radiantproduction/Vue/Creeradherent/index.php

<?php 
	// $this->titre = "INTER-SANTE - Ajout Adhérent"; 
	$dateAvenant = $_SESSION['dateAvenant_C'];
?>

<form method="post" action="Creeradherent/ajouteradherent">
	<INPUT class="sr-only" TYPE="text" id="idPolice" name="idPolice" value="<?= $_SESSION['idPolice_C'] ?>">
	<INPUT class="sr-only" TYPE="text" id="numeroPolice" name="numeroPolice" value="<?= $_SESSION['numeroPolice_C'] ?>">

	<fieldset>
		<legend> <?= _("Informations sur l'adhérent") ?> </legend>
		<table class="table table-responsive table-condensed" style='font-size:9pt;'  >
			<tbody>	
				<tr> 
					
					<td width="12%" > <?= _("Collège") ?> </td>
					<td>
						<SELECT style='font-size:9pt;'  class="form-control" id="idCollege" NAME="idCollege" required autofocus onChange="prorater_prime_adherent();" >
							<?php liste_options($college,""); ?>						
						</SELECT>	
					</td>
					
					<td width="10%" align="center"> <?= _("Avenant") ?> </td>
					<td>
						<SELECT style='font-size:9pt;'   class="form-control" id="idAvenant" NAME="idAvenant" required onChange="changer_avenant_incorporation();">
							<?php liste_options($avenant,""); ?>						
						</SELECT>	
					</td>
				</tr>
				
				<tr> 
					<td> <?= _("Nom Adh") ?> </td>
					<td> <INPUT style='font-size:9pt;'  class="form-control" TYPE="text" id="nom" NAME="nom" required style="text-transform: uppercase;"></td>

					<td align="center"> <?= _("Prénoms") ?> </td>
					<td> <INPUT style='font-size:9pt;'  class="form-control" TYPE="text" id="prenoms" NAME="prenoms" required></td>
				</tr>
				
				<tr> 
					<td><?= _("Nat Pièce") ?></td>
					<td>
						<SELECT class="form-control" id="codeNaturePiece" NAME="codeNaturePiece" required style='font-size:10pt;' 
						onChange="javascript:controler_piece_beneficiaire();" >
							<?php liste_options($naturepiece,""); ?>						
						</SELECT>	
					</td>
					
					<td align="center"><?= _("No Pièce") ?></td>
					<td>
						<INPUT class="form-control" TYPE="text" id="numeroPiece" NAME="numeroPiece" style='font-size:9pt;' 
						onblur="javascript:controler_piece_beneficiaire();" required autocomplete="off" >
					</td>

				</tr>

				<tr>
					<td colspan="4" style="height:8px; background-color:white;">
						<div id="div_controle_piece"></div>
					</td>
				</tr>

				<tr> 
					<td>Sex</td>
					<td>
						<SELECT style='font-size:9pt;'  class="form-control" id="sexe" NAME="sexe" required>
							<?php liste_options($sexe,""); ?>						
						</SELECT>						
					</td>

					<td align="center"> <?= _("Naissance") ?> </td>
					<td> <INPUT style='font-size:9pt;'  class="form-control datepicker" TYPE="text" id="dateNaissance" NAME="dateNaissance" required
					onchange="controle_age($('#dateNaissance').datepicker('getDate'), 'A')"></td>

				</tr>
				
				<tr> 
					<td> <?= _("Groupe Sang") ?> </td>
					<td>
						<SELECT style='font-size:9pt;'  class="form-control" id="codeGroupeSanguin" NAME="codeGroupeSanguin" required>
							<?php liste_options($groupesanguin,""); ?>						
						</SELECT>						
					</td>

					<td align="center"> <?= _("Sit Famil") ?> </td>
					<td>
						<SELECT style='font-size:9pt;'   class="form-control" id="codeSituationFamille" NAME="codeSituationFamille" required>
							<?php liste_options($situationfamille,""); ?>						
						</SELECT>						
					</td>
				</tr>
				
