<html>
<head><title>Test Service Web Editique</title></head>
<body>
<h1>Test Service Web insertion GED</h1>
<P>
<form method="post" enctype="multipart/form-data" action="/cgi-bin/edtk_inged.cgi">
<TABLE BORDER="0">
<TD><B>Fichier à archiver :</B></TD><TD>
<input type="file" id="EDM_FILENAME" name="EDM_FILENAME" size="20"/></TD>
<TR>
<TD><B>Référence de document : </B></TD>
<TD><select id="ED_REFIDDOC" name="ED_REFIDDOC"/>
<option>scan bordereau</option>
<option>scan facture</option>
<option>scan autre</option>
</select></TD>
<TR>
<TD><B>Entité Juridique : </B></TD>
<TD><select id="ED_CORP" name="ED_CORP"/>
<option>CORP_1</option>
<option>CORP_2</option>
<option>CORP_3</option>
<option>CORP_4</option>
</select></TD>
<TR>
<TD><B>Domaine métier : <B></TD>
<TD><select id="ED_SOURCE" name="ED_SOURCE"/>
<option>Santé</option>
<option>Prévoyance</option>
<option>AUTRE</option>
</select></TD>
<TR>
<TD><B>ID contact : </B></TD><TD><input type="text" name="ED_IDDEST"/></TD>
<TR>
<TD><B>Nom contact : </B></TD><TD><input type="text" name="ED_NOMDEST"/></TD>
<TR>
<TD>Ville contact : </TD><TD><input type="text" name="ED_VILLDEST"/></TD>
<TR>
<TD>Entité de gestion : </TD><TD><input type="text" name="ED_IDEMET"/></TD>
<TR>
<TD>Code contrat : </TD><TD><input type="text" name="ED_CLEGED1"/></TD>
<TR>
<TD>Début période acte : </TD><TD><input type="text" name="ED_CLEGED2"/></TD>
<TR>
<TD>Fin période acte : </TD><TD><input type="text" name="ED_CLEGED3"/></TD>
<TR>
<TD></TD><TD><input type="submit" value="Send"/></TD>
</TABLE>
</form>
<P>
<a href="./index.html">Test Services Web Editique</a>
</body>
</html>