ikan Uploader :
Directory : /var/www/html/shardahospital.org/pdms/application/views/
Upload File : |
| Current File : /var/www/html/shardahospital.org/pdms/application/views/opfeedback.php |
<?php echo link_tag('assests/css_live/style.css'); ?>
<script src="https://cdn.ckeditor.com/ckeditor5/33.0.0/classic/ckeditor.js"></script>
<div class="course-topsec slidesv">
<div class="container">
<div class="row">
<div class="col-md-12">
</div>
</div>
</div>
<svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 1440 60">
<path fill="currentColor" d="M0,0V60H1440V0A5771,5771,0,0,1,0,0Z"></path>
</svg>
</div>
<div class="sec-newd">
<div class="new-var">
<div class="login-logo">
<img src="<?=base_url('assests/imgs/logo_new.png')?>">
</div>
<h2>Feedback Form</h2>
<form method="post" action="<?=base_url('feedback/opfeedback/'.$record_num)?>">
<ul class="academy-secul">
<li>
<div class="icon">
<img src="<?=base_url('assests/imgs/User-avatar.png')?>">
</div>
<h5><?=ucwords($recordsArray['patient_name'])?></h5>
<p><?=ucwords($recordsArray['UHID'])?></p>
<div class="clearfix"></div>
</li>
</ul>
<ul class="feedback-ul">
<?php $k=1; foreach($checklistArray as $catrow) { ?>
<li><h3><?=$catrow['checklist']?></h3></li>
<?php
$timeArray = array('1'=>"Less than 10 minutes",'2'=>"10-15 minutes",'3'=>"15-20 minutes",'4'=>"20-30 minutes",'5'=>"More than 30 minutes");
foreach($questionsArray[$catrow['id']] as $qrow) { ?>
<li> <strong><?=$k?>. <?=$qrow['title']?></strong>
<div class="labels">
<?php foreach($ratingArray as $row) { ?>
<label ><input type="radio" value="<?=$row['id']?>" name="radio_<?=$recordsArray['slag_id'].'_'.$catrow['id'].'_'.$qrow['id']?>" /> <?=$row['title']?>
<?php if($qrow['question_custom_one']=='1') { echo '<p style="font-size:10px;">('.$timeArray[$row['id']].')</p>'; } ?>
</label>
<?php } ?>
</div>
</li>
<?php $k++; } ?>
<?php } ?>
</ul>
<ul class="feedback-ul">
<li>
<h4> Would you recommend <strong style="color:green;">Sharda Hospital</strong> to friends and family? <span style="color:red;">*</span></h4>
<div class="labels">
<label><input value='1' type="radio" name="radio_recommend" class="radio_recommend" checked required /> Yes </label>
<label><input value='0' type="radio" name="radio_recommend" class="radio_recommend" required /> No</label>
</div>
<textarea placeholder="Write Here...." name="recommend_coments" id="recommend_coments" style='display:none;'></textarea>
</li>
</ul>
<ul class="feedback-ul">
<li>
<h4>Any Additional or Comments </h4>
<textarea placeholder="Write Here...." name="additional_coments" id="additional_coments" ></textarea>
<script>
ClassicEditor
.create( document.querySelector( '#additional_coments' ) )
.then( editor => {
console.log( editor );
} )
.catch( error => {
console.error( error );
} );
</script>
</li>
</ul>
<input type="hidden" name="myslagid" id="myslagid" value="<?=$recordsArray['slag_id']?>" />
<input type="hidden" name="language_mode" id="language_mode" value="1" />
<input type="submit" class="button1" name="submit" value="Submit"/>
<input type="reset" class="button1" style="background:gray;" name="reset" value="Reset"/>
</form>
</div>
</div>
<script type="text/javascript">
$(document).ready(function() {
$('.radio_recommend').click(function() {
$('#recommend_coments').toggle("slide");
});
});
</script>
Kontol Shell Bypass