411 lines
19 KiB
PHP
411 lines
19 KiB
PHP
<?php
|
|
$cv = $this->controller->view_data['custom_values'];
|
|
?>
|
|
|
|
<script type="text/javascript">
|
|
$(function () {
|
|
$("#client_country").select2({
|
|
placeholder: "<?php _trans('country'); ?>",
|
|
allowClear: true
|
|
});
|
|
});
|
|
</script>
|
|
|
|
<form method="post">
|
|
|
|
<input type="hidden" name="_ip_csrf" value="<?= $this->security->get_csrf_hash() ?>">
|
|
|
|
<div id="headerbar">
|
|
<h1 class="headerbar-title"><?php _trans('client_form'); ?></h1>
|
|
<?php $this->layout->load_view('layout/header_buttons'); ?>
|
|
</div>
|
|
|
|
<div id="content">
|
|
|
|
<?php $this->layout->load_view('layout/alerts'); ?>
|
|
|
|
<input class="hidden" name="is_update" type="hidden"
|
|
<?php if ($this->mdl_clients->form_value('is_update')) {
|
|
echo 'value="1"';
|
|
} else {
|
|
echo 'value="0"';
|
|
} ?>
|
|
>
|
|
|
|
<div class="row">
|
|
<?php if ($custom_fields): ?>
|
|
|
|
<div class="col-xs-12 col-sm-6">
|
|
|
|
<div class="panel panel-default">
|
|
|
|
<div class="panel-heading">
|
|
<?php _trans('Customer Information'); ?>
|
|
</div>
|
|
|
|
<div class="panel-body">
|
|
<?php foreach ($custom_fields as $custom_field): ?>
|
|
<?php if ($custom_field->custom_field_location != 0) {
|
|
continue;
|
|
}
|
|
//print_r($custom_field);
|
|
print_field($this->mdl_clients, $custom_field, $cv);
|
|
?>
|
|
<?php endforeach; ?>
|
|
</div>
|
|
|
|
</div>
|
|
</div>
|
|
|
|
<?php endif; ?>
|
|
<div class="col-xs-12 col-sm-6">
|
|
|
|
<div class="panel panel-default">
|
|
<div class="panel-heading form-inline clearfix">
|
|
<?php _trans('personal_information'); ?>
|
|
|
|
<div class="pull-right">
|
|
<label for="client_active" class="control-label">
|
|
<?php _trans('active_client'); ?>
|
|
<input id="client_active" name="client_active" type="checkbox" value="1"
|
|
<?php if ($this->mdl_clients->form_value('client_active') == 1
|
|
|| !is_numeric($this->mdl_clients->form_value('client_active'))
|
|
) {
|
|
echo 'checked="checked"';
|
|
} ?>>
|
|
</label>
|
|
</div>
|
|
</div>
|
|
|
|
<div class="panel-body">
|
|
<div class="form-group">
|
|
<label for="client_name">
|
|
<?php _trans('Customer Name'); ?>
|
|
</label>
|
|
<input id="client_name" name="client_name" type="text" class="form-control" required
|
|
autofocus
|
|
value="<?php echo $this->mdl_clients->form_value('client_name', true); ?>">
|
|
</div>
|
|
|
|
<div class="form-group">
|
|
<label for="client_surname">
|
|
<?php _trans('Customer Surename(Optional)'); ?>
|
|
</label>
|
|
<input id="client_surname" name="client_surname" type="text" class="form-control"
|
|
value="<?php echo $this->mdl_clients->form_value('client_surname', true); ?>">
|
|
</div>
|
|
|
|
<div class="form-group no-margin">
|
|
<label for="client_language">
|
|
<?php _trans('language'); ?>
|
|
</label>
|
|
<select name="client_language" id="client_language" class="form-control simple-select">
|
|
<option value="system">
|
|
<?php _trans('use_system_language') ?>
|
|
</option>
|
|
<?php foreach ($languages as $language) {
