add_hospitalprofile.php 10.5 KB
<?php $id = $this->session->userdata('admin');  ?>
<div class="content-wrapper">
   <!-- Content Header (Page header) -->
   <section class="content-header">
      <h1>
         Add Hospital Profile Translation 
      </h1>
      <ol class="breadcrumb">
         <li><a href="<?php echo base_url();?>Welcome/"><i class="fa fa-user-md"></i>Home</a></li>
         <li><a href="<?php echo base_url(); ?>Hospitalprofile_Translation/view_hospitalprofile"> Hospital Profile Translation </a></li>
         <li class="active">Add Hospital Profile Translation</li>
      </ol>
   </section>
   <!-- Main content -->
   <section class="content">
      <div class="row">
         <!-- left column -->
         <div class="col-md-12">
            <?php
               if($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>
	<form role="form"  method="post" id="hospitalprofile_add" data-parsley-validate="" class="validate">
	 <input type="hidden" name="created_by" value="<?php echo $id; ?>">
	 <input type="hidden" name="created_date" value="<?php echo date('Y-m-d  H:i:s'); ?>" >
	 <input  type="hidden" name="lang['home_lang']" value="home_lang" >
	 <input  type="hidden" name="lang['login_lang']" value="login_lang" >
	 <input  type="hidden" name="lang['search_lang']" value="search_lang" >
	 <input  type="hidden" name="lang['doctorfilter_lang']" value="doctorfilter_lang" >
	 <input  type="hidden" name="lang['clinicfilter_lang']" value="clinicfilter_lang" >
     <input  type="hidden" name="lang['medicalfilter_lang']" value="medicalfilter_lang" >
	 <input  type="hidden" name="lang['hospitalfilter_lang']" value="hospitalfilter_lang" >
	 <input  type="hidden" name="lang['doctorprofile_lang']" value="doctorprofile_lang" >
	 <input  type="hidden" name="lang['clinicprofile_lang']" value="clinicprofile_lang" >
	 <input  type="hidden" name="lang['medicalprofile_lang']" value="medicalprofile_lang" >
	 <input  type="hidden" name="lang['hospital_lang']" value="hospital_lang" >
	 <input  type="hidden" name="lang['doctor_lang']" value="doctor_lang" >
	 <input  type="hidden" name="lang['patient_lang']" value="patient_lang" >
	 <input  type="hidden" name="lang['about_lang']" value="about_lang" >
 <input  type="hidden" name="lang['terms_lang']" value="terms_lang" >
         <div class="col-md-12">
            <!-- general form elements -->						 
            <div class="box">
               <div class="box-header with-border">
                  <h3 class="box-title">Add General Doctor Profile Details</h3>
				  <div class="edituser" tabindex='1'></div>
               </div>
               <!-- /.box-header -->
               <!-- form start -->
                <div class="box-body">                 
                     <div class="col-md-12">
					 	<div class="form-group has-feedback">
                            <label for="exampleInputEmail1">Language Name</label>
                             <input class="form-control  required regcom sample" placeholder="Language Name" name="lang['language']"  type="text"  required="">
                             <span class="glyphicon  form-control-feedback"></span>
                        </div>
				<!-- Home page Tab 1 -->
                       <input class="form-control  required regcom sample"   placeholder="Page Name" value="hospitalprofile_lang" name="lang['page_name']"  type="hidden">
					    <div class="form-group has-feedback">
                            <label for="exampleInputEmail1">Rate Us</label>
                             <input class="form-control  required regcom sample" placeholder="Rate Us" name="lang['hospitalprofile_slide_A1']"  type="text"  required="">
                             <span class="glyphicon  form-control-feedback"></span>
                        </div>
                         <div class="form-group has-feedback">
                            <label for="exampleInputEmail1">Gallery</label>
                             <input class="form-control  required regcom sample" placeholder="Gallery" name="lang['hospitalprofile_slide_A2']"  type="text"  required="">
                             <span class="glyphicon  form-control-feedback"></span>
                        </div>
					    <div class="form-group has-feedback">
                            <label for="exampleInputEmail1">About</label>
                            <input type="text" name="lang['hospitalprofile_slide_A3']" placeholder="About" class="form-control required regcom" required="">
                            <span class="glyphicon  form-control-feedback"></span>
                          </div>
					    <div class="form-group has-feedback">
                            <label for="exampleInputEmail1">Specialities</label>
                            <input type="text" name="lang['hospitalprofile_slide_A4']" placeholder="Specialities" class="form-control required regcom"  required="" >
                            <span class="glyphicon  form-control-feedback"></span>
                          </div>

