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<?php include "header2.php";?>
<link rel="icon" href="idilogo.png">
<style type="text/css">
<!--
-->
html{
background-size: cover;
height:100%;
color:black;
}
#feedback-page{
text-align:center;
}
#form-main{
width:100%;
float:left;
padding-top:0px;
}
#form-div {
font-family: 'Montserrat', Arial, Helvetica, sans-serif;
float:left;
width: 50%;
border: #fbfbfb solid 4px;
cursor:pointer;
background-color: #3498db;
color:white;
font-size:18px;
padding:5px;
-webkit-transition: all 0.3s;
-moz-transition: all 0.3s;
transition: all 0.3s;
margin-top:-4px;
margin-left:5px;
font-weight:700;
}
.feedback-input {
color:#3c3c3c;
font-family: Helvetica, Arial, sans-serif;
font-weight:500;
font-size: 18px;
border-radius: 0;
line-height: 22px;
background-color: #fbfbfb;
padding: 13px 13px 13px 54px;
margin-bottom: 10px;
width:100%;
-webkit-box-sizing: border-box;
-moz-box-sizing: border-box;
-ms-box-sizing: border-box;
box-sizing: border-box;
border: 3px solid rgba(0,0,0,0);
}
.feedback-input:focus{
background: #fff;
box-shadow: 0;
border: 3px solid #3498db;
color: #3498db;
outline: none;
padding: 13px 13px 13px 54px;
}
.focused{
color:#30aed6;
border:#30aed6 solid 3px;
}
/* Icons ---------------------------------- */
#name{
background-image: url(http://rexkirby.com/kirbyandson/images/name.svg);
background-size: 30px 30px;
background-position: 11px 8px;
background-repeat: no-repeat;
}
#name:focus{
background-image: url(http://rexkirby.com/kirbyandson/images/name.svg);
background-size: 30px 30px;
background-position: 8px 5px;
background-position: 11px 8px;
background-repeat: no-repeat;
}
#email{
background-image: url(http://rexkirby.com/kirbyandson/images/email.svg);
background-size: 30px 30px;
background-position: 11px 8px;
background-repeat: no-repeat;
}
#email:focus{
background-image: url(http://rexkirby.com/kirbyandson/images/email.svg);
background-size: 30px 30px;
background-position: 11px 8px;
background-repeat: no-repeat;
}
#comment{
background-image: url(http://rexkirby.com/kirbyandson/images/comment.svg);
background-size: 30px 30px;
background-position: 11px 8px;
background-repeat: no-repeat;
}
.textarea {
width: 100%;
height: 150px;
line-height: 150%;
resize:vertical;
padding: 10px;
}
.merah {
color: red;
}
input:hover, textarea:hover,
input:focus, textarea:focus {
background-color:white;
}
#button-blue{
font-family: 'Montserrat', Arial, Helvetica, sans-serif;
float:left;
width: 100%;
border: #fbfbfb solid 4px;
cursor:pointer;
background-color: #3498db;
color:white;
font-size:18px;
padding:5px;
-webkit-transition: all 0.3s;
-moz-transition: all 0.3s;
transition: all 0.3s;
margin-top:-4px;
margin-left:5px;
font-weight:700;
}
#button-blue:hover{
background-color: rgba(0,0,0,0);
color: #0493bd;
}
.submit:hover {
color: #3498db;
}
.ease {
width: 0px;
height: 74px;
background-color: #fbfbfb;
-webkit-transition: .3s ease;
-moz-transition: .3s ease;
-o-transition: .3s ease;
-ms-transition: .3s ease;
transition: .3s ease;
}
.submit:hover .ease{
width:100%;
background-color:#EEE;
}
.tengah {
background-image: linear-gradient(to right, #4682B4, #00FFFF, #00FA9A);
background:url(image/tdoc.jpg) no-repeat;
padding-left:5px;
padding-right:5px;
padding-top:5px;
padding-bottom:5px;
width: 950px;
float: left;
margin-top:5px;
margin-left: 50px;
-moz-border-radius: 7px;
-webkit-border-radius: 7px;
font-size: 14px;
}
@media only screen and (max-width: 580px) {
.tengah{
left: 3%;
margin-right: 3%;
width: 88%;
margin-left: 3%;
padding-left: 3%;
