24 lines
1.1 KiB
Smarty
Executable File
24 lines
1.1 KiB
Smarty
Executable File
{capture name=path}{l s='Espace pharmaciens'}{/capture}
|
|
{include file="$tpl_dir./breadcrumb.tpl"}
|
|
<div class="borderGreen">
|
|
<h1>[{l s='Espace pharmaciens'}]</h1>
|
|
<div class="espaceLogin">
|
|
<form action="#" method="post" class="std" onsubmit="checkform('formEspacePharmaciens')" id="formEspacePharmaciens">
|
|
<fieldset>
|
|
<h2 class="center uppercase times">{l s='Pharmaciens,'}<br/>{l s='vous pourrez bientôt accéder'}<br/>{l s='à votre espace dédié.'}</h2>
|
|
<h3 class="center">{l s='Soyez le premier informé en remplissant les champs ci-dessous'}</h3>
|
|
<p class="text">
|
|
<input type="text" class="inputText388" name="espaceMail" id="espaceMail" value="" placeHolder="{l s='E-mail'}">
|
|
</p>
|
|
<p class="text">
|
|
<input type="text" class="inputText388" name="espaceCIP" id="espaceCIP" value="" placeHolder="{l s='Code Client'}">
|
|
</p>
|
|
<p class="clear submit fleche_off">
|
|
<input type="submit" class="center uppercase times" value="{l s='Envoyer'}" id="submitMessage" name="submitMessage">
|
|
</p>
|
|
<div class="clear"></div>
|
|
</fieldset>
|
|
</form>
|
|
</div>
|
|
</div>
|