fix: set default x12 partner for item in billing manager (#7513)
[openemr.git] / templates / document_categories / general_upload.html
blob9bda718f76154c7f6f4592bd1e50bbbc48b7c1e2
1 <html>
2 <head>
4 <style>
5 <!--
6 td {
7 font-size:8pt;
8 font-family:helvetica;
10 a {
11 font-size:8pt;
12 font-family:helvetica;
15 -->
16 </style>
17 </head>
18 <body bgcolor="{$STYLE.BGCOLOR2}">
19 <form method=post enctype="multipart/form-data" action="{$FORM_ACTION}" onsubmit="return top.restoreSession()">
20 <input type="hidden" name="MAX_FILE_SIZE" value="64000000" />
21 <table>
22 <tr>
23 <td>{xlt t="Upload Document"}</td>
24 </tr>
25 <tr>
26 <td><input type="file" name="file"></td>
27 </tr>
28 <tr>
29 <td><input type="submit" value="{xla t='Upload'}"></td>
30 </tr>
31 {if !empty($file)}
32 <tr>
33 <td><br /><br /></td>
34 </tr>
35 <tr>
36 <td>{xlt t='Upload Report'}</td>
37 </tr>
38 <tr>
39 <td>{$error|text}</td>
40 </tr>
41 <tr>
42 <td><pre>{$file|text}</pre></td>
43 </tr>
44 {/if}
45 </table>
46 <input type="hidden" name="process" value="{$PROCESS|attr}" />
47 </form>
48 </body>
49 </html>