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Diffstat (limited to 'www/report.html')
| -rw-r--r-- | www/report.html | 37 |
1 files changed, 37 insertions, 0 deletions
diff --git a/www/report.html b/www/report.html new file mode 100644 index 0000000..7a853f6 --- /dev/null +++ b/www/report.html @@ -0,0 +1,37 @@ +<!DOCTYPE html> +<html> + <head> + <meta charset="utf-8" /> + <meta name="format-detection" content="telephone=no" /> + <meta name="msapplication-tap-highlight" content="no" /> + <!-- WARNING: for iOS 7, remove the width=device-width and height=device-height attributes. See https://issues.apache.org/jira/browse/CB-4323 --> + <meta name="viewport" content="user-scalable=no, initial-scale=1, maximum-scale=1, minimum-scale=1, width=device-width, height=device-height, target-densitydpi=device-dpi" /> + <link rel="stylesheet" type="text/css" href="css/index.css" /> + <script src="cordova.js"></script> + <script src="js/report.js"></script> + <title>FRC Team 4272 Safety - Report an injury</title> + </head> + <body id="report"> + <h1>Report an Injury</h1> + <form action="https://lukeshu.com/frc4272/app/reports" method="POST"> + <label><span>Name:</span><input type="text" name="name" /></label> + <label><span>Grade:</span> + <select name="grade"> + <option disabled selected value="">Select one</option> + <option value="9">9th / Freshman</option> + <option value="10">10th / Sophomore</option> + <option value="11">11th / Junion</option> + <option value="12">12th / Senior</option> + <option value="mentor">Mentor</option> + <option value="other">Other</option> + </select> + </label> + <label><span>Sub-team:</span><input type="text" name="subteam" /></label> + <label><span>Injury:</span><input type="text" name="injury" /></label> + <label>Detailed description of how the injury occurred <textarea></textarea></label> + <label>Detailed description of how the injury was treated <textarea></textarea></label> + <div id="camera-ui">Loading Camera...</div> + <input type="submit" value="Submit"/> + </form> + </body> +</html> |