ikan Uploader :
Directory : /var/www/html/shardahospital.org/incident/application/views/
Upload File : |
| Current File : /var/www/html/shardahospital.org/incident/application/views/complaintfeedback.php |
<div class="wrapper d-flex align-items-stretch">
<?php include('_parts/sidebar.php') ?>
<div id="content">
<?php include('_parts/user_internal_header.php') ?>
<div class="main-body">
<div class="headings">
<h4>Complaint Feedback</h4>
</div>
<div class="white-box">
<?php if($_GET['msg']=='success')
{?>
<p class="alert alert-success"><strong>Congratulation!</strong> Your feedback/suggestion has been successfully </p>
<?php } else if($_GET['msg']=='inprogress') { ?>
<p class="alert alert-info"><strong>Sorry</strong>, Your complain is In Progress and you can not submit your feedback/suggestion.</p>
<?php } else if($_GET['msg']=='notexist') { ?>
<p class="alert alert-danger"><strong>Invalid Incident Id</strong> Please enter valid Incidence Id. </p>
<?php } ?>
<form class="form-horizontal style-form" method="post" name="complaint" enctype="multipart/form-data">
<div class="form1">
<ul>
<li>
<label>Category <span style="color:red;">*</span></label>
<div class="category-radio">
<span class="radio-inline radio-input">
<input type="radio" id="not-satisfied" name="category" value="Not Satisfied" <?php if($compNumber!=''){ echo $checked = 'checked'; } ?>>
<label for="not-satisfied">Not Satisfied</label>
</span>
<span class="radio-inline radio-input">
<input type="radio" id="feedback" name="category" value="feedback" <?php if($compNumber==''){ echo $checked = 'checked'; } ?>>
<label for="feedback">Feedback</label>
</span>
<span class="radio-inline radio-input">
<input type="radio" id="suggestions" name="category" value="suggestions" >
<label for="suggestions">Suggestions</label>
</span>
</div>
</li>
<li>
<label>Registered Incident Id<span style="color:red;">*</span></label>
<select name="compNumber" class="form-control" required>
<option value=""> Select Incident Id</option>
<?php foreach($complaintsArray as $row) {?>
<option value="<?=$row['compNumber']?>"><?=$row['compNumber']?></option>
<?php }?>
</select>
</li>
<li>
<label>Mention Detail <span style="color:red;">*</span></label>
<textarea class="form-control" name="feedbackdetails" required="required" cols="10" rows="10" class="form-control" maxlength="4000" required></textarea>
</li>
<li>
<input type="submit" name="submit" value="Submit" class="btn button5" />
</li>
</ul>
</form>
</div>
</div>
</div>
<script src="<?=base_url('assets/js/popper.js'); ?>"></script>
<script src="<?=base_url('assets/js/main.js'); ?>"></script>
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