73 lines
3.0 KiB
PHP
73 lines
3.0 KiB
PHP
city_id<script>
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function validate() {
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var city_name = $('#remediation_status').val();
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if (city_name == '') {
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BootstrapDialog.alert('Please Enter remediation status .!!!');
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return false;
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}
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save_section();
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}
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</script>
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<style>
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#modal-add-city {
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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-city" role="dialog" aria-hidden="true">
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<form role="form" id="city_form" name="city_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">add remediation status</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="city ">remediation status</label>
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<input type="hidden" class="form-control" name="id" id="id" value="" />
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<input type="text" class="form-control" name="remediation_status" id="remediation_status" value="" />
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</div>
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<!-- <div class="form-group">
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<label for="user_role"> AC Per KM Cost </label>
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<input type="text" class="form-control" name="AC_cost" id="AC_cost" value="" />
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</div>
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<div class="form-group">
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<label for="user_role"> AC Ambulance Charge </label>
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<input type="text" class="form-control" name="AC_amb_charge" id="AC_amb_charge" value="" />
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</div>
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<div class="form-group">
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<label for="user_role"> NON-AC Per KM Cost </label>
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<input type="text" class="form-control" name="NON_AC_cost" id="NON_AC_cost" value="" />
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</div>
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<div class="form-group">
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<label for="user_role"> NON-AC Ambulance Charge </label>
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<input type="text" class="form-control" name="NON_AC_amb_charge" id="NON_AC_amb_charge" value="" />
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</div> -->
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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> |