30 lines
1.4 KiB
PHP
30 lines
1.4 KiB
PHP
<div id="div_saisie_ecart">
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<INPUT class="sr-only" TYPE="text" id="idBeneficiaireEcart" name="idBeneficiaireEcart" >
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<div id="recherche_assure" onkeypress="javascript:ctrlkeypressbeneficiaireecart(event);">
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<table class="table table-responsive table-condensed" style='font-size:8pt;' >
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<tbody>
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<tr>
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<td width="7%" > <?= _("No Bénéf") ?> </td>
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<td width="12%">
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<INPUT style='text-align:center; font-size:8pt;' class="form-control" TYPE="text" id="numeroBeneficiaire" name="numeroBeneficiaire"
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onChange="javascript:chercher_beneficiaireecart(this.value);" >
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</td>
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<td width="10%"> <button type="button" style="font-size:8pt;" class="form-control btn btn-primary" onclick="javascript:$('#numeroBeneficiaire').blur();" > <?= _("Rechercher...") ?> </button> </td>
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<td width="5%" align="center"> <?= _("Nom") ?> </td>
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<td> <INPUT style='text-align:center; font-size:8pt;' class="form-control" TYPE="text" readonly > </td>
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<td width="10%" align="center"> <?= _("Souscripteur") ?> </td>
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<td> <INPUT style='text-align:center; font-size:8pt;' class="form-control" TYPE="text" readonly > </td>
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<td width="5%" align="center"> <?= _("Lien") ?> </td>
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<td width="5%" > <INPUT style='text-align:center; font-size:8pt;' class="form-control" TYPE="text" readonly > </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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</div>
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