<input type='text' id='crPrenom' name='prenom' placeholder='Prénom' value='' required><br>
<input type='text' id='crNom' name='nom' placeholder='NOM' value='' required><br>
<input type='radio' name='civilite' value='M' id='civ1' class='crCiv' checked><label for='civ1'>Homme</label><br>
<input type='radio' name='civilite' value='F' id='civ2' class='crCiv'><label for='civ2'>Femme</label><br>
<input type='text' id='crAdr' name='adresse' placeholder='Adresse' value='' required><br>
<input type='text' id='crAdr2' name='adresse2' placeholder='Complément adresse' value=''><br>
<input type='text' id='crCP' name='code_postal' placeholder='09000' value='' required><span class='info'>Code postal</span><br>
<input type='text' id='crVille' name='ville' placeholder='Ville' value='' required><br>
<input type='text' id='crDN' name='date_naissance' placeholder='jj/mm/aaaa' value='' required><span class='info'>Date de naissance</span><br>
<input type='text' id='crLN' name='lieu_naissance' placeholder='Ville de naissance' value='' required><br>
<input type='text' id='crSecu' name='num_secu' placeholder='1 99 19 99 999 999 99' value='' required><span class='info'>Numéro de sécurité sociale</span><br>
<span>Choix du médecin traitant (optionnel)</span><br>
<select id='crMedecin' name='id_medecin'><?php
echo "<option value='.'>Médecins traitants</option>";
foreach (MedecinRepo::getAll() as $MEDECIN) {
echo "<option value='" . $MEDECIN['Id'] . "'>" . $MEDECIN['Nom'] . " " . $MEDECIN['Prenom'] . "</option>";
}
?>
</select>
<br>
<input type='hidden' name='command' value='Patient:add'>
<input type='submit' id='sbCreer' value='Créer le patient'>
</form>
</article>
</section>
</div>
