| Server IP : 162.214.74.102 / Your IP : 216.73.216.192 Web Server : Apache System : Linux dedi-4363141.lrsys.com.br 3.10.0-1160.119.1.el7.tuxcare.els25.x86_64 #1 SMP Wed Oct 1 17:37:27 UTC 2025 x86_64 User : lrsys ( 1015) PHP Version : 5.6.40 Disable Function : exec,passthru,shell_exec,system MySQL : ON | cURL : ON | WGET : ON | Perl : ON | Python : ON | Sudo : ON | Pkexec : ON Directory : /home/lrsys/www/lrsys_apps/leo/application/plugins/module_med_scheduling/views/agreement/ |
Upload File : |
<div class="wrapper wrapper-content">
{$action = 'create'}
{$title_action = $_L['Agreement_Add_Module']}
{if (!empty($agreements))}
{$action = 'update'}
{$title_action = $_L['Agreement_Edit_Module']}
{/if}
<form id="form-agreement" class="form-horizontal" method="post" >
<div class="row">
<div class="col-md-12">
<div id="ibox-form" class="ibox float-e-margins">
<div class="ibox-title">
<h5>{$title_action}</h5>
<a href="{$_url}module_med_scheduling/agreement/listAgreement"
class="btn btn-xs btn-primary btn-rounded pull-right">
<i class="fa fa-bars"></i> {$_L['Agreement_List']}
</a>
</div>
<div class="ibox-content" id="ibox_form">
<div class="alert alert-danger" id="emsg">
<span id="emsgbody"></span>
</div>
<div class="row">
<div class="col-md-6 col-sm-12 col-xs-12 top10">
<label class="control-label" >{$_L['Active'] }?</label>
<input type="checkbox" data-toggle="toggle" data-size="small" data-on="{$_L['Yes']}" data-off="{$_L['No']}" id="active" {if $agreement->active=='Y'}checked{/if} name="active" value="Y">
</div>
<div class="col-md-6 col-sm-12 col-xs-12 top10">
<label class="control-label" >{$_L['Scheduling Standard agreement']} <i class="fa fa-info-circle text-success" data-toggle="tooltip" data-placement="top" title="{$_L['The standard agreement is used in the registry of patients and by those without registered covenants.']}"></i></label>
<input type="checkbox" data-toggle="toggle" data-size="small" data-on="{$_L['Yes']}" data-off="{$_L['No']}" id="standard_agreement" {if $agreement->standard_agreement=='Y'}checked{/if} name="standard_agreement" value="Y">
</div>
<div class="col-md-12 col-sm-12 col-xs-12">
<label class="control-label" for="title">
{$_L['Agreement_Fantasy_Name']} <small class="red">*</small>
</label>
<input type="text" name="agreement_company_name" maxlength="90" id="agreement_company_name" {if $agreement->default==1}readonly{/if}
class="form-control" value="{$agreement->agreement_company_name}" required>
</div>
<div class="col-md-12 col-sm-12 col-xs-12">
<label class="control-label" for="title">
{$_L['Agreement_Company_Social_Reason']}
</label>
<input type="text" name="agreement_company_social_reason" maxlength="90" id="agreement_company_social_reason" {if $agreement->default==1}readonly{/if}
class="form-control" value="{$agreement->agreement_company_social_reason}">
</div>
<div class="col-sm-12 col-md-12 col-xs-12">
<label class="control-label" for="title">
{$_L['Scheduling Resposable']}
</label>
<select name="crm_accounts_id_responsable" id="crm_accounts_id_responsable" class="form-control responsable_select" style="width:100%">
{if $crm_accounts_id_responsable}
<option value="{$crm_accounts_id_responsable->id}">{$crm_accounts_id_responsable->account}</option>
{/if}
</select>
</div>
</div>
<div class="row">
<div class="col-md-12 col-sm-12 col-xs-12">
<label class="control-label" for="title">
{$_L['Agreement_ANS']}
</label>
<input type="text" name="register_ans" id="register_ans" class="form-control"
value="{$agreement->register_ans}" required>
</div>
<div class="col-md-12 col-sm-12 col-xs-12 top10">
<label class="control-label" >{$_L['Create Invoice'] }?</label>
<input type="checkbox" data-toggle="toggle" data-size="small" data-on="{$_L['Yes']}" data-off="{$_L['No']}" id="create_invoice" {if $agreement->create_invoice=='Y'}checked{/if} name="create_invoice" value="Y">
</div>
<!-- TODO COLOCAR NOVOS COMPOS PARA FATURAMENTO -->
<div class="col-md-12 col-sm-12 col-xs-12 top10" id="invoice-details">
<div class="row">
