sunrise-cms/public/html/contract-editInterment.html

<div class="modal" role="dialog">
  <div class="modal-background"></div>
  <div class="modal-card">
    <header class="modal-card-head">
      <h3 class="modal-card-title">Update Interment</h3>
      <button
        class="delete is-close-modal-button"
        aria-label="close"
        type="button"
      ></button>
    </header>
    <section class="modal-card-body">
      <form id="form--contractIntermentEdit">
        <input
          id="contractIntermentEdit--contractId"
          name="contractId"
          type="hidden"
          value=""
        />
        <input
          id="contractIntermentEdit--intermentNumber"
          name="intermentNumber"
          type="hidden"
          value=""
        />

        <div class="columns">
          <div class="column">
            <div class="field">
              <label class="label" for="contractIntermentEdit--deceasedName"
                >Name</label
              >
              <div class="control has-icons-right">
                <input
                  class="input"
                  id="contractIntermentEdit--deceasedName"
                  name="deceasedName"
                  type="text"
                  maxlength="200"
                  autocomplete="off"
                  required
                />
                <span class="icon is-right">
                  <i class="fas fa-asterisk" aria-hidden="true"></i>
                </span>
              </div>
            </div>
          </div>
        </div>
        <div class="field">
          <label class="label" for="contractIntermentEdit--deceasedAddress1"
            >Address</label
          >
          <div class="control">
            <input
              class="input"
              id="contractIntermentEdit--deceasedAddress1"
              name="deceasedAddress1"
              type="text"
              maxlength="50"
              placeholder="Line 1"
              autocomplete="off"
            />
          </div>
        </div>
        <div class="field">
          <div class="control">
            <input
              class="input"
              id="contractIntermentEdit--deceasedAddress2"
              name="deceasedAddress2"
              type="text"
              maxlength="50"
              placeholder="Line 2"
              aria-label="Address Line 2"
              autocomplete="off"
            />
          </div>
        </div>
        <div class="columns">
          <div class="column">
            <div class="field">
              <label class="label" for="contractIntermentEdit--deceasedCity"
                >City</label
              >
              <div class="control">
                <input
                  class="input"
                  id="contractIntermentEdit--deceasedCity"
                  name="deceasedCity"
                  type="text"
                  maxlength="20"
                  list="datalist--cityDefault"
                />
              </div>
            </div>
          </div>
          <div class="column">
            <div class="field">
              <label class="label" for="contractIntermentEdit--deceasedProvince"
                >Province</label
              >
              <div class="control">
                <input
                  class="input"
                  id="contractIntermentEdit--deceasedProvince"
                  name="deceasedProvince"
                  type="text"
                  maxlength="2"
                />
              </div>
            </div>
          </div>
          <div class="column">
            <div class="field">
              <label
                class="label"
                for="contractIntermentEdit--deceasedPostalCode"
                >Postal Code</label
              >
              <div class="control">
                <input
                  class="input"
                  id="contractIntermentEdit--deceasedPostalCode"
                  name="deceasedPostalCode"
                  type="text"
                  maxlength="7"
                  autocomplete="off"
                />
              </div>
            </div>
          </div>
        </div>
        <div class="columns">
          <div class="column">
            <div class="field">
              <label class="label" for="contractIntermentEdit--birthDateString">
                Date of Birth
              </label>
              <div class="control has-icons-left">
                <input
                  class="input"
                  id="contractIntermentEdit--birthDateString"
                  name="birthDateString"
                  type="date"
                />
                <span class="icon is-left">
                  <i class="fas fa-calendar" aria-hidden="true"></i>
                </span>
              </div>
            </div>
          </div>
          <div class="column">
            <div class="field">
              <label class="label" for="contractIntermentEdit--birthPlace">
                Place of Birth
              </label>
              <div class="control">
                <input
                  class="input"
                  id="contractIntermentEdit--birthPlace"
                  name="birthPlace"
                  type="text"
                  maxlength="100"
                  autocomplete="off"
                  list="datalist--cityDefault"
                />
              </div>
            </div>
          </div>
        </div>
        <div class="columns">
          <div class="column">
            <div class="field">
              <label class="label" for="contractIntermentEdit--deathDateString">
                Date of Death
              </label>
              <div class="control has-icons-left">
                <input
                  class="input"
                  id="contractIntermentEdit--deathDateString"
                  name="deathDateString"
                  type="date"
                />
                <span class="icon is-left">
                  <i class="fas fa-calendar" aria-hidden="true"></i>
                </span>
              </div>
            </div>
          </div>
          <div class="column">
            <div class="field">
              <label class="label" for="contractIntermentEdit--deathPlace">
                Place of Death
              </label>
              <div class="control">
                <input
                  class="input"
                  id="contractIntermentEdit--deathPlace"
                  name="deathPlace"
                  type="text"
                  maxlength="100"
                  autocomplete="off"
                  list="datalist--cityDefault"
                />
              </div>
            </div>
          </div>
        </div>
        <label class="label" for="contractIntermentEdit--deathAge"
          >Death Age</label
        >
        <div class="field has-addons">
          <div class="control">
            <button
              class="button"
              type="button"
              id="button--calculateDeathAge"
              aria-label="Calculate Age"
              disabled
            >
              <span class="icon is-small"
                ><i class="fas fa-calculator" aria-hidden="true"></i
              ></span>
            </button>
          </div>
          <div class="control is-expanded">
            <input
              class="input has-text-right"
              id="contractIntermentEdit--deathAge"
              name="deathAge"
              type="number"
              min="0"
              max="150"
            />
          </div>
          <div class="control is-expanded">
            <div class="select is-fullwidth">
              <select
                id="contractIntermentEdit--deathAgePeriod"
                name="deathAgePeriod"
                aria-label="Death Age Period"
              ></select>
            </div>
          </div>
        </div>
        <div class="field">
          <label
            class="label"
            for="contractIntermentEdit--intermentContainerTypeId"
            >Container</label
          >
          <div class="control">
            <div class="select is-fullwidth">
              <select
                id="contractIntermentEdit--intermentContainerTypeId"
                name="intermentContainerTypeId"
              >
                <option value="">(No Container)</option>
                <optgroup
                  label="Non-Cremated"
                  data-is-cremation-type="0"
                ></optgroup>
                <optgroup
                  label="Cremated"
                  data-is-cremation-type="1"
                ></optgroup>
              </select>
            </div>
          </div>
        </div>
      </form>
    </section>
    <footer class="modal-card-foot is-justify-content-right">
      <div class="buttons">
        <button
          class="button is-success"
          type="submit"
          form="form--contractIntermentEdit"
        >
          <span class="icon"
            ><i class="fas fa-save" aria-hidden="true"></i
          ></span>
          <span>Update Interment</span>
        </button>
        <button class="button is-close-modal-button" type="button">
          Cancel
        </button>
      </div>
    </footer>
  </div>
</div>