68 lines
4.0 KiB
PHP
Executable File
68 lines
4.0 KiB
PHP
Executable File
<div id="infosacte" style='font-size:10pt;'>
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<input class="sr-only" type="number" id="prixActe" name="prixActe" value="<?= $prixActe ?>">
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<input class="sr-only" type="number" id="valeurActe" name="valeurActe" value="<?= $valeurActe ?>">
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<input class="sr-only" type="number" id="montantTm" name="montantTm" value="<?= $montantTm ?>">
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<input class="sr-only" type="number" id="aRembourser" name="aRembourser" value="<?= $aRembourser ?>">
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<input class="sr-only" type="text" id="acteExclu" name="acteExclu" value="<?= $acteExclu ?>">
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<input class="sr-only" type="text" id="ententePrealable" name="ententePrealable" value="<?= $ententePrealable ?>">
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<table class="table table-responsive table-condensed" style='font-size:10pt;'>
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<tbody>
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<tr>
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<td width="15%" > <?= _("Prix") ?> </td>
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<td width="20%" > <input id="prixActe_info" name="prixActe_info" class="form-control" style="background-color: rgb(190,190,190);text-align: center; font-size:10pt;'" type="text" value="<?= format_N($prixActe) ?>" readonly> </td>
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<td width="15%" align="center"> Total </td>
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<td width="15%" > <input id="valeurActe_info" name="valeurActe_info" class="form-control" style="background-color: rgb(190,190,190);text-align: center; font-size:10pt;'" type="text" value="<?= format_N($valeurActe) ?>" readonly ></td>
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<td width="15%" align="center"> <?= _("T M") ?> </td>
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<td width="20%" > <input id="montantTm_info" name="montantTm_info" class="form-control" style="background-color: rgb(190,190,190);text-align: center; font-size:10pt;'" type="text" value="<?= format_N($montantTm) ?>" readonly ></td>
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</tr>
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<tr>
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<td> <?= _("Motif") ?> </td>
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<td colspan="5"><input id="motifHospit" name="motifHospit" class="form-control" style="background-color: rgb(190,190,190);text-align: center; font-size:10pt;" value="<?= $_SESSION['p_motifHospitalisation_C'] ?>" type="text" readonly></td>
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</tr>
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<tr>
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<td> <?= _("A Remb") ?> </td>
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<td > <input id="aRembourser_info" name="aRembourser_info" class="form-control" style="background-color: rgb(190,190,190);text-align: center; font-size:10pt;'" type="text" value="<?= format_N($aRembourser) ?>" readonly ></td>
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<td align="center"> <?= _("Accord?") ?> </td>
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<td align="center"> <input id="montantTm_info" name="montantTm_info" class="form-control" style="background-color: rgb(190,190,190);text-align: center; font-size:10pt;'" type="text" value="<?= div_oui_non($ententePrealable, $_SESSION['p_lang']); ?>" readonly > </td>
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<td align="center"> <?= _("No Chambre") ?> </td>
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<td> <input id="numeroChambre" name="numeroChambre" class="form-control" style="text-align: center; font-size:10pt;'" type="text"></td>
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</tr>
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<tr>
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<td> </td>
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<td colspan="5">
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<?php if ($acteExclu=="1"): ?>
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<input id="btn_enreg_chambre" name="btn_enreg_chambre" class = "form-control btn btn-danger" type="button" value="Chambre exclue! Demander Accord? / Room not covered! Request Agreement" disabled onClick="javascript:demanderaccordchambreexclu();" style='font-size:10pt;' >
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<?php else: ?>
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<?php if ($ententePrealable=="1"): ?>
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<input id="btn_enreg_chambre" name="btn_enreg_chambre" class = "form-control btn btn-warning" type="button" value="<?= _("Demander Accord") ?>" onClick="javascript:enregistrerchambre();" style='font-size:10pt;' >
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<?php else: ?>
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<input id="btn_enreg_chambre" name="btn_enreg_chambre" class = "form-control btn btn-primary" type="button" value="<?= _("Enregistrer") ?>" onClick="javascript:enregistrerchambre();" style='font-size:10pt;' >
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<?php endif; ?>
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<?php endif; ?>
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</td>
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</tr>
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</tbody>
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</table>
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<div id="div_fraisExclu">
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<input class="sr-only" type="text" id="fraisExclu" name="fraisExclu" value="0" >
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</div>
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<?php if ($acteExclu=="1"): ?>
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<div class="alert alert-danger" style="height:38px; padding:5px;">
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<H4> <?= _("NON COUVERT !") ?> </H4>
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</div>
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<?php endif; ?>
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</div>
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