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ABXinRLS/add-diagnosis.html

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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="utf-8">
<meta http-equiv="X-UA-Compatible" content="IE=edge">
<meta name="viewport" content="width=device-width, initial-scale=1">
<!-- The above 3 meta tags *must* come first in the head; any other head content must come *after* these tags -->
<title>ABXinRLS</title>
<!-- Bootstrap -->
<link href="css/bootstrap.min.css" rel="stylesheet">
<link href="css/main.css" rel="stylesheet">
<!-- HTML5 shim and Respond.js for IE8 support of HTML5 elements and media queries -->
<!-- WARNING: Respond.js doesn't work if you view the page via file:// -->
<!--[if lt IE 9]>
<script src="https://oss.maxcdn.com/html5shiv/3.7.3/html5shiv.min.js"></script>
<script src="https://oss.maxcdn.com/respond/1.4.2/respond.min.js"></script>
<![endif]-->
</head>
<body>
<div class="container">
<a href="index.html"><h1>ABXinRLS</h1></a>
<button onclick="goBack()">Go Back</button>
<h2 class="text-center">Add Diagnosis</h2>
<form>
<div class="form-group">
<label for="formGroupExampleInput">Diagnosis Name</label>
<input type="text" class="form-control" id="formGroupExampleInput" placeholder="Enter Diagnosis">
</div>
<div class="form-group">
<label for="formGroupExampleInput2">Antibiotic Name</label>
<input type="text" class="form-control" id="formGroupExampleInput2" placeholder="Enter Antibiotic">
</div>
<div class="row">
<div class="col-md-12">
<h5>Classification</h5>
<a class="btn btn-default btn-select">
<input type="hidden" class="btn-select-input" id="" name="" value="" />
<span class="btn-select-value">Gram-positive</span>
<span class='btn-select-arrow glyphicon glyphicon-chevron-down'></span>
<ul>
<li class="selected">Gram-positive</li>
<li>Gram-negative</li>
<li>Anaerobic</li>
</ul>
</a>
</div>
<div class="form-group">
<label for="formGroupExampleInput2">Organism Name</label>
<input type="text" class="form-control" id="formGroupExampleInput2" placeholder="Enter Antibiotic">
<button type="submit" class="btn btn-primary add-button">Add/Save Diagnosis</button>
</form>
</div>
</div>
</div>
<hr>
<!-- jQuery (necessary for Bootstrap's JavaScript plugins) -->
<script src="https://ajax.googleapis.com/ajax/libs/jquery/1.12.4/jquery.min.js"></script>
<!-- Include all compiled plugins (below), or include individual files as needed -->
<script src="js/bootstrap.min.js"></script>
<script src="js/main.js"></script>
</body>
</html>