%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>