TPA Name
*
TPA Short Name
*
Network Hospitals
*
E-Card Template
<?= isset($template_data) ? $template_data : '' ?>
Preview
TPA Logo
" id="uploadPreview0" class="avatar img-circle img-thumbnail" alt="TPA Logo" />
Upload
Front card Image
" id="uploadPreview1" class="avatar img-circle img-thumbnail" alt="avatar" />
Upload
Back card Image
" id="uploadPreview4" class="avatar img-circle img-thumbnail" alt="avatar" />
Upload
Submit
Cancel
Preview
×
 && !empty($tpa['tpa_logo']) ? base_url() . )