32 lines
1.6 KiB
PHP
32 lines
1.6 KiB
PHP
<form id="formData">
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<legend id="titre_formData">Ajouter des données</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="5%" align="center" class="required">Code</td>
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<td width="20%" ><INPUT class="form-control majuscule" TYPE="text" id="codeBureau" NAME="codeBureau" required AUTOCOMPLETE="OFF" autofocus ></td>
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<td width="5%" align="center" class="required">Libellé</td>
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<td width="20%" ><INPUT class="form-control majuscule" TYPE="text" id="libelle" NAME="libelle" required AUTOCOMPLETE="OFF" ></td>
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<td width="5%" align="center">Nom Respo.</td>
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<td width="20%" ><INPUT class="form-control majuscule" TYPE="text" id="nomRespon" NAME="nomRespon"></td>
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</tr>
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<tr>
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<td width="5%" align="center">Prénom Respo.</td>
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<td width="20%" ><INPUT class="form-control majuscule" TYPE="text" id="prenomRespon" NAME="prenomRespon"></td>
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<td width="5%" align="center">Tél. Fixe</td>
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<td width="20%" ><INPUT class="form-control" TYPE="tel" id="telephoneFixe" NAME="telephoneFixe"></td>
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<td width="5%" align="center">Tél. Mobile</td>
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<td width="20%" ><INPUT class="form-control" TYPE="tel" id="telephonePortable" NAME="telephonePortable"></td>
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</tr>
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<tr>
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<td width="5%" align="center">Email</td>
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<td colspan="5" ><INPUT class="form-control" TYPE="email" id="email" NAME="email"></td>
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</tr>
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</tbody>
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</table>
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</form>
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