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Viewing file:     add_did_form.php (3.8 KB)      -rw-r--r--
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<?
$this->load->view('cpanel/header');
?>

        <script src="<?=base_url()?>js/jquery.validationEngine-en.js" type="text/javascript"></script>
        <script src="<?=base_url()?>js/jquery.validationEngine.js" type="text/javascript"></script>



        <script>
        $(document).ready(function() {


            $("#formID").validationEngine()


            //$.validationEngine.loadValidation("#date")
            //alert($("#formID").validationEngine({returnIsValid:true}))
            //$.validationEngine.buildPrompt("#date","This is an example","error")              // Exterior prompt build example
            //$.validationEngine.closePrompt(".formError",true)                             // CLOSE ALL OPEN PROMPTS
        });

    </script>



<form id="formID"  method="post" action="<?=site_url('client/addEditDIDNumber')?>">

<input type='hidden' name='id_did' id='id_did' value='<?= $id_did?>' >
<input type='hidden' name='action' id='action' value='<?= $action?>' >
<div align="center">
<table width="80%" border="0" align="center" cellpadding="0" cellspacing="0">

  <tr>
    <td colspan="2" valign="top" style="padding-top:20px;">

      <img src="<?=base_url()?>images/s.gif" width="600" height="1" border="0" alt="" />
      <div id="module_info">

                  <span>&nbsp;&nbsp;&raquo;</span> <?=TITLE059?>  <span style='color:#BF0000'><?=$titleErrorMessage?> </span>  </div>

    </td>
  </tr>

  <tr>
    <td colspan="2" valign="top" style="padding-top:10px;padding-right:5px;">
    <!-- Account Information -->

<table width="100%" class="tableBorder" border="0"  cellpadding="2" cellspacing="2">
  <tr>
    <td colspan="2" class="mainTableTitle"><?=$titleMessage?></td>
  </tr>

<tr>
    <td class='formLabelRigit' width='30%' style='padding-top:10px;'>  DID number :  </td>
    <td class='formLabelLeft' width='70%' style='padding-top:10px;'>
    <?
    if($action=='Add')
    {
    ?>
    <input type='text' class='validate[required,custom[onlyNumberFormate],length[8,15]] formInput' name='didnumber' id='didnumber' style='width:150px;' value='<?= $didnumber?>' />
    <?
    }
    else
    {
    ?>
    <input type='text' class='validate[required,custom[onlyNumberFormate],length[8,15]] formInput' name='didnumber' id='didnumber' style='width:150px;' readonly value='<?= $didnumber?>' />
    <?
    }
    ?>
    <span style="padding:5px;font-size:11px;color:#FF0000">    *    </span>
    </td>
</tr>

<tr>
    <td class='formLabelRigit'>  Provider Name :  </td>
    <td class='formLabelLeft'>
    <select name="IDprovider" id="IDprovider" class = "validate[required] selectFrom">
     <?=$wholeSaleClientList?>
    </select>
    <span style="padding:5px;font-size:11px;color:#FF0000">    *    </span>
    </td>
</tr>


<tr>
    <td class='formLabelRigit'>  DID Type :  </td>
    <td class='formLabelLeft'>
    <select name="didType" id="didType" class = "validate[required] selectFrom">
     <?=$didTypeList?>
    </select>
    <span style="padding:5px;font-size:11px;color:#FF0000">    *    </span>
    </td>
</tr>


<tr>
    <td class='formLabelRigit'>  Location :  </td>
    <td class='formLabelLeft'><input type='text' class='validate[required,length[3,15]] formInput' name='location' id='location' style='width:120px;' value='<?= $location?>' />
    <span style="padding:5px;font-size:11px;color:#FF0000">    *    </span>
    </td>
</tr>



<tr>
    <td class='formLabelRigit'> Active :  </td>
    <td class='formLabelLeft'>

<?
if($status ==1)
$checkDisable = "checked='checked'";
else
$checkDisable = "";
?>
<input name="status"  type="checkbox" id="status" value="1" <?=$checkDisable?> />

</td>
</tr>



  <tr>
    <td>&nbsp;</td>
    <td>&nbsp;</td>
  </tr>
</table>

 </td>

  </tr>


  <tr>
    <td colspan="2" align="center" style="padding:15px;"><input type="submit" name="submit" value="<?= $action == 'Add' " Submit Now " "Edit Now" ?>" class="input-submit" /></td>
  </tr>


  <tr>
    <td>&nbsp;</td>
    <td>&nbsp;</td>
  </tr>
  <tr>
    <td>&nbsp;</td>
    <td>&nbsp;</td>
  </tr>
</table>
</div>
</form>



<?
$this->load->view('cpanel/footer');
?>

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