262 lines
9.2 KiB
PHP
262 lines
9.2 KiB
PHP
<div class="modal fade" id="form32" role="dialog" aria-hidden="true">
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<div class="modal-dialog modal-lg">
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<div class="modal-content">
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<div class="modal-header">
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</div>
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<form role="form" id="form_32" name="form_32" action="#" method="post">
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<div class="modal-body">
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<h3>
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<center>FORM-32</center>
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</h3>
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<div class="row">
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<div class="col-sm-12 table-responsive">
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<!-- <table
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id="table1"
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class="table table-striped table-bordered ordered-list"
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style="padding: 2px; margin: 2px;">
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<thead>
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<tr class="success">
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<th style="font-size: 9px; text-align: center;">Department/works</th>
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<th style="font-size: 9px; text-align: center;">Name of hazardous process</th>
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<th style="font-size: 9px; text-align: center;">Dangerous process/operation</th>
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<th style="font-size: 9px; text-align: center;">Nature of job or occupation</th>
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<th style="font-size: 9px; text-align: center;">Raw materials,products or by-products likely to be exposed to</th>
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</tr>
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</thead>
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<tbody>
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<tr>
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<td><input type="text" name="dept_works" id="dept_works" class="form-control"></td>
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<td><input type="text" name="name_hzd_process" id="name_hzd_process" class="form-control"></td>
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<td><input type="text" name="dangerous_process" id="dangerous_process" class="form-control"></td>
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<td><input type="text" name="nature_job" id="nature_job" class="form-control"></td>
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<td><input type="text" name="exposed_to" id="exposed_to" class="form-control"></td>
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</tr>
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</tbody>
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</table> -->
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<table id="table1" class="table table-striped table-bordered ordered-list" style="padding: 2px; margin: 2px;">
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<thead>
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<tr class="success">
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<!-- <th style="font-size: 9px; text-align: center;">Date of posting</th> -->
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<th style="font-size: 9px; text-align: center;">Date of leaving / transfer other work</th>
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<th style="font-size: 9px; text-align: center;">Reason for discharge/transfer to other work</th>
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<th style="font-size: 9px; text-align: center;">Signs and symptoms observed during examination</th>
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<th style="font-size: 9px; text-align: center;">Nature of tests and result thereof</th>
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</tr>
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</thead>
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<tbody>
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<tr>
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<!-- <td><input type="text" name="date_posting" id="date_posting" class="form-control"></td> -->
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<td><input type="date" name="date_leaving" id="date_leaving" class="form-control"></td>
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<td><input type="text" name="reason_for_discharge" id="reason_for_discharge" class="form-control"></td>
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<td><input type="text" name="signs_symptoms" id="signs_symptoms" class="form-control"></td>
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<td>
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<input type="text" name="nature_tests" id="nature_tests" class="form-control">
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<input type="hidden" name="medical_exam_id32" id="medical_exam_id32">
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</td>
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</tr>
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</tbody>
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</table>
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<table id="table1" class="table table-striped table-bordered ordered-list" style="padding: 2px; margin: 2px;">
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<thead>
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<tr class="success">
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<th style="font-size: 9px; text-align: center;">Period of temporary withdrawal from that work</th>
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<th style="font-size: 9px; text-align: center;">Reason for such withdrawal</th>
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<th style="font-size: 9px; text-align: center;">Date of declaring unfit for that work</th>
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<th style="font-size: 9px; text-align: center;">Date of issuing fitness certificate</th>
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</tr>
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</thead>
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<tbody>
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<tr>
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<td><input type="text" name="period_temp_withdrawal" id="period_temp_withdrawal" class="form-control"></td>
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<td><input type="text" name="reason_withdrawal" id="reason_withdrawal" class="form-control"></td>
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<td><input type="date" name="date_unfit" id="date_unfit" class="form-control "></td>
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<td><input type="date" name="date_fitness" id="date_fitness" class="form-control"></td>
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</tr>
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</tbody>
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</table>
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</div>
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</div>
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</div>
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<div class="modal-footer">
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<button type="button" class="btn btn-info btn-sm save_button" onclick="save_form32();">
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SAVE
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</button>
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<button type="button" class="btn btn-danger btn-sm" data-dismiss="modal">
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<i class="ace-icon fa fa-times bigger-110"></i>CANCEL
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</button>
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</div>
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</form>
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</div>
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</div>
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</div>
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<script type="text/javascript">
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function save_form32() {
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$.ajax({
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url: 'save_form32.php',
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type: "POST",
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data: $("#form_32").serialize(),
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success: function(data) {
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BootstrapDialog.alert('Details Saved Successfully.');
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},
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error: function(data) {
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BootstrapDialog.alert('Error Saving Details');