<div class="col-md-3 col-sm-12 col-xs-12">
<label class=" control-label" >{$_L['Scheduling Billing type']}</label>
<select class="form-control" name="tiss_billing_type" id="tiss_billing_type">
<option {if $agreement->tiss_billing_type=='day_of_month'}selected{/if} value="day_of_month">{$_L['Scheduling Day of month']}</option>
<option {if $agreement->tiss_billing_type=='day_after_closing'}selected{/if} value="day_after_closing">{$_L['Scheduling Days after closing']}</option>
</select>
</div>
<div class="col-md-3 col-sm-12 col-xs-12">
<label class=" control-label tiss_billing_type_label" >{$_L['Scheduling Day of month']}</label>
<input type="text" maxlength="2" value="{$agreement->tiss_billing_type_value}" name="tiss_billing_type_value"
id="tiss_billing_type_value" class="form-control">
</div>
<div class="col-md-3 col-sm-12 col-xs-12">
<label class="control-label" title="{$_L['Scheduling Days for payment desc']}">{$_L['Scheduling Days for payment']}</label>
<input type="text" maxlength="3" value="{if isset($agreement->days_for_payment)}{$agreement->days_for_payment}{/if}" name="days_for_payment"
id="days_for_payment" class="form-control">
</div>
<div class=" col-md-3 col-sm-12 col-xs-12">
<label class=" control-label" >{$_L['Payment Method Invoice']}</label>
<div class="input-group">
<select id="id_payment_method" name="id_payment_method" class="form-control" >
<option value="0">{$_L['None']}</option>
{foreach $payment_methods as $pmethod}
<option value="{$pmethod['id']}" {if isset($agreement->id_payment_method) && $agreement->id_payment_method == $pmethod['id']}selected{/if}>{$pmethod['name']}</option>
{/foreach}
<option value="-1">{$_L['Multiply']}</option>
</select>
</div>
</div>
<div class=" col-md-3 col-sm-12 col-xs-12">
<label class=" control-label" >{$_L['Scheduling Income Category']}</label>
<div class="input-group">
<select id="income_category_id" name="income_category_id" class="form-control" >
<option value="">{$_L['None']}</option>
{foreach $income_category as $category}
<option value="{$category['id']}" {if isset($agreement->income_category_id) && $agreement->income_category_id == $category['id']}selected{/if}>{$category['name']}</option>
{/foreach}
</select>
</div>
</div>
<div class=" col-md-3 col-sm-12 col-xs-12">
<label class=" control-label" >{$_L['Scheduling Cost Center']}</label>
<div class="input-group">
<select id="id_cost_center" name="id_cost_center" class="form-control" >
<option value="">{$_L['None']}</option>
{foreach $cost_center as $cc}
<option value="{$cc['id']}" {if isset($agreement->id_cost_center) && $agreement->id_cost_center == $cc['id']}selected{/if}>{$cc['name']}</option>
{/foreach}
</select>
</div>
</div>
<div class=" col-md-3 col-sm-12 col-xs-12">
<label class=" control-label" >{$_L['Scheduling Account']}</label>
<div class="input-group">
<select id="sys_accounts_id" name="sys_accounts_id" class="form-control" >
<option value="0">{$_L['None']}</option>
{foreach $sys_accounts as $sys_account}
<option value="{$sys_account['id']}" {if isset($agreement->sys_accounts_id) && $agreement->sys_accounts_id == $sys_account['id']}selected{/if}>{$sys_account['account']}</option>
{/foreach}
</select>
</div>
</div>
<div class="col-md-12 col-sm-12 col-xs-12">
<label class="control-label" title="{$_L['Scheduling Invoice Description']}">{$_L['Scheduling Invoice Description']}</label>
<textarea class="form-control" id="invoice_description" name="invoice_description">{if isset($agreement->invoice_description)}{$agreement->invoice_description}{/if}</textarea>
</div>
</div>
</div>
</div>
{if count($agreements)>0}
<div class="row top15" style="padding-top: 40px;">
<div class="col-md-6 col-sm-12 col-xs-12 top10">
<label class=" control-label" >{$_L['Scheduling Import procedures from another agreement']}?</label>
<input type="checkbox" data-toggle="toggle" data-size="small" data-on="{$_L['Yes']}" data-off="{$_L['No']}" id="import_procedures" {if $agreement->import_procedures=='Y'}checked{/if} name="import_procedures" value="Y">
</div>
