127 lines
6.8 KiB
PHP
127 lines
6.8 KiB
PHP
<div id="div_consulter_facture">
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<table class="table table-responsive table-condensed" style="font-size:9pt;">
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<tbody>
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<tr>
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<td width="7%"> <?= _("ID facture") ?> </td>
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<td width="13%"> <INPUT style="font-size:9pt;" class="form-control" value="<?= $this->nettoyer($facture['idFacture']) ?>" readonly></td>
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<td width="7%" style='text-align:center'> <?= _("No Benef") ?> </td>
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<td width="10%" ><INPUT style="font-size:9pt;" class="form-control" value="<?= $this->nettoyer($facture['numeroBeneficiaire']) ?>" readonly></td>
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<td width="7%" style='text-align:center'> <?= _("Bénéficiaire") ?> </td>
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<td width="25%" ><INPUT style="font-size:9pt;" class="form-control" value="<?= $this->nettoyer($facture['beneficiaire']) ?>" readonly></td>
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<td width="7%" style='text-align:center'> <?= _("Adhérent") ?> </td>
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<td><INPUT style="font-size:9pt;" class="form-control" value="<?= $this->nettoyer($facture['adherent']) ?>" readonly></td>
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</tr>
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<tr>
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<td > <?= _("Police") ?> </td>
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<td><INPUT style="font-size:9pt;" class="form-control" value="<?= $this->nettoyer($facture['numeroPolice']) ?>" readonly></td>
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<td style='text-align:center'> Categ</td>
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<td><INPUT style="font-size:9pt;" class="form-control" value="<?= $this->nettoyer($facture['codeProduit']) ?>" readonly></td>
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<td style='text-align:center'> E-mail / Tel </td>
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<td><INPUT style="font-size:9pt;" class="form-control" value="<?= $this->nettoyer($facture['emailAdherent']) ?> / <?= $this->nettoyer($facture['telAdherent']) ?>" readonly></td>
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<td style='text-align:center'> <?= _("Client") ?> </td>
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<td><INPUT style="font-size:9pt;" class="form-control" value="<?= $this->nettoyer($facture['souscripteur']) ?>" readonly></td>
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</tr>
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<tr>
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<td > Date </td>
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<td><INPUT style="font-size:9pt;" class="form-control" value="<?= dateheureFr($this->nettoyer($facture['dateSysteme'])) ?>" readonly></td>
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<td style='text-align:center'> User </td>
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<td><INPUT style="font-size:9pt;" class="form-control" value="<?= $this->nettoyer($facture['codeUtilisateur']) ?>" readonly></td>
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<td style='text-align:center'> <?= _("prestataire") ?> </td>
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<td><INPUT style="font-size:9pt;" class="form-control" value="<?= $this->nettoyer($facture['prestataire']) ?>" readonly></td>
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<td style='text-align:center'> <?= _("Etat fact") ?> </td>
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<td><INPUT style="font-size:9pt;" class="form-control" value="<?= $this->nettoyer($facture['etatfacture']) ?>" readonly></td>
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</tr>
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<tr>
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<td> <?= _("Frais") ?> </td>
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<td><INPUT style="font-size:9pt;" class="form-control" value="<?= format_N($this->nettoyer($facture['fraisReel'])) ?>" readonly></td>
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<td style='text-align:center'> <?= _("T M") ?> </td>
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<td><INPUT style="font-size:9pt;" class="form-control" value="<?= format_N($this->nettoyer($facture['montantTm'])) ?>" readonly></td>
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<td style='text-align:center'> <?= _("A Remb") ?> </td>
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<td><INPUT style="font-size:9pt;" class="form-control" value="<?= format_N($this->nettoyer($facture['montantArembourser'])) ?>" readonly></td>
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<td style='text-align:center'><?= _("Dépass") ?> </td>
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<td><INPUT style="font-size:9pt;" class="form-control" value="<?= format_N($this->nettoyer($facture['fraisExclu'])) ?>" readonly></td>
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</tr>
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<tr>
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<td> <?= _("Retenu") ?> </td>
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<td><INPUT style="font-size:9pt;" class="form-control" value="<?= format_N($this->nettoyer($facture['fraisRetenu'])) ?>" readonly></td>
