268 lines
7.6 KiB
PHP
268 lines
7.6 KiB
PHP
<!DOCTYPE html>
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<html lang="en">
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<head>
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<meta charset="UTF-8">
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<meta name="viewport" content="width=device-width, initial-scale=1.0">
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<style>
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.triangle1 {
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width: 0;
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height: 0;
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border-left: 10.24px solid transparent;
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border-right: 318.24px solid transparent;
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border-bottom: 75.5px solid #008C8C;
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position: absolute;
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top: -55.12px;
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left: -60.91px;
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transform: rotate(-12deg);
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}
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.triangle2 {
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width: 0;
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height: 0;
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border-left: 10.24px solid transparent;
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border-right: 550.24px solid transparent;
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border-bottom: 110.5px solid #19BBBB;
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position: absolute;
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top: -55.12px;
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left: -100.91px;
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transform: rotate(-20deg);
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}
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body {
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margin: 0;
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padding: 0;
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height: 100vh;
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background-color: #ffffff; /* Ganti dengan warna latar belakang yang diinginkan */
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}
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.content {
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padding: 20px;
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text-align: left;
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}
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.content img {
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width: 25%;
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max-width: 600px; /* batasan lebar maksimum gambar */
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margin-top: 20px; /* jarak antara segitiga dan gambar */
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}
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.corner-text {
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font-family: 'Calibri', sans-serif;
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font-size: 14px;
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color: #666666;
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position: absolute;
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}
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.top-right {
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top: 10px;
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right: 10px;
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}
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.bottom-right {
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bottom: 10px;
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right: 10px;
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}
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.bottom-left {
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bottom: 10px;
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left: 10px;
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text-align: left;
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}
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.title-container {
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display: flex;
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flex-direction: column;
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align-items: center;
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text-align: center;
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position: relative;
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margin-top: 40px;
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}
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.title {
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font-family: 'Calibri', sans-serif;
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font-size: 18px;
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margin-bottom: 5px;
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}
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.additional-text {
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font-family: 'Calibri', sans-serif;
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font-size: 12px;
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}
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.claim-info {
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font-family: 'Calibri', sans-serif;
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font-size: 14px;
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/* color: #008C8C; */
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text-align: left;
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margin-top: 20px;
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}
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table {
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width: 100%;
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border-collapse: collapse;
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margin-top: 10px;
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}
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table, th, td {
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/* border: 1px solid #008C8C; */
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}
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th, td {
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padding: 4px;
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text-align: left;
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}
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.hot-line {
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font-family: 'Calibri', sans-serif;
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background-color: #048B8C;
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text-align: center;
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align-items: center;
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font-size: 14px;
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margin-top: 10px;
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padding: 2px;
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color: #ffffff;
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}
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.txt-tindakan {
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font-family: 'Calibri', sans-serif;
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margin-top: 10px;
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font-size: 14px;
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}
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.txt-pernyataan {
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font-family: 'Calibri', sans-serif;
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margin-top: 40px;
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font-size: 14px;
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}
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</style>
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</head>
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<body>
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<div class="triangle2"></div>
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<div class="triangle1"></div>
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<div class="content">
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<div class="corner-text top-right">
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The Future Of Healthcare At Your Fingertips
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</div>
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<img src="data:image/png;base64,{{ base64_encode(file_get_contents( public_path('images/logo-default.png') )) }}">
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<div class="title-container">
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<div class="title">
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<b>SURAT JAMINAN</b>
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</div>
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<div class="additional-text">
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(SURAT JAMINAN INI HARUS DITANDATANGANI OLEH PASIEN)
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</div>
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</div>
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<table class="claim-info">
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<tr>
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<td style="width: 20%;">No. Klaim</td>
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<td style="width: 1%;">:</td>
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<td style="width: 29%;"></td>
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<td style="width: 20%;">Tanggal</td>
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<td style="width: 1%;">:</td>
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<td style="width: 29%;"></td>
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</tr>
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<tr>
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<td>Kepada</td>
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<td>:</td>
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<td></td>
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<td>Plan Polis</td>
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<td>:</td>
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<td></td>
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</tr>
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</table>
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<div class="hot-line">
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(HOT LINE LINK SEHAT)
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</div>
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<div class="txt-tindakan">
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Link Sehat bertindak mewakili perusahaan asuransi/penanggung untuk mengeluarkan Surat Jaminan Awal untuk peserta dibawah ini :
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</div>
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<table class="claim-info">
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<tr>
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<td style="width: 20%;">Jenis Surat Jaminan</td>
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<td style="width: 1%;">:</td>
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<td style="width: 29%;"><b>: SURAT JAMINAN AWAL</b></td>
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<td style="width: 20%;">Penjamin</td>
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<td style="width: 1%;">:</td>
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<td style="width: 29%;"></td>
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</tr>
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<tr>
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<td>Nama Peserta</td>
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<td>:</td>
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<td></td>
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<td>Nama Perusahaan</td>
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<td>:</td>
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<td></td>
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</tr>
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<tr>
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<td>Nama karayawan</td>
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<td>:</td>
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<td></td>
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<td>No. Polis</td>
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<td>:</td>
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<td></td>
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</tr>
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<tr>
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<td>Tanggal Lahir</td>
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<td>:</td>
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<td></td>
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<td>Produk</td>
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<td>:</td>
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<td></td>
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</tr>
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<tr>
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<td>Jenis Kelamin</td>
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<td>:</td>
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<td></td>
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<td>Tipe</td>
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<td>:</td>
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<td></td>
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</tr>
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<tr>
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<td>Member ID</td>
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<td>:</td>
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<td></td>
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<td>Status Polis</td>
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<td>:</td>
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<td></td>
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</tr>
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<tr>
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<td>Identitas Peserta</td>
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<td>:</td>
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<td></td>
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<td>Tanggal Mulai Akhir</td>
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<td>:</td>
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<td></td>
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</tr>
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<tr>
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<td>Hak Kamar Pasien</td>
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<td>:</td>
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<td></td>
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<td>Mata Uang</td>
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<td>:</td>
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<td></td>
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</tr>
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<tr>
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<td>Tanggal Pembayaran</td>
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<td>:</td>
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<td></td>
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<td>Rumah Sakit</td>
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<td>:</td>
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<td></td>
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</tr>
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<tr>
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<td></td>
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<td></td>
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<td></td>
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<td>Alamat</td>
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<td>:</td>
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<td></td>
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</tr>
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</table>
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<div class="txt-pernyataan">
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Surat Jaminan ini dinyatakan berlaku apabila disertai surat jaminan akhir dengan nominal yang tertera pada akhir perawatan.
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</div>
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<div class="corner-text bottom-right">
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The Future Of Healthcare At Your Fingertips
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</div>
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<div class="corner-text bottom-left">
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<b>PT Link Medis Sehat</b><br>
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<b>Primaya Hospital Corporate</b><br>
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Graha Cempaka Mas Blok D5-6<br>
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Jl. Let. Jend. Suprapto, Jakarta Pusat 10640, Indonesia<br>
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<b>Telp</b> (021) 4217746/47
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</div>
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</div>
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</body>
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</html> |