120 lines
4.6 KiB
PHP
120 lines
4.6 KiB
PHP
<?php $this->titre = "INTER-SANTE - Création Client"; ?>
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<form method="post" action="Creerclient/ajouter">
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<INPUT class="sr-only" TYPE="tel" id="telephoneBureau" NAME="telephoneBureau" value="">
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<INPUT class="sr-only" TYPE="tel" id="telephonedomicile" NAME="telephonedomicile" value="">
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<fieldset>
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<legend> <?= _("Informations client") ?> </legend>
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<table class="table table-responsive table-condensed" style='font-size:10pt;' >
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<tbody>
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<tr>
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<td width="10%" >Type</td>
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<td width="38%">
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<SELECT style='font-size:10pt;' onChange="controletytpeclient();" class="form-control" id="typeClient" NAME="typeClient" required autofocus>
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<?php liste_options($typeclient,""); ?>
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</SELECT>
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</td>
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<td width="15%" align="center"> <?= _("Titre") ?> </td>
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<td>
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<SELECT style='font-size:10pt;' class="form-control" id="codeTitre" NAME="codeTitre" required>
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<?php liste_options($titre,""); ?>
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</SELECT>
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</td>
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</tr>
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<tr>
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<td> <?= _("Nom") ?> </td>
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<td> <INPUT style='font-size:10pt;' class="form-control" TYPE="text" id="nom" NAME="nom" required style="text-transform: uppercase;"></td>
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<td align="center"> <?= _("Prénoms") ?> </td>
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<td><INPUT style='font-size:10pt;' class="form-control" TYPE="text" id="prenoms" NAME="prenoms" ></td>
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</tr>
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<tr>
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<td> <?= _("Adresse Géo") ?> </td>
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<td colspan="3"><INPUT style='font-size:10pt;' class="form-control" TYPE="text" id="adresseGeo" NAME="adresseGeo" ></td>
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</tr>
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<tr>
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<td> <?= _("Adresse Post") ?> </td>
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<td><INPUT style='font-size:10pt;' class="form-control" TYPE="text" id="boitepostale" NAME="boitepostale"></td>
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<td align="center"> <?= _("Pays") ?> </td>
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<td>
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<SELECT style='font-size:10pt;' onChange="ajaxListerVille();" class="form-control" id="codePays" NAME="codePays" required>
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<?php liste_options($pays,$_SESSION['codePaysSociete']); ?>
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</SELECT>
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</td>
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</tr>
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<tr>
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<td> <?= (isset($_SESSION['affichagedynamique']['Province'])) ? _($_SESSION['affichagedynamique']['Province']) : _("Province") ?> </td>
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<td>
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<div id="listeville">
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<SELECT style='font-size:10pt;' onChange="ajaxListerLocalite();" class="form-control" id="codeVille" NAME="codeVille" required>
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<?php liste_options($ville,""); ?>
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</SELECT>
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</div>
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</td>
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<td align="center"> <?= (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 style='font-size:10pt;' class="form-control" id="codeLocalite" NAME="codeLocalite" required>
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<?php liste_options($listelocalite,""); ?>
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</SELECT>
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</div>
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</td>
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</tr>
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<tr>
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<td> <?= _("Tél Portable") ?> </td>
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<td><INPUT style='font-size:10pt;' class="form-control" TYPE="tel" id="telephonePortable" NAME="telephonePortable" minlength="12" required ></td>
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<td align="center">Fax</td>
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<td><INPUT style='font-size:10pt;' class="form-control" TYPE="tel" id="fax" NAME="fax" ></td>
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</tr>
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<tr>
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<td>E-mail</td>
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<td><INPUT style='font-size:10pt;' class="form-control" TYPE="text" id="email" NAME="email" placeholder="E-mail obligatoire" required ></td>
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<td align="center"> <?= _("Secteur Activité") ?> </td>
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<td>
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<SELECT style='font-size:10pt;' class="form-control" id="codeSecteur" NAME="codeSecteur" required>
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<?php liste_options($secteuractivite,""); ?>
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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> <?= _("TIN / NID / Passeport") ?> </td>
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<td><INPUT style='font-size:10pt;' class="form-control" TYPE="text" id="registreCommerce" NAME="registreCommerce" required ></td>
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<td align="center"> <?= _("Langue") ?> </td>
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<td>
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<SELECT style='font-size:10pt;' class="form-control" id="codeLangueUser" NAME="codeLangueUser" required >
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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> </td>
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<td colspan="3" > <input style='font-size:10pt;' 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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<fieldset id="zonemandat" style="display:none">
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</fieldset>
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<fieldset id="zoneparticulier" style="display:none">
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</fieldset>
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</form>
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