<!-- Form Start -->
<div class="block">
    <div class="title lightTextShadow"><?php echo $this->lang->line('checkupinfo_edit'); ?></div>
    <br />
    <a href="<?= base_url() ?>checkupinfo/admin_checkupinfo/overview" class="button sub inlineBlock rnd3 lightTextShadow">
        <span><?php echo $this->lang->line('button_checkupinfo'); ?></span>
    </a>
    <a href="<?= base_url() ?>checkupinfo/admin_branch_category/overview" class="button sub inlineBlock rnd3 lightTextShadow">
        <span><?php echo $this->lang->line('button_branch_category'); ?></span>
    </a>
    <a href="<?= base_url() ?>checkupinfo/admin_product_type_category/overview" class="button sub inlineBlock rnd3 lightTextShadow">
        <span><?php echo $this->lang->line('button_product_type_category'); ?></span>
    </a>
    <a href="<?= base_url() ?>checkupinfo/admin_city_category/overview" class="button sub inlineBlock rnd3 lightTextShadow">
        <span><?php echo $this->lang->line('button_city_category'); ?></span>
    </a>   
    <div class="content">
        <?php echo form_open_multipart('checkupinfo/admin_checkupinfo/edit/' . $checkupinfo->chi_id, array('id' => 'checkupinfo_edit')) ?>
        <fieldset class="form boxStyle">                                


            <?php echo $this->template->flash_msg(); ?>

            <label for="chi_name" class="label"><?php echo $this->lang->line('chi_name'); ?></label>
            <input id="chi_name" class="textBox med rnd5" name="chi_name" value="<?= set_value('chi_name', $checkupinfo->chi_name) ?>"  />
            <?php echo form_error('chi_name'); ?>
            <br />
            <label for="chi_date" class="label"><?php echo $this->lang->line('chi_date'); ?></label>
            <input id="chi_date" class="textBox med rnd5" name="chi_date" value="<?= set_value('chi_date', $checkupinfo->chi_date) ?>"  />
            <?php echo form_error('chi_date'); ?>
            <br />
            <label for="chi_nationality" class="label"><?php echo $this->lang->line('chi_nationality'); ?></label>
            <input id="chi_nationality" class="textBox med rnd5" name="chi_nationality" value="<?= set_value('chi_nationality', $checkupinfo->chi_nationality) ?>"  />
            <?php echo form_error('chi_nationality'); ?>
            <br />
            <label for="chi_marital_status" class="label"><?php echo $this->lang->line('chi_marital_status'); ?></label>
            <input id="chi_marital_status" class="textBox med rnd5" name="chi_marital_status" value="<?= set_value('chi_marital_status', $checkupinfo->chi_marital_status) ?>"  />
            <?php echo form_error('chi_marital_status'); ?>
            <br />
            <label for="chi_qualific" class="label"><?php echo $this->lang->line('chi_qualific'); ?></label>
            <input id="chi_qualific" class="textBox med rnd5" name="chi_qualific" value="<?= set_value('chi_qualific', $checkupinfo->chi_qualific) ?>"  />
            <?php echo form_error('chi_qualific'); ?>
            <br />

            <label class="label"><?php echo $this->lang->line('chi_branch'); ?></label>
            <select size = "1" name="chi_branch_id" class="select rnd5">
                <?php foreach ($branch_category as $branch_cat): ?>
                    <option value="<?php echo $branch_cat['branch_id'] ?>" <?= set_select('chi_branch_id', $branch_cat['branch_id'], ($branch_cat['branch_id'] == $checkupinfo->chi_branch_id) ? TRUE : FALSE) ?>><?php echo $branch_cat['branch_name'] ?></option>
                <?php endforeach; ?>
            </select>
            <?php echo form_error('chi_branch'); ?>
            <br />
            <label class="label"><?php echo $this->lang->line('chi_city'); ?></label>
            <select size = "1" name="chi_city_id" class="select rnd5">
                <?php foreach ($city_category as $ct_cat): ?>
                    <option value="<?= $ct_cat['ct_id'] ?>" <?php echo set_select("chi_city_id", $ct_cat['ct_id'], ($ct_cat['ct_id'] == $checkupinfo->chi_city_id) ? TRUE : FALSE) ?>><?= $ct_cat['ct_name'] ?></option>
                <?php endforeach; ?>
            </select>
            <?php echo form_error('chi_city'); ?>
            <br />

