203 lines
8.2 KiB
PHP
Executable File
203 lines
8.2 KiB
PHP
Executable File
<?php
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$this->titre = "INTER SANTE - Modification Client";
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$codeLangueClient = $this->nettoyer($client['codeLangueClient']);
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if($this->nettoyer($client['typeClient'])=="E"){
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$readonlyparticulier ='';
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$readonlyentreprise ='readonly';
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}
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else{
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$readonlyparticulier = 'readonly';
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$readonlyentreprise ='';
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}
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?>
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<form method="post" action="Modifierclient/modifier">
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<fieldset>
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<legend> <?= _("Souscripteur Numéro") . " : " . $client['numeroClient']?> </legend>
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<table class="table table-responsive table-condensed">
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<tbody>
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<tr>
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<td width="10%" class="required">Type</td>
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<td width="38%">
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<select class="form-select" id="typeClient" NAME="typeClient" onChange="JAVASCRIPT:controletytpeclient();" required AUTOCOMPLETE="OFF">
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<?php liste_options($typeclient,$client['typeClient']); ?>
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</SELECT>
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</td>
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<td width="15%" align="center" class="required"> <?= _("Titre") ?> </td>
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<td>
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<select class="form-select" id="codeTitre" NAME="codeTitre" required AUTOCOMPLETE="OFF">
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<?php liste_options($titre,$client["codeTitre"]); ?>
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</SELECT>
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</td>
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</tr>
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<tr>
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<td class="required"> <?= _("Nom") ?> </td>
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<td><INPUT class="form-control" TYPE="text" id="nom" NAME="nom" value="<?=$client['nom']?>" required AUTOCOMPLETE="OFF" style="text-transform: uppercase;"></td>
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<td align="center"> <?= _("Prénoms") ?> </td>
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<td><INPUT class="form-control majuscule" TYPE="text" id="prenoms" NAME="prenoms" value="<?=$client['prenoms']?>" <?=$readonlyentreprise;?>></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" value="<?=$client['prefixePaiementMobile']?>"></td>
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<td align="center"> <?= _("Mobile Paiement") ?> </td>
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<td><INPUT class="form-control" TYPE="text" id="mobilePaiement" NAME="mobilePaiement" value="<?=$client['mobilePaiement']?>"></td>
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</tr>
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<tr>
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<td ><?= _("Tarif Actes") ?></td>
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<td >
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<select name="codeTarifActe" id="codeTarifActe" class="form-control selectpicker" data-live-search="true">
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<?= liste_options($tarifActe, $client['codeTarifActe'],false) ?>
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</select>
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</td>
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<td align="center"> <?= _("Pays") ?> </td>
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<td>
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<SELECT onChange="ajaxListerVille();" class="form-select" id="codePays" NAME="codePays">
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<?php liste_options($pays,$client['codePays']); ?>
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</SELECT>
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</td>
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</tr>
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<tr>
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<td > <?= (isset($_SESSION['affichagedynamique']['District / Région'])) ? _($_SESSION['affichagedynamique']['District / Région']) : _("District / Région") ?> </td>
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<td>
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<div id="listeville">
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<SELECT onChange="ajaxListerLocalite();" class="form-select" id="codeVille" NAME="codeVille" required AUTOCOMPLETE="OFF">
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<?php liste_options($ville,$client['codeVille']); ?>
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</SELECT>
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</div>
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</td>
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<td align="center"> <?= (isset($_SESSION['affichagedynamique']['Commune'])) ? _($_SESSION['affichagedynamique']['Commune']) : _("Commune") ?> </td>
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<td>
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<div id="listelocalite">
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<select class="form-select" id="codeLocalite" NAME="codeLocalite">
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<?php liste_options($listelocalite,$client['codeLocalite']); ?>
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</SELECT>
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</div>
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</td>
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</tr>
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<tr>
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<td> <?= _("Tél Bureau") ?> </td>
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<td><INPUT class="form-control" TYPE="tel" id="telephoneBureau" NAME="telephoneBureau" value="<?=$client['telephoneBureau']?>"></td>
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<td align="center"> <?= _("Tél Domicile") ?> </td>
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<td><INPUT class="form-control" TYPE="tel" id="telephonedomicile" NAME="telephonedomicile" value="<?=$client['telephonedomicile']?>"></td>
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</tr>
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<tr>
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<td class="required"> <?= _("Tél Portable") ?> </td>
