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<!DOCTYPE html>
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2025-12-14 22:50:00 +09:00
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<html xmlns="http://www.w3.org/1999/xhtml" xmlns:th="http://www.thymeleaf.org"
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xmlns:layout="http://www.ultraq.net.nz/thymeleaf/layout">
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2025-10-18 11:06:19 +09:00
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<head>
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2025-12-14 22:50:00 +09:00
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<meta charset="utf-8" />
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<meta name="viewport" content="width=device-width, initial-scale=1, shrink-to-fit=no">
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<title>메이드유 CRM</title>
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<!-- jQuery -->
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<script src="/js/web/jquery.min.js"></script>
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<script src="/js/web/jquery-ui.js"></script>
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<!-- Choices.js -->
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<link rel="stylesheet" href="https://cdn.jsdelivr.net/npm/choices.js/public/assets/styles/choices.min.css">
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<script src="https://cdn.jsdelivr.net/npm/choices.js/public/assets/scripts/choices.min.js"></script>
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<!-- Flatpickr -->
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<link rel="stylesheet" href="https://cdn.jsdelivr.net/npm/flatpickr/dist/flatpickr.min.css">
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<script src="https://cdn.jsdelivr.net/npm/flatpickr"></script>
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<script src="https://cdn.jsdelivr.net/npm/flatpickr/dist/l10n/ko.js"></script>
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<!-- CSS -->
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<link rel="stylesheet" href="/css/web/font.css">
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<link rel="stylesheet" href="/css/kiosk/new-patient.css">
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2025-10-18 11:06:19 +09:00
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</head>
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<th:block layout:fragment="layout_top_script">
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<script src="/js/kiosk/new-patient.js"></script>
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</th:block>
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<!--<th:block th:replace="/web/include/modal :: layout_modal"></th:block>-->
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<th:block layout:fragment="layout_content">
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<div id="newPatientForm" class="new-patient-container">
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<!-- Header -->
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<header class="page-header">
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<h1 class="title">신규 고객 등록</h1>
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</header>
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<!-- Body -->
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<main class="page-body">
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<div class="form-grid-layout">
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<!-- Column 1: Basic Info -->
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<section class="form-section-card col-card">
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<div class="section-title">기본 정보</div>
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<!-- Nationality -->
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<div class="form-row">
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<label class="required">국적</label>
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<select id="selectNationality" name="nationality">
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<option value="">국적 선택</option>
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</select>
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</div>
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<!-- Name -->
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<div class="form-row">
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<label class="required">고객명</label>
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<input type="text" name="modalUserName" placeholder="이름을 입력하세요" />
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</div>
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<!-- Birthday -->
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<div class="form-row">
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<label>생년월일</label>
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<div class="date-input-wrapper">
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<input name="modalBirthday" type="text" placeholder="YYYY-MM-DD" readonly />
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<span class="age-text txtAge"></span>
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<img src="/image/web/calendar.svg" alt="calendar">
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</div>
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</div>
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<!-- Gender -->
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<div class="form-row">
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<label>성별</label>
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<div class="radio-group">
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<div class="radio-item">
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<input type="radio" name="modalGender" id="genderF" value="F" />
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<label for="genderF">여자</label>
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</div>
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<div class="radio-item">
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<input type="radio" name="modalGender" id="genderM" value="M" />
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<label for="genderM">남자</label>
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</div>
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</div>
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</div>
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<!-- Identification (Dynamic) -->
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<div class="form-row foreigner_box">
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<label>식별정보</label>
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<select id="selectIdentification" name="identificationType">
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<option value="pno" selected>여권번호</option>
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<option value="arc">외국인등록번호</option>
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</select>
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<div class="passport_number_box">
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<input name="modalUserPno" type="text" placeholder="여권번호 입력" />
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</div>
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<div class="foreigner_number_box split-inputs" style="display:none;">
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<input name="modalUserArc1" type="text" placeholder="000000" maxlength="6" />
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<span class="split-divider">-</span>
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<input name="modalUserArc2" type="password" placeholder="0000000" maxlength="7" />
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</div>
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</div>
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<div class="form-row local_box">
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<label>주민등록번호</label>
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<div class="split-inputs">
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<input name="modalUserRrn1" type="text" placeholder="000000" maxlength="6" />
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<span class="split-divider">-</span>
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<input name="modalUserRrn2" type="password" placeholder="0000000" maxlength="7" />
