<?php require_once("../include/class.php");?>
<?php require_once("../include/header.php");?>
<?php require_once("../include/nav_top.php");?>
<?php require_once("../include/sidebar.php");?>
<?php include("table_name.php");?>

<div id="main-content">
  <div class="container-fluid">
  
    <ul class="breadcrumb">
      <li><a href="../<?php echo $name_folder ?>/list.php"><?php echo ucfirst($name_table) ?></a><span class="divider">&raquo;</span></li>
      <li class="active">Add</li>
    </ul>
    
    
    
    
    <div class="row-fluid">
			<div class="span12">
				<div class="nonboxy-widget">
					<div class="widget-head">
						<h5><i class="black-icons blocks_images"></i> From  </h5>
					</div>
                 
					<div class="widget-content">
						<div class="widget-box">
                        	<form class="form-horizontal well" id="fm_phonenumber" name="fm_phonenumber" action="add_save.php"  onSubmit="return checkform_phonenumber();"   method="post" enctype="multipart/form-data">
								<fieldset>
									
                                     <div class="control-group">
										<label class="control-label"> ID ร้าน </label>
										<div class="controls">
                                        <input type="text" name="idshop" value="<?php echo $_GET['id'];?>">
										</div>
									</div>
                                    
                                   <div class="control-group">
										<label class="control-label">ธนาคาร </label>
										<div class="controls">
                                        <select name="bank">
										<?php
                                        $list_ct = array('table'=>'bank','where'=>'status =1','order'=> "ORDER BY name ASC");				  
										$view_ct = $view_db->view($list_ct);
										$result_ct = $view_db->q_re($view_ct);
										while($row_ct = $view_db->q_ro($result_ct))
										{
											?><option value="<?php echo $row_ct['id']?>"><?php echo $row_ct['name']?></option><?php
										}
										?>
                                        </select>
										</div>
									</div>
                                   
                                    <div class="control-group">
										<label class="control-label">จำนวนวัน </label>
										<div class="controls">
                                        <input type="text" name="day" value="">
										</div>
									</div>
                                    
                                    <div class="control-group">
										<label class="control-label">ยอดที่ชำระ </label>
										<div class="controls">
                                        <input type="text" name="amount" value="">
										</div>
									</div>
                                    
                                    <?php
                                    $getnumber = date('d-m-Y');
									?>
                                     <div class="input-append date" id="datepicker" data-date="<?php echo $getnumber; ?>" data-date-format="dd-mm-yyyy">
                                    <div class="control-group">

                                        <label class="control-label"> วันเวลาที่ชำระเงิน </label>
                                        <div class="controls">
                                            <div class="input-append">
                                                <input size="16" type="text"  name="dmy" value="<?php echo $getnumber; ?>">
                                                <span class="add-on margin-fix"><i class="icon-th"></i></span>
                                            </div>
                                        </div>
                                        <div class="controls" style="margin-top:10px;">
                                        	<select name="d_h" style="width:50px;margin-right:10px;">
                                            	<?php 
												for($i=0;$i<=23;$i++)
												{
													?><option value="<?php echo str_pad($i, 2, "0", STR_PAD_LEFT); ?>"><?php echo str_pad($i, 2, "0", STR_PAD_LEFT); ?></option><?php
												}
												?>
                                            </select>:
                                            <select name="d_i" style="width:50px;margin-right:10px;">
                                            	<?php 
												for($i=0;$i<=59;$i++)
												{
													?><option value="<?php echo str_pad($i, 2, "0", STR_PAD_LEFT); ?>"><?php echo str_pad($i, 2, "0", STR_PAD_LEFT); ?></option><?php
												}
												?>
                                            </select>:
                                            <select name="d_s" style="width:50px;margin-right:10px;">
                                            	<?php 
												for($i=0;$i<=59;$i++)
												{
													?><option value="<?php echo str_pad($i, 2, "0", STR_PAD_LEFT); ?>"><?php echo str_pad($i, 2, "0", STR_PAD_LEFT); ?></option><?php
												}
												?>
                                            </select>
                                        </div>
                                    </div>
                                    </div>
                                    
                                    <div class="control-group">
										<label class="control-label">อัพโหลด ใบสลิป </label>
										<div class="controls">
                                        <input type="file" name="file" value="">
										</div>
									</div>
                                    
                                   
								</fieldset>
								<div class="form-actions">
									<button class="btn btn-primary" type="submit">Save changes</button>
									<a href="list.php" class="btn" role="button">Cancel</a>
								</div>
							</form>
                           
                            
							</div>
						</div>
                        
                        
					</div>
				</div>
			</div>
			
	</div>
    
    
    
    
    
  </div>
</div>

<?php require_once("../include/footer_js.php");?>
</body>
</html>