%PDF-
%PDF-
Mini Shell
Mini Shell
<!doctype html>
<html lang="pt-Br">
<head>
<meta charset="utf-8" />
<meta http-equiv="X-UA-Compatible" content="IE=edge,chrome=1" />
<title>VACIVITTA - LAUDO</title>
<meta content='width=device-width, initial-scale=1.0, maximum-scale=1.0, user-scalable=0' name='viewport' />
<meta name="viewport" content="width=device-width" />
<link rel="apple-touch-icon" sizes="76x76" href="assets/img/apple-icon.png" />
<link rel="icon" type="image/png" href="assets/img/favicon.png" />
<!-- Fonts and icons -->
<link rel="stylesheet" type="text/css" href="https://fonts.googleapis.com/css?family=Roboto:300,400,500,700|Roboto+Slab:400,700|Material+Icons" />
<link rel="stylesheet" href="https://maxcdn.bootstrapcdn.com/font-awesome/latest/css/font-awesome.min.css" />
<!-- CSS Files -->
<link href="assets/css/bootstrap.min.css" rel="stylesheet" />
<link href="assets/css/material-bootstrap-wizard.css" rel="stylesheet" />
<!-- CSS Just for demo purpose, don't include it in your project -->
<link href="assets/css/demo.css" rel="stylesheet" />
</head>
<body>
<div class="image-container set-full-height">
<!-- Creative Tim Branding -->
<a href="http://creative-tim.com">
<div class="logo-container">
</div>
</a>
<!-- Big container -->
<div class="container">
<div class="row">
<div class="col-sm-8 col-sm-offset-2">
<!-- Wizard container -->
<div class="wizard-container">
<div class="card wizard-card" data-color="purple" id="wizard">
<form action="process.php" method="POST">
<!-- You can switch " data-color="rose" " with one of the next bright colors: "blue", "green", "orange", "purple" -->
<div class="wizard-header">
<h3 class="wizard-title">
Gerador de Laudos
</h3>
<h5>Formulário de dados para laudo.</h5>
</div>
<div class="wizard-navigation">
<ul>
<li><a href="#location" data-toggle="tab">DADOS PESSOAIS</a></li>
<li><a href="#facilities" data-toggle="tab">DADOS DO TESTE</a></li>
</ul>
</div>
<div class="tab-content">
<div class="tab-pane" id="location">
<div class="row">
<div class="col-sm-12">
<h4 class="info-text"> Vamos começar com alguns detalhes básicos!</h4>
</div>
<div class="col-sm-5 col-sm-offset-1">
<div class="form-group label-floating">
<label>CPF</label>
<input type="text" class="form-control" id="cpf" name="cpf">
</div>
<div class="form-group label-floating">
<label>NOME</label>
<input type="text" class="form-control" id="nome" name="nome">
</div>
</div>
<div class="col-sm-5">
<div class="form-group label-floating">
<label>E-MAIL</label>
<input type="text" class="form-control" id="email" name="email">
</div>
<div class="form-group label-floating">
<label>DATA DE NASCIMENTO</label>
<input type="text" class="form-control" id="nascimento" name="nascimento">
</div>
</div>
</div>
</div>
<div class="tab-pane" id="facilities">
<h4 class="info-text"> Nos conte mais algumas informações sobre o teste! </h4>
<div class="row">
<div class="col-sm-5 col-sm-offset-1">
<div class="form-group label-floating">
<label>MATERIAL</label>
<select class="form-control" name="material" id="material">
<option disabled="" selected=""></option>
<option value="Swab de nasofaringe">Swab de nasofaringe</option>
</select>
</div>
<div class="form-group label-floating">
<label>DATA COLETA</label>
<input type="date" class="form-control" id="datacoleta" name="datacoleta">
</div>
<div class="form-group label-floating">
<label>RESULTADO</label>
<select class="form-control" name="resultado" id="resultado">
<option value="1">POSITIVO</option>
<option value="0">NEGATIVO</option>
</select>
</div>
</div>
<div class="col-sm-5">
<div class="form-group label-floating">
<label>MARCA DO INSUMO</label>
<select class="form-control" name="marca" id="marca">
<option value="AdvaGen">AdvaGen</option>
<option value="Wama">Wama</option>
</select>
</div>
<div class="form-group label-floating">
<label>HORA COLETA</label>
<input type="time" class="form-control" id="horacoleta" name="horacoleta">
</div>
<div class="form-group label-floating">
<label>LOTE</label>
<input type="text" class="form-control" id="lote" name="lote">
</div>
</div>
<div class="col-sm-5 col-sm-offset-1">
<div class="form-group label-floating">
<label>REGISTRO ANVISA</label>
<input type="text" class="form-control" id="registro" name="registro">
</div>
</div>
<div class="col-sm-5">
<div class="form-group label-floating">
<label>VALIDADE</label>
<input type="date" class="form-control" id="validade" name="validade">
</div>
</div>
</div>
</div>
</div>
<div class="wizard-footer">
<div class="pull-right">
<input type='button' class='btn btn-next btn-fill btn-primary btn-wd' name='next' value='Próximo' />
<input type='submit' class='btn btn-finish btn-fill btn-primary btn-wd' name='finish' value='Concluir' />
</div>
<div class="pull-left">
<input type='button' class='btn btn-previous btn-fill btn-default btn-wd' name='previous' value='Anterior' />
</div>
<div class="clearfix"></div>
</div>
</form>
</div>
</div> <!-- wizard container -->
</div>
</div> <!-- row -->
</div> <!-- big container -->
<div class="footer">
<div class="container text-center">
<p style="color: rgb (114, 115, 118);"> Vacivitta Ltda.</p>
</div>
</div>
</div>
</body>
<!-- Core JS Files -->
<script src="assets/js/jquery-2.2.4.min.js" type="text/javascript"></script>
<script src="assets/js/bootstrap.min.js" type="text/javascript"></script>
<script src="assets/js/jquery.bootstrap.js" type="text/javascript"></script>
<!-- Plugin for the Wizard -->
<script>
var temporiza;
$("#cpf").on("input", function() {
clearTimeout(temporiza);
temporiza = setTimeout(function() {
var numCpf = $("#cpf").val();
var url = "https://api.cpfcnpj.com.br/0fb7dc1966668a8bb466d8ac49bf6c7c/7/" + numCpf + "";
$.ajax({
url: url,
type: "get",
dataType: "json",
success: function(dados) {
console.log(dados);
$("#nome").val(dados.nome);
$("#nascimento").val(dados.nascimento);
}
})
}, 1000);
})
</script>
<script src="assets/js/material-bootstrap-wizard.js"></script>
<!-- More information about jquery.validate here: http://jqueryvalidation.org/ -->
<script src="assets/js/jquery.validate.min.js"></script>
</html>
Zerion Mini Shell 1.0