mirror of
https://github.com/OpenXE-org/OpenXE.git
synced 2024-11-15 12:37:14 +01:00
73 lines
4.1 KiB
Smarty
73 lines
4.1 KiB
Smarty
<br><br><table width="60%" style="background-color: #fff; border: solid 1px #000;" align="center">
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<tr>
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<td align="center">
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<br>
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<form action="" method="post">
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<h1>Paketmarken Drucker für Go!<font color=red>[ZUSATZ]</font></h1>
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<br>
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<br>
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<b>Empfänger</b>
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<br>
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<br>
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<table>
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<tr><td>
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<table>
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<tr><td>Name:</td><td><input type="text" size="36" value="[NAME]" name="name" id="name"><script type="text/javascript">document.getElementById("name").focus(); </script></td></tr>
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<tr><td>Name 2:</td><td><input type="text" size="36" value="[NAME2]" name="name2"></td></tr>
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<tr><td>Name 3:</td><td><input type="text" size="36" value="[NAME3]" name="name3"></td></tr>
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<tr><td>Land:</td><td>[EPROO_SELECT_LAND]</td></tr>
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<tr><td>PLZ/ort:</td><td><input type="text" name="plz" size="5" value="[PLZ]"> <input type="text" size="30" name="ort" value="[ORT]"></td></tr>
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<tr><td>Strasse/Hausnummer:</td><td><input type="text" size="30" value="[STRASSE]" name="strasse"> <input type="text" size="5" name="hausnummer" value="[HAUSNUMMER]"></td></tr>
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<tr><td>Landesvorwahl:</td><td><input type="text" size="6" value="[LANDESVORWAHL]" name="landesvorwahl"> Ortsvorwahl: <input type="text" size="6" value="[ORTSVORWAHL]" name="ortsvorwahl"> Telefon: <input type="text" size="15" value="[TELEFON]" name="telefon"></td></tr>
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</table>
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</td><td>
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<table>
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<tr><td>Anzahl Pakete:</td><td><input type="text" name="anzahl" size="5" value="1"></td></tr>
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<tr><td>Gewicht:</td><td><input type="text" name="kg" size="5" value="2"> <i>kg</i></td></tr>
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<!--<tr><td>Foto:</td><td><img src="http://t3.gstatic.com/images?q=tbn:QTV_X4YJEI2p7M:http://notebook.pege.org/2005-inode/paket.jpg"></td></tr>
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<tr><td></td><td><input type="button" value="Nochmal Wiegen+Foto"></td></tr>-->
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</table>
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</tr>
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</table>
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<br><br>
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<table align="center">
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<tr><td colspan="2"><b>Service</b></td></tr>
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<tr><td>Nachnahme:</td><td><input type="checkbox" name="nachnahme" value="1" [NACHNAHME]> (Betrag: [BETRAG] EUR)<input type="hidden" name="betrag" value="[BETRAG]"></td></tr>
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<tr><td>frei:</td><td><input type="checkbox" name="frei" value="1" [FREI] /></td></tr>
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<tr><td>Selbstanlieferung:</td><td><input type="checkbox" name="selbstanlieferung" [SELBSTANLIEFERUNG] value="1" /></td></tr>
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<tr><td>Wunsch-Zustelldatum:</td><td><input type="text" size="10" id="zustelldatum" name="zustelldatum" value="[ZUSTELLDATUM]" /></td></tr>
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<tr><td>Abholdatum:</td><td><input type="text" size="10" id="abholdatum" name="abholdatum" value="[ABHOLDATUM]" /></td></tr>
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<tr><td>Selbstabholung:</td><td><input type="checkbox" name="selbstabholung" [SELBSTABHOLUNG] value="1" /></td></tr>
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<!-- <tr><td>Versichert 2500 EUR:</td><td><input type="checkbox" name="versichert" value="1" [VERSICHERT] /></td></tr>
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<tr><td>Versichert 25000 EUR:</td><td><input type="checkbox" name="extraversichert" value="1" [EXTRAVERSICHERT] /></td></tr>
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-->
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<tr><td>Inhalt:</td><td><input type="text" name="inhalt" size="30" value="[INHALT]" /></td></tr>
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<tr><td>Zustellhinweise: </td><td><input type="text" name="Zustellhinweise" size="30" value="[ZUSTELLHINWEISE]" /></td></tr>
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</table>
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<br><br>
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<center><input style="background-color: #FF8080" type="submit" value="Paketmarke drucken" name="drucken">
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<input type="button" value="{|Andere Versandart auswählen|}" onclick="window.location.href='index.php?module=versanderzeugen&action=wechsel&id=[ID]'" name="anders">
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<!--<input type="button" value="Abbrechen">--></center>
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</form>
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</td></tr></table>
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<br><br>
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<script type="text/JavaScript" language="javascript">
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$(document).ready(function() {
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$( "#abholdatum" ).datepicker({ dateFormat: 'dd.mm.yy',dayNamesMin: ['SO', 'MO', 'DI', 'MI', 'DO', 'FR', 'SA'], firstDay:1,
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showWeek: true, monthNames: ['Januar', 'Februar', 'März', 'April', 'Mai',
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'Juni', 'Juli', 'August', 'September', 'Oktober', 'November', 'Dezember'], });
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$( "#zustelldatum" ).datepicker({ dateFormat: 'dd.mm.yy',dayNamesMin: ['SO', 'MO', 'DI', 'MI', 'DO', 'FR', 'SA'], firstDay:1,
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showWeek: true, monthNames: ['Januar', 'Februar', 'März', 'April', 'Mai',
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'Juni', 'Juli', 'August', 'September', 'Oktober', 'November', 'Dezember'], });
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});
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</script>
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