93 lines
3.4 KiB
PHP
93 lines
3.4 KiB
PHP
<?php
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/**
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* @copyright 2009-2010 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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* @param URL $this->return_url
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*/
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$return_url = isset($this->return_url) ? $this->return_url : BASE_URL.'/interments';
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?>
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<h2>Add Interment</h2>
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<form method="post" action="<?php echo BASE_URL; ?>/interments/addInterment.php">
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<fieldset><legend>Interment Info</legend>
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<input type="hidden" name="return_url" value="<?php echo $return_url; ?>" />
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<table>
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<tr><td><label for="interment-cemetery_id" class="required">Cemetery</label></td>
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<td><select name="interment[cemetery_id]" id="interment-cemetery_id"
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onchange="COB.populateSections(this.options[this.selectedIndex].value,'interment-section_id','<?php echo BASE_URL; ?>')">
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<option></option>
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<?php
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$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="interment-section_id">Section</label></td>
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<td><select name="interment[section_id]" id="interment-section_id">
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<option></option>
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</select>
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<label for="interment-lot">Lot</label>
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<input name="interment[lot]" id="interment-lot" size="5" maxlength="5" />
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</td>
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</tr>
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<tr><td><label for="interment-book">Book</label></td>
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<td><input name="interment[book]" id="interment-book" size="4" maxlength="4" />
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<label for="interment-pageNumber">Page</label>
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<input name="interment[pageNumber]" id="interment-pageNumber" size="5" maxlength="5" />
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</td>
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</tr>
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<tr><td><label for="interment-firstname">First</label></td>
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<td><input name="interment[firstname]" id="interment-firstname" /></td>
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</tr>
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<tr><td><label for="interment-middleInitial">MI</label></td>
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<td><input name="interment[middleInitial]" id="interment-middleInitial" size="1" maxlength="1" />
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</td>
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</tr>
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<tr><td><label for="interment-lastname">Last</label></td>
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<td><input name="interment[lastname]" id="interment-lastname" /></td>
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</tr>
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<tr><td><label for="interment-birthPlace">Place of Birth</label></td>
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<td><input name="interment[birthPlace]" id="interment-birthPlace" />
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</td>
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</tr>
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<tr><td><label for="interment-lastResidence">Last Residence</label></td>
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<td><input name="interment[lastResidence]" id="interment-lastResidence" />
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</td>
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</tr>
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<tr><td><label for="interment-deceasedDate">Date of Death</label></td>
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<td><input name="interment[deceasedDate]" id="interment-deceasedDate" size="10" />
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<label for="interment-age">Age</label>
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<input name="interment[age]" id="interment-age" size="3" maxlength="3" />
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<label for="interment-sex">Gender</label>
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<select name="interment[sex]" id="interment-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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</table>
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<div><label for="interment-notes">Notes</label></div>
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<div><textarea name="interment[notes]" id="interment-notes" rows="3" cols="60"></textarea></div>
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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 $return_url; ?>';">
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Cancel
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</button>
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</fieldset>
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</form>
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