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create-invoice.html
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<!DOCTYPE html>
<html lang="pt-BR">
<head>
<meta charset="utf-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0, user-scalable=0">
<link rel="shortcut icon" type="image/x-icon" href="assets/img/favicon.ico">
<title>Preclinic - Medical & Hospital - Bootstrap 4 Admin Template</title>
<link rel="stylesheet" type="text/css" href="assets/css/bootstrap-admin.min.css">
<link rel="stylesheet" type="text/css" href="assets/css/font-awesome.min.css">
<link rel="stylesheet" type="text/css" href="assets/css/select2.min.css">
<link rel="stylesheet" type="text/css" href="assets/css/bootstrap-datetimepicker.min.css">
<link rel="stylesheet" type="text/css" href="assets/css/style.css">
<!--[if lt IE 9]>
<script src="assets/js/html5shiv.min.js"></script>
<script src="assets/js/respond.min.js"></script>
<![endif]-->
</head>
<body>
<div class="main-wrapper">
<div class="header">
<div class="header-left">
<a href="admin.html" class="logo">
<img src="assets/img/logo-white.png" width="38" height="35" alt="">
<span><img src="assets/img/logo-name.png" width="125" height="35"></span>
</a>
</div>
<a id="toggle_btn" href="javascript:void(0);"><i class="fa fa-bars"></i></a>
<a id="mobile_btn" class="mobile_btn float-left" href="#sidebar"><i class="fa fa-bars"></i></a>
<ul class="nav user-menu float-right">
<li class="nav-item dropdown has-arrow">
<a href="#" class="dropdown-toggle nav-link user-link" data-toggle="dropdown">
<span class="user-img">
<img class="rounded-circle" src="assets/img/user.jpg" width="24" alt="Admin">
<span class="status online"></span>
</span>
<span>Usuario</span>
</a>
<div class="dropdown-menu">
<a class="dropdown-item" href="profile.html">Meu Perfil</a>
<a class="dropdown-item" href="edit-profile.html">Editar Perfil</a>
<a class="dropdown-item" href="settings.html">Configurações</a>
<a class="dropdown-item" href="index.html">Sair</a>
</div>
</li>
</ul>
<div class="dropdown mobile-user-menu float-right">
<a href="#" class="dropdown-toggle" data-toggle="dropdown" aria-expanded="false"><i class="fa fa-ellipsis-v"></i></a>
<div class="dropdown-menu dropdown-menu-right">
<a class="dropdown-item" href="profile.html">Meu Perfil</a>
<a class="dropdown-item" href="edit-profile.html">Editar Perfil</a>
<a class="dropdown-item" href="settings.html">Configurações</a>
<a class="dropdown-item" href="index.html">Página Paciente</a>
<a class="dropdown-item" href="index.html">Sair</a>
</div>
</div>
</div>
<div class="sidebar" id="sidebar">
<div class="sidebar-inner slimscroll">
<div id="sidebar-menu" class="sidebar-menu">
<ul>
<li class="menu-title">Menu</li>
<li class="active">
<a href="admin.html"><i class="fa fa-dashboard"></i> <span>Tela Inicial</span></a>
</li>
<li>
<a href="dentists.html"><i class="fa fa-user-md"></i> <span>Dentistas</span></a>
</li>
<li>
<a href="patients.html"><i class="fa fa-wheelchair"></i> <span>Pacientes</span></a>
</li>
<li>
<a href="agenda.html"><i class="fa fa-calendar"></i> <span>Agenda</span></a>
</li>
<li>
<a href="prox-consult.html"><i class="fa fa-calendar"></i> <span>Próximas Consultas</span> <span class="badge badge-pill bg-primary float-right">5</span></a>
</li>
<li>
<a href="horarios.html"><i class="fa fa-calendar-check-o"></i> <span>Horários Atendimento</span></a>
</li>
<li class="submenu">
<a href="#"><i class="fa fa-money"></i> <span> Gerenciar Caixa </span> <span class="menu-arrow"></span></a>
<ul style="display: none;">
<li><a href="ganho.html">Incluir Ganho</a></li>
<li><a href="gasto.html">Incluir Gasto</a></li>
<li><a href="caixa.html">Caixa detalhado</a></li>
<li><a href="lucros.html">Visualização Lucros</a></li>
</ul>
</li>
<li>
<a href="procedimentos.html"><i class="fa fa-edit"></i> <span>Procedimentos</span></a>
</li>
<li class="submenu">
<a href="#"><i class="fa fa-book"></i> <span> Emissões </span> <span class="menu-arrow"></span></a>
<ul style="display: none;">
<li><a href="emit-atestado.html">Atestados</a></li>
<li><a href="emit-prontuario.html">Prontuários</a></li>
<li><a href="emit-receita.html">Receitas</a></li>
</ul>
</li>
<li class="submenu">
<a href="#"><i class="fa fa-flag-o"></i> <span> Visualizações </span> <span class="menu-arrow"></span></a>
<ul style="display: none;">
<li><a href="fornecedores.html"> Fornecedores </a></li>
<li><a href="estoque.html"> Estoque </a></li>
</ul>
</li>
<li class="menu-title">Outros</li>
<li class="submenu">
<a href="javascript:void(0);"><i class="fa fa-share-alt"></i> <span>Cadastros</span> <span class="menu-arrow"></span></a>
<ul style="display: none;">
<li>
<a href="add-patient.html"><span>Pacientes</span></a>
</li>
<li>
<a href="add-fornecedor.html"><span>Fornecedores</span></a>
</li>
<li>
<a href="add-material.html"><span>Material & Medicamento</span></a>
</li>
</ul>
</li>
<li>
<a href="casos.html"><i class="fa fa-cube"></i> <span>Casos Ortodônticos</span></a>
</li>
<li>
<a href="settings.html"><i class="fa fa-cog"></i> <span>Configurações</span></a>
</li>
</ul>
</div>
</div>
