183 lines
12 KiB
PHP
183 lines
12 KiB
PHP
<?php $this->titre = "INTER-SANTE - Modification Bénéficiaire";
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$idMvt = $mouvementassure['id'];
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$aCorriger = $mouvementassure['aCorriger'];
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$motif = $mouvementassure['motif'];
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$idBeneficiaire = $beneficiaire['idBeneficiaire'];
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?>
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<div id="div_adherent" class="container-fluid py-3 animate__animated animate__fadeIn">
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<div class="d-flex justify-content-between align-items-center mb-2">
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<h1 class="text-primary fw-bold mb-0">
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<i class="fas fa-user-edit me-2 text-primary"></i><?= _("Modifier le bénéficiaire") ?>
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<span class="badge bg-primary ms-2 small"><?= $beneficiaire['numeroBeneficiaire'] ?></span>
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</h1>
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<div class="text-end">
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<small class="text-uppercase opacity-75 d-block" style="font-size: 10pt; letter-spacing: 1px;"><?= _("POLICE") ?></small>
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<span class="fw-bold"><?= $this->nettoyer($_SESSION['numeroPolice_C']) ?></span>
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</div>
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</div>
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<div class="row mb-2 justify-content-center">
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<div class="col-md-8 col-lg-6">
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<?php if($nombreGed > 0): ?>
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<div class="alert alert-success d-flex align-items-center py-2 px-3 border-0 shadow-sm" style="border-radius: 12px; background-color: #e8f5e9;">
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<i class="fas fa-check-circle fa-2x text-success me-3"></i>
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<div class="flex-grow-1">
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<h6 class="mb-0 fw-bold small text-success"><?= est_anglophone() ? 'Verified Folder' : 'Dossier Vérifié'; ?></h6>
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<small class="text-dark opacity-75" style="font-size: 8.5pt;"><?= est_anglophone() ? 'Identity documents are up to date.' : 'Les documents d’identité sont à jour.'; ?></small>
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</div>
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<a href="Gedbeneficiaireprod/" class="btn btn-success btn-sm rounded-pill px-3 ms-2">
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<i class="fas fa-folder-open me-2"></i><?= _("GED") ?>
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</a>
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</div>
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<?php else: ?>
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<div class="alert alert-danger d-flex align-items-center py-2 px-3 border-0 shadow-sm animate__animated animate__pulse animate__infinite" style="border-radius: 12px; background-color: #ffebee;">
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<i class="fas fa-exclamation-triangle fa-2x text-danger me-3"></i>
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<div class="flex-grow-1">
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<h6 class="mb-0 fw-bold small text-danger"><?= est_anglophone() ? 'Incomplete File' : 'Dossier Incomplet'; ?></h6>
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<small class="text-dark fw-bold" style="font-size: 8.5pt;"><?= est_anglophone() ? 'Missing ID documents.' : 'Pièces d’identité manquantes.'; ?></small>
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</div>
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<a href="Gedbeneficiaireprod/" class="btn btn-danger btn-sm rounded-pill px-3 ms-2 shadow-sm">
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<i class="fas fa-upload me-2"></i><?= _("Ouvrir la GED") ?>
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</a>
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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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<form method="post" action="Modifierbeneficiaire/modifier/<?=$beneficiaire['id']?>/">
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<input type="hidden" name="idPolice" value="<?= $_SESSION['idPolice_C'] ?>">
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<input type="hidden" name="numeroPolice" value="<?= $_SESSION['numeroPolice_C'] ?>">
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<input type="hidden" name="idAdherent" value="<?= $_SESSION['idAdherent_C'] ?>">
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<input type="hidden" name="numeroAdherent" value="<?= $_SESSION['numeroAdherent_C'] ?>">
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<input type="hidden" name="codeProduit" value="<?= $adherent['codeProduit'] ?>">
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<div class="card shadow-sm border-0" style="border-radius: 15px;">
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<div class="card-body p-4">
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<div class="row g-3 mb-4 bg-light p-3 rounded-3 border">
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<div class="col-md-6">
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<label class="form-label small text-muted text-uppercase fw-bold mb-1"><?= _("Adhérent Principal") ?></label>
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<div class="h6 mb-0 text-primary fw-bold"><i class="fas fa-user-tie me-2"></i><?= $adherent['nom'] ?> <?= $adherent['prenoms'] ?></div>
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</div>
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<div class="col-md-6 border-start ps-4">
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<label class="form-label small text-muted text-uppercase fw-bold mb-1"><?= _("Collège / Produit") ?></label>
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<div class="h6 mb-0 text-dark fw-bold"><i class="fas fa-shield-alt me-2 text-secondary"></i><?= $adherent['libelleCollege'] ?></div>
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</div>
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</div>
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<h6 class="text-primary text-uppercase small fw-bold mb-4 border-bottom pb-2">
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<i class="fas fa-info-circle me-2"></i><?= _("Informations Personnelles") ?>
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</h6>
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<div class="row g-2">
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<div class="col-md-6">
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<label class="form-label fw-bold small"><?= _("Date d'Entrée") ?> <span class="text-danger">*</span></label>
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<div class="input-group">
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<span class="input-group-text bg-white"><i class="fas fa-calendar-check text-primary"></i></span>
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<input class="form-control datepicker fw-bold" type="text" id="dateEntree" name="dateEntree" value="<?= dateLang($this->nettoyer($beneficiaire['dateEntree']), $_SESSION['lang']) ?>" required>
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</div>
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</div>
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<div class="col-md-6">
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<label class="form-label fw-bold small"><?= _("Date de Naissance") ?> <span class="text-danger">*</span></label>
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<div class="input-group">
