
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}
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</style>
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<div class="modal fade" id="modal-add-health_risk" name="modal-add-health_risk" role="dialog" aria-hidden="true">
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<form role="form" id="health_risk_form" name="health_risk_form" action="#" method="post">
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<div class="modal-dialog">
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<div class="modal-content">
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<div class="widget-header">
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<h5 class="widget-title">Health Risk</h5>
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<div class="widget-toolbar">
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<div class="widget-menu">
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<a href="#" class="close" data-action="close" data-dismiss="modal">
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<i class="ace-icon fa fa-times"></i>
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</a>
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</div>
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</div>
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</div>
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<div class="modal-body">
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<div class="form-group">
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<label for="role">Health Risk Name</label>
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<input type="hidden" class="form-control" name="health_risk_id"
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id="health_risk_id" />
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<input type="text" class="form-control" name="health_risk_name"
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id="health_risk_name" maxlength="100" placeholder="Enter Health Risk Name" required/>
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</div>
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<div class="form-group">
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<label for="health_risk">Health Advice Category</label>
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<input type="text" class="form-control" name="health_risk_cat"
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id="health_risk_cat" maxlength="10" placeholder="Enter Health Risk Category" required/>
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</div>
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<div class="widget-toolbox padding-8 clearfix" >
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<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>
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<button type="button" class="btn btn-danger btn-sm" data-dismiss="modal"><i class="ace-icon fa fa-times bigger-110"></i>Cancel</button>
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</div>
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</div>
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</div>
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</form>
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</div>
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