ikan Uploader :
Directory : /var/www/html/shardadiagnostics.in/application/modules/vendor/views/
Upload File : |
| Current File : /var/www/html/shardadiagnostics.in/application/modules/vendor/views/add_lead.php |
<?php
$timeNow = time();
?>
<script src="<?= base_url('assets/ckeditor/ckeditor.js') ?>"></script>
<link rel="stylesheet" href="<?= base_url('assets/bootstrap-select-1.12.1/bootstrap-select.min.css') ?>">
<div class="row">
<div class="col-md-12">
<?php
if ($this->session->flashdata('error_leads')) {
?>
<div class="alert alert-danger"><?= implode('<br>', $this->session->flashdata('error_leads')) ?></div>
<?php
}
?>
<div class="content">
<form class="form-box" method="POST" enctype="multipart/form-data">
<div class="row">
<div class="col-md-4">
<?php
foreach ($languages->result() as $language) {
?>
<label>Patient Name<span class="req_red" style="color:red">*</span></label>
<div class="form-group">
<input type="text" name="full_name" placeholder="Enter Name" class="form-control" value="<?= $_POST['full_name']?>">
</div>
<?php
}
$i = 0;
?>
</div>
<div class="col-md-4">
<div class="form-group for-shop">
<label>Contact Number<span class="req_red" style="color:red">*</span></label>
<input type="text" name="mobile_number" maxlength="10" onkeyup="if (/\D/g.test(this.value)) this.value = this.value.replace(/\D/g,'')" placeholder="Enter Contact Number" class="form-control" value="<?= $_POST['mobile_number'];?>">
</div>
</div>
<div class="col-md-4">
<div class="form-group for-shop">
<label>Email Id</label>
<input type="text" name="email_id" placeholder="Enter Email Id" class="form-control" value="<?= $_POST['email_id']?>">
</div>
</div>
<div class="col-md-12">
<div class="form-group">
<label for="description<?= $i ?>">Description</label>
<textarea name="description" rows="5" class="form-control"><?= $trans_load != null && isset($trans_load[$language->abbr]['description']) ? $trans_load[$language->abbr]['description'] : $_POST['description'] ?></textarea>
</div>
</div>
<div class="col-md-12">
<div class="form-group for-shop">
<label>Upload Prescription<span class="req_red" style="color:red">*</span></label>
<input type="file" name="prescription" class="form-control">
</div>
</div>
<div class="col-md-12">
<button type="submit" name="setLead" class="btn btn-green">Add Lead</button>
</div>
</form>
</div>
</div>
</div>
<!-- Modal Upload More Images -->
<div class="modal fade" id="modalMoreImages" tabindex="-1" role="dialog" aria-labelledby="myModalLabel">
<div class="modal-dialog" role="document">
<div class="modal-content">
<div class="modal-header">
<button type="button" class="close" data-dismiss="modal" aria-label="Close"><span aria-hidden="true">×</span></button>
<h4 class="modal-title" id="myModalLabel"><?= lang('vendor_up_more_imgs') ?></h4>
</div>
<div class="modal-body">
<form id="uploadImagesForm">
<input type="hidden" value="<?= isset($_POST['folder']) ? $_POST['folder'] : $timeNow ?>" name="folder">
<label for="others"><?= lang('vendor_select_images') ?></label>
<input type="file" name="others[]" id="others" multiple />
</form>
</div>
<div class="modal-footer">
<button type="button" class="btn btn-default finish-upload">
<span class="finish-text"><?= lang('finish') ?></span>
<img src="<?= base_url('assets/imgs/load.gif') ?>" class="loadUploadOthers" alt="">
</button>
</div>
</div>
</div>
</div>
<script src="<?= base_url('assets/bootstrap-select-1.12.1/js/bootstrap-select.min.js') ?>"></script>
<script>
$('#choose_cat').on('change', function() {
// alert( this.value ); // or $(this).val()
if(this.value == "3") {
$('#Package').show();
$('#test_include').hide();
} else {
$('#Package').hide();
$('#test_include').show();
}
});
</script>
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