|
|
$client_lang = $this->mdl_clients->form_value('client_language');
|
|
?>
|
|
<option value="<?php echo $language; ?>"
|
|
<?php check_select($client_lang, $language) ?>>
|
|
<?php echo ucfirst($language); ?>
|
|
</option>
|
|
<?php } ?>
|
|
</select>
|
|
</div>
|
|
|
|
</div>
|
|
</div>
|
|
|
|
</div>
|
|
|
|
</div>
|
|
|
|
<div class="row">
|
|
<div class="col-xs-12 col-sm-6">
|
|
<div class="panel panel-default">
|
|
|
|
<div class="panel-heading">
|
|
<?php _trans('Address 1'); ?>
|
|
</div>
|
|
|
|
<div class="panel-body">
|
|
<div class="form-group">
|
|
<label for="client_address_1"><?php _trans('street_address'); ?></label>
|
|
|
|
<div class="controls">
|
|
<input type="text" name="client_address_1" id="client_address_1" class="form-control"
|
|
value="<?php echo $this->mdl_clients->form_value('client_address_1', true); ?>">
|
|
</div>
|
|
</div>
|
|
|
|
<div class="form-group">
|
|
<label for="client_address_2"><?php _trans('Village'); ?></label>
|
|
|
|
<div class="controls">
|
|
<input type="text" name="client_address_2" id="client_address_2" class="form-control"
|
|
value="<?php echo $this->mdl_clients->form_value('client_address_2', true); ?>">
|
|
</div>
|
|
</div>
|
|
|
|
<div class="form-group">
|
|
<label for="client_city"><?php _trans('city'); ?></label>
|
|
|
|
<div class="controls">
|
|
<input type="text" name="client_city" id="client_city" class="form-control"
|
|
value="<?php echo $this->mdl_clients->form_value('client_city', true); ?>">
|
|
</div>
|
|
</div>
|
|
|
|
<div class="form-group">
|
|
<label for="client_state"><?php _trans('state'); ?></label>
|
|
|
|
<div class="controls">
|
|
<input type="text" name="client_state" id="client_state" class="form-control"
|
|
value="<?php echo $this->mdl_clients->form_value('client_state', true); ?>">
|
|
</div>
|
|
</div>
|
|
|
|
<div class="form-group">
|
|
<label for="client_zip"><?php _trans('zip_code'); ?></label>
|
|
|
|
<div class="controls">
|
|
<input type="text" name="client_zip" id="client_zip" class="form-control"
|
|
value="<?php echo $this->mdl_clients->form_value('client_zip', true); ?>">
|
|
</div>
|
|
</div>
|
|
|
|
<div class="form-group">
|
|
<label for="client_country"><?php _trans('country'); ?></label>
|
|
|
|
<div class="controls">
|
|
<select name="client_country" id="client_country" class="form-control">
|
|
<option value=""><?php _trans('none'); ?></option>
|
|
<?php foreach ($countries as $cldr => $country) { ?>
|
|
<option value="<?php echo $cldr; ?>"
|
|
<?php check_select($selected_country, $cldr); ?>
|
|
><?php echo $country ?></option>
|
|
<?php } ?>
|
|
</select>
|
|
</div>
|
|
</div>
|
|
|
|
<!-- Custom Fields -->
|
|
<?php foreach ($custom_fields as $custom_field): ?>
|
|
<?php if ($custom_field->custom_field_location != 1) {
|
|
continue;
|
|
} ?>
|
|
<?php print_field($this->mdl_clients, $custom_field, $cv); ?>
|
|
<?php endforeach; ?>
|
|
</div>
|
|
|
|
</div>
|
|
|
|
</div>
|
|
<div class="col-xs-12 col-sm-6">
|
|
|
|
<div class="panel panel-default">
|
|
|
|
