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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>

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