
 <?php  require ("inc/includes.php");

 require ("inc/header.php"); 


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<section>
<article >

<h2>Demande</h2>
<p style="color:red; font-weight:bold; text-align:right"> <span style="color:#000000">Numéro de la demande</span>  &nbsp&nbsp&nbsp 000000</p>

 <form method="post" action="index.php">
  
<!-- LES INPUTS HORIZONTAL -->

	<div  class="col-sm-12" >
		<div class="form-group">
			<label for="text">Date de demande</label>&nbsp&nbsp&nbsp&nbsp <input  value="<?php echo date(" d/m/Y H:i "); ?>" name="dateofbirth" id="dateofbirth"  style="width:28%; position: relative; ">
	
</div>
	</div>

	<div class="col-sm-12" >
		<div class="form-group ">
			<label for="date">Date reception de la demande</label> <input  value="<?php echo date(" d/m/Y H:i "); ?>" name="dateofbirth" id="dateofbirth"  style="width:28%; position: relative; ">

		</div>
	</div>
			
	

	<div  class="col-sm-12" >
		<div class="form-group ">
			<label for="text">Type de client</label>&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp
			
<select name="pets" id="pet-select" minlength="4" style="width:68%; position: relative;"  >
    <option value="Client biocollection thematique">Client biocollection thematique</option>
	<a href="../secretaire/"><option value="Client biocollection thematique">Client biocollection thematique en cours</option></a>

    <option value="Client IPCI (Local ?)">Client IPCI (Local ?)</option>
    <option value="Client CI, mais hors IPCI (national?)">Client CI, mais hors IPCI (national?)</option>
    <option value="Client CI, mais hors IPCI (national?)">Client hors IPCI (international ?)</option>
</select>
</div>
	</div>
	
	
	<div  class="col-sm-12" >
		<div class="form-group">
			<label for="text">Nom du demandeur</label>&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp
			
<select name="pets" id="pet-select" minlength="4" style="width:68%; position: relative;" style="min-width:50%"  >
    <option value=""></option>
    <option value="Identité">Identité</option>
    <option value="Structure">Structure</option>
    <option value="Adresse">Adresse</option>
    <option value="Geographique">Geographique</option>
</select>
</div>
	</div>
	
	
	<div  class="col-sm-12" >
	
		<div class="form-group">
			<label for="text">Motif</label>&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp
			
<select name="pets" id="pet-select" minlength="4" style="width:68%; position: relative;" style="min-width:50%"  >
    <option value=""></option>
    <option value="Mise en collection">Mise en collection</option>
    <option value="Intégration de collection">Intégration de collection</option>
    <option value="Collection thématique">Collection thématique</option>
    <option value="Collection simple">Collection simple</option>
</select>
</div>
	</div>




		
<!-- FIN DES INPUTS HORIZONTAL -->

  </form>
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                  <a href="originebio.php"><button type="submit" class="btn btn-second " style="border: 1px solid #adb0bb8f;border-radius: 1.25rem; float:right;"> Suivant</button></a>
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