MERMS/MermsEmrWeb
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fix

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This commit is contained in:
Olusesan Ameye
2020-10-25 16:08:50 -04:00
parent 3c4e23d8bd
commit ccb6ccbe79
3 changed files with 46 additions and 13 deletions
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providerwww/application/views/register.php
+7 -7
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@@ -31,43 +31,43 @@ if (!isset($facility_text) || $facility_text == '') {
<div class="register p-5">
<h1 class="mb-2">Merms Providers</h1>
<p>Welcome, Please create your account.</p>
<form action="/register" method='POST' class="mt-2 mt-sm-5">
<form action="/register/startacc" method='POST' class="mt-2 mt-sm-5">
<div class="row">
<div class="col-12">
<div class="form-group">
<label class="control-label">Practice Name*</label>
<input type="text" class="form-control" placeholder="Practice name" />
<input type="text" class="form-control" name="practice_name" value="<?=isset($practice_name)?$practice_name:''?>" placeholder="Practice name" />
</div>
</div>
<div class="col-12 col-sm-6">
<div class="form-group">
<label class="control-label">First Name*</label>
<input type="text" class="form-control" placeholder="First Name" />
<input type="text" class="form-control" name="firstname" value="<?=isset($firstname)?$firstname:''?>" placeholder="First Name" />
</div>
</div>
<div class="col-12 col-sm-6">
<div class="form-group">
<label class="control-label">Last Name*</label>
<input type="text" class="form-control" placeholder="Last Name" />
<input type="text" class="form-control" name="lastname" value="<?=isset($lastname)?$lastname:''?>" placeholder="Last Name" />
</div>
</div>
<div class="col-12">
<div class="form-group">
<label class="control-label">Email*</label>
<input type="email" class="form-control" placeholder="Email" />
<input type="email" class="form-control" name="email" value="<?=isset($email)?$email:''?>" placeholder="Email" />
</div>
</div>
<div class="col-12">
<div class="form-group">
<label class="control-label">Username*</label>
<input type="text" class="form-control" placeholder="Username" />
<input type="text" class="form-control" name="username" value="<?=isset($username)?$username:''?>" placeholder="Username" />
</div>
</div>
<div class="col-12">
<div class="form-group">
<label class="control-label">Password*</label>
<input type="password" class="form-control" placeholder="Password" />
<input type="password" class="form-control" name="password" value="<?=isset($password)?$password:''?>" placeholder="Password" />
</div>
</div>
<div class="col-12">