255 lines
9.6 KiB
PHP
Executable File
255 lines
9.6 KiB
PHP
Executable File
<?php $this->titre = "INTER-SANTE - Ajout Adhérent"; ?>
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<form method="post" action="Creerbeneficiaire/ajouter">
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<INPUT class="sr-only" TYPE="text" id="idPolice" name="idPolice" value="<?= $_SESSION['idPolice_C'] ?>">
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<INPUT class="sr-only" TYPE="text" id="numeroPolice" name="numeroPolice" value="<?= $_SESSION['numeroPolice_C'] ?>">
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<INPUT class="sr-only" TYPE="text" id="idAdherent" name="idAdherent" value="<?= $_SESSION['idAdherent_C'] ?>">
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<INPUT class="sr-only" TYPE="text" id="numeroAdherent" name="numeroAdherent" value="<?= $_SESSION['numeroAdherent_C'] ?>">
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<fieldset>
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<legend> <?= _("Informations sur le Bénéficiaire") ?> </legend>
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<table class="table table-responsive table-condensed">
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<tbody>
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<tr>
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<td width="10%" class="required"> <?= _("Avenant") ?> </td>
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<td>
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<SELECT class="form-control" id="idAvenant" NAME="idAvenant" required autofocus onChange="changer_avenant_incorporation_beneficiaire();">
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<?php liste_options($avenant,""); ?>
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</SELECT>
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</td>
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<td width="10%" align="center" class="required"> <?= _("Entrée") ?> </td>
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<td>
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<div id="div_date_avenant">
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<INPUT class="form-control datepicker" TYPE="text" id="dateEntree" NAME="dateEntree" value="<?= dateLang($_SESSION['dateAvenant_C']) ?>" required
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onChange="prorater_prime_beneficiaire();">
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</div>
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</td>
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</tr>
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<tr>
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<td class="required"> <?= _("Nom Bénéf") ?> </td>
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<td><INPUT class="form-control majuscule" TYPE="text" id="nomBeneficiaire" NAME="nomBeneficiaire" value="<?= $adherent['nom'] ?>" required style="text-transform: uppercase;"></td>
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<td align="center" class="required"> <?= _("Prénoms") ?> </td>
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<td><INPUT class="form-control majuscule" TYPE="text" id="prenomsBeneficiaire" NAME="prenomsBeneficiaire" required></td>
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</tr>
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<tr>
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<td class="required"> <?= _("Statut") ?> </td>
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<td>
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<SELECT class="form-control" id="codeLienParente" NAME="codeLienParente" onChange="prorater_prime_beneficiaire();" required>
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<?php liste_options($lienparente,""); ?>
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</SELECT>
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</td>
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<td align="center" class="required"> Sexe </td>
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<td>
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<SELECT class="form-control" id="sexe" NAME="sexe" required>
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<?php liste_options($sexe,""); ?>
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</SELECT>
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</td>
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</tr>
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<td class="required"> <?= _("Naissance") ?> </td>
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<td>
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<INPUT class="form-control datepicker" TYPE="text" id="dateNaissance" NAME="dateNaissance" required
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onchange="controle_age($('#dateNaissance').datepicker('getDate'), $('#codeLienParente').val())">
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</td>
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<td align="center" class="required"> <?= _("Nat Pièce") ?> </td>
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<td>
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<SELECT class="form-control majuscule" id="codeNaturePiece" NAME="codeNaturePiece" required>
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<?php liste_options($naturepiece,""); ?>
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</SELECT>
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</td>
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</tr>
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<tr>
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<td> <?= _("No Pièce") ?> </td>
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<td><INPUT class="form-control majuscule" TYPE="text" id="numeroPiece" NAME="numeroPiece">
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<td align="center" class="required"> <?= _("Groupe Sang") ?> </td>
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<td>
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<SELECT class="form-control" id="codeGroupeSanguin" NAME="codeGroupeSanguin" required>
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<?php liste_options($groupesanguin,""); ?>
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</SELECT>
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</td>
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</tr>
