} 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);