</div>
<div class="page-wrapper">
<div class="content">
<div class="row">
<div class="col-sm-12">
<h4 class="page-title">Criar Entrada - Incluir entrada de dinheiro</h4>
</div>
</div>
<div class="row">
<div class="col-sm-12">
<form>
<div class="row">
<div class="col-sm-6 col-md-3">
<div class="form-group">
<label>Paciente <span class="text-danger">*</span></label>
<select class="select">
<option>Please Select</option>
<option>Charles Ortega</option>
<option>Denise Stevens</option>
<option>Jennifer Robinson</option>
</select>
</div>
</div>
<div class="col-sm-6 col-md-3">
<div class="form-group">
<label>Especialidade <span class="text-danger">*</span></label>
<select class="select">
<option>Select Department</option>
<option>Dentista</option>
<option>Endodontia</option>
</select>
</div>
</div>
<div class="col-sm-6 col-md-3">
<div class="form-group">
<label>Email</label>
<input class="form-control" type="email">
</div>
</div>
<div class="col-sm-6 col-md-3">
<div class="form-group">
<label>Taxa</label>
<select class="select">
<option>Select Tax</option>
<option>ICMS</option>
</select>
</div>
</div>
<div class="col-sm-6 col-md-3">
<div class="form-group">
<label>Endereço Paciente</label>
<textarea class="form-control" rows="3"></textarea>
</div>
</div>
<div class="col-sm-6 col-md-3">
<div class="form-group">
<label>Endereço Faturamento</label>
<textarea class="form-control" rows="3"></textarea>
</div>
</div>
<div class="col-sm-6 col-md-3">
<div class="form-group">
<label>Data Entrada <span class="text-danger">*</span></label>
<div class="cal-icon">
<input class="form-control datetimepicker" type="text">
</div>
</div>
</div>
<div class="col-sm-6 col-md-3">
<div class="form-group">
<label>Data Confirmação <span class="text-danger">*</span></label>
<div class="cal-icon">
<input class="form-control datetimepicker" type="text">
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-md-12 col-sm-12">
<div class="table-responsive">
<table class="table table-hover table-white">
<thead>
<tr>
<th style="width: 20px">#</th>
<th class="col-sm-2">Item</th>
<th class="col-md-6">Description</th>
<th style="width:100px;">Unit Cost</th>
<th style="width:80px;">Qty</th>
<th>Amount</th>
<th> </th>
</tr>
</thead>
<tbody>
<tr>
<td>1</td>
<td>
<input class="form-control" type="text" style="min-width:150px">
</td>
<td>
<input class="form-control" type="text" style="min-width:150px">
</td>
<td>
<input class="form-control" style="width:100px" type="text">
</td>
<td>
<input class="form-control" style="width:80px" type="text">
</td>
<td>
<input class="form-control form-amt" readonly="" style="width:120px" type="text">
</td>
<td><a href="javascript:void(0)" class="text-success font-18" title="Add"><i class="fa fa-plus"></i></a></td>
</tr>
<tr>
<td>2</td>
<td>
<input class="form-control" type="text" style="min-width:150px">
</td>
<td>
<input class="form-control" type="text" style="min-width:150px">
</td>
<td>
<input class="form-control" style="width:100px" type="text">
</td>
<td>
<input class="form-control" style="width:80px" type="text">
</td>
<td>
<input class="form-control form-amt" readonly="" style="width:120px" type="text">
</td>
<td><a href="javascript:void(0)" class="text-danger font-18" title="Remove"><i class="fa fa-trash-o"></i></a></td>
</tr>
</tbody>
</table>
</div>
<div class="table-responsive">
<table class="table table-hover table-white">
<tbody>
<tr>
<td></td>
<td></td>
<td></td>
<td></td>
<td class="text-right">Total</td>
<td style="text-align: right; padding-right: 30px;width: 230px">0</td>
</tr>
<tr>
<td colspan="5" class="text-right">Tax</td>
<td style="text-align: right; padding-right: 30px;width: 230px">
<input class="form-control text-right form-amt" value="0" readonly="" type="text">
</td>
</tr>
<tr>
<td colspan="5" class="text-right">
Discount %
</td>
<td style="text-align: right; padding-right: 30px;width: 230px">
<input class="form-control text-right" type="text">
</td>
</tr>
<tr>
<td colspan="5" style="text-align: right; font-weight: bold">
Grand Total
</td>
<td style="text-align: right; padding-right: 30px; font-weight: bold; font-size: 16px;width: 230px">
$ 0.00
</td>
</tr>
</tbody>
</table>
</div>
<div class="row">
<div class="col-md-12">
<div class="form-group">
<label>Other Information</label>
<textarea class="form-control"></textarea>
</div>
</div>
</div>
</div>
</div>
<div class="text-center m-t-20">
<button class="btn btn-grey submit-btn m-r-10">Salvar & Enviar</button>
<button class="btn btn-primary submit-btn">Salvar</button>
</div>
</form>
</div>
</div>
</div>
</div>
</div>
<div class="sidebar-overlay" data-reff=""></div>
<script src="assets/js/jquery-3.2.1.min.js"></script>
<script src="assets/js/popper.min.js"></script>
<script src="assets/js/bootstrap-admin.min.js"></script>
<script src="assets/js/jquery.slimscroll.js"></script>
<script src="assets/js/moment.min.js"></script>
<script src="assets/js/select2.min.js"></script>
<script src="assets/js/bootstrap-datetimepicker.min.js"></script>
<script src="assets/js/app.js"></script>
</body>
<!-- create-invoice24:07-->
</html>