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<?php
session_start();
include 'connection.php';
$id=$_REQUEST['id'];
$sql1="select * from leads where lid=$id";
$result1=mysqli_query($con,$sql1)or die(mysqli_error());
$row1=mysqli_fetch_array($result1);
$address=$row1['address'];
?>
<!doctype html>
<html lang="en" data-layout="vertical" data-sidebar="dark" data-sidebar-image="img-1" data-sidebar-size="lg" data-preloader="disable" data-theme="default" data-topbar="light" data-bs-theme="light" data-theme-color="0">
<head>
<meta charset="utf-8">
<title>TMK System - Dashboard</title>
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<meta content="Minimal Admin & Dashboard Template" name="description">
<meta content="Themesbrand" name="author">
<!-- App favicon -->
<link rel="shortcut icon" href="assets/images/favicon.png">
<!-- Fonts css load -->
<link rel="preconnect" href="https://fonts.googleapis.com">
<link rel="preconnect" href="https://fonts.gstatic.com" crossorigin>
<link id="fontsLink" href="https://fonts.googleapis.com/css2?family=Poppins:wght@300;400;500;600;700&display=swap" rel="stylesheet">
<!-- Layout config Js -->
<script src="assets/js/layout.js"></script>
<!-- Bootstrap Css -->
<link href="assets/css/bootstrap.min.css" rel="stylesheet" type="text/css">
<!-- Icons Css -->
<link href="assets/css/icons.min.css" rel="stylesheet" type="text/css">
<!-- App Css-->
<link href="assets/css/app.min.css" rel="stylesheet" type="text/css">
<!-- custom Css-->
<link href="assets/css/custom.min.css" rel="stylesheet" type="text/css">
</head>
<body>
<!-- Begin page -->
<div id="layout-wrapper">
<?php include 'header.php'; ?>
<!-- ============================================================== -->
<div class="main-content">
<div class="page-content wrapper">
<div class="container-fluid">
<!-- start page title -->
<div class="row">
<div class="col-12">
<div class="page-title-box d-sm-flex align-items-center justify-content-between">
<div class="page-title-right">
<ol class="breadcrumb m-0">
<li class="breadcrumb-item"><a href="javascript: void(0);">Customer Management</a></li>
<li class="breadcrumb-item active">Add As Customer :</li>
</ol>
</div>
</div>
</div>
</div>
<!-- end page title -->
<div class="row">
<div class="col-xxl-12">
<div class="card">
<div class="card-header">
<h4 class="card-title mb-0">New Customer Details :
</h4>
</div><!-- end card header -->
<div class="card-body">
<form name="form1" data-toggle="validator" action="customer_add_code.php?id=<?php echo $id;?>" method="post" enctype="multipart/form-data">
<div class="row">
<div class="col-md-6">
<div class="mb-3">
<label for="firstNameinput" class="form-label">BILL NUMBER</label>
<input type="text" class="form-control" id="inputLand" placeholder="BILL NUMBER" name="order_no" required>
</div>
</div>
<div class="col-md-6">
<div class="mb-3">
<label for="firstNameinput" class="form-label">HOUSE NAME</label>
<input type="text" class="form-control" id="inputLand" placeholder="HOUSE NAME" name="address" value="<?php echo $address;?>" required>
</div>
</div>
<div class="col-md-6" >
<div class="mb-3">
<label for="address1ControlTextarea" class="form-label">AREA</label>
<input type="text" class="form-control" id="inputLand" placeholder="AREA" name="city">
</div>
</div>
<div class="col-md-6">
<div class="mb-3">
<label for="firstNameinput" class="form-label">MUNCIPALITY/ PANCHAYATH</label>
<input type="text" class="form-control" id="inputLand" placeholder="MUNCIPALITY/ PANCHAYATH" name="munci" value="<?php echo $munci;?>" required>
</div>
</div>
<div class="col-md-6">
<div class="mb-3">
<label for="firstNameinput" class="form-label">THALUK</label>
<input type="text" class="form-control" id="inputLand" placeholder="THALUK" name="thaluk" value="<?php echo $thaluk;?>" required>
</div>
</div>
<div class="col-md-6" >
<div class="mb-3">
<label for="address1ControlTextarea" class="form-label">DISTRICT</label>
<select class="form-control" id="inputLand" name="district" required>
<option value="">Select</option>
<option value="Alappuzha">Alappuzha</option>
<option value="Ernakulam">Ernakulam</option>
<option value="Idukki">Idukki</option>
<option value="Kannur">Kannur</option>
<option value="Kasaragod">Kasaragod</option>
<option value="Kollam">Kollam</option>
<option value="Kottayam">Kottayam</option>
<option value="Kozhikode">Kozhikode</option>
<option value="Malappuram">Malappuram</option>
<option value="Palakkad">Palakkad</option>
<option value="Pathanamthitta">Pathanamthitta</option>
