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

61 lines
2.9 KiB
PHP

<style>
#modal-add-medicine {
overflow-y: scroll;
}
</style>
<div class="modal fade" id="model-checkup-parameter" role="dialog" aria-hidden="true">
<form role="form" id="checkup_parameter_form" name="checkup_parameter_form" action="#" method="post">
<div class="modal-dialog">
<div class="modal-content">
<div class="widget-header">
<h5 class="widget-title"> Checkup Parameter Group Form</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="row">
<div class="form-group col-sm-6">
<input type="hidden" name="group_id" id="group_id">
<label for="firm_code">Group Tital</label>
<input type="text" class="form-control" name="group_tital" id="group_tital"
autofocus="autofocus" value="" placeholder="Enter CheckUp Parameter group Tital."
required />
</div>
<div class="form-group col-sm-6">
<label for="group_section">Group Section</label>
<select name="group_section" id="group_section" class="form-control chosen-select">
<option value="" selected disabled> select section</option>
<?php echo generateOption('checkup_form_section', 'section_name', 'section_id', '', ''); ?>
</select>
</div>
<div class="form-group col-sm-6">
<input type="hidden" name="group_id" id="group_id">
<label for="firm_code">Group no</label>
<input type="text" class="form-control" name="group_no" id="group_no" autofocus="autofocus"
value="" placeholder="Enter CheckUp Parameter group no." required />
</div>
</div>
</div>
<div class="widget-toolbox padding-8 clearfix">
<button type="button" class="btn btn-info btn-sm save_button"
onclick="validate_checkup_parameter();"><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>