| 1 |
{if ($done)} |
| 2 |
<p class="ptext">Va¹i podaci su primljeni na obradu. Kliknite <a href="?section=knjiznica" class="underlined">ovdje</a> za nastavak. </p> |
| 3 |
{else} |
| 4 |
<p class="ptext">Molimo Vas, upi¹ite ili ispravite podatke o Va¹oj zdravstvenoj ustanovi. Podaci æe biti proslijeðeni na na¹ e-mail. Nakon provjere autentiènosti dobivenih podataka, podaci æe biti objavljeni u Adresaru ustanova. </p> |
| 5 |
<form method=post action="?section={$section}&section_menu={$section_menu}&section_menu2={$section_menu2}"> |
| 6 |
<center><table border=0 cellspacing=0 cellpadding=4 bgcolor="#DAF0E5" width="100%"> |
| 7 |
<tr><td align=left valign=middle colspan=2 height=10> </td></tr> |
| 8 |
<tr><td align=center colspan=2><table border=0 cellspacing=0 cellpadding=10 width="100%"> |
| 9 |
<tr><td align=left valign=middle width="25%"><b>Naziv ustanove:</b></td><td align=left valign=middle><input type="text" size="20" name="ustanova" value="{$ustanova}" style="width:100%;"></td></tr> |
| 10 |
<tr><td align=left valign=middle width="25%"><b>Ulica i kuæni broj:</b></td><td align=left valign=middle><input type="text" size="20" name="adresa" value="{$adresa}" style="width:100%;"></td></tr> |
| 11 |
<tr><td align=left valign=middle width="25%"><b>Po¹tanski broj:</b></td><td align=left valign=middle><input type="text" size="20" name="posta" value="{$posta}" style="width:100%;"></td></tr> |
| 12 |
<tr><td align=left valign=middle width="25%"><b>Mjesto:</b></td><td align=left valign=middle><input type="text" size="20" name="mjesto" value="{$mjesto}" style="width:100%;"></td></tr> |
| 13 |
<tr><td align=left valign=middle width="25%"><b>Broj telefona ustanove:</b></td><td align=left valign=middle><input type="text" size="20" name="telefon" value="{$telefon}" style="width:100%;"></td></tr> |
| 14 |
<tr><td align=left valign=middle width="25%"><b>WWW adresa:</b></td><td align=left valign=middle><input type="text" size="20" name="www" value="{$www}" style="width:100%;"></td></tr> |
| 15 |
<tr><td align=left valign=middle width="25%"><b>E-mail:</b></td><td align=left valign=middle><input type="text" size="20" name="email" value="{$email}" style="width:100%;"></td></tr> |
| 16 |
<tr><td align=left valign=top width="25%"><b>Napomene:</b></td><td align=left valign=middle><textarea cols="20" rows=4 wrap=virtual name="napomene" style="width:100%;">{$napomene}</textarea></td></tr> |
| 17 |
<tr><td align=left colspan=2> </td></tr> |
| 18 |
<tr><td align=left valign=middle width="25%"><b>Kontakt osoba:</b></td><td align=left valign=middle><input type="text" size="20" name="kontakt" value="{$kontakt}" style="width:100%;"></td></tr> |
| 19 |
<tr><td align=left valign=middle width="25%"><b>Telefon:</b></td><td align=left valign=middle><input type="text" size="20" name="ktel" value="{$ktel}" style="width:100%;"></td></tr> |
| 20 |
<tr><td align=left valign=middle width="25%"><b>E-mail:</b></td><td align=left valign=middle><input type="text" size="20" name="kemail" value="{$kemail}" style="width:100%;"></td></tr> |
| 21 |
</td></tr></table> |
| 22 |
<tr><td align=left valign=top class="small3"> {if ($error)} Gre¹ka kod slanja podataka. Molimo, poku¹ajte ponovo kasnije.{/if}</td><td align=right valign=bottom><input type=submit name="posalji" value="Po¹alji" class="bsmall"> </td></tr> |
| 23 |
<tr><td align=left valign=middle colspan=2 height=10> </td></tr> |
| 24 |
</table></center><br> |
| 25 |
</form> |
| 26 |
{/if} |
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