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<tr>
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<td> <?= _("Tél Port") ?> </td>
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<td><INPUT class="form-control" TYPE="tel" id="telephonePortable" NAME="telephonePortable"></td>
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<td align="center"> <?= _("Prorata Prime?") ?> </td>
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<td>
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<SELECT class="form-control" id="prorata" NAME="prorata" required onChange="prorater_prime_beneficiaire();">
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<?php liste_options($ouinonprorata,"1",true); ?>
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</SELECT>
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</td>
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</tr>
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<tr>
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<td>
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<?php
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if(isset($_SESSION['composanteprime']['Carte']))
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{
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echo _($_SESSION['composanteprime']['Carte']);
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}
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else
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{
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echo _("Frais Carte");
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}
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?>
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</td>
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<td > <INPUT style='font-size:9pt;' class="form-control" id="fraisCarte" NAME="fraisCarte" TYPE="text" value="<?=$fraisCarte?>" onChange="prorater_prime_beneficiaire();"> </td>
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<td><input style="text-align:center;color:red;" class="form-control" type="text" id="agepersonne" name="agepersonne" value="Age : 0" readonly ></td>
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<td align='center'> <input class = "form-control btn btn-info" type="button" value="<?= _("Calculer la prime") ?>" onClick="prorater_prime_beneficiaire();"> </td>
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</tr>
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<tr>
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<td><?= _("No CMU") ?></td>
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<td>
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<INPUT class="form-control majuscule" TYPE="text" id="numeroCmu" NAME="numeroCmu" >
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</td>
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<td colspan="2" ><input class = "form-control btn btn-primary" type="submit" value="<?= _("Enregistrer") ?>" /></td>
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</tr>
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</tbody>
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</table>
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</fieldset>
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<div id="div_prime">
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<table class="table table-responsive table-condensed" style='font-size:8pt; text-align:center'>
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<thead>
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<tr>
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<th style='text-align:center'> <?= _("Décompte de primes") ?> </th>
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<th style='text-align:center'> <?= _("Primes Annuelles") ?> </th>
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<th style='text-align:center'> <?= _("Primes proratées") ?> </th>
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</tr>
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</thead>
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<tfoot>
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<tr>
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<td align='center'> <?= _("Prime TTC") ?> </td>
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<td align='center'> <?= format_N($this->nettoyer($beneficiaire_temp['primeTtc_an'])) ?></td>
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<td align='center'> <?= format_N($this->nettoyer($beneficiaire_temp['primeTtc'])) ?></td>
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</tr>
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<tr style='color:blue;'>
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<td align='center'> <?= _("Prime Nette Statisque") ?> </td>
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<td align='center'> <?= format_N($this->nettoyer($beneficiaire_temp['primeNetteStat_an'])) ?></td>
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<td align='center'> <?= format_N($this->nettoyer($beneficiaire_temp['primeNetteStat'])) ?></td>
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</tr>
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</tfoot>
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<tbody>
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<tr>
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<td> <?= _("Prime de Base") ?> </td>
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<td> <?= format_N($this->nettoyer($beneficiaire_temp['primeBeneficiaire_an']))?> </td>
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<td> <?= format_N($this->nettoyer($beneficiaire_temp['primeBeneficiaire']))?> </td>
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</tr>
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<tr>
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<td> <?= _("Garanties Optionnelles") ?> </td>
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<td> <?= format_N($this->nettoyer($beneficiaire_temp['surprimeOption_an']))?> </td>
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<td> <?= format_N($this->nettoyer($beneficiaire_temp['surprimeOption']))?> </td>
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</tr>
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<tr>
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<td> <?= _("Rachat Ticket Modérateur") ?> </td>