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<span class="input-group-text bg-white"><i class="fas fa-birthday-cake text-danger"></i></span>
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<input class="form-control datepicker fw-bold" type="text" id="dateNaissance" name="dateNaissance" value="<?= dateLang($this->nettoyer($beneficiaire['dateNaissance']), $_SESSION['lang']) ?>" required>
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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 fw-bold small"><?= _("Nom") ?> <span class="text-danger">*</span></label>
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<input class="form-control text-uppercase fw-bold border-primary" type="text" id="nomBeneficiaire" name="nomBeneficiaire" value="<?= $beneficiaire['nomBeneficiaire'] ?>" required>
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</div>
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<div class="col-md-6">
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<label class="form-label fw-bold small"><?= _("Prénoms") ?> <span class="text-danger">*</span></label>
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<input class="form-control fw-bold border-primary" type="text" id="prenomsBeneficiaire" name="prenomsBeneficiaire" value="<?= $beneficiaire['prenomsBeneficiaire'] ?>" required autofocus>
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</div>
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<div class="col-md-4">
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<label class="form-label fw-bold small"><?= _("Lien Parenté") ?></label>
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<select class="form-select bg-light fw-bold" id="codeLienParente" name="codeLienParente">
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<?php liste_options($lienparente,$beneficiaire['codeLienParente'],true); ?>
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</select>
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</div>
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<div class="col-md-4">
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<label class="form-label fw-bold small"><?= _("Sexe") ?></label>
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<select class="form-select bg-light fw-bold" id="sexe" name="sexe">
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<?php liste_options($sexe,$beneficiaire['sexe'],true); ?>
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</select>
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</div>
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<div class="col-md-4">
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<label class="form-label fw-bold small"><?= _("Groupe Sanguin") ?></label>
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<select class="form-select bg-light fw-bold" id="codeGroupeSanguin" name="codeGroupeSanguin">
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<?php liste_options($groupesanguin,$beneficiaire['codeGroupeSanguin'],true); ?>
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</select>
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</div>
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<h6 class="text-primary text-uppercase small fw-bold mt-5 mb-3 border-bottom pb-2">
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<i class="fas fa-id-card me-2"></i><?= _("Documents & Contact") ?>
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</h6>
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<div class="col-md-4">
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<label class="form-label fw-bold small"><?= _("Nature Pièce") ?></label>
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<select class="form-select border-info" id="codeNaturePiece" name="codeNaturePiece">
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<?php liste_options($naturepiece,$beneficiaire['codeNaturePiece'],true); ?>
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</select>
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</div>
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<div class="col-md-4">
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<label class="form-label fw-bold small"><?= _("N° Pièce") ?></label>
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<input class="form-control border-info" type="text" id="numeroPiece" name="numeroPiece" value="<?=$beneficiaire['numeroPiece']?>">
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</div>
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<div class="col-md-4">
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<label class="form-label fw-bold small"><?= _("Téléphone Portable") ?></label>
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<div class="input-group">
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<span class="input-group-text bg-info text-white"><i class="fas fa-phone"></i></span>
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<input class="form-control fw-bold border-info" type="tel" id="telephonePortable" name="telephonePortable" value="<?= $beneficiaire['telephonePortable'] ?>" placeholder="00000000">
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</div>
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</div>
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</div>
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<?php if($aCorriger == "1"): ?>
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<label class="control-label mt-3 fw-bold mb-1 text-danger"><?= _("Correction demandée");?></label>
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<div class="well well-sm w-100" style="min-height: 120px; background-color: #f3f2f1; margin-bottom: 0;">
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<?= nl2br($motif); ?>
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</div>
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<?php endif; ?>
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<div class="row mt-5">
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<div class="col-12 d-flex justify-content-between align-items-center">
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<div>
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<a href="javascript:history.back()" class="btn btn-light border px-4">
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<i class="fas fa-arrow-left me-2 text-muted"></i><?= _("Retour") ?>
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</a>
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</div>
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<div class="d-flex gap-2">
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<?php if($aCorriger == "1"): ?>
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<button type="button" class="btn btn-info px-4 shadow-sm fw-bold animate__animated animate__pulse animate__infinite text-white" onclick="confirmer_correction(<?= $idMvt; ?>, <?= $idBeneficiaire; ?>)">
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<i class="fas fa-check-double me-2"></i><?= _("Confirmer la Correction") ?>
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</button>
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<?php endif; ?>
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<button type="submit" class="btn btn-primary px-4 shadow-sm fw-bold">
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<i class="fas fa-save me-2"></i><?= _("Enregistrer les Modifications") ?>
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</button>
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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>
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</form>
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</div>
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<style>
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.form-control:focus, .form-select:focus {
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border-color: #0d6efd;
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box-shadow: 0 0 0 0.25rem rgba(13, 110, 253, 0.1);
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}
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input.text-uppercase { text-transform: uppercase; }
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</style>
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