						 <div class="form-group has-feedback">
                            <label for="exampleInputEmail1">Amenities</label>
                            <input type="text" name="lang['hospitalprofile_slide_A7']" placeholder="Amenities" class="form-control required regcom"  required="">
                            <span class="glyphicon  form-control-feedback"></span>
                          </div> 
						 <div class="form-group has-feedback">
                            <label for="exampleInputEmail1">Insurance Partner</label>
                            <input type="text" name="lang['hospitalprofile_slide_A8']" placeholder="Insurance Partner" class="form-control required regcom"  required="">
                            <span class="glyphicon  form-control-feedback"></span>
                          </div> 	
	             <div class="form-group has-feedback">
                            <label for="exampleInputEmail1">Affiliations</label>
                            <input type="text" name="lang['hospitalprofile_slide_A5']" placeholder="Affiliations" class="form-control required regcom"  required="" >
                            <span class="glyphicon  form-control-feedback"></span>
                          </div>
              <div class="form-group has-feedback">
                            <label for="exampleInputEmail1">Memberships</label>
                            <input type="text" name="lang['hospitalprofile_slide_A6']" placeholder="Memberships" class="form-control required regcom"  required="" >
                            <span class="glyphicon  form-control-feedback"></span>
                          </div> 
              <div class="form-group has-feedback">
                            <label for="exampleInputEmail1">Awards</label>
                            <input type="text" name="lang['hospitalprofile_slide_A14']" placeholder="Awards" class="form-control required regcom"  required="" >
                            <span class="glyphicon  form-control-feedback"></span>
                          </div>
						  
						   <div class="form-group has-feedback">
                            <label for="exampleInputEmail1">Select a Speciality Doctor</label>
                            <input type="text" name="lang['hospitalprofile_slide_A15']" placeholder="Select a Speciality Doctor" class="form-control required regcom"  required="" >
                            <span class="glyphicon  form-control-feedback"></span>
                          </div>
						   <div class="form-group has-feedback">
                            <label for="exampleInputEmail1">View Profile</label>
                            <input type="text" name="lang['hospitalprofile_slide_A9']" placeholder="View Profile" class="form-control required regcom"  required="" >
                            <span class="glyphicon  form-control-feedback"></span>
                          </div>
						   <div class="form-group has-feedback">
                            <label for="exampleInputEmail1">Book Online</label>
                            <input type="text" name="lang['hospitalprofile_slide_A10']" placeholder="Book Online" class="form-control required regcom"  required="" >
                            <span class="glyphicon  form-control-feedback"></span>
                          </div>
						   <div class="form-group has-feedback">
                            <label for="exampleInputEmail1">Sorry, No records found. Please try with different keywords.</label>
                            <input type="text" name="lang['hospitalprofile_slide_A11']" placeholder="Sorry, No records found. Please try with different keywords." class="form-control required regcom"  required="" >
                            <span class="glyphicon  form-control-feedback"></span>
                          </div>
						   <div class="form-group has-feedback">
                            <label for="exampleInputEmail1">Appointment Details</label>
                            <input type="text" name="lang['hospitalprofile_slide_A12']" placeholder="Appointment Details" class="form-control required regcom"  required="" >
                            <span class="glyphicon  form-control-feedback"></span>
                          </div>
						  <div class="form-group has-feedback">
                            <label for="exampleInputEmail1">Close</label>
                            <input type="text" name="lang['hospitalprofile_slide_A13']" placeholder="Close" class="form-control required regcom"  required="" >
                            <span class="glyphicon  form-control-feedback"></span>
                          </div>
					<!---Home page Tab 4-->  

			  </div>				   
		   </div>
			<div class="box">
				 <div class="box-body">
				   <div class="col-md-12">
					 <div class="form-group has-feedback">                                       
                            <input type="button" class="btn btn-primary" value="Submit"  name="Save" id="hospitalprofileadd">
                            <button type="reset" class="btn btn-primary">Reset </button>
                        </div> 
				   </div>
				  </div> 
            </div>	
            <!-- /.box -->
         </div>
		 </form> 
      </div>
      <!-- /.row -->
   </section>
   <!-- /.content -->
</div>
<script>
base_url = "<?php echo base_url(); ?>";
config_url = "<?php echo base_url(); ?>";
</script>