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<td> <?= format_N($this->nettoyer($beneficiaire_temp['surprimeTm_an']))?> </td>
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<td> <?= format_N($this->nettoyer($beneficiaire_temp['surprimeTm']))?> </td>
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</tr>
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<tr>
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<td> <?= _("Surprimes Diverses") ?> </td>
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<td> <?= format_N($this->nettoyer($beneficiaire_temp['surprimeAnt_an']))?> </td>
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<td> <?= format_N($this->nettoyer($beneficiaire_temp['surprimeAnt']))?> </td>
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</tr>
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<tr>
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<td> <?= _("Prime Nette de commission") ?> </td>
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<td> <?= format_N($this->nettoyer($beneficiaire_temp['primeNette_an'])) ?></td>
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<td> <?= format_N($this->nettoyer($beneficiaire_temp['primeNette'])) ?> </td>
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</tr>
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<tr>
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<td> <?= _("Commission Gestion") ?> </td>
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<td> <?= format_N($this->nettoyer($beneficiaire_temp['commissionGestion_an'])) ?></td>
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<td> <?= format_N($this->nettoyer($beneficiaire_temp['commissionGestion'])) ?></td>
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</tr>
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<tr>
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<td> <?= _("Commission Courtage") ?> </td>
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<td> <?= format_N($this->nettoyer($beneficiaire_temp['commission_an'])) ?></td>
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<td> <?= format_N($this->nettoyer($beneficiaire_temp['commission'])) ?></td>
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</tr>
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<tr>
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<td> <?= _("Commission Commerciaux") ?> </td>
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<td> <?= format_N($this->nettoyer($beneficiaire_temp['commissionAutre_an'])) ?></td>
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<td> <?= format_N($this->nettoyer($beneficiaire_temp['commissionAutre'])) ?></td>
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</tr>
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<tr>
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<td> <?= _("Accessoires") ?> </td>
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<td> <?= format_N($this->nettoyer($beneficiaire_temp['accessoire_an'])) ?></td>
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<td> <?= format_N($this->nettoyer($beneficiaire_temp['accessoire'])) ?> </td>
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</tr>
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<tr>
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<td> <?= _("Accessoires Garant") ?> </td>
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<td> <?= format_N($this->nettoyer($beneficiaire_temp['accessoireGarant_an'])) ?></td>
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<td> <?= format_N($this->nettoyer($beneficiaire_temp['accessoireGarant'])) ?> </td>
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</tr>
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<tr>
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<td> <?= _("Prime Nette") ?> </td>
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<td> <?= format_N($this->nettoyer($beneficiaire_temp['primeHt_an'])) ?></td>
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<td> <?= format_N($this->nettoyer($beneficiaire_temp['primeHt'])) ?> </td>
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</tr>
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<tr>
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<td> <?= (isset($_SESSION['composanteprime']['Taxes'])) ? _($_SESSION['composanteprime']['Taxes']) : _("Taxes") ?> </td>
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<td> <?= format_N($this->nettoyer($beneficiaire_temp['taxe_an'])) ?></td>
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<td> <?= format_N($this->nettoyer($beneficiaire_temp['taxe'])) ?> </td>
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</tr>
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<tr>
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<td>
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<?php
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if(isset($_SESSION['composanteprime']['Cartes']))
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{
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echo _($_SESSION['composanteprime']['Cartes']);
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}
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else
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{
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echo _("Cartes");
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}
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?>
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</td>
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<td> <?= format_N($this->nettoyer($beneficiaire_temp['fraisCarte_an'])) ?></td>
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<td> <?= format_N($this->nettoyer($beneficiaire_temp['fraisCarte'])) ?></td>
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</tr>
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</tbody>
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</table>
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</div>
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</form>
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<?php if (isset($msgErreur)): ?>
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<div class="alert alert-danger" style="height:30px; padding:5px;" >
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<H4><?= $msgErreur ?></H4>
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</div>
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<?php endif; ?>
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