prestation/Vue/Demandederogation/index.php
2025-12-01 18:54:33 +00:00

45 lines
1.4 KiB
PHP

<?php
$this->titre = "INTER-SANTE - Demande de dérogation";
?>
<form id="frmderogation" name="frmderogation" method="post" >
<legend> <?= _("Demande de dérogation") ?> </legend>
<INPUT class="sr-only" id="libelleDerogation" name="libelleDerogation" type="text" value="">
<table class="table table-responsive table-condensed" style='font-size:10pt;'>
<tbody>
<tr>
<td width="15%" class="required"> <?= _("Dérogation") ?> </td>
<td>
<SELECT class="form-control selectpicker" data-live-search="true" id="codeDerogation" NAME="codeDerogation" required autofocus style='font-size:10pt;'>
<?php liste_options($derogation,""); ?>
</SELECT>
</td>
</tr>
<tr>
<td class="required"> <?= _("Motivations") ?> </td>
<td colspan="5"><INPUT class="form-control" TYPE="text" id="observations" NAME="observations" required style='font-size:10pt;' ></td>
</tr>
<tr>
<td> </td>
<td> <input id="btn_enreg" name="btn_enreg" class = "form-control btn btn-primary" type="button" value="<?= _("Envoyer la demande") ?>" onClick="javascript:enregistrerdemandederogation();" style='font-size:10pt;' > </td>
</tr>
</tbody>
</table>
<?php if (isset($msgErreur)): ?>
<div id ="msgErreur" class="alert alert-danger" style="height:38px; padding:5px;" >
<H4><?= $msgErreur ?></H4>
</div>
<?php endif; ?>
</form>
<div id ="div_wait">
</div>