{% extends 'base_widget.html.twig' %} {% block title %}Reference{% endblock %} {% block body %} {% set referer = app.request.get('ref')|default('/') %}
{% form_theme referenceForm 'bootstrap_4_layout.html.twig' %} {{ form_start(referenceForm) }} {{ form_row(referenceForm._token) }}
{{ form_label(referenceForm.autorName, 'ФИО налогоплательщика:', {'label_attr': {'class': 'mb-0'}}) }} {{ form_widget(referenceForm.autorName, {'attr': {'class': 'form-control'}}) }}
{{ form_label(referenceForm.phone, 'Телефон:', {'label_attr': {'class': 'mb-0'}}) }} {{ form_widget(referenceForm.phone, {'attr': { 'class': 'form-control', 'data-controller': 'inputMask' }}) }}
{{ form_label(referenceForm.birthDate, 'Дата рождения налогоплательщика:', {'label_attr': {'class': 'mb-0'}}) }} {{ form_widget(referenceForm.birthDate, {'attr': { 'class': 'form-control', 'data-controller': 'datePicker', 'range': 'false' }}) }}
{{ form_label(referenceForm.inn, 'ИНН налогоплательщика:', {'label_attr': {'class': 'mb-0'}}) }} {{ form_widget(referenceForm.inn, {'attr': {'class': 'form-control'}}) }}
{{ form_label(referenceForm.responsible, 'Получаю документы за:', {'label_attr': {'class': 'mb-0'}}) }} {{ form_widget(referenceForm.responsible, {'attr': { 'class': 'reference-responsible form-control', 'data-count' : '0', }}) }}
{{ form_label(referenceForm.filial, 'Клиника, где оказывались услуги:', {'label_attr': {'class': 'mb-0'}}) }} {{ form_widget(referenceForm.filial, {'attr': { 'class': 'reference-filial form-control', }}) }}
{{ form_label(referenceForm.periodFirst, 'Начало периода:', {'label_attr': {'class': 'mb-0'}}) }} {{ form_widget(referenceForm.periodFirst, {'attr': { 'class': 'reference-period-first', 'type' : 'date', 'value' : "now"|date_modify("-1 year")|date("Y-01-01") }}) }}
{{ form_label(referenceForm.periodLast, 'Конец периода:', {'label_attr': {'class': 'mb-0'}}) }} {{ form_widget(referenceForm.periodLast, {'attr': { 'class': 'reference-period-last', 'type' : 'date', 'value' : "now"|date_modify("-1 year")|date("Y-12-31") }}) }}
{{ form_label(referenceForm.sending, 'Пакет документов прошу выдать:', {'label_attr': {'class': 'mb-0'}}) }} {{ form_widget(referenceForm.sending, {'attr': { 'class': 'reference-sending', }}) }}
{{ form_label(referenceForm.filialSending, 'Клиника, где получить справку:', {'label_attr': {'class': 'mb-0'}}) }} {{ form_widget(referenceForm.filialSending, {'attr': {'class': 'form-control'}}) }}
{{ form_end(referenceForm) }}
{% endblock %}