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<td style='text-align:center'> <?= _("Forcé") ?> </td>
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<td><INPUT style="font-size:9pt;" class="form-control" value="<?= format_N($this->nettoyer($facture['montantForce'])) ?>" readonly></td>
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<td style='text-align:center'> <?= _("Redressé") ?> </td>
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<td><INPUT style="font-size:9pt;" class="form-control" value="<?= format_N($this->nettoyer($facture['montantRedresse'])) ?>" readonly></td>
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<td style='text-align:center'> <?= _("A Payer") ?> </td>
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<td><INPUT style="font-size:9pt;" class="form-control" value="<?= format_N($this->nettoyer($facture['montantApayer'])) ?>" readonly></td>
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</tr>
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<tr>
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<td > <?= _("T Payant") ?> </td>
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<?php if ($facture['tiersPayant']=="1"): ?>
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<td align='center'> <input type="checkbox" checked disabled></td>
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<?php else: ?>
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<td align='center'> <input type="checkbox" disabled></td>
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<?php endif; ?>
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<td style='text-align:center'> <?= _("Gest Conf") ?> </td>
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<?php if ($facture['gc']=="1"): ?>
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<td align='center'> <input type="checkbox" checked disabled></td>
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<?php else: ?>
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<td align='center'> <input type="checkbox" disabled></td>
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<?php endif; ?>
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<td style='text-align:center'> <?= _("No Decpte") ?> </td>
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<td><INPUT style="font-size:9pt;" class="form-control" value="<?= $this->nettoyer($facture['numeroDecompte']) ?>" readonly></td>
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<td style='text-align:center'> <?= _("No Lot") ?> </td>
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<td><INPUT style="font-size:9pt;" class="form-control" value="<?= $this->nettoyer($facture['numeroLotDecompte']) ?>" readonly></td>
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</tr>
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<tr>
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<td > <?= _("Vérificat") ?> </td>
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<td><INPUT style="font-size:9pt;" class="form-control" value="<?= $this->nettoyer($facture['userControle']) ?>" readonly></td>
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<td style='text-align:center'> <?= _("Dat Decpte") ?> </td>
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<td><INPUT style="font-size:9pt;" class="form-control" value="<?= dateFr($this->nettoyer($facture['dateDecompte'])) ?>" readonly></td>
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<td style='text-align:center'> <?= _("Dat Reglt") ?> </td>
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<td><INPUT style="font-size:9pt;" class="form-control" value="<?= dateheureFr($this->nettoyer($facture['heureReglement'])) ?>" readonly></td>
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<td style='text-align:center'> <?= _("Payé") ?> </td>
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<td><INPUT style="font-size:9pt;" class="form-control" value="<?= format_N($this->nettoyer($facture['montantPaye'])) ?>" readonly></td>
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</tr>
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</tbody>
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</table>
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<table class="table table-responsive table-condensed" style='font-size:12pt;' >
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<tbody>
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<tr>
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<td> <button type="button" style="font-size:10pt;" class="form-control btn btn-info" onclick="javascript:consulterfacturefeuillemaladie();" > <?= _("Feuille maladie...") ?></button> </td>
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<td> <button type="button" style="font-size:10pt;" class="form-control btn btn-info" onclick="javascript:consulterfactureprestationactes();" > <?= _("Prestations...") ?></button> </td>
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<td> <button type="button" style="font-size:10pt;" class="form-control btn btn-info" onclick="javascript:consulterfacturemedicaments();" > <?= _("Medicaments...") ?></button> </td>
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<td> <button type="button" style="font-size:10pt;" class="form-control btn btn-info" onclick="javascript:consulterfactureged();" > <?= _("G E D ...") ?> </button> </td>
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</tr>
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</tbody>
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</table>
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</div>
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