45 lines
2.4 KiB
PHP
Executable File
45 lines
2.4 KiB
PHP
Executable File
<div class="card">
|
|
<div class="card-header bg-info text-white">
|
|
<h5 class="mb-0"><?= _("Réseau de Soins");?></h5>
|
|
</div>
|
|
<div class="card-body">
|
|
<form method="GET" action="" accept-charset="UTF-8" onsubmit="showOverlay()" id="form_statistique">
|
|
<input id="idPolice" name="idPolice" type="hidden" value="">
|
|
<input id="idAdherent" name="idAdherent" type="hidden" value="564">
|
|
<input id="idBeneficiaire" name="idBeneficiaire" type="hidden" value="">
|
|
|
|
<div class="row mb-3">
|
|
<div class="col-md-4">
|
|
<label for="recherche" class="form-label fw-bold"><?= _("Recherche prestataire");?></label>
|
|
<input class="form-control" id="recherche" name="recherche" type="text" placeholder="Rechercher un prestataire...">
|
|
</div>
|
|
<div class="col-md-4">
|
|
<label for="idCollege" class="form-label fw-bold"><?= _("Collège");?></label>
|
|
<select class="form-control js-select2" id="idCollege" name="idCollege">
|
|
<?php liste_options_consultation($college, ""); ?>
|
|
</select>
|
|
</div>
|
|
<div class="col-md-4">
|
|
<label for="idLocalite" class="form-label fw-bold"><?= _("Localité");?></label>
|
|
<select class="form-control selectpicker js-select2" data-live-search="true" id="idLocalite" name="idLocalite">
|
|
<?php liste_options_consultation($localite, ""); ?>
|
|
</select>
|
|
</div>
|
|
</div>
|
|
|
|
<div class="row mb-3">
|
|
<div class="col-md-6">
|
|
<label for="idPrestataire" class="form-label fw-bold"><?= _("Prestataire");?></label>
|
|
<select class="form-control selectpicker js-select2" data-live-search="true" id="idPrestataire" name="idPrestataire">
|
|
<?php liste_options_consultation($prestataire, ""); ?>
|
|
</select>
|
|
</div>
|
|
<div class="col-md-6 d-flex align-items-end">
|
|
<button type="button" class="form-control btn btn-primary" onclick="javascript:afficher_ListeReseauSoins();"><?= _("Filtrer");?>
|
|
</div>
|
|
</div>
|
|
</form>
|
|
</div>
|
|
</div>
|
|
|
|
<div id="div_reseausoins" ></div>
|