%PDF- %PDF-
Direktori : /home/vacivi36/sistemaparcerias/hcenf/ |
Current File : /home/vacivi36/sistemaparcerias/hcenf/padrao.php |
<?php // Inicia sessões session_start(); // Verifica se existe os dados da sessão de login if(!isset($_SESSION["usuarioId"]) || !isset($_SESSION["usuarioNome"])) { // Usuário não logado! Redireciona para a página de login header("Location: ../index.php"); exit; } ?> <!DOCTYPE html> <html lang="pt-Br"> <head> <meta charset="UTF-8"> <meta name="viewport" content="width=device-width, initial-scale=1.0"> <meta http-equiv="X-UA-Compatible" content="ie=edge"> <title>Vacivitta</title> <!-- Font Icon --> <link rel="icon" type="image/png" href="../assets/img/favicon.png"> <link rel="stylesheet" href="fonts/material-icon/css/material-design-iconic-font.min.css"> <link rel="stylesheet" href="vendor/nouislider/nouislider.min.css"> <!-- Main css --> <link rel="stylesheet" href="css/style.css"> </head> <body> <div class="main"> <div class="container"> <div class="signup-content"> <div class="signup-form"> <!--<img src="../assets/img/" style="margin-left: 119px; width: 70%;margin-top: -55px;margin-bottom: -20px;" alt="Logo"> --> <form method="POST" class="register-form" id="register-form" action="cadastro.php"> <div class="form-row"> <div class="form-group"> <div class="form-input"> <label for="nome" class="required">Nome Completo</label> <input type="text" name="nome" id="nome" /> </div> <div class="form-input"> <label for="endereco">Endereço</label> <input type="text" name="endereco" id="endereco" /> </div> <div class="form-input"> <label for="bairro">Bairro</label> <input type="text" name="bairro" id="bairro" /> </div> <div class="form-input"> <label for="cidade" class="required">Cidade</label> <input type="text" name="cidade" id="cidade" /> </div> <div class="form-input"> <label for="estado" >Estado</label> <input type="text" name="estado" id="estado" /> </div> </div> <div class="form-group"> <!--<div class="form-radio"> <div class="label-flex"> <label for="payment">Payment Mode</label> <a href="#" class="form-link">Payment Detail</a> </div> <div class="form-radio-group"> <div class="form-radio-item"> <input type="radio" name="payment" id="cash" checked> <label for="cash">Cash</label> <span class="check"></span> </div> <div class="form-radio-item"> <input type="radio" name="payment" id="cheque"> <label for="cheque">Cheque</label> <span class="check"></span> </div> <div class="form-radio-item"> <input type="radio" name="payment" id="demand"> <label for="demand">Demand Draf</label> <span class="check"></span> </div> </div> </div>--> <div class="form-input"> <label for="celular" class="required">Celular</label> <input type="text" name="celular" id="celular" /> </div> <div class="form-input"> <label for="datateste" class="required">Data do Teste</label> <input type="date" name="datateste" id="datateste" /> </div> <div class="form-select"> <div class="label-flex"> <label for="tipoteste" class="required">Tipo de teste</label> </div> <div class="select-list"> <select style=" box-sizing: border-box; border: 1px solid #ebebeb; padding: 14px 20px; border-radius: 5px; -moz-border-radius: 5px; -webkit-border-radius: 5px; -o-border-radius: 5px; -ms-border-radius: 5px; font-size: 14px; font-family: 'Poppins'; width: 100%;" name="tipoteste" id="tipoteste" class="tipoteste"> <option value="">Selecione</option> <option value="Teste rápido IGG/IGM">Teste rápido IGG/IGM</option> <option value="Teste de Antígenos">Teste de Antígenos</option> <option value="RT-PCR">RT-PCR</option> <option value="Anticorpos Neutralizantes">Anticorpos Neutralizantes</option> </select> </div> </div> <div class="form-input"> <label for="quantidade" class="required">Quantidade de Testes</label> <input type="text" name="quantidade" id="quantidade" /> </div> <div class="form-select"> <div class="label-flex"> <label for="tipo" class="required">Turno do Agendamento</label> </div> <div class="select-list"> <select style=" box-sizing: border-box; border: 1px solid #ebebeb; padding: 14px 20px; border-radius: 5px; -moz-border-radius: 5px; -webkit-border-radius: 5px; -o-border-radius: 5px; -ms-border-radius: 5px; font-size: 14px; font-family: 'Poppins'; width: 100%;" name="tipo" id="tipo" class="tipo"> <option value="">Selecione</option> <option value="Manhã">Manhã</option> <option value="Tarde">Tarde</option> </select> </div> </div> <h3><br><br>Campos com <font color="#b90000">*</font> são obrigatórios.</h3> </div> </div> <div class="form-submit"> <input type="submit" value="Enviar" class="submit" id="submit" name="submit" /> <input type="submit" value="Limpar" class="submit" id="reset" name="reset" /> <input type="submit" value="Sair" class="submit" id="sair" name="sair" /> </div> </form> </div> </div> </div> </div> <!-- JS --> <script src="vendor/jquery/jquery.min.js"></script> <script src="vendor/nouislider/nouislider.min.js"></script> <script src="vendor/wnumb/wNumb.js"></script> <script src="vendor/jquery-validation/dist/jquery.validate.min.js"></script> <script src="vendor/jquery-validation/dist/additional-methods.min.js"></script> <script src="js/main.js"></script> </body><!-- This templates was made by Colorlib (https://colorlib.com) --> </html>