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_product.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_booking')) {
?>
<div class="alert alert-danger"><?= implode('<br>', $this->session->flashdata('error_booking')) ?></div>
<?php
}
?>
<div class="content">
<form class="form-box" method="POST" enctype="multipart/form-data">
<h3>Patient Details</h3>
<div class="row">
<div class="col-md-4">
<?php
foreach ($languages->result() as $language) {
?>
<label>Patient Name<span class="req_red">*</span></label>
<div class="form-group">
<input type="text" name="name" placeholder="Patient Name" value="<?= $trans_load != null && isset($trans_load[$language->abbr]['title']) ? $trans_load[$language->abbr]['title'] : $_POST['name']; ?>" class="form-control">
</div>
<?php
}
$i = 0;
?>
</div>
<div class="col-md-4">
<div class="form-group for-shop">
<label>Contact Number<span class="req_red">*</span></label>
<input type="text" name="phone" placeholder="Contact Number" onkeyup="if (/\D/g.test(this.value)) this.value = this.value.replace(/\D/g,'')" maxlength="10" value="<?=$_POST['phone']; ?>" class="form-control">
</div>
</div>
<div class="col-md-4">
<div class="form-group for-shop">
<label>Email Id<span class="req_red">*</span></label>
<input type="text" name="email" placeholder="Email Id" value="<?= $_POST['email']; ?>" class="form-control" >
</div>
</div>
<div class="col-md-4">
<div class="form-group for-shop">
<label>Age</label>
<input type="text" name="age" placeholder="Age" value="<?= $_POST['age']; ?>" class="form-control">
</div>
</div>
<div class="col-md-4">
<div class="form-group for-shop">
<label>Gender:</label>
<select class="form-control" name="gender" id="gender">
<option value=" ">Select Gender</option>
<option value="Male" <?php if($_POST['gender']=='Male'){ echo 'selected="selected"';} ?>>Male</option>
<option value="Female" <?php if($_POST['gender']=='Female'){ echo 'selected="selected"';} ?> >Female</option>
</select>
</div>
</div>
</div>
<h3>Booking Details</h3>
<div class="row">
<div class="col-md-6">
<div class="form-group for-shop">
<label>Test/Package<span class="req_red">*</span></label>
<select class="form-control" name="shop_categorie" id="choose_cat">
<option value=" ">Select Category</option>
<?php foreach ($shop_categories as $key_cat => $shop_categorie) { ?>
<option <?= isset($_POST['shop_categorie']) && $_POST['shop_categorie'] == $key_cat ? 'selected=""' : '' ?> value="<?= $key_cat ?>">
<?php
foreach ($shop_categorie['info'] as $nameAbbr) {
if ($nameAbbr['abbr'] == $this->config->item('language_abbr')) {
echo $nameAbbr['name'];
}
}?>
</option>
<?php } ?>
</select>
</div>
</div>
<div class="col-md-6">
<div class="form-group for-shop">
<label>Risk Area<span class="req_red">*</span></label>
<select class="selectpicker form-control show-tick show-menu-arrow" name="risk_categorie">
<option value=" ">Select Related Risk Area</option>
<?php foreach ($risk_categories as $risk_cat) {?>
<option value="<?= $risk_cat->id ?>" <?php if($_POST['risk_categorie']== $risk_cat->id) { echo ' selected="selected" '; } ?>>
<?= $risk_cat->name ?>
</option>
<?php }?>
</select>
</div>
</div>
<div class="col-md-6">
<?= $trans_load[$language->abbr]['test_id'] ?>
<div class="form-group for-shop" id="test_include" style="display:none;">
<label>Tests<span class="req_red">*</span></label>
<?php
$test_id_array=explode(",",$_POST['test_id']);
$i=0; ?>
<select name="related_test[ ]" class="selectpicker form-control show-tick show-menu-arrow" multiple>
<?php foreach($tests as $key=>$val) { ?>
<option <?php if(in_array($val->id,$test_id_array)) { echo ' selected="selected"'; } ?> value="<?php echo $val->id; ?>"><?php echo $val->title; ?></option>
