<!-- Content Wrapper. Contains page content --> <div class="content-wrapper"> <!-- Content Header (Page header) --> <section class="content-header"> <h1> Manage Promocode </h1> </section> <!-- Main content --> <section class="content"> <div class="row"> <!-- Add --> <div class="col-md-12"> <?php if($this->session->flashdata('message')) { $message = $this->session->flashdata('message'); ?> <div class="alert alert-<?php echo $message['class']; ?>"> <button class="close" data-dismiss="alert" type="button">×</button> <?php echo $message['message']; ?> </div> <?php } ?> </div> <div class="col-md-12"> <!-- general form elements --> <div class="box box-info box-solid"> <div class="box-header with-border"> <h3 class="box-title">Manage Promocode</h3> <div class="pull-right box-tools"> <button class="btn btn-info btn-sm" title="" data-toggle="tooltip" data-widget="collapse" data-original-title="Collapse"> <i class="fa fa-minus"></i> </button> </div> </div><!-- /.box-header --> <!-- form start --> <form role="form" method="post" id="add_promocode_form" enctype="multipart/form-data"> <div class="box-body"> <div class="form-group col-md-10"> <label>Promo Name</label> <input type="text" name="promo_name" data-parsley-length="[8,8]" class="form-control required" placeholder="Enter Complaint Name" data-parsley-required> </div> <div class="form-group col-md-10"> <label>Description</label> <textarea name="description" data-parsley-length="[15,500]" type="text" class="ip_reg_form_input form-control reset-form-custom" placeholder="Description" data-parsley-required></textarea> </div> <div class="form-group col-md-10"> <label>Image</label> <input type="file" name="image" class="form-control" value="" accept="image/*" data-parsley-required> <!-- <img src" alt="" style="width:100px; height:100px"/> --> </div> <div class="form-group col-md-10"> <label>Date range</label> <div class="input-group"> <div class="input-group-addon"> <i class="fa fa-calendar"></i> </div> <input type="text" class="form-control" id="reservation" name="valid_from" data-parsley-required="true"> </div> </div> <div class="form-group col-md-10"> <label>Amount(in %)</label> <input type="text" name="amount" class="form-control required" placeholder="Enter Amount" data-parsley-required> </div> <div class="form-group col-md-10"> <label>Choose Doctors</label> <select class="form-control select2" multiple="multiple" placeholder="Select a State" style="width: 100%;" name="doctor_id[]" data-parsley-required="true"> <?php foreach ($data as $key => $value) { ?> <option value="<?php echo $value->id?>"><?php echo $value->name?></option> <?php } ?> </select> </div> <div class="form-group col-md-10"> <label>Status</label> <select class="form-control select2" data-placeholder="Select Status" style="width: 100%;" name="status"> <!-- <option value="-1">Select Status</option> --> <option value="Active" selected>Active</option> <option value="Inactive">Inactive</option> </select> </div> </div><!-- /.box-body --> <div class="box-footer"> <button type="submit" class="btn btn-info">Submit</button> </div> </form> </div><!-- /.box --> </div> <!--/.col (Add) --> </div> <!-- /.row --> </section><!-- /.content --> </div> <!-- /.content-wrapper -->