<?php
ob_start();
require("includes/check_auth_user.php");
require("includes/dbconnect.php");
include('includes/function.php');

$formname = "Medical Help Report";
$action = "medihelprep_fr.php";

$admin = $_SESSION["admin_" . $dbname];
$zdb = $_SESSION["zdbyear_" . $dbname];

$zyear = right($zdb, 4);
//$mfrdate = getzdates($zyear, 'S');
//$mtodate = getzdates($zyear, 'E');

// $myyear = $_SESSION[$myyear];
$zroot = $_SESSION["zdbroot"];

mysqli_select_db($conn, $zdb);


//browse($zyear);
include("includes/linkshead.php");
?>
<!-- <script src="MyScript/monfromtodt.js" type="text/javascript"></script> -->
</head>

<body>
    <form method='POST' action="<?= $action; ?>">
        <!-- Default box -->
        <div>
            <div class="col-lg-5 col-md-12 col-sm-12 col-xs-12  pad">
                <div class="panel panel-default">
                    <div class="panel-heading">
                        <h3 class="panel-title"><?php echo $formname; ?></h3>
                        <div class="actions pull-right">
                        </div>
                    </div>
                    <div class="panel-body">

                        <div class="row">
                            <div class="col-lg-3 col-md-3 col-sm-3 col-xs-3 text-right pad">
                                <label class="label-control ">From Date</label>
                            </div>
                            <div class="col-lg-5 col-md-5 col-sm-8 col-xs-8 pad">
                                <input type="date" name="fromdt" class="form-control fromdt" value="<?php echo date('Y-m-d') ?>">
                            </div>
                        </div>
                        <div class="row">
                            <div class="col-lg-3 col-md-3 col-sm-3 col-xs-3 text-right pad">
                                <label class="label-control ">To Date</label>
                            </div>
                            <div class="col-lg-5 col-md-5 col-sm-8 col-xs-8 pad">
                                <input type="date" name="todt" class="form-control todt" value="<?php echo date('Y-m-d', strtotime("+30 days"))  ?>">
                            </div>
                        </div>



                        <div class="row">
                            <div class="col-lg-3 col-md-3 col-sm-3 col-xs-3 text-right pad">
                                <label class="label-control ">Member No.</label>
                            </div>
                            <div class="col-lg-2 col-md-6 col-sm-6 col-xs-6 pad">
                                <select name="memno" class="form-control select2">
                                    <option value=""></option>
                                    <?php
                                    $getfam = mysqli_query($conn, "SELECT memno FROM medihelp order by memno") or die(mysqli_error($conn));
                                    while ($fetfam = mysqli_fetch_array($getfam)) {
                                        echo "<option value='$fetfam[memno]'>$fetfam[memno]</option>";
                                    }
                                    ?>
                                </select>
                            </div>
                        </div>

                        <div class="row">
                            <div class="col-lg-3 col-md-3 col-sm-3 col-xs-3 text-right pad">
                                <label class="label-control ">Member Name</label>
                            </div>
                            <div class="col-lg-5 col-md-6 col-sm-6 col-xs-6 pad">
                                <select name="memname" class="form-control select2">
                                    <option value=""></option>
                                    <?php
                                    $gten = mysqli_query($conn, "SELECT memname FROM `medihelp`  ORDER BY memname") or die(mysqli_error($conn));
                                    while ($member = mysqli_fetch_array($gten)) {
                                        echo "<option value='$member[memname]'>$member[memname]</option>";
                                    }
                                    ?>
                                </select>
                            </div>
                        </div>
                        <div class="row">

                            <div class="col-lg-3 col-md-3 col-sm-3 col-xs-3 text-right pad">
                                <label class="label-control ">Gender</label>
                            </div>
                            <div class="col-lg-2 col-md-6 col-sm-6 col-xs-6 pad">
                                <select name="gender" class="form-control select2">
                                    <option value=""></option>
                                    <option value='M'>MALE</option>
                                    <option value='F'>FEMALE</option>
                                </select>
                            </div>
                        </div>


                        <div class="row">
                            <div class="col-lg-3 col-md-3 col-sm-3 col-xs-3 text-right pad">
                                <label class="label-control ">Occupation</label>
                            </div>
                            <div class="col-lg-5 col-md-6 col-sm-6 col-xs-6 pad">
                                <select name="occupation" class="form-control select2">
                                    <option value=""></option>
                                    <?php
                                    $getoccu = mysqli_query($conn, "SELECT occupation FROM `medihelp` order by `occupation`") or die(mysqli_error($conn));
                                    while ($fetoccu = mysqli_fetch_array($getoccu)) {
                                        echo "<option value='$fetoccu[occupation]'>$fetoccu[occupation]</option>";
                                    }
                                    ?>
                                </select>
                            </div>
                        </div>

                        <div class="row">

                            <div class="col-lg-3 col-md-3 col-sm-3 col-xs-3 text-right pad">
                                <label class="label-control ">Scope</label>
                            </div>
                            <div class="col-lg-3 col-md-6 col-sm-6 col-xs-6 pad">
                                <select name="scope" class="form-control select2">
                                    <option value="">All</option>
                                    <option value='P'>Pending</option>
                                    <option value='S'>Sanctioned</option>
                                </select>
                            </div>
                        </div>


                    </div>
                    <div class="panel-footer">
                        <div class="text-center pad">
                            <div class="panel-footer">
                                <?php include("includes/but_rep.php"); ?>
                            </div>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </form>
    <?php include("includes/linksfoot.php"); ?>
</body>

</html>