templates/x12_partners/general_edit.html

   1 <form name="x12_partner" method="post" action="{$FORM_ACTION}" onsubmit="return top.restoreSession()">
   2 <table CELLSPACING="0" CELLPADDING="3" border="0">
   3 <tr>
   4         <td colspan="2">{xl t='X12 Partner'}</td>
   5 </tr>
   6 <tr>
   7         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >{xl t='Partner'}&nbsp;{xl t='Name'}</td>
   8         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" ><input type="text" size="20" name="name" value="{$partner->get_name()}"/></td>
   9 </tr>
  10 <tr>
  11         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >{xl t='ID'}&nbsp;{xl t='Number'}&nbsp;({xl t='ETIN'})</td>
  12         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" ><input type="text" size="20" name="id_number" value="{$partner->get_id_number()}"/></td>
  13 </tr>
  14 <tr>
  15         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >{xl t='Receiver ID Qualifier (ISA07)'}</td>
  16         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" >{html_options name="x12_isa07" options=$partner->get_idqual_array() selected=$partner->get_x12_isa07()}</td>
  17 </tr>
  18 <tr>
  19         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >{xl t='Receiver ID (ISA08)'}</td>
  20         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" ><input type="text" size="20" name="x12_receiver_id" value="{$partner->get_x12_receiver_id()}"/></td>
  21 </tr>
  22 <tr>
  23         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >{xl t='Sender ID Qualifier (ISA05)'}</td>
  24         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" >{html_options name="x12_isa05" options=$partner->get_idqual_array() selected=$partner->get_x12_isa05()}</td>
  25 </tr>
  26 <tr>
  27         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >{xl t='Sender ID (ISA06)'}</td>
  28         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" ><input type="text" size="20" name="x12_sender_id" value="{$partner->get_x12_sender_id()}"/></td>
  29 </tr>
  30 <tr>
  31         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >{xl t='Acknowledgment Requested (ISA14)'}</td>
  32         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" >{html_options name="x12_isa14" options=$partner->get_x12_isa14_array() selected=$partner->get_x12_isa14()}</td>
  33 </tr>
  34 <tr>
  35         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >{xl t='Usage Indicator (ISA15)'}</td>
  36         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" >{html_options name="x12_isa15" options=$partner->get_x12_isa15_array() selected=$partner->get_x12_isa15()}</td>
  37 </tr>
  38 <tr>
  39         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >{xl t='Application Sender Code (GS02)'}</td>
  40         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" ><input type="text" size="20" name="x12_gs02" value="{$partner->get_x12_gs02()}"/></td>
  41 </tr>
  42 <tr>
  43         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >{xl t='Submitter EDI Access Number (PER06)'}</td>
  44         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" ><input type="text" size="20" name="x12_per06" value="{$partner->get_x12_per06()}"/></td>
  45 </tr>
  46 <tr>
  47         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >{xl t='Version'}</td>
  48         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" ><input type="text" size="20" name="x12_version" value="{$partner->get_x12_version()}"/></td>
  49 </tr>
  50 <tr>
  51         <td COLSPAN="1" ALIGN="LEFT" VALIGN="MIDDLE" >{xl t='Processing'}&nbsp;{xl t='Format'}</td>
  52         <td COLSPAN="2" ALIGN="LEFT" VALIGN="MIDDLE" >{html_options name="processing_format" options=$partner->get_processing_format_array() selected=$partner->get_processing_format()}</td>
  53 </tr>
  54 <tr>
  55         <td>
  56                 {if $partner->get_id() eq ""}
  57                         <input type="submit" value="{xl t='Add'}" />
  58                 {else}
  59                         <input type="submit" value="{xl t='Update'}" />
  60                 {/if}
  61         </td>
  62 </tr>
  63 </table>
  64 <input type="hidden" name="id" value="{$partner->id}" />
  65 <input type="hidden" name="process" value="{$PROCESS}" />
  66 </form>