92 lines
3.1 KiB
PHP
92 lines
3.1 KiB
PHP
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<?php
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/**
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* @copyright 2009 City of Bloomington, Indiana
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* @license http://www.gnu.org/copyleft/gpl.html GNU/GPL, see LICENSE.txt
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* @author Cliff Ingham <inghamn@bloomington.in.gov>
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*/
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?>
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<h1>Add Internment</h1>
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<form method="post" action="<?php echo $_SERVER['SCRIPT_NAME']; ?>">
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<fieldset><legend>Internment Info</legend>
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<table>
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<tr><td><label for="internment-section">Section</label></td>
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<td><input name="internment[section]" id="internment-section"
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size="5" maxlength="5" />
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<label for="internment-lot">Lot</label>
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<input name="internment[lot]" id="internment-lot"
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size="5" maxlength="5" />
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</td>
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</tr>
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<tr><td><label for="internment-book">Book</label></td>
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<td><input name="internment[book]" id="internment-book"
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size="4" maxlength="4" />
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<label for="internment-pageNumber">Page</label>
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<input name="internment[pageNumber]" id="internment-pageNumber"
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size="5" maxlength="5" />
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</td>
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</tr>
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<tr><td><label for="internment-firstname">Name</label></td>
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<td><label for="internment-firstname">First</label>
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<input name="internment[firstname]" id="internment-firstname" />
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<label for="internment-middleInitial">MI</label>
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<input name="internment[middleInitial]" id="internment-middleInitial" />
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<label for="internment-lastname">Last</label>
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<input name="internment[lastname]" id="internment-lastname" />
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</td>
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</tr>
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<tr><td><label for="internment-birthPlace">Place of Birth</label></td>
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<td><input name="internment[birthPlace]" id="internment-birthPlace" />
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</td>
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</tr>
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<tr><td><label for="internment-lastResidence">Last Residence</label></td>
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<td><input name="internment[lastResidence]" id="internment-lastResidence" />
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</td>
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</tr>
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<tr><td><label for="internment-deceasedDate">Date of Death</label></td>
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<td><input name="internment[deceasedDate]" id="internment-deceasedDate" size="10" />
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<label for="internment-age">Age</label>
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<input name="internment[age]" id="internment-age" size="3" maxlength="3" />
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<label for="internment-sex">Gender</label>
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<select name="internment[sex]" id="internment-sex">
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<option></option>
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<option>M</option>
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<option>F</option>
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</select>
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</td>
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</tr>
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<tr><td><label for="internment-cemetery_id">Cemetery</label></td>
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<td><select name="internment[cemetery_id]" id="internment-cemetery_id">
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<option></option>
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<?php
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$list = new CemeteryList();
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$list->find();
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foreach ($list as $cemetery) {
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$name = View::escape($cemetery->getName());
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echo "<option value=\"{$cemetery->getId()}\">$name</option>";
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}
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?>
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</select>
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</td>
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</tr>
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<tr><td><label for="internment-notes">Notes</label></td>
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<td><textarea name="internment[notes]" id="internment-notes" rows="3" cols="60"></textarea>
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</td>
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</tr>
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</table>
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<button type="submit" class="submit">Submit</button>
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<button type="button" class="cancel" onclick="document.location.href='<?php echo BASE_URL; ?>/internments';">
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Cancel
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</button>
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</fieldset>
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</form>
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