106 lines
4.8 KiB
HTML
106 lines
4.8 KiB
HTML
{% extends "layouts/base.html" %}
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{% load i18n %}
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{% block title %}{% if source %}{% trans "Edit Source" %}{% else %}{% trans "Create Source" %}{% endif %}{% endblock %}
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{% block content %}
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<div class="container-fluid">
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<!-- Page Header -->
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<div class="d-flex justify-content-between align-items-center mb-4">
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<div>
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<nav aria-label="breadcrumb">
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<ol class="breadcrumb mb-2">
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<li class="breadcrumb-item">
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<a href="{% url 'px_sources:source_list' %}">{% trans "PX Sources" %}</a>
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</li>
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<li class="breadcrumb-item active" aria-current="page">
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{% if source %}{% trans "Edit Source" %}{% else %}{% trans "Create Source" %}{% endif %}
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</li>
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</ol>
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</nav>
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<h2 class="mb-1">
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<i class="bi bi-{% if source %}pencil-square{% else %}plus-circle{% endif %} text-warning me-2"></i>
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{% if source %}{% trans "Edit Source" %}{% else %}{% trans "Create Source" %}{% endif %}
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</h2>
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{% if source %}
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<p class="text-muted mb-0">{{ source.name_en }}</p>
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{% endif %}
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</div>
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<div>
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<a href="{% url 'px_sources:source_list' %}" class="btn btn-outline-secondary">
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<i class="bi bi-arrow-left me-1"></i> {% trans "Back to List" %}
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</a>
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</div>
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</div>
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<!-- Form Card -->
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<div class="card">
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<div class="card-header">
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<h5 class="card-title mb-0">
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<i class="bi bi-form me-2"></i>{% trans "Source Information" %}
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</h5>
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</div>
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<div class="card-body">
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<form method="post" enctype="multipart/form-data">
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{% csrf_token %}
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<div class="row">
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<div class="col-md-6">
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<div class="mb-3">
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<label for="name_en" class="form-label">
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{% trans "Name (English)" %} <span class="text-danger">*</span>
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</label>
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<input type="text" class="form-control" id="name_en" name="name_en"
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value="{{ source.name_en|default:'' }}" required
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placeholder="{% trans 'e.g., Patient Portal' %}">
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</div>
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</div>
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<div class="col-md-6">
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<div class="mb-3">
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<label for="name_ar" class="form-label">
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{% trans "Name (Arabic)" %}
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</label>
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<input type="text" class="form-control" id="name_ar" name="name_ar"
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value="{{ source.name_ar|default:'' }}" dir="rtl"
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placeholder="{% trans 'e.g., بوابة المرضى' %}">
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</div>
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</div>
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</div>
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<div class="mb-3">
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<label for="description" class="form-label">
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{% trans "Description" %}
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</label>
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<textarea class="form-control" id="description" name="description"
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rows="4" placeholder="{% trans 'Describe this source channel...' %}">{{ source.description|default:'' }}</textarea>
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<small class="form-text text-muted">
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{% trans "Optional: Additional details about this source" %}
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</small>
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</div>
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<div class="mb-4">
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<div class="form-check form-switch">
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<input class="form-check-input" type="checkbox" id="is_active" name="is_active"
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{% if source.is_active|default:True %}checked{% endif %}>
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<label class="form-check-label" for="is_active">
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{% trans "Active" %}
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</label>
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</div>
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<small class="form-text text-muted">
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{% trans "Uncheck to deactivate this source (it won't appear in dropdowns)" %}
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</small>
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</div>
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<div class="d-flex gap-2">
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<button type="submit" class="btn btn-primary">
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<i class="fas fa-save"></i> {% trans "Save" %}
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</button>
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<a href="{% url 'px_sources:source_list' %}" class="btn btn-secondary">
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{% trans "Cancel" %}
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</a>
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</div>
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</form>
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</div>
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</div>
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</div>
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{% endblock %} |