<div class="panel-heading">
|
|
<?php _trans('Address 2'); ?>
|
|
</div>
|
|
|
|
<div class="panel-body">
|
|
<!-- <div class="form-group">
|
|
<label for="client_gender"><?php _trans('gender'); ?></label>
|
|
|
|
<div class="controls">
|
|
<select name="client_gender" id="client_gender" class="form-control simple-select">
|
|
<?php
|
|
$genders = array(
|
|
trans('gender_male'),
|
|
trans('gender_female'),
|
|
trans('gender_other'),
|
|
);
|
|
foreach ($genders as $key => $val) { ?>
|
|
<option value=" <?php echo $key; ?>" <?php check_select($key, $this->mdl_clients->form_value('client_gender')) ?>>
|
|
<?php echo $val; ?>
|
|
</option>
|
|
<?php } ?>
|
|
</select>
|
|
</div>
|
|
</div>
|
|
|
|
<div class="form-group has-feedback">
|
|
<label for="client_birthdate"><?php _trans('birthdate'); ?></label>
|
|
<?php
|
|
$bdate = $this->mdl_clients->form_value('client_birthdate');
|
|
if ($bdate && $bdate != "0000-00-00") {
|
|
$bdate = date_from_mysql($bdate);
|
|
} else {
|
|
$bdate = '';
|
|
}
|
|
?>
|
|
<div class="input-group">
|
|
<input type="text" name="client_birthdate" id="client_birthdate"
|
|
class="form-control datepicker"
|
|
value="<?php _htmlsc($bdate); ?>">
|
|
<span class="input-group-addon">
|
|
<i class="fa fa-calendar fa-fw"></i>
|
|
</span>
|
|
</div>
|
|
</div>
|
|
|
|
<?php if ($this->mdl_settings->setting('sumex') == '1'): ?>
|
|
|
|
<div class="form-group">
|
|
<label for="client_avs"><?php _trans('sumex_ssn'); ?></label>
|
|
<?php $avs = $this->mdl_clients->form_value('client_avs'); ?>
|
|
<div class="controls">
|
|
<input type="text" name="client_avs" id="client_avs" class="form-control"
|
|
value="<?php echo htmlspecialchars(format_avs($avs)); ?>">
|
|
</div>
|
|
</div>
|
|
|
|
<div class="form-group">
|
|
<label for="client_insurednumber"><?php _trans('sumex_insurednumber'); ?></label>
|
|
<?php $insuredNumber = $this->mdl_clients->form_value('client_insurednumber'); ?>
|
|
<div class="controls">
|
|
<input type="text" name="client_insurednumber" id="client_insurednumber"
|
|
class="form-control"
|
|
value="<?php echo htmlentities($insuredNumber); ?>">
|
|
</div>
|
|
</div>
|
|
|
|
<div class="form-group">
|
|
<label for="client_veka"><?php _trans('sumex_veka'); ?></label>
|
|
<?php $veka = $this->mdl_clients->form_value('client_veka'); ?>
|
|
<div class="controls">
|
|
<input type="text" name="client_veka" id="client_veka" class="form-control"
|
|
value="<?php echo htmlentities($veka); ?>">
|
|
</div>
|
|
</div>
|
|
|
|
<?php endif; ?>-->
|
|
|
|
|
|
<?php foreach ($custom_fields as $custom_field): ?>
|
|
<?php if ($custom_field->custom_field_location != 3) {
|
|
continue;
|
|
} ?>
|
|
<?php print_field($this->mdl_clients, $custom_field, $cv); ?>
|
|
<?php endforeach; ?>
|
|
</div>
|
|
|
|
</div>
|
|
|
|
</div>
|
|
|
|
</div>
|
|
|
|
<div class="row">
|
|
<div class="col-xs-12 col-sm-6">
|
|
|
|
<div class="panel panel-default">
|
|
|
|
<div class="panel-heading">
|
|
<?php _trans('contact_information'); ?>
|
|
</div>
|
|
|
|
<div class="panel-body">
|
|
<div class="form-group">
