|
@@ -0,0 +1,123 @@
|
|
|
+<%@ taglib uri="http://java.sun.com/jsp/jstl/core" prefix="c"%>
|
|
|
+<%@ taglib prefix="fmt" uri="http://java.sun.com/jsp/jstl/fmt" %>
|
|
|
+<%@ taglib prefix="form" uri="http://www.springframework.org/tags/form"%>
|
|
|
+<%@ page language="java" contentType="text/html; charset=UTF-8"
|
|
|
+ pageEncoding="UTF-8"%>
|
|
|
+<jsp:include page="${data._INCLUDE}/header.jsp"></jsp:include>
|
|
|
+<script>
|
|
|
+$( function(){
|
|
|
+ $( "#newForm" ).validate({
|
|
|
+ rules: {
|
|
|
+ managerPhone : {
|
|
|
+ phoneValid : true
|
|
|
+ }
|
|
|
+ },
|
|
|
+ onkeyup: function( element, event ) {
|
|
|
+ $( element ).valid();
|
|
|
+ },
|
|
|
+ onfocusout: function (element) {
|
|
|
+ $( element ).val( $.trim( $( element ).val() ) );
|
|
|
+ $( element ).valid();
|
|
|
+ },
|
|
|
+ submitHandler: function(form) {
|
|
|
+ form.submit();
|
|
|
+ }
|
|
|
+ });
|
|
|
+})
|
|
|
+</script>
|
|
|
+</head>
|
|
|
+<body>
|
|
|
+ <div class="wrapper">
|
|
|
+ <jsp:include page="${data._INCLUDE}/sidebar.jsp"></jsp:include>
|
|
|
+
|
|
|
+ <div class="main">
|
|
|
+ <jsp:include page="${data._INCLUDE}/top.jsp"></jsp:include>
|
|
|
+
|
|
|
+ <main class="content">
|
|
|
+ <div class="container-fluid p-0">
|
|
|
+ <!-- 환자관리 : 신규환자 등록 START -->
|
|
|
+ <div class="row">
|
|
|
+ <div class="col-12 col-lg-6">
|
|
|
+ <h1 class="h3 mb-3">생활치료센터 비대면진료시스템 API 서비스</h1>
|
|
|
+ </div>
|
|
|
+ <div class="col-12 col-lg-6 text-right">
|
|
|
+ <nav aria-label="breadcrumb">
|
|
|
+ <ol class="breadcrumb">
|
|
|
+ <li class="breadcrumb-item"><a href="javscript:;">Home</a></li>
|
|
|
+ <li class="breadcrumb-item active">API 서비스 신청</li>
|
|
|
+ </ol>
|
|
|
+ </nav>
|
|
|
+ </div>
|
|
|
+ </div>
|
|
|
+ <div class="row">
|
|
|
+ <div class="col-12">
|
|
|
+ <div class="card">
|
|
|
+ <form action="./edit/update" id="newForm" method="post">
|
|
|
+ <div class="card-body">
|
|
|
+ <table class="table mobile-table">
|
|
|
+ <colgroup>
|
|
|
+ <col style="width:15%">
|
|
|
+ <col style="width:35%">
|
|
|
+ <col style="width:15%">
|
|
|
+ <col style="width:35%">
|
|
|
+ </colgroup>
|
|
|
+ <tr>
|
|
|
+ <th><span class="fix">*</span>신청자 명</th>
|
|
|
+ <td colspan="3">
|
|
|
+ <input type="hidden" name="managerId" value="<c:out value="${info.managerId}" />">
|
|
|
+ <input name="managerName" value="<c:out value="${info.managerName}" />" type="text" class="form-control" placeholder="신청자 이름을 입력해주세요." required>
|
|
|
+ </td>
|
|
|
+ </tr>
|
|
|
+ <tr>
|
|
|
+ <th>병원 명</th>
|
|
|
+ <td colspan="3">
|
|
|
+ <c:out value="${info.cooperativeName}" />
|
|
|
+ </td>
|
|
|
+ </tr>
|
|
|
+ <tr>
|
|
|
+ <th><span class="fix">*</span>부서 명</th>
|
|
|
+ <td colspan="3">
|
|
|
+ <input name="departmentName" type="text" class="form-control" value="<c:out value="${info.departmentName}" />" placeholder="부서 명을 입력해주세요." required>
|
|
|
+ </td>
|
|
|
+ </tr>
|
|
|
+ <tr>
|
|
|
+ <th><span class="fix">*</span>이메일 주소</th>
|
|
|
+ <td colspan="3">
|
|
|
+ <input name="managerEmail" type="text" class="form-control" value="<c:out value="${info.managerEmail}" />" placeholder="이메일 주소를 입력해주세요." required>
|
|
|
+ </td>
|
|
|
+ </tr>
|
|
|
+ <tr>
|
|
|
+ <th><span class="fix">*</span>전화번호</th>
|
|
|
+ <td colspan="3">
|
|
|
+ <input name="managerPhone" value="<c:out value="${info.managerPhone}" />" type="text" class="form-control" placeholder="신청자 전화번호를 입력해주세요." required>
|
|
|
+ </td>
|
|
|
+ </tr>
|
|
|
+ <tr>
|
|
|
+ <th><span class="fix">*</span>사용 목적</th>
|
|
|
+ <td colspan="3">
|
|
|
+ <textarea name="usePurpose" class="form-control" rows="10" cols="" name="content" placeholder="사용 목적을 입력해주세요" maxlength="4000" required><c:out value="${info.usePurpose}" /></textarea>
|
|
|
+ </td>
|
|
|
+ </tr>
|
|
|
+ </table>
|
|
|
+ <div class="row mt-3">
|
|
|
+ <div class="col-12">
|
|
|
+ <div class="text-right">
|
|
|
+ <button type="button" class="btn btn-outline-primary w100" onclick="history.back();">취소</button>
|
|
|
+ <button type="submit" class="btn btn-primary w100">수정</button>
|
|
|
+ </div>
|
|
|
+ </div>
|
|
|
+ </div>
|
|
|
+ </div>
|
|
|
+ </form>
|
|
|
+ </div>
|
|
|
+ </div>
|
|
|
+ </div>
|
|
|
+ <!-- 환자관리 : 신규환자 등록 END -->
|
|
|
+ </div>
|
|
|
+ </main>
|
|
|
+
|
|
|
+ <jsp:include page="${data._INCLUDE}/footer.jsp"></jsp:include>
|
|
|
+ </div>
|
|
|
+ </div>
|
|
|
+</body>
|
|
|
+</html>
|