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@ -132,7 +132,7 @@
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<div class="col-md-4">
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<label class="form-label small text-muted"><?= _("Téléphone Portable") ?></label>
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<input class="form-control" type="tel" id="telephonePortable" name="telephonePortable" value="<?= $_SESSION['telephonePortable'] ?>">
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<input class="form-control" type="tel" id="telephonePortable" name="telephonePortable" value="<?= $_SESSION['indicatifTelephone'] ?>">
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</div>
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<div class="col-md-4">
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<label class="form-label small text-muted"><?= _("E-mail") ?></label>
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@ -32,7 +32,7 @@
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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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<input class="form-control fw-bold bg-white" type="text" value="<?= $numeroDemandeRemboursement; ?>" disabled>
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</div>
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</div>
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@ -41,14 +41,14 @@
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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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<input class="form-control small" type="text" value="<?= $adherent." (".$numeroAdherent.")"; ?>" disabled>
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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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<input class="form-control small" type="text" value="<?= $beneficiaire." (".$numeroBeneficiaire.")"; ?>" disabled>
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</div>
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</div>
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</div>
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@ -56,6 +56,7 @@
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<hr class="text-muted opacity-25">
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<div class="row g-3">
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<?php if($codeStatutPaiement=="2"): ?>
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<div class="col-12">
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<label class="form-label fw-bold"><?= _("Décision de validation") ?> <span class="text-danger">*</span></label>
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<select class="form-select border-primary" id="codeStatutPaiementAjax" name="codeStatutPaiementAjax">
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@ -71,15 +72,36 @@
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id="motifRejetRh"
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rows="4"></textarea>
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</div>
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<?php else: ?>
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<div class="col-12">
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<label class="form-label fw-bold"><?= _("Décision de validation") ?> <span class="text-danger">*</span></label>
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<select class="form-select border-primary" id="codeStatutPaiementAjax" name="codeStatutPaiementAjax" disabled>
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<?php liste_options($reponsedemande, $codeStatutPaiement); ?>
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</select>
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</div>
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<div class="col-12">
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<label class="form-label fw-bold"><?= _("Motif ou Observation") ?></label>
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<textarea class="form-control"
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placeholder="<?= _("Saisissez ici le motif (obligatoire en cas de refus)..."); ?>"
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name="motifRejetRh"
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id="motifRejetRh"
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rows="4" disabled></textarea>
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</div>
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<?php endif; ?>
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</div>
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</div>
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</div>
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<div class="modal-footer bg-light">
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<?php if($codeStatutPaiement=="2"): ?>
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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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<?php else: ?>
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<button type="button" class="btn btn-outline-secondary px-4" data-bs-dismiss="modal"><?= _("Fermer") ?></button>
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<?php endif; ?>
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</div>
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</div>
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</div>
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