83 lines
2.7 KiB
PHP
83 lines
2.7 KiB
PHP
<?php
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session_start();
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include("../core/main.php");
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include("../include/function.php");
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?>
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<form action="ranap/save_dpmp.php" name="dpmp" method="post" id="dpmp">
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<input type="hidden" name="IDXDAFTAR" value="<?php echo $_REQUEST['id_admission'];?>" />
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<input type="hidden" name="NOMR" value="<?php echo $_REQUEST['nomr'];?>" />
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<input type="hidden" name="RUANG" value="<?php echo $userdata['noruang'];?>" />
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<table width="95%" class="tb" border="0">
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<tr valign="top">
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<td width="17%">DIIT :</td>
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<td colspan="2">
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Shift :
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<input type="radio" name="SHIFT" value="1"/> Pagi
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<input type="radio" name="SHIFT" value="2"/> Siang
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<input type="radio" name="SHIFT" value="3"/> Sore
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<span style="padding-left:100px;">Snack :
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<input type="radio" name="SNA CK" value="1"/> Pagi
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<input type="radio" name="SNACK" value="2"/> Sore</span> </td>
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</tr>
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<tr>
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<td>TYPE MAKANAN</td>
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<td width="30%">
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<select name="TYPEMAKANAN" class="text">
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<option selected="selected"> -Pilih- </option>
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<option value="1">MAKANAN BIASA</option>
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<option value="2">MAKANAN KHUSUS</option>
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</select>
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</td>
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<td width="53%">KETERANGAN TAMBAHAN</td>
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</tr>
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<tr>
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<td>KETERANGAN</td>
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<td>
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<select name="KETERANGAN" class="text">
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<option selected="selected"> -Pilih- </option>
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<option value="1">TKTP</option>
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<option value="2">RG</option>
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<option value="3">DL</option>
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<option value="4">DH</option>
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<option value="5">DM</option>
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<option value="6">DJ</option>
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<option value="7">TP</option>
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<option value="8">RP.r</option>
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<option value="9">RP</option>
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<option value="10">LAIN-LAIN</option>
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</select>
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</td>
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<td rowspan="5" valign="top"><textarea name="KETERANGANTAMBAHAN" class="text" cols="50" rows="6"></textarea></td>
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</tr>
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<tr>
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<td>JENIS MAKANAN</td>
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<td>
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<select name="JENISMAKANAN" class="text">
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<option selected="selected"> -Pilih- </option>
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<option value="1">Nasi</option>
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<option value="2">Lauk</option>
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<option value="3">Bubur Sonde</option>
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<option value="4">Cair</option>
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<option value="5">Sonde</option>
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</select>
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</td>
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</tr>
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<tr>
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<td> </td>
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<td><input type="submit" name="Submit" value="Simpan" class="text" onclick="newsubmitform (document.getElementById('dpmp'),'ranap/save_dpmp.php','valid_save_dpmp',validatetask); return false;"/></td>
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</tr>
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<tr>
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<td> </td>
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<td> </td>
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</tr>
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<tr>
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<td> </td>
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<td> </td>
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</tr>
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</table>
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</form>
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<div id="valid_save_dpmp">
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<?php include("save_dpmp.php"); ?>
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