331 lines
12 KiB
PHP
Executable File
331 lines
12 KiB
PHP
Executable File
<?php $this->titre = "INTER SANTE - Créer un Prestataire"; ?>
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<INPUT class="sr-only" TYPE="text" id="nomForm" NAME="nomForm" value="frmcreerprestataire" readonly>
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<legend> <?= _("Informations Nouveau Prestataire") ?> </legend>
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<div >
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<table class="table table-responsive table-condensed" style="font-size:10pt">
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<tbody>
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<tr>
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<td width="12%" class="required"> <?= _("Nom") ?> </td>
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<td width="22%"><INPUT class="form-control majuscule" TYPE="text" id="libelle" NAME="libelle" required AUTOCOMPLETE="OFF" autofocus ></td>
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<td width="12%" align="center" > <?= _("Catégorie") ?> </td>
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<td >
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<select class="form-select" id="categoriePresataire" NAME="categoriePresataire" onChange="JAVASCRIPT:changeTypePrestataire()" >
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<?php liste_options($categorie, ""); ?>
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</SELECT>
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</td>
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<td width="12%" align="center" class="required">Type</td>
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<td width="22%">
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<div id="div_type_prestataire">
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<SELECT class="form-select" id="codeTypePrestataire" NAME="codeTypePrestataire" required AUTOCOMPLETE="OFF">
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<?php liste_options($typeprestataire, ""); ?>
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</SELECT>
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</div>
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</td>
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</tr>
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<tr>
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<td class="required"> <?= _("Pays") ?> </td>
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<td >
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<SELECT onChange="ajaxListerVille();" class="form-select" id="codePays" NAME="codePays" required AUTOCOMPLETE="OFF">
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<?php liste_options($pays, $_SESSION['codePaysSociete']); ?>
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</SELECT>
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</td>
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<td align="center" class="required"> <?= (isset($_SESSION['affichagedynamique']['Région'])) ? _($_SESSION['affichagedynamique']['Région']) : _("Région") ?> </td>
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<td>
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<div id="listeville">
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<SELECT onChange="ajaxListerLocalite();" class="form-select" id="codeVille" NAME="codeVille" required AUTOCOMPLETE="OFF">
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<?php liste_options($ville, ""); ?>
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</SELECT>
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</div>
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</td>
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<td align="center" class="required"> <?= (isset($_SESSION['affichagedynamique']['Commune'])) ? _($_SESSION['affichagedynamique']['Commune']) : _("Commune") ?> </td>
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<td>
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<div id="listelocalite">
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<select class="form-select" id="codeLocalite" NAME="codeLocalite" required AUTOCOMPLETE="OFF">
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<?php liste_options($listelocalite, "" ); ?>
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</SELECT>
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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> <?= _("Indicatif") ?> </td>
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<td><INPUT class="form-control" TYPE="text" id="prefixePaiementMobile" NAME="prefixePaiementMobile"></td>
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<td align="center"> <?= _("Mobile Paiement") ?> </td>
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<td><INPUT class="form-control" TYPE="text" id="mobilePaiement" NAME="mobilePaiement"></td>
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<td align="center"> <?= _("Numéro pour Sms") ?> </td>
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<td><INPUT class="form-control" TYPE="tel" id="smsGestionPrestataire" NAME="smsGestionPrestataire" ></td>
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</tr>
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<tr>
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<td> <?= _("Téléphone Fixe") ?> </td>
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<td ><INPUT class="form-control" TYPE="tel" id="telephoneFixe" NAME="telephoneFixe" ></td>
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<td align="center"> <?= _("Fax") ?> </td>
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<td><INPUT class="form-control" TYPE="tel" id="faxPrestataire" NAME="faxPrestataire" ></td>
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<td align="center"> <?= _("Téléphone Mobile") ?> </td>
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<td><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 class="required"> <?= _("Type Decompte") ?> </td>
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<td>
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<select class="form-select" id="codeTypeDecompte" NAME="codeTypeDecompte" required AUTOCOMPLETE="OFF">
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<?php liste_options($typedecompte, ""); ?>
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</SELECT>
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</td>
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<td align="center" > <?= _("Numéro de Compte") ?> </td>
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<td><INPUT class="form-control" TYPE="text" id="numeroCompte" NAME="numeroCompte" ></td>
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<td align="center" class="required"> <?= _("Convention?") ?> </td>
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<td>
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<select class="form-select" id="conventionne" NAME="conventionne" required AUTOCOMPLETE="OFF">
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<?php liste_options($ouinonconvention, ""); ?>
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</SELECT>
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</td>
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</tr>
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<tr>
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<td class="required"> E-mail </td>
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<td ><INPUT class="form-control" TYPE="email" id="emailGestionPrestataire" NAME="emailGestionPrestataire" placeholder="E-mail obligatoire" required AUTOCOMPLETE="OFF" ></td>
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<td align="center" class="required"> <?= _("Ville Signature") ?> </td>
