/src/beheer/schade_toevoegen.php

<?php

	$sqlAanmelding = "SELECT * FROM aanvragen WHERE aanvraag_id = '".$_GET["id"]."'";

	$conn = mysql_connect('91.184.10.91', 'mysqlgratisgolf', 'g0lfp0l1s');
	mysql_select_db('gratisgolfpolis', $conn);

	$result = mysql_query("SELECT * FROM user WHERE id='".$_COOKIE["bid"]."'");
	$aantal = mysql_num_rows($result);

	if($aantal==1){
		$row = mysql_fetch_array($result);
		$bid = $row["id"];
		$bname = $row['name'];

	} else {
		header("Location:login.html");
	}
	
	
	$resultAanmelding = mysql_query( $sqlAanmelding );
	$rowAanmelding = mysql_fetch_array($resultAanmelding);
	$certnr = $_GET["id"] + 110000;
	
?>
<form action="index.php?act=insertschade&id=<?=$_GET['id']?>" method="post">
    <table width="900" style="background-color:#eeeeee; color:#000000; font-family:Arial, Helvetica, sans-serif; font-size:11px; font-weight:normal;">
        <tr height="30">
            <td colspan="3" align="center" style="background-color:#137601; color:#f0b300; font-family:Arial, Helvetica, sans-serif; font-size:14px; font-weight:bold;">gratisgolfpolis.nl | Schades</td>
        </tr> 
         <tr valign="top">
            <td width="150"><b>Cerificaat nr.</b></td>
            <td></td>
            <td><?=$certnr?></td>
        </tr>      
         <tr valign="top">
            <td width="150"><b>Aanhef</b></td>
            <td></td>
            <td><?=$rowAanmelding["geslacht"]?></td>
        </tr>    
         <tr valign="top">
            <td width="150"><b>Voorl.</b></td>
            <td></td>
            <td><?=$rowAanmelding["voorletters"]?></td>
        </tr>    
         <tr valign="top">
            <td width="150"><b>Naam</b></td>
            <td></td>
            <td><?=$rowAanmelding["achternaam"]?></td>
        </tr>    
         <tr valign="top">
            <td width="150"><b>Adres</b></td>
            <td></td>
            <td><?=$rowAanmelding["adres"]?></td>
        </tr>    
         <tr valign="top">
            <td width="150"><b>Postcode</b></td>
            <td></td>
            <td><?=$rowAanmelding["postcode"]?></td>
        </tr>    
         <tr valign="top">
            <td width="150"><b>Woonplaats</b></td>
            <td></td>
            <td><?=$rowAanmelding["woonplaats"]?></td>
        </tr>
        <tr><td colspan="3"><hr noshade size="2"/></td></tr>    
         <tr valign="top">
            <td width="150"><b>Schadedatum</b></td>
            <td></td>
            <td><input type="text" name="schadedatum" size="10" maxlength="10"/></td>
        </tr>
         <tr valign="top">
            <td width="150"><b>Schadeoorzaak</b></td>
            <td></td>
            <td><input type="text" name="oorzaak" size="85"/></td>
        </tr>  
          <tr valign="top">
            <td width="150"><b>Schadesoort</b></td>
            <td></td>
            <td>
            	<select name="schadesoort">
                	<option value="1">verlies clubs
                	<option value="2">diefstal clubs (op GC)
                	<option value="3">diefstal clubs (uit auto)
                	<option value="4">diefstal clubs (inbraak)
                	<option value="5">shaftbreuk clubs
                	<option value="6">diefstal kleding
                	<option value="7">hole-in-one
                	<option value="8">brand
                	<option value="9">overigen                  
                </select>
            </td>
        </tr>
         <tr valign="top">
            <td width="150"><b>Reserve EUR</b></td>
            <td></td>
            <td><input type="text" name="reserve" size="10"/></td>
        </tr>
         <tr valign="top">
            <td width="150"><b>Uitkering EUR</b></td>
            <td></td>
            <td><input type="text" name="uitkering" size="10"/></td>
        </tr>
         <tr valign="top">
            <td width="150"><b>Notadatum</b></td>
            <td></td>
            <td><input type="text" name="notadatum" size="10" maxlength="10"/></td>
        </tr>
         <tr valign="top">
            <td width="150"><b>Opmerkingen</b></td>
            <td></td>
            <td><textarea name="opmerkingen" cols="50" rows="5"></textarea></td>
        </tr>
        
    </table>
    <input type="submit" value="Opslaan" />
</form>