padding-right: 3%;
font-size: 14px;
}
}
</style>
<link rel="stylesheet" href="//code.jquery.com/ui/1.12.1/themes/base/jquery-ui.css">
<script type="text/javascript">
function show(str){
document.getElementById('sh2').style.display = 'none';
document.getElementById('sh1').style.display = 'block';
}
function show2(sign){
document.getElementById('sh2').style.display = 'block';
document.getElementById('sh1').style.display = 'none';
}
</script>
<title>Ikatan Dokter Indonesia</title>
<body>
<div class="tengah">
<strong>
<title>
<center><h4><strong>chek Persiapan Dokumen Rekomendasi</strong></h4>
</center>
</title>
</strong>
<?php
$tglBayar = date('Y-m-d');
$hari = date('Y-m-d');
$npm = $_GET['npm'];
//$nmlead = $_GET['nmlead'];
$data = mysqli_query($konek, "SELECT * FROM h_anggota WHERE npm='$_GET[npm]' " );
$d=mysqli_fetch_array($data);
$view = isset($d['view']) ? $d['view'] : null;
$ahli = $d['ahli'];
?>
<form action="<?php echo $_SERVER["PHP_SELF"];?>" method="post">
<br>
<center><b>Click tombol sesuai data anda dan tujuan Pengajuan :</b></center>
<br>
<div class="card-body">
<div class="row">
<div class="col-md-6">
<div class="form-group ">
<strong>Status Keanggotaan IDI Bandung:</strong><br>
<input type="radio" name="anggota" value="anggota_IDI" checked > Anggota IDI Bandung <br>
<br>
<strong>Keahlian : </strong><br>
<?php
if( $ahli ='Dokter Umum'){
?>
<input type="radio" name="ahli" value="dokter_umum" checked > Dokter Umum <br>
<?php
}else{
?>
<input type="radio" name="ahli" value="dokter_umum" checked> Dokter Umum <br>
<?php
}
?>
<br>
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<strong>Status Pengajuan :</strong><br>
<?php
if( $view ='1'){
?>
<input type="radio" name="status" value="rekom_baru" checked > Pengajuan Baru <br>
<?php
}else{
?>
<input type="radio" name="status" value="rekom_baru" checked > Pengajuan Baru <br>
<?php
}
?>
<br>
<strong> Jenis Pengajuan :</strong><br>
<input type="radio" name="perihal" onChange="show(this.value)" value="p2kb" checked > <b>Pengajuan Perpanjangan STR Dokter Umum </b><br>
<p>
<br>
</p>
</div>
</div>
<?php $npm=$_GET['npm']; ?>
<p class="name"><input name="npm" readonly type="hidden" value="<?php echo $npm ?>" />
<br>
<br>
<br>
<input type="submit" name="pilih" id="button-blue" value="Proses Syarat Pengajuan">
</form>
<?php
if($_SERVER['REQUEST_METHOD']=='POST'){
// cara satu satu
if (isset($_POST['pilih'])) {
//$rs = isset($_POST['rs']) ? $_POST['rs'] : null;
// $klinik = isset($_POST['klinik']) ? $_POST['klinik'] : null;
// $puskesmas = isset($_POST['puskesmas']) ? $_POST['puskesmas'] : null;
// $pribadi = isset($_POST['pribadi']) ? $_POST['pribadi'] : null;
$npm = $_POST['npm'] ;
$perihal = $_POST['perihal'];
$kota = $_POST['kota'];
$anggota = $_POST['anggota'];
$ahli = $_POST['ahli'];
$status = $_POST['status'];
$jumlah = $_POST['jumlah'];
// $instansi = $_POST['instansi'];
mysqli_query($konek, "DELETE FROM peserta WHERE npm='$npm' AND data='syarat' ");
mysqli_query($konek, "DELETE FROM h_registrasi WHERE npm='$npm' AND data='syarat' ");
mysqli_query($konek,"INSERT into peserta(rs,klinik,puskesmas,pribadi,anggota,kota,perihal,npm,ahli,status,validasi,jumlah,data) VALUES('".$rs."','".$klinik."','".$puskesmas."','".$pribadi."','".$anggota."','".$kota."','".$perihal."','$npm','$ahli','$status','proses','1','syarat')");
header("location:syarat_rekomp2kb.php?npm=$npm&perihal=$perihal");
}
}
?>
<br>
</div>
</div>
</div>
</div>
<br> <br>
<!-- jQuery first, then Popper.js, then Bootstrap JS -->
</body>
<!-- proses edit data -->