} else {
?>
<form action="<?php
echo OutilsUrl::composer("medicament", "details");
?>
" method="GET" class="form-inline">
<?php
OutilsUrl::formComposerInput("medicament", "details");
?>
<div class="form-group">
<select class="form-control" name="depot" id="depot" onchange="this.form.submit()">
<?php
foreach ($lesMedicaments as $unMedicament) {
?>
<option <?php
OutilsForm::selectedCompose($leMedicamentDepot, $unMedicament["MED_DEPOTLEGAL"]);
?>
><?php
echo $unMedicament["MED_NOMCOMMERCIAL"];
?>
</option>
<?php
}
?>
</select>
</div>
<div class="btn-group" role="group" aria-label="Navigation">
<?php
if ($leMedicament) {
if ($leMedicamentPrecedant) {
?>
<select class="form-control" name="choixMotif" id="choixMotif" onchange='changerInputActifParSelectChoix(this, "motifAutre", "autre-saisie");'>
<option value="-1">--</option>
<?php
foreach ($lesMotifs as $unMotifId => $unMotifInfo) {
?>
<option <?php
OutilsForm::selectedCompose($choixMotif, $unMotifId);
?>
><?php
echo $unMotifInfo;
?>
</option><?php
}
?>
<option <?php
OutilsForm::selectedCompose($choixMotif, "autre-saisie");
?>
>Autre, preciser</option>
</select>
<?php
OutilsForm::validProbleme($valid["choixMotif"], "La motif choisi");
?>
</div>
<div class="col-sm-6">
<label for="motifAutre">Autre motif</label>
<input <?php
OutilsForm::disabled(!$motifAutreActive);
?>
type="text" class="form-control" name="motifAutre" id="motifAutre" placeholder="Motif..." <?php
OutilsForm::value($motifAutre);
?>
} else {
?>
<form action="<?php
echo OutilsUrl::composer("praticien", "details");
?>
" method="GET" class="form-inline">
<?php
OutilsUrl::formComposerInput("praticien", "details");
?>
<div class="form-group">
<select class="form-control" name="num" id="depot" onchange="this.form.submit()">
<?php
foreach ($lesPraticiens as $unPraticien) {
?>
<option <?php
OutilsForm::selectedCompose($lePraticienNum, $unPraticien["PRA_NUM"]);
?>
><?php
echo $unPraticien["PRA_NOM"] . " " . $unPraticien["PRA_PRENOM"];
?>
</option>
<?php
}
?>
</select>
</div>
<div class="btn-group" role="group" aria-label="Navigation">
<?php
if ($lePraticien) {
if ($lePraticienPrecedant) {
?>
<!-- vue : compte-rendu/ajax-saisie-echantillons.multidata.form -->
<td>
<select class="form-control" name="<?php
echo OutilsMultidataForm::genererName($multidataParam, "choixMedicament");
?>
">
<option value="">--</option>
<?php
foreach ($lesMedicaments as $unMedicament) {
?>
<option <?php
OutilsForm::selectedCompose($choixMedicament, $unMedicament['MED_DEPOTLEGAL']);
?>
><?php
echo $unMedicament['MED_NOMCOMMERCIAL'] . " (" . $unMedicament['MED_DEPOTLEGAL'] . ")";
?>
</option><?php
}
?>
</select>
<?php
OutilsForm::validProbleme($valid["choixMedicament"], "Le médicament");
?>
</td>
<td>
<input type="number" min="1" max="500" class="form-control" name="<?php
echo OutilsMultidataForm::genererName($multidataParam, "qteOfferte");
?>
" placeholder="Quantité offerte" <?php
OutilsForm::value($qteOfferte);
?>
OutilsForm::validProbleme($valid_captcha, "Le captcha");
?>
</div>
<div class="form-group">
<label for="question">Question/Remarque/Bug</label>
<select class="form-control" name="question" id="question">
<option <?php
OutilsForm::selectedCompose($question, "question");
?>
>Question</option>
<option <?php
OutilsForm::selectedCompose($question, "remarque");
?>
>Remarque</option>
<option <?php
OutilsForm::selectedCompose($question, "erreur");
?>
>Erreur/Bug</option>
</select>
<?php
OutilsForm::validProbleme($valid_question, "Question/Remarque/Bug");
?>
</div>
<div class="form-group">
<label for="message">Message</label>
<textarea rows="8" class="form-control" name="message" id="message" maxlength="512" placeholder="Message"><?php
echo $message;
?>
</textarea>
<?php
OutilsForm::validProblemePourNombreDeCaractere($valid_message, "Le message", strlen($message), 3, 512);