<?php }?>
</select>
</div>
</div>
<div class="col-md-6">
<?= $trans_load[$language->abbr]['test_id'] ?>
<div class="form-group for-shop" id="package" style="display:none;">
<label>Packages<span class="req_red">*</span></label>
<?php
$test_id_array=explode(",",$_POST['test_id']);
$i=0; ?>
<select name="related_test[ ]" class="selectpicker form-control show-tick show-menu-arrow" multiple>
<?php foreach($packages as $key=>$val) { ?>
<option <?php if(in_array($val->id,$test_id_array)) { echo ' selected="selected"'; } ?> value="<?php echo $val->id; ?>"><?php echo $val->title; ?></option>
<?php }?>
</select>
</div>
</div>
<div class="col-md-6">
<div class="form-group for-shop">
<label>Booking Date<span class="req_red">*</span></label>
<input type="text" name="booking_date" id="datepicker" data-date-format="yyyy-mm-dd" placeholder="Fasting Time" value="<?= $_POST['booking_date']?>" class="form-control date">
</div>
</div>
<div class="col-md-6">
<div class="form-group for-shop">
<label>Booking Time Slot<span class="req_red">*</span></label>
<select name="collection_time" id="collection_time" class="form-control">
<option value="" > - Please Select - </option>
<?php foreach($collection_time as $key=>$value) { ?>
<option value="<?=$key?>" <?php if($_POST['collection_time'] == $key) { echo 'selected = "selected" '; } ?> ><?=$value?></option>
<?php } ?>
</select>
</div>
</div>
<div class="col-md-6">
<div class="form-group for-shop" id="precautions">
<label>City<span class="req_red">*</span></label>
<select name="city" id="city" class="form-control">
<option value="" > - Please Select - </option>
<option value="Noida" <?php if(trim($booking_details['city']) == "Noida" || trim($_POST['city'])=="Noida") { echo 'selected = "selected" '; } ?> >Noida</option>
<option value="Greater Noida" <?php if(trim($booking_details['city']) == "Greater Noida" || trim($_POST['city'])== "Greater Noida") { echo 'selected = "selected" '; } ?> >Greater Noida</option>
</select>
</div>
</div>
<div class="col-md-6">
<div class="form-group for-shop">
<label>Address<span class="req_red">*</span></label>
<input type="text" name="address" placeholder="Address" value="<?= $trans_load != null && isset($trans_load[$language->abbr]['address']) ? $trans_load[$language->abbr]['address'] : $_POST['address'] ?>" class="form-control">
</div>
</div>
<div class="col-md-12">
<div class="form-group for-shop">
<label>Need a hard copy of report?(50 only)</label>
<input type="checkbox" value="1" name="hardCopy" id="needHardCopy" <?php if($_POST['hardCopy']==1){echo 'checked';} ?>>
</div>
</div>
<div class="col-md-6">
<input type="hidden" name="booking_enqiry_id" id="booking_enqiry_id" value="<?=$_GET['lead']?>" />
<button type="submit" name="setProduct" class="btn btn-green">Upload Booking</button>
</div>
</div>
</form>
</div>
</div>
</div>
<!-- Modal Upload More Images -->
<div class="modal fade" id="modalMoreImages" tabindex="-1" role="dialog" aria-labelledby="myModalLabel">
<div class="modal-dialog" role="document">
<div class="modal-content">
<div class="modal-header">
<button type="button" class="close" data-dismiss="modal" aria-label="Close"><span aria-hidden="true">×</span></button>
<h4 class="modal-title" id="myModalLabel"><?= lang('vendor_up_more_imgs') ?></h4>
</div>
<div class="modal-body">
<form id="uploadImagesForm">
<input type="hidden" value="<?= isset($_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") {
$('#test_include').hide();
$('#package').show();
} else {
$('#test_include').show();
$('#package').hide();
}
});
</script>
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