33 lines
1.9 KiB
PHP
Executable File

<div class="modal fade notes-modal" id="notes_modal" tabindex="-1" role="dialog" aria-labelledby="exampleModalLabel" aria-hidden="true">
<div class="modal-dialog" role="document">
<div class="modal-content">
<div class="modal-header">
<h5 class="modal-title">
<?php echo lang("Notes");?></h5>
<div class="bg-lg m-auto">
<button type="button" class="close" data-dismiss="modal">&times;</button>
</div>
</div>
<form role="form" method="post" enctype="multipart/form-data" class="acceptence-edit-form"
action="<?=base_url()?>caregivers/saveEditFromCaregiverAcceptencePage">
<input type="hidden" name="<?php echo $this->security->get_csrf_token_name(); ?>" value="<?php echo $this->security->get_csrf_hash(); ?>" />
<input type="hidden" name="form_type" value="<?=_USER_ADDED_NOTES_?>">
<input type="hidden" class="perform-type" name="perform_type" value="edit">
<input type="hidden" name="cg_id" value="<?=$nurse->id?>">
<input type="hidden" name="verification_id" value="<?=$verification_id[_VERIFY_HEALTH_ASSESMENT_][0]?>">
<input type="hidden" name="progress" class="ref-progress" value="0">
<input type="hidden" name="short_code" class="short-code" value="">
<div class="modal-body">
</div>
<div class="modal-footer">
<button type="button" class="btn btn-secondary bg-danger" data-dismiss="modal"><?php echo lang('Close'); ?> </button>
<button type="submit" class="btn btn-primary" name="submit" id="submitBtn"><?php echo lang('Update');?></button>
</div>
</form>
</div>
</div>
</div>