| Current Path : /home1/savoy/public_html/savoyglobal.net/drafthr/system/application/views/Claims/ |
Linux gator3171.hostgator.com 4.19.286-203.ELK.el7.x86_64 #1 SMP Wed Jun 14 04:33:55 CDT 2023 x86_64 |
| Current File : /home1/savoy/public_html/savoyglobal.net/drafthr/system/application/views/Claims/addclaimpolicy.php |
<?php
/*
* To change this template, choose Tools | Templates
* and open the template in the editor.
*/
?>
<?php
$attributes = array('id' => 'customForm','class'=>'endform');
echo form_open_multipart('',$attributes);
?>
<fieldset>
<legend>Add Claim Policy No</legend>
<?php
?>
<input type="hidden" name="endid" id="endid" value="<?php echo $endid; ?>">
<ul>
<li>
<?php
$data1 = array(
'name' => 'endpolicyno',
'id' => 'endpolicyno',
);
?>
<label for="country">Claim Policy No.</label>
<?php
echo form_input($data1);?>
</li>
<li><label for="submit"> </label>
<button type="button" id="button1" class="clickimage" onclick="addclaimpolicyno()">Save</button>
</li>
</ul>
</fieldset>
<?php echo form_close();?>