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<td>
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<INPUT class="form-control" TYPE="tel" id="telephonePortable" NAME="telephonePortable" value="<?=$client['telephonePortable']?>" required>
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</td>
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<td align="center">Fax</td>
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<td><INPUT class="form-control" TYPE="tel" id="fax" NAME="fax" value="<?=$client['fax']?>"></td>
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</tr>
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<tr>
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<td class="required">E-mail</td>
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<td>
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<INPUT class="form-control" TYPE="text" id="email" NAME="email" value="<?=$client['email']?>" required AUTOCOMPLETE="OFF">
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</td>
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<td align="center" > <?= _("Secteur Activité") ?> </td>
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<td>
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<select class="form-control selectpicker" data-live-search="true" id="codeSecteur" NAME="codeSecteur" value="<?=$client['codeSecteur']?>">
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<?php liste_options($secteuractivite,$client['codeSecteur']); ?>
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</SELECT>
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</td>
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</tr>
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<tr>
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<td > <?= _("Mandataire") ?> </td>
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<td><INPUT class="form-control" TYPE="text" id="nomMandataire" NAME="nomMandataire" value="<?=$client['nomMandataire']?>" style="text-transform: uppercase;" placeholder="Nom & Prénoms" <?=$readonlyparticulier;?> ></td>
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<td align="center"> <?= _("Mobile Mandataire") ?> </td>
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<td><INPUT class="form-control" TYPE="tel" id="telephonePortablemandataire" NAME="telephonePortablemandataire" value="<?=$client['telephonePortablemandataire']?>" <?=$readonlyparticulier;?>></td>
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</tr>
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<tr>
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<td> <?= _("Fixe Mandataire") ?> </td>
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<td><INPUT class="form-control" TYPE="tel" id="telephoneFixemandataire" NAME="telephoneFixemandataire" value="<?=$client['telephoneFixemandataire']?>" <?=$readonlyparticulier;?>></td>
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<td align="center"> <?= _("E-mail Mandataire") ?> </td>
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<td><INPUT class="form-control" TYPE="email" id="emailMandataire" NAME="emailMandataire" placeholder="E-mail obligatoire" value="<?=$client['emailMandataire']?>" <?=$readonlyparticulier;?> > </td>
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</tr>
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<tr>
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<td> <?= _("Registre Comm") ?> </td>
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<td>
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<INPUT class="form-control" TYPE="text" id="registreCommerce" NAME="registreCommerce" value="<?=$client['registreCommerce']?>" placeholder="Régistre de Commerce" >
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</td>
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<td align="center" class="required"> <?= _("Langue") ?> </td>
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<td>
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<select class="form-select" id="codeLangueUser" NAME="codeLangueUser" required>
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<?php liste_options($langue, $codeLangueClient, true); ?>
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</SELECT>
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</td>
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</tr>
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<tr>
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<td > <?= _("Seuil RD (%)") ?> </td>
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<td> <INPUT style='font-size:10pt;' class="form-control" id="seuilRdClient" NAME="seuilRdClient" TYPE="number" value="<?=$client['seuilRdClient']?>" min="0" max="100"></td>
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<td align='center'> <?= _("Type Remboursement") ?> </td>
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<td >
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<SELECT style="font-size:10pt;" class="form-control selectpicker" data-live-search="true" id="codeTypeRemboursement" NAME="codeTypeRemboursement">
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<?php liste_options($typeremboursement, $this->nettoyer($client['codeTypeRemboursement']),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 > <?= _("Mode Paiement") ?> </td>
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<td>
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<select class="form-select" id="codeModePaiement" NAME="codeModePaiement" style='font-size:10pt;' >
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<?php liste_options($modepaiement, $client['codeModePaiement']); ?>
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</SELECT>
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</td>
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<td align="center"> <?= _("RIB") ?> </td>
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<td>
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<INPUT class="form-control" TYPE="text" id="rib" NAME="rib" style='font-size:10pt;' value="<?=$client['rib']?>">
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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 ><INPUT class="form-control majuscule" TYPE="text" id="adresseGeo" NAME="adresseGeo" value="<?=$client['adresseGeo']?>"></td>
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<td align="center"> <?= _("Adresse Postale") ?> </td>
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<td><INPUT class="form-control" TYPE="text" id="boitepostale" NAME="boitepostale" value="<?=$client['boitepostale']?>"></td>
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</tr>
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<tr>
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<td colspan="4" style="height:30px; background-color:white;"></td>
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</tr>
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<tr>
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<td colspan="4" ><input class = "form-control btn btn-primary" type="submit" value="<?= _("Enregistrer") ?>" /></td>
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</tr>
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</tbody>
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</table>
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</fieldset>
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</form>
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