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<td><INPUT class="form-control" TYPE="text" id="villeSignature" NAME="villeSignature" required AUTOCOMPLETE="OFF"></td>
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<td align="center" class="required"> <?= _("Gestion réseau?") ?> </td>
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<td>
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<select class="form-select" id="gestionreseau" NAME="gestionreseau" required AUTOCOMPLETE="OFF">
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<?php liste_options($ouinongestionreseau, ""); ?>
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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 > <?= _("Tarif Acte") ?> </td>
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<td >
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<select class="form-control selectpicker" data-live-search="true" id="codeTarifActe" NAME="codeTarifActe">
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<?php liste_options($tarifActe, "", false); ?>
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</SELECT>
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</td>
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<td align="center"> <?= _("Tarif Médicament") ?> </td>
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<td>
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<select class="form-control selectpicker" data-live-search="true" id="codeTarifMedicament" NAME="codeTarifMedicament">
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<?php liste_options($tarifsmedicament, ""); ?>
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</SELECT>
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</td>
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<td align="center"> <?= _("Tarif Optique") ?> </td>
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<td>
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<select class="form-control selectpicker" data-live-search="true" id="codeTarifOptique" NAME="codeTarifOptique">
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<?php liste_options($tarifsoptique, ""); ?>
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</SELECT>
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</td>
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</tr>
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<tr>
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<td > <?= _("Banque") ?> </td>
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<td >
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<select class="form-select" id="codeBanque" NAME="codeBanque">
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<?php liste_options($banque, ""); ?>
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</SELECT>
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</td>
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<td align="center"> <?= _("Code Banque") ?> </td>
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<td><INPUT class="form-control" TYPE="text" id="codeBanqueInterne" NAME="codeBanqueInterne" ></td>
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<td align="center" > <?= _("Code Guichet") ?> </td>
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<td><INPUT class="form-control" TYPE="text" id="codeGuichet" NAME="codeGuichet" ></td>
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</tr>
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<tr>
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<td> <?= _("Compte bancaire") ?> </td>
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<td ><INPUT class="form-control" TYPE="text" id="numeroCompteBancaire" NAME="numeroCompteBancaire" ></td>
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<td align="center"> <?= _("Clé Rib") ?> </td>
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<td> <INPUT class="form-control" TYPE="text" id="cleRib" NAME="cleRib" ></td>
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<td align="center"> Iban </td>
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<td> <INPUT class="form-control" TYPE="text" id="iban" NAME="iban" ></td>
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</tr>
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<tr>
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<td> <?= _("Intititulé Compte") ?> </td>
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<td ><INPUT class="form-control" TYPE="text" id="intituleCompteBancaire" NAME="intituleCompteBancaire" ></td>
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<td align="center"> <?= _("Registre Commerce") ?> </td>
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<td><INPUT class="form-control" TYPE="text" id="registreCommerce" NAME="registreCommerce" ></td>
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<td align="center"> <?= _("Langue") ?> </td>
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<td>
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<select class="form-select" id="codeLangueUser" NAME="codeLangueUser" >
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<?php liste_options($langue, $_SESSION['codeLangueSociete'] ); ?>
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</SELECT>
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</td>
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</tr>
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<tr>
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<td> <?= _("Responsable") ?> </td>
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<td ><INPUT class="form-control" TYPE="text" id="nomResponsable" NAME="nomResponsable" ></td>
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<td align="center"> <?= _("Correspondant") ?> </td>
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<td> <INPUT class="form-control" TYPE="text" id="nomInterlocuteur" NAME="nomInterlocuteur" ></td>
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<td align="center"> <?= _("Filtre Médecin?") ?> </td>
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<td>
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<select class="form-select" id="filtreMedecin" NAME="filtreMedecin">
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<?php liste_options($ouinonfiltremed, "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 class="required"> <?= _("Référencé?") ?> </td>
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<td>
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<select class="form-select" id="centreReference" NAME="centreReference" required AUTOCOMPLETE="OFF">
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<?php liste_options($ouinonreference, "0",true); ?>
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</SELECT>
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</td>
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<td align="center"> <?= _("Appliquer Tarif Nuit/Férié?") ?> </td>
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<td>
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<select class="form-select" id="appliquerTarifNuit" NAME="appliquerTarifNuit">
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<?php liste_options($ouinontarifnuit, "0",true); ?>
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</SELECT>
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</td>
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<td align="center"> <?= _("Latitude") ?> </td>
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<td> <INPUT class="form-control" TYPE="number" id="latitude" NAME="latitude" value="0.0000000000"></td>
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</tr>
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<tr >
