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Current Path : /home1/savoy/public_html/savoyglobal.net/drafthr/system/application/views/Master/ |
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/Master/addexclusion.php |
<?php if ( ! defined('BASEPATH')) exit('No direct script access allowed');?> <div class="select-bar"> <label> <img src="<?=base_url()?>/assets/images/backbutton.png" title="Back" class="clickimage" onclick="loadexclusion()" alt="Back" align = "center" width="25" height="25" /></label> </div> <fieldset> <legend>Add Exclusion</legend> <?php $attributes = array('id' => 'customForm'); echo form_open('master/addexclusion',$attributes);?> <ul> <li> <?php echo '<label for="Segment">Insurance Classification</label>'; echo "<select name='segment_id' id='segment_id' onchange=\"showcover()\">"; echo "<option value='0'>Select Insurance Classification</option>"; if (count($segment)) { foreach ($segment as $key => $list) { echo "<option value='". $list['id'] . "'>" . $list['segment'] . "</option>"; } echo "</select>"; } ?> <span id="segment_idInfo" class="red_bold">*</span> </li> <li id="coverlist"> <label for="country">Type Of Cover</label> <?php echo "<select name='cover_id' id='cover_id' >"; echo "<option value='0'>Select Type Of Cover</option></select>"; ?> <span id="cover_idInfo" class="red_bold">*</span> </li> <li> <label for="country">Exclusion</label> <?php $data = array( 'name' => 'exclusion', 'id' => 'exclusion', 'value' => '', 'style' =>'width:250px;' ); echo form_input( $data).form_error($data); ?><span id="exclusionInfo" class="red_bold">*</span> </li> <li> <label for="country">Description</label> <?php echo form_textarea('description').form_error('description'); ?> </li> <li><label for="submit"> </label> <button type="submit" id="submit" class="clickimage" onclick="return validateform('segment_id','cover_id','exclusion');">Save</button> </li> </ul> <?php echo form_close();?> </fieldset>