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</div>
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</div>
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</section>
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<!-- Column 2: Contact Info -->
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<section class="form-section-card col-card">
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<div class="section-title">연락처 및 동의</div>
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<!-- User Type -->
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<div class="form-row">
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<label>고객구분</label>
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<select id="selectUserType" name="userType">
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<option value="">고객구분 선택</option>
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</select>
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</div>
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<!-- Phone 1 -->
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<div class="form-row">
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<label class="required">연락처</label>
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<input name="modalPhoneNumber" type="tel" placeholder="010-0000-0000" />
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</div>
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<!-- Phone 2 -->
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<div class="form-row">
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<label>보조 연락처</label>
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<input name="modalPhoneNumber2" type="tel" placeholder="010-0000-0000" />
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</div>
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<!-- Photo Refusal -->
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<div class="form-row">
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<label>사진 거부</label>
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<div class="radio-group">
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<div class="radio-item">
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<input type="radio" name="modalRefusePhotoYn" id="photoY" value="Y" checked />
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<label for="photoY">예</label>
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</div>
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<div class="radio-item">
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<input type="radio" name="modalRefusePhotoYn" id="photoN" value="N" />
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<label for="photoN">아니오</label>
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</div>
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</div>
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</div>
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<!-- SMS -->
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<div class="form-row">
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<label>SMS 수신여부</label>
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<div class="radio-group">
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<div class="radio-item">
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<input type="radio" name="modalSmsYn" id="smsY" value="Y" checked />
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<label for="smsY">예</label>
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</div>
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<div class="radio-item">
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<input type="radio" name="modalSmsYn" id="smsN" value="N" />
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<label for="smsN">아니오</label>
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</div>
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</div>
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</div>
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</section>
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<!-- Column 3: Additional Info -->
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<section class="form-section-card col-card">
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<div class="section-title">기타 정보</div>
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<!-- Treatment -->
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<div class="form-row">
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<label>관심진료</label>
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<select id="selectTreatment" name="treatment">
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<option value="">관심진료 선택</option>
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</select>
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</div>
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<!-- Channel -->
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<div class="form-row">
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<label>방문경로</label>
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<select id="selectChannel" name="channel">
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<option value="">방문경로 선택</option>
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</select>
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</div>
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<!-- Recommender -->
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<div class="form-row">
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<label>추천인</label>
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<div class="searchIntroUser" style="position:relative; cursor:pointer;">
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<input type="text" name="modalRecommendId" placeholder="검색하여 선택하세요" readonly
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style="cursor:pointer; padding-right:40px;" />
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<img src="/image/web/search_B.svg" alt="search"
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style="position:absolute; right:12px; top:50%; transform:translateY(-50%); width:18px;">
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</div>
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</div>
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<!-- Etc -->
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<div class="form-row">
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<label>특이 사항 (시술/약물)</label>
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<textarea name="modalEtc" placeholder="특이사항을 입력하세요"></textarea>
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</div>
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<!-- Memo -->
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<div class="form-row">
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<label>고객 메모</label>
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<textarea name="modalMemo" placeholder="메모를 입력하세요"></textarea>
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</div>
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</section>
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</div>
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</main>
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<!-- Footer -->
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<footer class="page-footer">
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<!-- Use project standard classes -->
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<button type="button" class="cancel_btn btnCancle">취소</button>
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<button type="button" class="registration_bth btnSave">등록 완료</button>
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</footer>
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</div>
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</th:block>
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2026-01-16 00:58:09 +09:00
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2025-12-14 22:50:00 +09:00
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<th:block layout:fragment="layout_script">
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2026-01-16 00:58:09 +09:00
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2025-10-18 11:06:19 +09:00
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</th:block>
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2025-10-18 11:06:19 +09:00
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</html>
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