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//return;
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}
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});
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}
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$('.datepicker').datepicker({
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format: 'dd/mm/yyyy', //use this option to display seconds
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'setDate': new Date(),
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endDate: "+1d",
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minDate: new Date() - 10,
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icons: {
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time: 'fa fa-clock-o',
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date: 'fa fa-calendar',
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up: 'fa fa-chevron-up',
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down: 'fa fa-chevron-down',
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previous: 'fa fa-chevron-left',
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next: 'fa fa-chevron-right',
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today: 'fa fa-arrows ',
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clear: 'fa fa-trash',
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close: 'fa fa-times'
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}
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})
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// $('#date_leaving').datepicker({
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// format: 'dd/mm/yyyy',//use this option to display seconds
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// //'setDate': new Date(),
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// endDate: "+1d",
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// //minDate: new Date()-10,
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// icons: {
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// time: 'fa fa-clock-o',
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// date: 'fa fa-calendar',
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// up: 'fa fa-chevron-up',
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// down: 'fa fa-chevron-down',
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// previous: 'fa fa-chevron-left',
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// next: 'fa fa-chevron-right',
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// today: 'fa fa-arrows ',
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// clear: 'fa fa-trash',
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// close: 'fa fa-times'
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// }
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// }).datepicker("setDate", new Date());
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// $('#date_unfit').datepicker({
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// format: 'dd/mm/yyyy',//use this option to display seconds
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// //'setDate': new Date(),
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// endDate: "+1d",
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// //minDate: new Date()-10,
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// icons: {
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// time: 'fa fa-clock-o',
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// date: 'fa fa-calendar',
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// up: 'fa fa-chevron-up',
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// down: 'fa fa-chevron-down',
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// previous: 'fa fa-chevron-left',
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// next: 'fa fa-chevron-right',
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// today: 'fa fa-arrows ',
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// clear: 'fa fa-trash',
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// close: 'fa fa-times'
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// }
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// }).datepicker("setDate", new Date());
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// $('#date_fitness').datepicker({
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// format: 'dd/mm/yyyy',//use this option to display seconds
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// //'setDate': new Date(),
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// endDate: "+1d",
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// //minDate: new Date()-10,
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// icons: {
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// time: 'fa fa-clock-o',
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// date: 'fa fa-calendar',
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// up: 'fa fa-chevron-up',
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// down: 'fa fa-chevron-down',
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// previous: 'fa fa-chevron-left',
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// next: 'fa fa-chevron-right',
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// today: 'fa fa-arrows ',
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// clear: 'fa fa-trash',
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// close: 'fa fa-times'
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// }
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// }).datepicker("setDate", new Date());
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</script>
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<link rel="stylesheet" href="assets/font-awesome/4.5.0/css/font-awesome.min.css" />
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<!-- page specific plugin styles -->
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<link rel="stylesheet" href="assets/css/jquery-ui.custom.min.css" />
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<link rel="stylesheet" href="assets/css/chosen.min.css" />
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<link rel="stylesheet" href="assets/css/bootstrap-datepicker3.min.css" />
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<link rel="stylesheet" href="assets/css/bootstrap-timepicker.min.css" />
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<link rel="stylesheet" href="assets/css/daterangepicker.min.css" />
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<link rel="stylesheet" href="assets/css/bootstrap-datetimepicker.min.css" />
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<link rel="stylesheet" href="assets/css/bootstrap-colorpicker.min.css" />
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<script type="text/javascript" src="js/typeahead.bundle.js"></script>
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<script src="assets/js/jquery-ui.custom.min.js"></script>
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<script src="assets/js/jquery.ui.touch-punch.min.js"></script>
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<script src="assets/js/chosen.jquery.min.js"></script>
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<script src="assets/js/spinbox.min.js"></script>
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<script src="assets/js/bootstrap-datepicker.min.js"></script>
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<script src="assets/js/bootstrap-timepicker.min.js"></script>
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<script src="assets/js/jquery.dataTables.min.js"></script>
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<script src="assets/js/jquery.dataTables.bootstrap.min.js"></script>
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<script src="assets/js/dataTables.buttons.min.js"></script>
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<script src="assets/js/buttons.flash.min.js"></script>
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<script src="assets/js/buttons.html5.min.js"></script>
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<script src="assets/js/buttons.print.min.js"></script>
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<script src="assets/js/buttons.colVis.min.js"></script>
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<script src="assets/js/dataTables.select.min.js"></script>
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<script src="assets/js/moment.min.js"></script>
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<script src="assets/js/daterangepicker.min.js"></script>
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<script src="assets/js/bootstrap-datetimepicker.min.js"></script>
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<script src="assets/js/bootstrap-colorpicker.min.js"></script>
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<script src="assets/js/jquery.knob.min.js"></script>
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<script src="assets/js/autosize.min.js"></script>
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<script src="assets/js/jquery.inputlimiter.min.js"></script>
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<script src="assets/js/jquery.maskedinput.min.js"></script>
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<script src="assets/js/bootstrap-tag.min.js"></script>
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<script src="assets/js/ace-elements.min.js"></script> |