<?php
if(isset($_POST['getpass'])) 
{
   PatientManager::Gatepassfinal("$_GET[prescriptionid]","$_GET[patientid]","$_POST[Checklist_Filed]","$_POST[Ambulance_Required]","$_POST[Discharge_Handover]","$_POST[Time_Exit]","$_POST[Follow_Visit]","$_POST[entered_by]");
}
?>


    <form name="getpass" method="post" >
               <h2 align="center">Create Gate pass </h2>
    
               <br>
      
	
      <table id="example2" class="table table-bordered table-hover">
          <tr><td><span style="font-size: 20px">Discharge Checklist Filed </span> </td><td><label >
  <input type="checkbox" class='ace ace-switch ace-switch-6'   name='Checklist_Filed'>
  <span class="lbl"></span>
</label>
</td>
</tr>
<tr><td><span style="font-size: 20px">Ambulance Required and Booked </span> </td><td><label >
  <input type="checkbox" class='ace ace-switch ace-switch-6'   name='Ambulance_Required'>
  <span class="lbl"></span>
</label>
</td>
</tr> 
<tr><td><span style="font-size: 20px">Discharge Handover with NOC </span> </td><td><label >
  <input type="checkbox" class='ace ace-switch ace-switch-6'   name='Discharge_Handover'>
  <span class="lbl"></span>
</label>
</td>
</tr> 


        <tr><td><span style="font-size: 20px">Time of Exit</span> </td><td>
  <input type="time" name='Time_Exit' class='form-control'>
 
</td>
</tr> 
              
              </thead>
                  
                   </tbody>
  <tfoot>
          </tfoot>
        </table>   
        

<input type="submit" name="getpass" value="Save" class='btn btn-success'>
</form>