-
Notifications
You must be signed in to change notification settings - Fork 0
/
form-wizard-vertical.php
214 lines (213 loc) · 13.5 KB
/
form-wizard-vertical.php
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
<?php
require_once("header.php");
?>
<!-- Page Content -->
<div id="content-page" class="content-page">
<div class="container-fluid">
<div class="row">
<div class="col-sm-12 col-lg-12">
<div class="iq-card">
<div class="iq-card-header d-flex justify-content-between">
<div class="iq-header-title">
<h4 class="card-title">Vertical Wizard</h4>
</div>
</div>
<div class="iq-card-body">
<div class="row">
<div class="col-md-3">
<ul id="top-tabbar-vertical" class="p-0">
<li class="active" id="personal">
<a href="javascript:void();">
<i class="ri-lock-unlock-line text-primary"></i><span>Personal</span>
</a>
</li>
<li id="contact">
<a href="javascript:void();">
<i class="ri-user-fill text-danger"></i><span>Contact</span>
</a>
</li>
<li id="official">
<a href="javascript:void();">
<i class="ri-camera-fill text-success"></i><span>Official</span>
</a>
</li>
<li id="payment">
<a href="javascript:void();">
<i class="ri-check-fill text-warning"></i><span>Payment</span>
</a>
</li>
</ul>
</div>
<div class="col-md-9">
<form id="form-wizard3" class="text-center">
<!-- fieldsets -->
<fieldset>
<div class="form-card text-left">
<div class="row">
<div class="col-12">
<h3 class="mb-4">User Information:</h3>
</div>
</div>
<div class="row">
<div class="col-md-12">
<div class="form-group">
<label for="fname">First Name: *</label>
<input type="text" class="form-control" id="fname" name="fname" placeholder="First Name" required="required" />
</div>
</div>
<div class="col-md-12">
<div class="form-group">
<label for="lname">Last Name: *</label>
<input type="text" class="form-control" id="lname" name="lname" placeholder="Last Name" />
</div>
</div>
<div class="col-md-12">
<div class="form-group">
<label>Gender: *</label>
<div class="form-check">
<div class="custom-control custom-radio custom-control-inline">
<input type="radio" id="customRadio1" name="customRadio" class="custom-control-input">
<label class="custom-control-label" for="customRadio1"> Male</label>
</div>
<div class="custom-control custom-radio custom-control-inline">
<input type="radio" id="customRadio2" name="customRadio" class="custom-control-input">
<label class="custom-control-label" for="customRadio2"> Female</label>
</div>
</div>
</div>
</div>
<div class="col-md-12">
<div class="form-group">
<label for="dob">Date Of Birth: *</label>
<input type="text" class="form-control date-input basicFlatpickr" id="dob" placeholder="Selete Date" />
</div>
</div>
</div>
</div>
<button id="submit" type="button" name="next" class="btn btn-primary next action-button float-right" value="Next" >Next</button>
</fieldset>
<fieldset>
<div class="form-card text-left">
<div class="row">
<div class="col-12">
<h3 class="mb-4">Contact Information:</h3>
</div>
</div>
<div class="row">
<div class="col-md-12">
<div class="form-group">
<label for="email">Email Id: *</label>
<input type="email" class="form-control" id="email" name="email" placeholder="Email Id" />
</div>
</div>
<div class="col-md-12">
<div class="form-group">
<label for="ccno">Contact Number: *</label>
<input type="text" class="form-control" id="ccno" name="ccno" placeholder="Contact Number" />
</div>
</div>
<div class="col-md-12">
<div class="form-group">
<label for="city">City: *</label>
<input type="text" class="form-control" id="city" name="city" placeholder="City." />
</div>
</div>
<div class="col-md-12">
<div class="form-group">
<label for="state">State: *</label>
<input type="text" class="form-control" id="state" name="state" placeholder="State." />
</div>
</div>
</div>
</div>
<button type="button" name="next" class="btn btn-primary next action-button float-right" value="Next" >Next</button>
<button type="button" name="previous" class="btn btn-dark previous action-button-previous float-right mr-3" value="Previous" >Previous</button>
</fieldset>
<fieldset>
<div class="form-card text-left">
<div class="row">
<div class="col-12">
<h3 class="mb-4">Official Information:</h3>
</div>
</div>
<div class="row">
<div class="col-md-12">
<div class="form-group">
<label for="empid">Employee Id: *</label>
<input type="email" class="form-control" id="empid" name="empid" placeholder="Employee Id." />
</div>
</div>
<div class="col-md-12">
<div class="form-group">
<label for="desg">Designation: *</label>
<input type="text" class="form-control" id="desg" name="desg" placeholder="Designation." />
</div>
</div>
<div class="col-md-12">
<div class="form-group">
<label for="accname">Departmrnt Name: *</label>
<input type="text" class="form-control" id="accname" name="accname" placeholder="Departmrnt Name." />
</div>
</div>
<div class="col-md-12">
<div class="form-group">
<label for="workhour">Working Hour: *</label>
<input type="text" class="form-control" id="workhour" name="workhour" placeholder="Working Hour." />
</div>
</div>
</div>
</div>
<button type="button" name="next" class="btn btn-primary next action-button float-right" value="Submit" >Submit</button>
<button type="button" name="previous" class="btn btn-dark previous action-button-previous float-right mr-3" value="Previous" >Previous</button>
</fieldset>
<fieldset>
<div class="form-card text-left">
<div class="row">
<div class="col-12">
<h3 class="mb-4 text-left">Payment:</h3>
</div>
</div>
<div class="row">
<div class="col-md-12">
<div class="form-group">
<label for="panno">Pan No: *</label>
<input type="text" class="form-control" id="panno" name="panno" placeholder="Pan No." />
</div>
</div>
<div class="col-md-12">
<div class="form-group">
<label for="accno">Account No: *</label>
<input type="text" class="form-control" id="accno" name="accno" placeholder="Account No." />
</div>
</div>
<div class="col-md-12">
<div class="form-group">
<label for="holname">Account Holder Name: *</label>
<input type="text" class="form-control" id="holname" name="accname" placeholder="Account Holder Name." />
</div>
</div>
<div class="col-md-12">
<div class="form-group">
<label for="ifsc">IFSC Code: *</label>
<input type="text" class="form-control" id="ifsc" name="ifsc" placeholder="IFSC Code." />
</div>
</div>
</div>
</div>
<a class="btn btn-primary action-button float-right" href="form-wizard-vertical.php" >Submit</a>
<button type="button" name="previous" class="btn btn-dark previous action-button-previous float-right mr-3" value="Previous" >Previous</button>
</fieldset>
</form>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
<!-- Wrapper END -->
<?php
require_once("footer.php");
?>