extranet/application/views/default/scripts/saisie/lienpp.phtml

<input type="hidden" name="pp" value="1"/>

<div class="fieldgrp">
<label>Nom</label>
<div class="field">
<input type="text" name="nom" value="<?=$this->nom?>"/>
</div>
</div>

<div class="fieldgrp">
<label>Nom d'usage</label>
<div class="field">
<input type="text" name="nom_usage" value="<?=$this->nom_usage?>"/>
</div>
</div>

<div class="fieldgrp">
<label>Prénom(s)</label>
<div class="field">
<input type="text" name="prenom" value="<?=$this->prenom?>"/>
</div>
</div>

<div class="fieldgrp">
<label>Civilité</label>
<div class="field">
<input type="radio" name="civilite" value="M"<?php if ($this->civilite=='M') echo ' checked'; ?>/>M.
<input type="radio" name="civilite" value="Mme"<?php if ($this->civilite=='Mme') echo ' checked'; ?>/>Mme
<input type="radio" name="civilite" value="Mlle"<?php if ($this->civilite=='Mlle') echo ' checked'; ?>/>Mlle
</div>
</div>

<div class="fieldgrp">
<label>Né(e) le</label>
<div class="field">
<input type="text" size="10" name="naissance_date" value="<?=$this->naissance_date?>"/>
à <input type="text" name="naissance_lieu" value="<?=$this->naissance_lieu?>"/>
<select name="naissance_dept_pays">
<option>-</option>
<?php foreach($this->countries as $code => $item) {?>
<?php $select = ''; if ($this->naissance_dept_pays==$code) $select = 'selected';?>
<option value="<?=$code?>"<?=$select?>><?=$item['libPays']?></option>
<?php }?>
</select>
</div>
</div>

<div class="fieldgrp">
<label>Nationnalité</label>
<select name="nat">
<option>-</option>
<?php foreach($this->countries as $code => $item) {?>
<?php $select = ''; if ($this->nat==$code) $select = 'selected';?>
<option value="<?=$code?>"<?=$select?>><?=$item['libPays']?></option>
<?php }?>
</select>
</div>
</div>

<div class="fieldgrp">
<label>Adresse</label>
<div class="field">
<input type="text" name="adresse_num" size="4" value="<?=$this->adresse_num?>"/>
<input type="text" name="adresse_btq" size="1" value="<?=$this->adresse_btq?>"/>
<input type="text" name="adresse_codvoie" size="4" value="<?=$this->adresse_codvoie?>"/>
<input type="text" name="adresse_libvoie" size="32" value="<?=$this->adresse_libvoie?>"/>
</div>
</div>

<div class="fieldgrp">
<label>Adresse complément</label>
<div class="field">
<input type="text" name="adresse_comp" size="40" value="<?=$this->adresse_comp?>"/>
</div>
</div>

<div class="fieldgrp">
<label>CP</label>
<div class="field">
<input type="text" name="adresse_cp" value="<?=$this->adresse_cp?>"/>
</div>
</div>

<div class="fieldgrp">
<label>Ville</label>
<div class="field">
<input type="text" name="adresse_ville" value="<?=$this->adresse_ville?>"/>
</div>
</div>

<div class="fieldgrp">
<label>Pays</label>
<div class="field">
<select name="adresse_pays">
<option value="">-</option>
<?php foreach($this->countries as $code => $item) {?>
<?php $select = ''; if ($this->adresse_pays==$code) $select = 'selected';?>
<option value="<?=$code?>"<?=$select?>><?=$item['libPays']?></option>
<?php }?>
</select>
</div>
</div>