<?php
/*----------------------------------------------------------------------------------|  www.vdm.io  |----/
				fdsh 
/-------------------------------------------------------------------------------------------------------/

	@version		1.0.39
	@build			4th April, 2023
	@created		17th December, 2020
	@package		Reservation
	@subpackage		default.php
	@author			farhad shahbazi <http://farhad.com>	
	@copyright		Copyright (C) 2015. All Rights Reserved
	@license		GNU/GPL Version 2 or later - http://www.gnu.org/licenses/gpl-2.0.html
  ____  _____  _____  __  __  __      __       ___  _____  __  __  ____  _____  _  _  ____  _  _  ____ 
 (_  _)(  _  )(  _  )(  \/  )(  )    /__\     / __)(  _  )(  \/  )(  _ \(  _  )( \( )( ___)( \( )(_  _)
.-_)(   )(_)(  )(_)(  )    (  )(__  /(__)\   ( (__  )(_)(  )    (  )___/ )(_)(  )  (  )__)  )  (   )(  
\____) (_____)(_____)(_/\/\_)(____)(__)(__)   \___)(_____)(_/\/\_)(__)  (_____)(_)\_)(____)(_)\_) (__) 

/------------------------------------------------------------------------------------------------------*/

// No direct access to this file
defined('_JEXEC') or die('Restricted access');


?>
<?php echo $this->toolbar->render(); ?>
<!--[JCBGUI.site_view.default.34.$$$$]-->
<section id="doctorsignup">
    <div class="row justify-content-center">
        <div class="col-md-8">
            <form method="post" action="" id="adminForm">

                <div class="form-group">
                    <label>نام و نام خانوادگی</label>
                    <input type="text" name="jform[name]" class="form-control">
                </div>
                <div class="form-group">
                    <?php //echo $this->form->getLabel('msn'); ?>    
                    <?= $this->form->getInput('msn'); ?>
                </div>
                <div class="form-group">
                    <?= $this->form->getLabel('catid') ?>
                    <select id="jform_catid_level1" class="form-control">
                        <option>Default select</option>
                    </select>
                </div>
                <div class="form-group">
                    <select id="jform_catid" name="jform[catid]" class="form-control">

                    </select>
                </div>
                <div class="form-group">
                    <?= $this->form->getLabel('capitalid') ?>
                    <select id="jform_capitalid" name="jform[capitalid]" class="form-control">
                        <option>Default select</option>
                    </select>
                </div>
                <div class="form-group">
                    <select id="jform_cityid" name="jform[cityid]" class="form-control">
                    </select>
                </div>
                <div class="form-group">
                    <?= $this->form->getLabel('phonenumber'); ?>
                    <?= $this->form->getInput('phonenumber'); ?>
                </div>
                <div class="form-group">
                    <?= $this->form->getLabel('officephone'); ?>
                    <?= $this->form->getInput('officephone'); ?>
                </div>
                <div class="form-group">
                    <?= $this->form->getLabel('address'); ?>
                    <?= $this->form->getInput('address'); ?>
                </div>
                <div class="form-group">
                    <label for="">رمز عبور</label>
                    <input type="password" name="jform[password]" class="form-control" required>
                </div>
                <div class="form-group">
                    <label for="">کد امنیتی</label>
                    <input type="text" name="captcha" class="form-control">
                </div>
                <button type="submit" class="btn btn-primary">ثبت نام</button>

                <input type="hidden" name="jform[userid]" value="0" class="form-control">
                <input type="hidden" name="<?= JSession::getFormToken(); ?>" id="token">
                <input type="hidden" name="task" value="doctorsignup.signup">
            </form>
        </div>
    </div>
</section><!--[/JCBGUI$$$$]-->


<?php if (isset($this->items) && isset($this->pagination) && isset($this->pagination->pagesTotal) && $this->pagination->pagesTotal > 1): ?>
	<div class="pagination">
		<?php if ($this->params->def('show_pagination_results', 1)) : ?>
			<p class="counter pull-right"> <?php echo $this->pagination->getPagesCounter(); ?> <?php echo $this->pagination->getLimitBox(); ?></p>
		<?php endif; ?>
		<?php echo $this->pagination->getPagesLinks(); ?>
	</div>
<?php endif; ?>