|
|
<label for="client_phone"><?php _trans('phone_number'); ?></label>
|
|
|
|
<div class="controls">
|
|
<input type="text" name="client_phone" id="client_phone" class="form-control"
|
|
value="<?php echo $this->mdl_clients->form_value('client_phone', true); ?>">
|
|
</div>
|
|
</div>
|
|
|
|
<div class="form-group">
|
|
<label for="client_fax"><?php _trans('fax_number'); ?></label>
|
|
|
|
<div class="controls">
|
|
<input type="text" name="client_fax" id="client_fax" class="form-control"
|
|
value="<?php echo $this->mdl_clients->form_value('client_fax', true); ?>">
|
|
</div>
|
|
</div>
|
|
|
|
<div class="form-group">
|
|
<label for="client_mobile"><?php _trans('mobile_number'); ?></label>
|
|
|
|
<div class="controls">
|
|
<input type="text" name="client_mobile" id="client_mobile" class="form-control"
|
|
value="<?php echo $this->mdl_clients->form_value('client_mobile', true); ?>">
|
|
</div>
|
|
</div>
|
|
|
|
<div class="form-group">
|
|
<label for="client_email"><?php _trans('email_address'); ?></label>
|
|
|
|
<div class="controls">
|
|
<input type="text" name="client_email" id="client_email" class="form-control"
|
|
value="<?php echo $this->mdl_clients->form_value('client_email', true); ?>">
|
|
</div>
|
|
</div>
|
|
|
|
<div class="form-group">
|
|
<label for="client_web"><?php _trans('web_address'); ?></label>
|
|
|
|
<div class="controls">
|
|
<input type="text" name="client_web" id="client_web" class="form-control"
|
|
value="<?php echo $this->mdl_clients->form_value('client_web', true); ?>">
|
|
</div>
|
|
</div>
|
|
|
|
<!-- Custom fields -->
|
|
<?php foreach ($custom_fields as $custom_field): ?>
|
|
<?php if ($custom_field->custom_field_location != 2) {
|
|
continue;
|
|
} ?>
|
|
<?php print_field($this->mdl_clients, $custom_field, $cv); ?>
|
|
<?php endforeach; ?>
|
|
</div>
|
|
|
|
</div>
|
|
|
|
</div>
|
|
|
|
<div class="col-xs-12 col-sm-6">
|
|
|
|
<div class="panel panel-default">
|
|
<div class="panel-heading">
|
|
<?php _trans('tax_information'); ?>
|
|
</div>
|
|
|
|
<div class="panel-body">
|
|
<div class="form-group">
|
|
<label for="client_vat_id"><?php _trans('vat_id'); ?></label>
|
|
|
|
<div class="controls">
|
|
<input type="text" name="client_vat_id" id="client_vat_id" class="form-control"
|
|
value="<?php echo $this->mdl_clients->form_value('client_vat_id', true); ?>">
|
|
</div>
|
|
</div>
|
|
|
|
<div class="form-group">
|
|
<label for="client_tax_code"><?php _trans('tax_code'); ?></label>
|
|
|
|
<div class="controls">
|
|
<input type="text" name="client_tax_code" id="client_tax_code" class="form-control"
|
|
value="<?php echo $this->mdl_clients->form_value('client_tax_code', true); ?>">
|
|
</div>
|
|
</div>
|
|
|
|
<!-- Custom fields -->
|
|
<?php foreach ($custom_fields as $custom_field): ?>
|
|
<?php if ($custom_field->custom_field_location != 4) {
|
|
continue;
|
|
} ?>
|
|
<?php print_field($this->mdl_clients, $custom_field, $cv); ?>
|
|
<?php endforeach; ?>
|
|
</div>
|
|
|
|
</div>
|
|
|
|
</div>
|
|
</div>
|
|
|
|
</div>
|
|
</form>
|