            <label for="chi_phone_number" class="label"><?php echo $this->lang->line('chi_phone_number'); ?></label>
            <input id="chi_phone_number" class="textBox med rnd5" name="chi_phone_number" value="<?= set_value('chi_phone_number', $checkupinfo->chi_phone_number) ?>"  />
            <?php echo form_error('chi_phone_number'); ?>
            <br />
            <label for="chi_mobile_number" class="label"><?php echo $this->lang->line('chi_mobile_number'); ?></label>
            <input id="chi_mobile_number" class="textBox med rnd5" name="chi_mobile_number" value="<?= set_value('chi_mobile_number', $checkupinfo->chi_mobile_number) ?>"  />
            <?php echo form_error('chi_mobile_number'); ?>
            <br />
            <label for="chi_mobile_number2" class="label"><?php echo $this->lang->line('chi_mobile_number2'); ?></label>
            <input id="chi_mobile_number2" class="textBox med rnd5" name="chi_mobile_number2" value="<?= set_value('chi_mobile_number2', $checkupinfo->chi_mobile_number2) ?>"  />
            <?php echo form_error('chi_mobile_number2'); ?>
            <br />
            <label for="chi_account_mail" class="label"><?php echo $this->lang->line('chi_account_mail'); ?></label>
            <input id="chi_account_mail" class="textBox med rnd5" name="chi_account_mail" value="<?= set_value('chi_account_mail', $checkupinfo->chi_account_mail) ?>"  />
            <?php echo form_error('chi_account_mail'); ?>
            <br />
            <label for="chi_account_twitter" class="label"><?php echo $this->lang->line('chi_account_twitter'); ?></label>
            <input id="chi_account_twitter" class="textBox med rnd5" name="chi_account_twitter" value="<?= set_value('chi_account_twitter', $checkupinfo->chi_account_twitter) ?>"  />
            <?php echo form_error('chi_account_twitter'); ?>
            <br />
            <label for="chi_account_facebook" class="label"><?php echo $this->lang->line('chi_account_facebook'); ?></label>
            <input id="chi_account_facebook" class="textBox med rnd5" name="chi_account_facebook" value="<?= set_value('chi_account_facebook', $checkupinfo->chi_account_facebook) ?>"  />
            <?php echo form_error('chi_account_facebook'); ?>
            <br />
            <label for="chi_account_anstaqram" class="label"><?php echo $this->lang->line('chi_account_anstaqram'); ?></label>
            <input id="chi_account_facebook" class="textBox med rnd5" name="chi_account_anstaqram" value="<?= set_value('chi_account_anstaqram', $checkupinfo->chi_account_anstaqram) ?>"  />
            <?php echo form_error('chi_account_anstaqram'); ?>
            <br />
            <label for="chi_production_experience" class="label"><?php echo $this->lang->line('chi_production_experience'); ?></label>
            <input id="chi_production_experience" class="textBox med rnd5" name="chi_production_experience" value="<?= set_value('chi_production_experience', $checkupinfo->chi_production_experience) ?>"  />
            <?php echo form_error('chi_production_experience'); ?>
            <br />


            <label class="label"><?php echo $this->lang->line('chi_product_type'); ?></label>
            <select size = "1" name="chi_product_type_id" class="select rnd5">
                <?php foreach ($product_type_category as $pt_cat): ?>
                    <option value="<?php echo $pt_cat['pt_id'] ?>" <?= set_select('chi_product_type_id', $pt_cat['pt_id'], ($pt_cat['pt_id'] == $checkupinfo->chi_product_type_id) ? TRUE : FALSE) ?>><?php echo $pt_cat['pt_name'] ?></option>
                <?php endforeach; ?>
            </select>
            <?php echo form_error('chi_product_type'); ?>
            <br />

            <label for="chi_product_desc" class="label"><?php echo $this->lang->line('chi_product_desc'); ?></label>
            <textbranch id="chi_product_desc" rows="6" cols="0" class="textbranch lrg rnd5" name="chi_product_desc" ><?= set_value('chi_product_desc', $checkupinfo->chi_product_desc) ?></textbranch>
            <?php echo form_error('chi_product_desc'); ?>
            <br />

            <br />
            <label for="chi_show_accept" class="label">
                <?php echo $this->lang->line('chi_show_accept'); ?>
            </label>
            <input type="checkbox" name="chi_show_accept" id="chk1" value="1" <?php echo set_checkbox("chi_show_accept", "1", ($checkupinfo->chi_show_accept == 1) ? TRUE : FALSE); ?> />
            <label for="chk1"><?php echo $this->lang->line('yes'); ?></label>
            <?php echo form_error('chi_show_accept'); ?>
            <br />

            <label for="chi_other_participation" class="label"><?php echo $this->lang->line('chi_other_participation'); ?></label>
            <input id="chi_other_participation" class="textBox med rnd5" name="chi_other_participation" value="<?= set_value('chi_other_participation', $checkupinfo->chi_other_participation) ?>"  />
            <?php echo form_error('chi_other_participation'); ?>
            <br />
            <label for="chi_markting_type" class="label">
                <?php echo $this->lang->line('chi_markting_type'); ?>
            </label>
            <input type="checkbox" name="chi_markting_type" id="chk1" value="1" <?php echo set_checkbox("hide", "1", TRUE); ?> />
            <label for="chk1"><?php echo $this->lang->line('direct'); ?></label>
            <input type="checkbox" name="chi_markting_type" id="chk1" value="2" />
            <label for="chk1"><?php echo $this->lang->line('mail'); ?></label>
            <input type="checkbox" name="chi_markting_type" id="chk1" value="3"  />
            <label for="chk1"><?php echo $this->lang->line('shippers'); ?></label>
            <?php echo form_error('chi_markting_type'); ?>
            <br />

            <label for="chi_notice" class="label"><?php echo $this->lang->line('chi_notice'); ?></label>
            <textbranch id="checkupinfo_desc" rows="6" cols="0" class="textbranch lrg rnd5" name="chi_notice" ><?= set_value('chi_notice', $checkupinfo->chi_notice) ?></textbranch>
            <?php echo form_error('chi_notice'); ?>
            <br />
            <br />

            <label class="label">هل تريد تفعيل الاسرة ؟</label>
            <input type="checkbox" name="hide" id="chk1" value="1" <?php echo set_checkbox("hide", "1", ($checkupinfo->chi_hide == 1) ? TRUE : FALSE); ?> />
            <label for="chk1"><?php echo $this->lang->line('active'); ?></label>
            <br />

            <div class="center">
                <input id="submit" type="submit" value="تفريغ الحقول" class="button sub inlineBlock rnd3 lightTextShadow" />
                <input id="submit" type="submit" value="أدخل" class="button sml inlineBlock rnd5 drkTextShadow" />
            </div>
        </fieldset>
        <?php echo form_close(); ?>
    </div>
</div>