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@ -17,59 +17,69 @@
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}
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?>
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<div class="modal-dialog" style="max-width:70%" role="document">
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<div class="modal-content">
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<div class="modal-header">
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<button type="button" class="close" data-bs-dismiss="modal">×</button>
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<legend class="modal-title" style="text-align:center;"><?= _('Valider une demande')?></legend>
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<div class="modal-dialog modal-lg" role="document">
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<div class="modal-content shadow-lg border-0">
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<div class="modal-header bg-light border-bottom">
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<h5 class="modal-title fw-bold text-primary">
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<i class="fas fa-check-circle me-2"></i><?= _('Valider une demande') ?>
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</h5>
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<button type="button" class="btn-close" data-bs-dismiss="modal" aria-label="Close"></button>
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</div>
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<div class="modal-body">
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<div class="modal-body p-4">
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<div id="div_motif">
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<table class="table table-responsive table-condensed" style='font-size:12pt;'>
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<tbody>
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<tr>
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<td width="15%"> <?= _("Demande N°");?></td>
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<td colspan="3">
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<input style="font-size:10pt;" class ="form-control" type="text" value="<?= $numeroDemandeRemboursement; ?>" readonly>
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</td>
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</tr>
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<tr>
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<td > <?= _("Titulaire");?></td>
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<td >
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<input style="font-size:10pt;" class ="form-control" type="text" value="<?= $adherent."(".$numeroAdherent.")"; ?>" readonly>
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</td>
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<td style='text-align:center' width="8%"> <?= _("Patient");?></td>
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<td >
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<input style="font-size:10pt;" class ="form-control" type="text" value="<?= $beneficiaire."(".$numeroBeneficiaire.")"; ?>" readonly>
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</td>
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</tr>
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<tr>
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<td ><?= _("Etat validation");?></td >
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<td colspan="3">
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<select class="form-select form-select-sm border-primary-subtle" id="codeStatutPaiement" name="codeStatutPaiement">
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<div class="mb-4">
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<label class="form-label small fw-bold text-muted text-uppercase"><?= _("Référence de la demande") ?></label>
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<div class="input-group shadow-sm">
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<span class="input-group-text bg-white"><i class="fas fa-hashtag text-primary"></i></span>
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<input class="form-control fw-bold bg-white" type="text" value="<?= $numeroDemandeRemboursement; ?>" readonly>
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</div>
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</div>
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<div class="row g-3 mb-4">
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<div class="col-md-6">
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<label class="form-label small fw-bold text-muted text-uppercase"><?= _("Titulaire (Adhérent)") ?></label>
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<div class="input-group">
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<span class="input-group-text bg-light"><i class="fas fa-user-shield"></i></span>
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<input class="form-control small" type="text" value="<?= $adherent." (".$numeroAdherent.")"; ?>" readonly>
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</div>
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</div>
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<div class="col-md-6">
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<label class="form-label small fw-bold text-muted text-uppercase"><?= _("Patient (Bénéficiaire)") ?></label>
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<div class="input-group">
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<span class="input-group-text bg-light"><i class="fas fa-user"></i></span>
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<input class="form-control small" type="text" value="<?= $beneficiaire." (".$numeroBeneficiaire.")"; ?>" readonly>
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</div>
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</div>
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</div>
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<hr class="text-muted opacity-25">
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<div class="row g-3">
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<div class="col-12">
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<label class="form-label fw-bold"><?= _("Décision de validation") ?> <span class="text-danger">*</span></label>
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<select class="form-select border-primary" id="codeStatutPaiement" name="codeStatutPaiement">
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<?php liste_options($reponsedemande, $codeStatutPaiement); ?>
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</select>
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</td>
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</tr>
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</div>
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<tr>
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<td class="required" width="8%"> <?= _("Motif");?></td>
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<td colspan="3">
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<textarea class="form-control-sm" placeholder="<?= _("Obligatoire si refus");?>" name="motifRejetRh" id="motifRejetRh" rows="5" required style="width:100%;"></textarea>
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</td>
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</tr>
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<tr>
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<td colspan="4">
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<input style="font-size:10pt;" class = "form-control btn btn-primary" type="button" value="<?= _("Enregistrer") ?>" onClick="javascript:enregistrer_validation_rd(<?= $idDemande ?>);">
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</td>
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</tr>
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</tbody>
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</table>
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<div class="col-12">
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<label class="form-label fw-bold"><?= _("Motif ou Observation") ?></label>
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<textarea class="form-control"
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placeholder="<?= _("Saisissez ici le motif (obligatoire en cas de refus)..."); ?>"
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name="motifRejetRh"
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id="motifRejetRh"
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rows="4"></textarea>
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</div>
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</div>
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</div>
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</div>
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<div class="modal-footer">
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<button type="button" id="" class="btn btn-default" data-bs-dismiss="modal" ><?= _("Fermer") ?></button>
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<div class="modal-footer bg-light">
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<button type="button" class="btn btn-outline-secondary px-4" data-bs-dismiss="modal"><?= _("Annuler") ?></button>
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<button type="button" class="btn btn-primary px-5 shadow" onClick="javascript:enregistrer_validation_rd(<?= $idDemande ?>);">
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<i class="fas fa-save me-2"></i><?= _("Enregistrer la décision") ?>
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</button>
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</div>
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</div>
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</div>
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