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<?php include "header2.php"; ?>
<style type="text/css">
<!--
-->
@import url(http://fonts.googleapis.com/css?family=Montserrat:400,700);
html{
background-size: cover;
height:100%;
}
#feedback-page{
text-align:center;
}
#form-main{
width:100%;
float:left;
padding-top:0px;
}
#form-div {
background-image: linear-gradient(to right, #4682B4, #00FFFF, #00FA9A);
padding-left:35px;
padding-right:35px;
padding-top:35px;
padding-bottom:50px;
width: 450px;
float: left;
margin-top:5px;
margin-left: 300px;
-moz-border-radius: 7px;
-webkit-border-radius: 7px;
}
.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;
}
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:24px;
padding-top:22px;
padding-bottom:22px;
-webkit-transition: all 0.3s;
-moz-transition: all 0.3s;
transition: all 0.3s;
margin-top:-4px;
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:white;
}
@media only screen and (max-width: 580px) {
#form-div{
left: 3%;
margin-right: 3%;
width: 88%;
margin-left: 0;
padding-left: 3%;
padding-right: 3%;
}
</style>
<link rel="icon" href="idilogo.png">
<?php
$tglBayar = date('Y-m-d');
?>
<style type="text/css">
<!--
.style1 {font-size: 18px}
-->
</style>
<br>
<div class="container">
<?php
$sql = mysqli_query($konek, "select *, count(praktek) + 1 as praktek from d_prakang WHERE npm='$_GET[npm]' order by praktek desc limit 1");
$ke = isset($d['praktek']) ? $d['praktek'] : '1';
while($d=mysqli_fetch_array($sql)){
$ke = $d['praktek'];
}
?>
<?php
$id=$_GET['id'];
$npm=$_GET['npm'];
$query=$konek->query("SELECT * FROM d_prakang WHERE id='$id' ");
$dp=$query->fetch_assoc();
$wilker = "$dp[wilker]";
$hari = "$dp[hari]";
$jam = "$dp[jam1]";
$id = "$dp[id]";
?>
<div id="form-div">
<p align="center"><strong> FORM DATA PRAKTEK </strong></p>
</p>
<form method="post" action="rev_prak2.php" enctype="multipart/form-data">
<input name="id" class="form-control" type="hidden" value="<?php echo $_GET['id'] ?>" />
<p class="name"><input name="view" type="hidden" class="form-control" value="<?php echo $_GET['view'] ?>" />
<input name="npm" class="form-control" type="hidden" value="<?php echo $_GET['npm'] ?>" />
<input name="tglrev" class="form-control" readonly type="hidden" id="datepicker" value="<?php echo $tglBayar ?>" size="11">
<label for="tbayar">Praktek Sebagai</label><br>
<input name="ahli" readonly class="form-control" value="<?php echo $dp['ahli'] ?>" />
</p>
<label for="ket">Telpon</label>
<input name="telp" class="form-control" type="number" value="<?php echo $dp['telp'] ?>" size="11" placeholder="Isi No Telp" required />
</p>
<label for="ket">Sarana Tempat Praktek </label>
<input name="wilker" class="form-control" type="text" value="<?php echo $dp['wilker'] ?>" size="11" placeholder="Isi lokasi Praktek ex, RS Al Islam, Klinik Kimia farma" required/>
</p>
<label for="tbayar">Alamat Praktek </label>
<br>
<input name="alamat" placeholder="Isi Alamat Praktik" class="form-control" value="<?php echo $dp['alamat'] ?>" required/>
</p>
<label for="ket">Hari Praktek</label>
<input name="hari" class="form-control" type="text" value="<?php echo $dp['hari'] ?>" size="11" placeholder="Isi Hari Praktek, ex: Senin - Sabtu" required/>
</p>
<label for="ket">Jam Praktek </label>
<input name="jam1" class="form-control" type="text" value="<?php echo $dp['jam1'] ?>" size="11" placeholder="Isi Jam Praktek, ex: 08.00-12.00 wIB" required/>
</p>
<p> </p>
<div class="submit">
<input type="submit" id="button-blue" value="Submit" />
<div class="ease">
</div>
</div>
</form>
</div>
</div>
<p> </p> <p> </p>
</div>
<br><br>
<!-- proses edit data -->
</div>