invisio v2.0

<?php
@session_start();

include('../../../config/main_function.php');
$secure = "cAh3DrJACzw4RbU";
$connection = connectDB($secure);

if ($connection) {

$receipt_id = mysqli_real_escape_string($connection, $_POST['receipt_id']);

$sql = "SELECT * FROM tbl_receipt_head WHERE receipt_id= '$receipt_id'";
    $res = mysqli_query($connection, $sql);
    $row = mysqli_fetch_assoc($res);
}
?>

.select2-dropdown {
        z-index: 3051;
    }
</style>
<div class="modal-header">
    <h4 class="modal-title">เพิ่มใบเสร็จ</h4>
    <button type="button" class="close" data-dismiss="modal" aria-label="Close"><span aria-hidden="true">&times;</span></button>
</div>
<div class="modal-body">
    <form id="frm_editReceipt" method="POST" enctype="multipart/form-data">
        <input type="hidden" id="member_id" name="member_id" value="<?php echo $row['member_id']; ?>">
        <input type="hidden" id="receipt_id" name="receipt_id" value="<?php echo $receipt_id; ?>">
        <div class="row">
            <div class="form-group col-6">
                <div class="form-group" id="data_1">
                    <label class="font-normal">วันที่ออกใบเสร็จ</label>
                    <div class="input-group date">
                        <span class="input-group-addon"><i class="fa fa-calendar"></i></span>
                        <input type="input" class="form-control date" value="<?php echo date("d/m/Y", strtotime($row['receipt_date'])); ?>" name="receipt_date" id="receipt_date" autocomplete="off">
                    </div>
                </div>
            </div>

<div class="form-group col-6">
                <label class="font-normal">ลูกค้า</label>
                <div class="input-group mb-3">
                    <input type="text" class="form-control" id="member_name" name="member_name" value="<?php echo $row['customer_name']; ?>" placeholder="ชื่อลูกค้า" aria-describedby="button-addon2">
                    <button type="button" class="btn btn-primary" id="button-addon2" onclick="GetModalMenber()"><i class="fa fa-search"></i></button>
                </div>
            </div>
            <div class="form-group col-6">
                <label class="font-normal">เลขที่อ้างอิง</label>
                <input type="text" class="form-control" id="ref_number" name="ref_number" value="<?php echo $row['ref_invoice_id']; ?>" placeholder="เลขที่ใบแจ้งหนี้ , ชื่อลูกค้า , เบอร์โทรติดต่อ">
            </div>

<div class="form-group col-6">
                <label class="font-normal">เลขประจำตัวผู้เสียภาษี</label>
                <input type="text" class="form-control" id="customer_tax_no" name="customer_tax_no" value="<?php echo $row['customer_tax_no']; ?>">
            </div>
            <div class="form-group col-6">
                <label class="font-normal">เบอร์โทรติดต่อ</label>
                <input type="text" class="form-control" id="customer_phone" name="customer_phone" value="<?php echo $row['customer_phone']; ?>">
            </div>
            <div class="form-group col-6">
                <label class="font-normal">อีเมล</label>
                <input type="text" class="form-control" id="customer_email" name="customer_email" value="<?php echo $row['customer_email']; ?>">
            </div>
            <div class="form-group col-12">
                <label class="font-normal">ที่อยู่</label>
                <input type="text" class="form-control" id="customer_address" name="customer_address" value="<?php echo $row['customer_address']; ?>">
            </div>
            <div class="form-group col-12">
                <label class="font-normal">หมายเหตุ</label>
                <textarea name="recipt_remark" id="recipt_remark" cols="30" rows="5" class="form-control"><?php echo $row['remark']; ?></textarea>
            </div>
        </div>
    </form>
</div>
<div class="modal-footer">
    <button type="button" class="btn btn-primary" onclick="SubmitEditReceipt()"><i class="fa fa-check"></i>&nbsp;บันทึก</button>
    <button type="button" class="btn btn-white" data-dismiss="modal">ปิด</button>
</div>