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81 lines (81 loc) · 5.2 KB
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<?php
include(__DIR__.'/layout.php');
$jsonfile = null;
if ($_SERVER['REQUEST_METHOD'] === "GET") { $jsonfile = $obj->edit($_GET); }
if ($_SERVER['REQUEST_METHOD'] === "POST") { $obj->edit($_POST); }
?>
<div class="container-fluid mt-2">
<div class="row">
<div class="col-md-12">
<div class="card">
<div class="card-header">
<h4 class="h6 mb-0 text-uppercase">json object</h4>
</div>
<div class="card-body">
<form action="edit.php" method="post">
<div class="row">
<div class="col-md-6">
<input type="hidden" name="id" value="<?php echo $_GET['id']; ?>"/>
<div class="form-group">
<label>Policy holder name</label>
<input type="text" name="name" class="form-control" placeholder="Name" value="<?php echo $jsonfile['name'];?>">
</div>
<div class="form-group">
<label>Policy holder number</label>
<input type="text" name="number" class="form-control" placeholder="Mobile Number" value="<?php echo $jsonfile['number'];?>">
</div>
<div class="form-group">
<label>Policy number</label>
<input type="text" name="policyNo" class="form-control" placeholder="Policy number" value="<?php echo $jsonfile['policyNo'];?>">
</div>
<div class="form-group">
<label>Policy FUP</label>
<input type="date" name="fup" class="form-control" placeholder="FUP" value="<?php echo $jsonfile['fup'];?>">
</div>
<div class="form-group">
<label>Policy DOC</label>
<input type="date" name="doc" class="form-control" placeholder="DOC" value="<?php echo $jsonfile['doc'];?>">
</div>
<div class="form-group">
<label>Policy Pay Mode</label>
<input type="text" name="payMode" class="form-control" placeholder="Pay Mode" value="<?php echo $jsonfile['payMode'];?>">
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label>Policy Plan no</label>
<input type="text" name="planNo" class="form-control" placeholder="Plan Number" value="<?php echo $jsonfile['planNo'];?>">
</div>
<div class="form-group">
<label>Policy premium</label>
<input type="text" name="premium" class="form-control" placeholder="Premium" value="<?php echo $jsonfile['premium'];?>">
</div>
<div class="form-group">
<label>Policy SA</label>
<input type="text" name="sumAssured" class="form-control" placeholder="SA" value="<?php echo $jsonfile['sumAssured'];?>">
</div>
<div class="form-group">
<label>Policy T</label>
<input type="text" name="term" class="form-control" placeholder="Term" value="<?php echo $jsonfile['term'];?>">
</div>
<div class="form-group">
<label>Policy Maturity Date</label>
<input type="date" name="maturityDate" class="form-control" placeholder="Maturity Date" value="<?php echo $jsonfile['maturityDate'];?>">
</div>
<div class="form-group">
<label>Policy holder DOB</label>
<input type="date" name="birthday" class="form-control" placeholder="Birthday" value="<?php echo $jsonfile['birthday'];?>">
</div>
</div>
</div>
<div class="form-group text-center mt-3">
<button class="btn btn-primary">UPDATE</button>
</div>
</form>
</div>
</div>
</div>
</div>
</div>
</body>
</html>