23 lines
1.4 KiB
PHP
23 lines
1.4 KiB
PHP
<form id="formData">
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<legend id="titre_formData">Modification des données</legend>
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<INPUT class="sr-only" TYPE="text" id = "id" name = "id" value="<?=$affection['id']?>">
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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="8%" ><INPUT class="form-control majuscule" TYPE="text" id="codeAffection" NAME="codeAffection" required AUTOCOMPLETE="OFF" autofocus value="<?= $this->nettoyer($affection['codeAffection']); ?>" ></td>
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<td width="5%" align="center" class="required">Type</td>
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<td width="15%">
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<select name="codeTypeAffection" id="codeTypeAffection" class="form-control" required AUTOCOMPLETE="OFF" >
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<?= liste_options($typeaffection,$this->nettoyer($affection['codeTypeAffection']),true) ?>
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</select>
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</td>
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<td width="5%" align="center" class="required">Libellé</td>
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<td width="30%" ><INPUT class="form-control majuscule" TYPE="text" id="libelle" NAME="libelle" required AUTOCOMPLETE="OFF" value="<?= $this->nettoyer($affection['libelle']); ?>"></td>
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<td width="5%" align="center">Libellé Eng</td>
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<td width="27%" ><INPUT class="form-control majuscule" TYPE="text" id="libelleEng" NAME="libelleEng" value="<?= $this->nettoyer($affection['libelleEng']); ?>"></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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