PHP dropDownPoli Examples

Example #1

File: view_list_kunjungan.php Project: arbudt/semar_server

<!-- HTML POP UP  -->
<div id="modalListDataKunjungan" class="modal hide fade modal-list-data2" data-backdrop="static" tabindex="-1" role="dialog" aria-labelledby="myModalLabel" aria-hidden="true">
    <div class="modal-header btn-info">
        <button type="button" class="close close-list-rekap" data-dismiss="modal" aria-hidden="true">x</button>
        <h4>List Kunjungan Poli</h4>
    </div>
    <div class="modal-body">
        <form class="well form-inline" method="post" id="formListDataKunjungan">
            <div class="row-fluid">
                <div class="span5">   
                    <table>
                        <tr>
                            <td class="title"><input type="checkbox" id="listCekPoliKunjungan" name="listCekPoliKunjungan" value="1"/>&nbsp;<label for="listCekPoliKunjungan">Poli</label></td>
                            <td><?php 
dropDownPoli('name="listPoliKunjungan" id="listPoliKunjungan" class="listPoliKunjungan" ');
?>
</td>
                        </tr>
                        <tr>
                            <td class="title"><input type="checkbox" id="listCekNoRmKunjungan" name="listCekNoRmKunjungan" value="1"/>&nbsp;<label for="listCekNoRmKunjungan">No Rm</label></td>
                            <td>
                                <input type="text" name="listNoRmKunjungan" id="listNoRmKunjungan" value=""/>
                            </td>
                        </tr>
                        <tr>
                            <td class="title"><input type="checkbox" id="listCekNamaKunjungan" name="listCekNamaKunjungan" value="1"/>&nbsp;<label for="listCekNamaKunjungan">Nama</label></td>
                            <td>
                                <input type="text" name="listNamaKunjungan" id="listNamaKunjungan" value=""/>
                            </td>
                        </tr>

Example #2

File: view_pelayanan.php Project: arbudt/semar_client

                    <tr>
                        <td class="labelField">Alergi</td>
                        <td><textarea name="alergi" id="alergi" class="alergi uraian" readonly></textarea></td>
                    </tr>
                </table>
            </div>
            <div class="span6">
                <table>
                    <tr>
                        <td class="labelField">No Anritan</td>
                        <td><input type="text" name="noAntrian" id="noAntrian" value="" class="noAntrian" readonly/></td>
                    </tr>
                    <tr>
                        <td class="labelField">Poliklinik</td>
                        <td><?php 
dropDownPoli('name="poli" id="poli" class="poli" required');
?>
</td>
                    </tr>
                    <tr>
                        <td class="labelField">Tanggal Periksa</td>
                        <td>
                            <div id="datePickerTanggalPeriksa" class="input-append date">
                                <input class="input input-small" data-format="dd-MM-yyyy" type="text" name="tanggalPeriksa" id="tanggalPeriksa" value="<?php 
echo tglSekarang();
?>
" readonly>
                                <span class="add-on">
                                    <i data-time-icon="icon-time" data-date-icon="icon-calendar"></i>
                                </span>
                            </div>