templates/auth/registration.html.twig line 1

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  1. {% extends 'base.html.twig' %}
  3. {% block title %}Inscription | Créez votre compte sur RMS - Professionnels et Structures de Santé{% endblock %}
  5. {% block description %}
  6. Inscrivez-vous sur RMS pour accéder à des services dédiés aux professionnels et structures de santé. Créez votre compte en quelques étapes simples et commencez à bénéficier de nos fonctionnalités. Inscription gratuite et rapide!
  7. {% endblock %}
  11. {% block body %}
  12.     {% include ("pages/job/header.html.twig") %}
  13.    <div id="registration" >
  16.     <section class="container register mt4">
  17.         <div v-if="!viewform">
  18.             <p style="color: white" v-html="messages"></p>
  19.         </div>
  20.         <div class="row" v-if="viewform">
  21.             <div class="col-md-3 register-left" >
  22.                 {#<img src="{{ asset('build/images/med_site.png') }}" alt=""/>#}
  23.                 <h3>Bienvenue</h3>
  24.                 <p>Vous n'avez pas encore de compte ?<br>Inscrivez-vous dès maintenant !!</p>
  26.                 <button><a  href="{{ url('app_login') }}"> Se Connecter </a></button>
  27.             </div>
  28.             <div class="col-md-9 register-right">
  29.                         <h3 class="register-heading">Créer votre  compte RMS</h3>
  31.                         <div class="row register-form">
  33.                             <div class="col-md-6">
  34.                                 <div class="form-group">
  35.                                     <input type="text" class="form-control" v-model="form.nom" placeholder="Nom * " required  />
  36.                                     <span class="text-danger"> ${errors.nom}</span>
  37.                                 </div>
  38.                                 <div class="form-group">
  39.                                     <input type="text" class="form-control"  placeholder="Prenom *" v-model="form.prenom" required />
  40.                                     <span class="text-danger"> ${errors.prenom}</span>
  41.                                 </div>
  43.                                 <div class="form-group">
  44.                                     <input type="password" @blur="passwordValide()" class="form-control" placeholder="Mot de passe  *"  v-model="form.password" required />
  45.                                     <span class="text-danger "> <p v-html="errors.password"></p></span>
  46.                                 </div>
  47.                                 <div class="form-group">
  48.                                     <input type="password" @blur="repeatPassword()" class="form-control" v-model="form.repeatPassword" placeholder="Confirmer votre mot de passe  *" required />
  49.                                     <span class="text-danger"> ${errors.repeatPassword}</span>
  50.                                 </div>
  51.                                 <div class="form-group">
  52.                                     <div class="maxl">
  53.                                         <h4>Genre</h4>
  54.                                         <label class="radio inline">
  55.                                             <input type="radio" name="gender" value="1" checked  v-model="form.civilite">
  56.                                             <span> Masculin </span>
  57.                                         </label>
  58.                                         &nbsp;&nbsp;
  59.                                         <label class="radio inline">
  60.                                             <input type="radio" name="gender" value="0"  v-model="form.civilite">
  61.                                             <span> Feminin </span>
  62.                                         </label>
  63.                                     </div>
  64.                                 </div>
  65.                             </div>
  66.                             <div class="col-md-6">
  67.                                 <div class="form-group">
  68.                                     <input type="text" class="form-control" placeholder="E-mail *"  required v-model="form.email" />
  69.                                     <span class="text-danger"> ${errors.email}</span>
  70.                                 </div>
  71.                                 <div class="form-group">
  72.                                     <input type="text" minlength="10" maxlength="10"  required v-model="form.telephone" name="txtEmpPhone" class="form-control" placeholder="Telephone *" value="" />
  73.                                     <span class="text-danger"> ${errors.telephone}</span>
  74.                                 </div>
  75.                                 <div class="form-group">
  76.                                     <select class="form-control" v-model="form.type" required>
  77.                                         <option class="hidden"  value="" selected disabled>Vous êtes ?</option>
  78.                                         <option value="1">Professionnel de santé</option>
  79.                                         <option value="2">Structure de santé</option>
  80.                                     </select>
  81.                                     <span class="text-danger"> ${errors.type}</span>
  82.                                 </div>
  83.                                 <div class="form-group">
  84.                                         <input type="text" class="form-control" placeholder="Adresse "  v-model="form.adresse" value="" />
  85.                                 </div>
  86.                                 <button type="button" class="btnlogin"  @click="onSubmit()" value=""> Soumettre </button>
  87.                             </div>
  89.                         </div>
  90.                     </div>
  93.         </div>
  95.     </section>
  96.    </div>
  98. {% endblock %}