<script>
function validate() {
    var employer_contractor = $('#employer_contractor').val();
    if (employer_contractor == '') {
        BootstrapDialog.alert('Please Enter Employer/Contractor Name.!!!');
        return false;
    }
    // var remarks = $('#remarks').val();
    // 	if(remarks == ''){
    // 		BootstrapDialog.alert('Please Enter Remarks.!!!');
    // 		return false;
    // 	}

    save_employer_contractor();
}
</script>
<style>
#modal-add-patient {
    overflow-y: scroll;
}
</style>
<div class="modal fade" id="modal-add-employer-contractor" name="modal-add-employer-contractor" role="dialog"
    aria-hidden="true">
    <form role="form" id="employer-contractor_form" name="employer-contractor_form" action="#" method="post">
        <div class="modal-dialog">
            <div class="modal-content">
                <div class="widget-header">
                    <h5 class="widget-title">Employer / Contractor 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="form-group">
                        <label for="role">Employer / Contractor Name</label>
                        <input type="hidden" class="form-control" name="id" id="id" value="" required />
                        <input type="text" class="form-control" name="employer_contractor" id="employer_contractor"
                            maxlength="70" placeholder="Enter employer / Contractor Name" required />
                    </div>

                    <div class="form-group">
                        <label for="role">Code</label>

                        <input type="text" class="form-control" name="employer_contractor_code"
                            id="employer_contractor_code" maxlength="70" placeholder="Enter employer / Contractor Code"
                            required />
                    </div>
                    <div class="form-group">
                        <label for="role">Address</label>

                        <input type="text" class="form-control" name="employer_contractor_address"
                            id="employer_contractor_address" maxlength="70" placeholder="Enter Address details "
                            required />
                    </div>
                    <div class="form-group">
                        <label for="role">Contact</label>

                        <input type="text" class="form-control" name="employer_contractor_contact"
                            id="employer_contractor_contact" maxlength="70" placeholder="Enter Contact details"
                            required />
                    </div>

                    <div class="form-group">
                        <label for="role">Email</label>

                        <input type="text" class="form-control" name="employer_contractor_email"
                            id="employer_contractor_email" maxlength="70" placeholder="Enter Email details" required />
                    </div>
                    <div class="form-group">
                        <label for="ailment">Remarks</label>
                        <input type="text" class="form-control" name="remarks" id="remarks" maxlength="70"
                            placeholder="Enter Remarks" required />
                    </div>

                </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>