				<tr> 
					<td> <?= _("Nb Enfants") ?> </td>
					<td> <input style='font-size:9pt;'  class="form-control" type="number" id="nombreEnfants" name="nombreEnfants" min="0" max="10" value="0"></td>

					<td align="center"> <?= _("Pays") ?> </td>
					<td>
						<SELECT style='font-size:9pt;'   onChange="ajaxListerVille();" class="form-control" id="codePays" NAME="codePays" required>
							<?php liste_options($pays, $codePays); ?>						
						</SELECT>						
					</td>
				</tr>

				<tr> 
					<td> <?= (isset($_SESSION['affichagedynamique']['Province'])) ? _($_SESSION['affichagedynamique']['Province']) : _("Province") ?> </td>
					<td>
						<div id="listeville">
							<SELECT style='font-size:10pt;'   onChange="ajaxListerLocalite();" class="form-control" id="codeVille" NAME="codeVille" required>
								<?php liste_options($ville, $codeVille); ?>						
							</SELECT>
						</div>
					</td>

					<td align="center"> <?= (isset($_SESSION['affichagedynamique']['Commune'])) ? _($_SESSION['affichagedynamique']['Commune']) : _("Commune") ?> </td>
					<td>
						<div id="listelocalite">
							<SELECT style='font-size:10pt;'  class="form-control" id="codeLocalite" NAME="codeLocalite" required>
								<?php liste_options($localite, $codeLocalite); ?>						
							</SELECT>
						</div>
					</td>
				</tr>
				
				<tr> 
					<td> <?= _("Adresse Géo") ?> </td>
					<td> <INPUT style='font-size:9pt;'  class="form-control" TYPE="text" id="adresseGeo" NAME="adresseGeo"></td>

					<td align="center"> <?= _("Adresse Post") ?> </td>
					<td> <INPUT style='font-size:9pt;'  class="form-control" TYPE="text" id="adressePostale" NAME="adressePostale"></td>
				</tr>

				<tr> 
					<td> <?= _("Tél Port") ?> </td>
					<td>
						<INPUT style='font-size:9pt;'  class="form-control" TYPE="tel" id="telephonePortable" NAME="telephonePortable" required minlength="12" autocomplete="off" >
					</td>					

					<td align="center"> <?= _("Tél Fixe") ?> </td>
					<td> <INPUT style='font-size:9pt;'  class="form-control" TYPE="tel" id="telephonFixe" NAME="telephonFixe"></td>					
				</tr>			

				<tr> 
					<td> <?= _("Entrée") ?> </td>
					<td>
						<div id="div_date_avenant">
							<INPUT style='font-size:9pt;' class="form-control datepicker" TYPE="text" id="dateEntree" NAME="dateEntree" value="<?= dateLang($_SESSION['dateAvenant_C']) ?>" required
							onChange="prorater_prime_adherent();">
						</div>
					</td>

					<td align="center">E-mail</td>
					<td> <INPUT style='font-size:9pt;'  class="form-control" TYPE="email" id="email" NAME="email" placeholder="E-mail" autocomplete="off" ></td>	
					
				</tr>			

				<tr> 
					<td> <?= _("Prorata Prime?") ?> </td>
					<td>
						<SELECT style='font-size:9pt;'  class="form-control" id="prorata" NAME="prorata" required onChange="prorater_prime_adherent();">
							<?php liste_options($ouinonprorata,"1",true); ?>						
						</SELECT>
					</td>
					

					<td> <input style="text-align:center;color:red; font-size:9pt;" class="form-control" type="text" id="agepersonne" name="agepersonne" value="Age : 0" readonly ></td>
					
					<td> <input style='font-size:9pt;' class = "form-control btn btn-primary" type="submit" value="<?= _("Enregistrer") ?>" /></td>										
				</tr>			
			</tbody>
		</table>	
	</fieldset>
	
	<div id="div_prime">	
		
	</div>				
</form> 

<?php if (isset($msgErreur)): ?>
	<div class="alert alert-danger" style="height:30px; padding:5px;" >
	  <H4><?= $msgErreur ?></H4>
	</div>	
<?php endif; ?>