<script> function validate(){ save_medicine(); } </script> <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 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-12"> <label for="firm_code">Checkup Parameter Name</label> <input type="text" class="form-control" name="checkup_parameter_name" id="checkup_parameter_name" autofocus="autofocus" value="" placeholder="Enter CheckUp Parameter Name" required/> </div> </div> <div class="row"> <div class="form-group col-sm-12"> <label for="firm_code">Select Section Name</label> <select name="checkup_section_id" id="checkup_section_id" class="form-control" > <?php echo generateOption('checkup_form_section','section_name','section_id','',''); ?> </select> <!-- <input type="text" class="form-control" name="checkup_section_name" id="checkup_section_name" autofocus="autofocus" value="" placeholder="Enter CheckUp Section Name" required/> --> </div> </div> <div class="row"> <div class="form-group col-sm-6"> <label for="firm_code">Starting Range</label> <input type="number" class="form-control" name="checkup_starting_range" id="checkup_starting_range" autofocus="autofocus" value="" placeholder="Enter Starting Range" required/> </div> <div class="form-group col-sm-6"> <label for="firm_code">Ending Range</label> <input type="number" class="form-control" name="checkup_ending_range" id="checkup_ending_range" autofocus="autofocus" value="" placeholder="Enter Ending Range" required/> </div> </div> <div class="row"> <div class="form-group col-sm-6"> <label for="firm_code">Less Risk</label> <select multiple="" style="" class="chosen-select form-control" id="checkup_less_risk" name="checkup_less_risk[]" data-placeholder="" > <?php echo generateOption('health_risk','health_risk_name','health_risk_id','',''); ?> </select> </div> <div class="form-group col-sm-6"> <label for="firm_code">More Risk</label> <select multiple="" style="" class="chosen-select form-control" id="checkup_more_risk" name="checkup_more_risk[]" data-placeholder="" > <?php echo generateOption('health_risk','health_risk_name','health_risk_id','',''); ?> </select> </div> </div> <div class="row"> <div class="col-sm-6"> <label class="control-label" for="health_advice_name">Less Advice</label> <select multiple="" style="" class="chosen-select form-control" id="checkup_less_advice" name="checkup_less_advice[]" data-placeholder="" > <?php echo generateOption('health_advice','health_advice_name','health_advice_id','',''); ?> </select> </div> <div class="col-sm-6"> <label class="control-label" for="health_advice_name">More Advice</label> <select multiple="" style="" class="chosen-select form-control" id="checkup_more_advice" name="checkup_more_advice[]" data-placeholder="" > <?php echo generateOption('health_advice','health_advice_name','health_advice_id','',''); ?> </select> </div> </div> </div> <div class="widget-toolbox padding-8 clearfix" > <button type="button" class="btn btn-info btn-sm save_button" onclick="save_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>