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<td>
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<?= _("Mode de biométrie") ?>
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</td>
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<td>
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<select class="form-select" id="codeModeBiometrie" NAME="codeModeBiometrie" required AUTOCOMPLETE="OFF" >
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<?php liste_options($modeBiometrie, $codeModeBiometrie, true); ?>
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</SELECT>
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</td>
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<td align="center"> <?= _("Autre Téléphone") ?> </td>
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<td> <INPUT class="form-control" TYPE="tel" id="contactInterlocuteur" NAME="contactInterlocuteur" ></td>
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<td align="center"> <?= _("Longitude") ?> </td>
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<td> <INPUT class="form-control" TYPE="number" id="longitude" NAME="longitude" value="-0.0000000000"></td>
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</tr>
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<tr id="ligne_pharmacie" >
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<td > <?= _("Ajoute Médicament?") ?> </td>
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<td>
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<select class="form-select" id="accesAjoutPh" NAME="accesAjoutPh">
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<?php liste_options($ouinonajoutepha, "0", true); ?>
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</SELECT>
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</td>
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<td align="center"> <?= _("Ajoute Prescription?") ?> </td>
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<td>
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<select class="form-select" id="ajoutPrescription" NAME="ajoutPrescription">
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<?php liste_options($ouinonajoutepres, "0", true); ?>
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</SELECT>
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</td>
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<td align="center"> <?= _("Vente Partielle?") ?> </td>
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<td>
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<select class="form-select" id="interdirVentePartielleMedicament" NAME="interdirVentePartielleMedicament">
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<?php liste_options($ouinonventepar, "0", 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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<?= _("Pharmacie Interne?") ?>
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</td>
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<td>
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<select class="form-select" id="pharmacieInterne" NAME="pharmacieInterne">
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<?php liste_options($ouinonPharmacie, "0",true); ?>
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</SELECT>
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</td>
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<td align="center"> <?= _("Lunetterie Interne?") ?> </td>
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<td>
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<select class="form-select" id="optiqueInterne" NAME="optiqueInterne">
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<?php liste_options($ouinonOptique, "0",true); ?>
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</SELECT>
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</td>
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<td align="center"> <?= _("Appliquer Tarif Prestataire?") ?> </td>
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<td>
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<select class="form-select" id="appliquerTarifPrestataire" NAME="appliquerTarifPrestataire">
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<?php liste_options($ouinontarifprestataire, "1",true); ?>
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</SELECT>
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</td>
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</tr>
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<tr >
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<td>
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<?= _("Activer OTP?") ?>
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</td>
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<td>
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<select class="form-select" id="activerOtp" NAME="activerOtp">
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<?php liste_options($ouinonactiverOtp, "0",true); ?>
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</SELECT>
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</td>
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<td align="center"> <?= _("Filtrage IP?") ?> </td>
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<td>
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<select class="form-select" id="filtrerIp" NAME="filtrerIp">
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<?php liste_options($ouinonfiltrerIp, "0",true); ?>
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</SELECT>
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</td>
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<td align="center"> <?= _("Autoriser Bon Principal?") ?> </td>
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<td>
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<select class="form-select" id="autoriserUnBonPrincipal" NAME="autoriserUnBonPrincipal">
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<?php liste_options($autoriserUnBonPrincipalOuinon, "0",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> <?= _("Adresse Géo.") ?> </td>
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<td colspan="2"><INPUT class="form-control" TYPE="text" id="adresseGeo" NAME="adresseGeo"></td>
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<td align="center"> <?= _("Adresse Postale") ?> </td>
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<td colspan="2"><INPUT class="form-control" TYPE="text" id="adressePost" NAME="adressePost"></td>
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</tr>
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<tr>
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<td colspan="6" height="20"></td>
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</tr>
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<tr>
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<td > </td>
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<td > <input id="btn_enreg" name="btn_enreg" class = "form-control btn btn-primary" type="button" value="<?= _("Enregistrer") ?>" onClick="javascript:creer_prestataire();" style='font-size:10pt;' > </td>
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<td colspan="3"></td>
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<td > <input class = "form-control btn btn-warning" type="button" value="<?= _("Annuler") ?>" onClick="javascript:param_prestataire();" style='font-size:10pt;' > </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 id="div_idPrestataire">
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<input class="sr-only" type="text" id="idPrestataire" name="idPrestataire" >
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</div>
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