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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"> | |
<link href="https://fonts.googleapis.com/icon?family=Material+Icons" | |
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> | |
<div class="col-xs-12"> | |
<a> | |
<i onclick="goBack()" class="material-icons btn-info arrow-bck">arrow_back</i> | |
</a> | |
</div> | |
<h2 class="text-center add-heading">Add Diagnosis</h2> | |
<form> | |
<div class="form-group col-xs-10 col-xs-offset-1 col-md-6 col-md-offset-3"> | |
<label for="formGroupExampleInput">Diagnosis Name</label> | |
<input type="text" class="form-control" id="formGroupExampleInput" placeholder="Enter Diagnosis"> | |
</div> | |
<div class="form-group col-xs-10 col-xs-offset-1 col-md-6 col-md-offset-3"> | |
<label for="formGroupExampleInput2">Antibiotic Name</label> | |
<input type="text" class="form-control" id="formGroupExampleInput2" placeholder="Enter Antibiotic"> | |
</div> | |
<div class="row"> | |
<div class="col-xs-10 col-xs-offset-1 col-md-6 col-md-offset-3"> | |
<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> | |
<div class="form-group col-xs-10 col-xs-offset-1 col-md-6 col-md-offset-3"> | |
<label for="formGroupExampleInput2">Organism Name</label> | |
<input type="text" class="form-control" id="formGroupExampleInput2" placeholder="Enter Organism"> | |
</div> | |
<div> | |
<div class="col-xs-10 col-xs-offset-1 col-md-6 col-md-offset-3"> | |
<button type="submit" class="btn btn-primary add-button">Add/Save Diagnosis</button> | |
</div> | |
</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> |