KLEENAPP/KleenAppWeb
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Olusesan Ameye
2019-05-25 23:11:05 -04:00
commit 16f48376bc
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utragent/application/views/agent/extra/locations_form.php
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<fieldset class="content-group">
<legend id="location_name" class="text-bold">Add New Location</legend>
<input type="hidden" id="location_id" name="location_id" value="0">
<!-- Basic text input -->
<!-- Basic text input -->
<div class="form-group">
<label class="control-label col-lg-3">Branch Name <span class="text-danger">*</span></label>
<div class="col-lg-9">
<input type="text" id="loc_name" name="loc_name" class="form-control" required="required" placeholder="Location Name">
</div>
</div>
<!-- /basic text input -->
<!-- Basic text input -->
<div class="form-group">
<label class="control-label col-lg-3">Phone <span class="text-danger">*</span></label>
<div class="col-lg-9">
<input type="text" id="phone" name="phone" class="form-control" required="required" placeholder="phone">
</div>
</div>
<!-- /basic text input -->
<!-- Input with icons -->
<div class="form-group has-feedback">
<label class="control-label col-lg-3">Address <span class="text-danger">*</span></label>
<div class="col-lg-9">
<input type="text" id="street" name="street" class="form-control" required="required" placeholder="Address">
</div>
</div>
<!-- /input with icons -->
<!-- Input with icons -->
<div class="form-group has-feedback">
<label class="control-label col-lg-3">City <span class="text-danger">*</span></label>
<div class="col-lg-9">
<input type="text" id="city" name="city" class="form-control" required="required" placeholder="City">
</div>
</div>
<!-- /input with icons -->
<!-- Multiple select -->
<div class="form-group">
<label class="control-label col-lg-3">State <span class="text-danger">*</span></label>
<div class="col-lg-9">
<?=$states_combo?>
</div>
</div>
<!-- /multiple select -->
<!-- Input group -->
<div class="form-group">
<label class="control-label col-lg-3">Zipcode <span class="text-danger">*</span></label>
<div class="col-lg-9">
<div class="input-group">
<input type="text" id="zipcode" name="zipcode" class="form-control" required="required" placeholder="Zipcode">
</div>
</div>
</div>
<!-- /input group -->
<div class="text-right">
<button type="submit" class="btn btn-primary btn-xs">Submit <i class="icon-arrow-right14 position-right"></i></button>
</div>
</fieldset>