</div>
<div class="row import_agreement">
<div class="col-md-12 col-sm-12 col-xs-12 top10">
<label class="control-label" >{$_L['Scheduling agreement']}</label>
<select class="form-control" name="import_agreement">
{foreach $agreements as $a}
<option value="{$a->id}">{$a->agreement_company_name}</option>
{/foreach}
</select>
</div>
</div>
{/if}
<div class="row hide">
<div class="col-md-4 col-sm-12 col-xs-12">
<label for=""
class="control-label">{$_L['Scheduling Expiration Date'] } </label>
<input type="text" class="form-control" id="expiration_date" name="expiration_date" datepicker
data-date-format="{$_c['formatDate']}" data-auto-close="true"
value="{if not empty($agreement->expiration_date)}{date( $_c['df'], strtotime($agreement->expiration_date))}{/if}">
<span class='help-block'>{$_L['Scheduling This date is used in reports and does not block agendas for the agreement.']} </span>
</div>
</div>
<div class='row' >
<div class="col-xs-12 div_form"> <h2>{$_L['Scheduling TISS'] }</h2> </div>
<div class="col-md-6 col-sm-12 col-xs-12 top10">
<label class=" control-label" >{$_L['Scheduling Enable TISS']}?</label>
<input type="checkbox" data-toggle="toggle" data-size="small" data-on="{$_L['Yes']}" data-off="{$_L['No']}" id="enable_tiss" {if $agreement->enable_tiss=='Y'}checked{/if} name="enable_tiss" value="Y">
</div>
</div>
<div class='row tiss_options' >
<div class="col-md-4 col-sm-12 col-xs-12 top10">
<label class="control-label" >{$_L['Scheduling Version TISS']}</label>
<select class="form-control" name="tiss_version">
<option {if $agreement->tiss_version=='03.02.01'}selected{/if} value="03.02.01">03.02.01</option>
</select>
</div>
<div class="col-md-4 col-sm-12 col-xs-12 top10">
<label class=" control-label" >{$_L['Scheduling Register of the establishment at the operator']}</label>
<input type="text" maxlength="15" value="{$agreement->tiss_register_operation}" name="tiss_register_operation" id="tiss_register_operation" class="form-control"
value="">
</div>
<div class="col-md-4 col-sm-12 col-xs-12 top10">
<label class=" control-label" >{$_L['Scheduling Number of last issued guide']}</label>
<input type="text" maxlength="7" value="{$agreement->tiss_number_last_guide}" name="tiss_number_last_guide" id="tiss_number_last_guide" class="form-control"
value="">
</div>
</div>
<div class='row' >
<div class="col-xs-12 div_form"> <h2>{$_L['Scheduling Professionals who use this type of agreement']}</h2> </div>
<table class="table table-bordered table-hover sys_table footable" >
<thead>
<tr>
<th class="col-xs-1">{$_L['Active']}</th>
<th>{$_L['Name']}</th>
<th class="col-xs-3">{$_L['Scheduling Professional registration at the operator']}
<i class="fa fa-info-circle text-success" data-toggle="tooltip" data-placement="top" title="{$_L['Scheduling Registration number of the professional at the operator, provided at the accreditation.']}"></i>
</th>
</tr>
</thead>
<tbody>
{if count($doctors) > 0}
{foreach $doctors as $a}
<tr>
<td><input type="checkbox" {if isset($doctorsAgrement[$a->id])}checked{/if} class="form-control doctor_check" data-id='{$a->id}' name="doctor_{$a->id}" value="Y"></td>
<td>{$a->name}</td>
<td> <input type="text" value="{if isset($doctorsAgrement[$a->id])}{$doctorsAgrement[$a->id]}{/if}" {if !isset($doctorsAgrement[$a->id])}disabled=""{/if} required="" maxlength="7" name="number_agreement_{$a->id}" id="number_agreement_{$a->id}" class="form-control" ></td>
</tr>
{/foreach}
{else}
<tr>
<td colspan="3">
{$_L['No_Records_Found']}
</td>
</tr>
{/if}
</tbody>
</table>
</div>
<div class="row" style="margin-top:20px">
<div class=" col-md-12 form-group">
<div class="col-lg-10">
<input type="hidden" id="agreementId" name="id" value="{$agreement->id}">
<button class="md-btn md-btn-primary waves-effect waves-light" type="submit" id="submit">
<i class="fa fa-check"></i> {$_L['Submit']}
</button>
| <a href="{$_url}module_med_scheduling/agreement/listAgreement">{$_L['Or Cancel']}</a>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</form>
</div>