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add_client.php
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add_client.php
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<?php include('./constant/layout/head.php');?>
<?php include('./constant/layout/header.php');?>
<?php include('./constant/layout/sidebar.php');?>
<div class="page-wrapper">
<div class="row page-titles">
<div class="col-md-5 align-self-center">
<h3 class="text-primary">Add Consumer</h3> </div>
<div class="col-md-7 align-self-center">
<ol class="breadcrumb">
<li class="breadcrumb-item"><a href="javascript:void(0)">Home</a></li>
<li class="breadcrumb-item active">Add Client</li>
</ol>
</div>
</div>
<div class="container-fluid">
<div class="row">
<div class="col-lg-8" style=" margin-left: 10%;">
<div class="card">
<div class="card-title">
</div>
<div id="add-brand-messages"></div>
<div class="card-body">
<div class="input-states">
<form class="form-horizontal" method="POST" id="submitProductForm" action="php_action/createclient.php" method="POST" enctype="multipart/form-data">
<input type="hidden" name="currnt_date" class="form-control">
<div class="form-group">
<div class="row">
<label class="col-sm-3 control-label"> Name</label>
<div class="col-sm-9">
<input type="text" class="form-control" id="name" placeholder=" Name" name="name" autocomplete="off" required="" />
</div>
</div>
</div>
<div class="form-group">
<div class="row">
<label class="col-sm-3 control-label">Gender</label>
<div class="col-sm-9">
<select class="form-control" id="brandName" name="gender">
<option value="Female">Female</option>
<option value="Male">Male</option>
</select></div>
</div>
</div>
<div class="form-group">
<div class="row">
<label class="col-sm-3 control-label">Mobile No
</label>
<div class="col-sm-9">
<input type="text" class="form-control" id="" placeholder="" name="mob_no" autocomplete="off" required="" />
</div>
</div>
</div>
<div class="form-group">
<div class="row">
<label class="col-sm-3 control-label"> ID Proof Number</label>
<div class="col-sm-9">
<input type="text" class="form-control" id="" placeholder="" name="reffering" autocomplete="off" required="" />
</div>
</div>
</div>
<div class="form-group">
<div class="row">
<label class="col-sm-3 control-label">Address</label>
<div class="col-sm-9">
<textarea type="text" class="form-control" id="" placeholder="" name="address" autocomplete="off" required="" style="height: 150px;"></textarea>
</div>
</div>
</div>
<div class="form-group">
<div class="row">
<label class="col-sm-3 control-label">Upload Image:</label>
<div class="col-sm-9">
<div id="kv-avatar-errors-1" class="center-block" style="display:none;"></div>
<div class="kv-avatar center-block">
<input type="file" class="form-control" id="productImage" name="productImage" class="file-loading" style="width:auto;"/>
</div>
</div>
</div>
</div>
<button type="submit" name="create" id="createProductBtn" class="btn btn-primary btn-flat m-b-30 m-t-30">Submit</button>
</form>
</div>
</div>
</div>
</div>
</div>
<?php include('./constant/layout/footer.php');?>