contrib/forms/contacts/view.php

   1 <!-- Forms generated from formsWiz -->
   2 <?php
   3 include_once("../../globals.php");
   4 ?>
   5 <html><head>
   6 <?php html_header_show();?>
   7 <link rel=stylesheet href="<?php echo $css_header;?>" type="text/css">
   8 </head>
   9 <body <?php echo $top_bg_line;?> topmargin=0 rightmargin=0 leftmargin=2 bottommargin=0 marginwidth=2 marginheight=0>
  10 <?php
  11 include_once("$srcdir/api.inc");
  12 $obj = formFetch("form_contacts", $_GET["id"]);
  13 ?>
  14 <form method=post action="<?php echo $rootdir?>/forms/contacts/save.php?mode=update&id=<?php echo $_GET["id"];?>" name="my_form">
  15 <span class="title">Contacts</span><Br><br>
  16 <table>
  17 <tr>
  18 <td valign=top>
  19 <table>
  20 <tr><td><span class=text>OD Base Curve: </span></td><td><input size=4 type=entry name="od_base_curve" value="<?php echo $obj{"od_base_curve"};?>" ></td></tr>
  21 <tr><td><span class=text>OD Sphere: </span></td><td><input size=4 type=entry name="od_sphere" value="<?php echo $obj{"od_sphere"};?>" ></td></tr>
  22 <tr><td><span class=text>OD Cylinder: </span></td><td><input size=4 type=entry name="od_cylinder" value="<?php echo $obj{"od_cylinder"};?>" ></td></tr>
  23 <tr><td><span class=text>OD Axis: </span></td><td><input size=4 type=entry name="od_axis" value="<?php echo $obj{"od_axis"};?>" ></td></tr>
  24 <tr><td><span class=text>OD Diameter: </span></td><td><input size=4 type=entry name="od_diameter" value="<?php echo $obj{"od_diameter"};?>" ></td></tr>
  25 </table>
  26 </td>
  27 <td valign=top>
  28 <table>
  29 <tr><td><span class=text>OS Base Curve: </span></td><td><input size=4 type=entry name="os_base_curve" value="<?php echo $obj{"os_base_curve"};?>" ></td></tr>
  30 <tr><td><span class=text>OS Sphere: </span></td><td><input size=4 type=entry name="os_sphere" value="<?php echo $obj{"os_sphere"};?>" ></td></tr>
  31 <tr><td><span class=text>OS Cylinder: </span></td><td><input size=4 type=entry name="os_cylinder" value="<?php echo $obj{"os_cylinder"};?>" ></td></tr>
  32 <tr><td><span class=text>OS Axis: </span></td><td><input size=4 type=entry name="os_axis" value="<?php echo $obj{"os_axis"};?>" ></td></tr>
  33 <tr><td><span class=text>OS Diameter: </span></td><td><input size=4 type=entry name="os_diameter" value="<?php echo $obj{"os_diameter"};?>" ></td></tr>
  34 </table>
  35 </td>
  36 </tr>
  37 </table>
  38
  39 <table>
  40 <tr>
  41 <td><span class=text>Material: </span></td><td><input size=4 type=entry name="material" value="<?php echo $obj{"material"};?>" ></td>
  42 <td><span class=text>Color: </span></td><td><input size=4 type=entry name="color" value="<?php echo $obj{"color"};?>" ></td>
  43 <td><span class=text>Bifocal Type: </span></td><td><input size=4 type=entry name="bifocal_type" value="<?php echo $obj{"bifocal_type"};?>" ></td>
  44 <td><span class=text>Add: </span></td><td><input size=4 type=entry name="add_value" value="<?php echo $obj{"add_value"};?>" ></td>
  45 <td><span class=text>V/A Far: </span></td><td><input size=4 type=entry name="va_far" value="<?php echo $obj{"va_far"};?>" ></td>
  46 <td><span class=text>V/A Near: </span></td><td><input size=4 type=entry name="va_near" value="<?php echo $obj{"va_near"};?>" ></td>
  47 </tr>
  48 </table>
  49
  50 <table>
  51 <tr>
  52 <td valign=top>
  53 <span class=text>Additional Notes: </span><br><textarea cols=40 rows=8 wrap=virtual name="additional_notes" ><?php echo $obj{"additional_notes"};?></textarea><br>
  54 </td>
  55 </tr>
  56 </table>
  57
  58 <br>
  59 <a href="javascript:top.restoreSession();document.my_form.submit();" class="link_submit">[Save]</a>
  60 <br>
  61 <a href="<?php echo $GLOBALS['form_exit_url']; ?>" class="link" onclick="top.restoreSession()">[Don't Save Changes]</a>
  62 </form>
  63 <?php
  64 formFooter();
  65 ?>