<option value="Thiruvananthapuram">Thiruvananthapuram</option>
<option value="Thrissur">Thrissur</option>
<option value="Wayanad">Wayanad</option>
</select>
</div>
</div>
<!--end col-->
<div class="col-md-6">
<div class="mb-3">
<label for="citynameInput" class="form-label">STATE</label>
<input type="text" class="form-control" id="inputLand" placeholder="STATE" name="state">
</div>
</div>
<!--end col-->
<div class="col-md-6">
<div class="mb-3">
<label for="citynameInput" class="form-label">PIN CODE</label>
<input type="text" class="form-control" id="inputEmail" placeholder="PIN CODE" name="pin">
</div>
</div>
<!--<div class="col-md-6">
<div class="mb-3">
<label for="citynameInput" class="form-label">GST NUMBER</label>
<input type="text" class="form-control" id="inputEmail" placeholder="GST NUMBER" name="gst" >
</div>
</div>-->
<!--<div class="col-md-6">
<div class="mb-3">
<label for="citynameInput" class="form-label">BUSINESS FOR MONTH</label>
<input type="text" class="form-control" id="inputEmail" placeholder="BUSINESS FOR MONTH" name="program">
</div>
</div>-->
<div class="col-md-6">
<div class="mb-3">
<label for="citynameInput" class="form-label">NET METER DATE</label>
<input type="date" class="form-control" id="inputEmail" placeholder="PROGRAM DATE" name="program_date">
</div>
</div>
<div class="col-md-6">
<div class="mb-3">
<label for="citynameInput" class="form-label">TAXABLE AMOUNT</label>
<input type="file" class="form-control" id="inputEmail" placeholder="TAXABLE AMOUNT" name="famount" >
</div>
</div>
<div class="col-md-6">
<div class="mb-3">
<label for="citynameInput" class="form-label">TOTAL AMOUNT</label>
<input type="file" class="form-control" id="inputEmail" placeholder="TOTAL AMOUNT" name="totalamount">
</div>
</div>
<div class="col-md-6">
<div class="mb-3">
<label for="citynameInput" class="form-label">PRODUCT</label>
<select class="form-control" name="excecutive" >
<option value="0">SELECT PRODUCT</option>
<?php
$sqlsp="select * from product_list order by name asc";
$resultsp=mysqli_query($con,$sqlsp)or die(mysqli_error());
while($rowsp=mysqli_fetch_array($resultsp)){
?>
<option value="<?php echo $rowsp['name'];?>"><?php echo $rowsp['name'];?></option>
<?php }?>
</select>
</div>
</div>
<div class="col-md-6">
<div class="mb-3">
<label for="citynameInput" class="form-label">Document 1</label>
<input type="file" class="form-control" id="inputEmail" placeholder="Document1" name="doc1">
</div>
</div>
<div class="col-md-6">
<div class="mb-3">
<label for="citynameInput" class="form-label">Document 2</label>
<input type="file" class="form-control" id="inputEmail" placeholder="Document 2" name="doc2">
</div>
</div>
<div class="col-md-6">
<div class="mb-3">
<label for="citynameInput" class="form-label">Document 3</label>
<input type="file" class="form-control" id="inputEmail" placeholder="Document 3" name="doc3">
</div>
</div>
<div class="col-md-6">
<div class="mb-3">
<label for="citynameInput" class="form-label">Document 4</label>
<input type="file" class="form-control" id="inputEmail" placeholder="Document 4 " name="doc4">
</div>
</div>
<div class="col-md-12">
<div class="mb-3">
<label for="citynameInput" class="form-label">DATE OF INSTALLATION</label>
<input type="text" class="form-control" id="txtarea1" name="doi" placeholder="DATE OF INSTALLATION">
</div>
</div>
<div class="col-md-12">
<div class="mb-3">
<label for="citynameInput" class="form-label">REMARKS</label>
<input type="text" class="form-control" id="txtarea1" name="remarks" placeholder="Put your remarks here.">
</div>
</div>
<!--end col-->
<div class="col-md-12">
<div class="text-end">
<button type="submit" class="btn btn-primary form-control" name="submit">Submit</button>
</div>
</div>
<!--end col-->
</div>
<!--end row-->
</form>
</div>
</div>
</div> <!-- end col -->
</div>
</div>
<!-- container-fluid -->
</div>
<!-- End Page-content -->
<?php
include 'footer.php';
?>
</div>
<!-- end main content-->
</div>
<!-- END layout-wrapper -->
<!-- JAVASCRIPT -->
<script src="assets/libs/bootstrap/js/bootstrap.bundle.min.js"></script>
<script src="assets/libs/simplebar/simplebar.min.js"></script>
<script src="assets/js/plugins.js"></script>
<!-- prismjs plugin -->
<script src="assets/libs/prismjs/prism.js"></script>
<script src="assets/js/app.js"></script>
<script>
function change() {
var eID = document.getElementById("status");
var dayVal = eID.options[eID.selectedIndex].value;
if(dayVal == 'Closed'){
$('#text_area').show();
}
else{
$('#text_area').hide();
}
}
function script(){$('#text_area').hide();}
</script>
</body>
</html>