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customer_registration.html
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<!DOCTYPE html>
<html lang="en">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=UTF-8">
<!-- Meta, title, CSS, favicons, etc. -->
<meta charset="utf-8">
<meta http-equiv="X-UA-Compatible" content="IE=edge">
<meta name="viewport" content="width=device-width, initial-scale=1">
<title>Jagath Tailoring Centre</title>
<!-- Bootstrap -->
<link href="vendors/bootstrap/dist/css/bootstrap.min.css" rel="stylesheet">
<!-- Font Awesome -->
<link href="vendors/font-awesome/css/font-awesome.min.css" rel="stylesheet">
<!-- NProgress -->
<link href="vendors/nprogress/nprogress.css" rel="stylesheet">
<!-- iCheck -->
<link href="vendors/iCheck/skins/flat/green.css" rel="stylesheet">
<!-- bootstrap-wysiwyg -->
<link href="vendors/google-code-prettify/bin/prettify.min.css" rel="stylesheet">
<!-- Select2 -->
<link href="vendors/select2/dist/css/select2.min.css" rel="stylesheet">
<!-- Switchery -->
<link href="vendors/switchery/dist/switchery.min.css" rel="stylesheet">
<!-- starrr -->
<link href="vendors/starrr/dist/starrr.css" rel="stylesheet">
<!-- bootstrap-daterangepicker -->
<link href="vendors/bootstrap-daterangepicker/daterangepicker.css" rel="stylesheet">
<!-- Custom Theme Style -->
<link href="build/css/custom.css" rel="stylesheet">
<link href="build/css/main.css" rel="stylesheet">
</head>
<body class="nav-md">
<div class="container body">
<div class="main_container">
<div class="col-md-3 left_col">
<div class="left_col scroll-view">
<div class="navbar nav_title" style="border: 0;">
<a href="index.html" class="site_title"><span>Jagath Tailoring Centre</span></a>
</div>
<div class="clearfix"></div>
<!-- menu profile quick info -->
<div class="profile clearfix">
<div class="profile_pic">
<img src="build/images/admin_avatar.png" alt="..." class="img-circle profile_img">
</div>
<div class="profile_info">
<span>Welcome,</span>
<h2>Admin</h2>
</div>
</div>
<!-- /menu profile quick info -->
<br />
<!-- sidebar menu -->
<div id="sidebar-menu" class="main_menu_side hidden-print main_menu">
<div class="menu_section">
<h3>General</h3>
<ul class="nav side-menu">
<li><a href="index.html"><i class="fa fa-home"></i> Home</a></li>
<li><a href="category.html"><i class="fa fa-edit"></i>Category</a></li>
<li><a href="material.html"><i class="fa fa-edit"></i>Material</a></li>
<li><a href="items.html"><i class="fa fa-edit"></i>Items</a></li>
<li><a href="customer_registration.html"><i class="fa fa-edit"></i>Customer Registration</a></li>
<li><a href="employee_registration.html"><i class="fa fa-edit"></i>Employee Registration</a></li>
<li><a href="employee_allowance.html"><i class="fa fa-edit"></i>Employee Allowance</a></li>
</ul>
</div>
</div>
<!-- /sidebar menu -->
<!-- /menu footer buttons -->
<div class="sidebar-footer hidden-small">
<a data-toggle="tooltip" data-placement="top" title="Settings">
<span class="glyphicon glyphicon-cog" aria-hidden="true"></span>
</a>
<a data-toggle="tooltip" data-placement="top" title="FullScreen">
<span class="glyphicon glyphicon-fullscreen" aria-hidden="true"></span>
</a>
<a data-toggle="tooltip" data-placement="top" title="Lock">
<span class="glyphicon glyphicon-eye-close" aria-hidden="true"></span>
</a>
<a data-toggle="tooltip" data-placement="top" title="Logout" href="login.html">
<span class="glyphicon glyphicon-off" aria-hidden="true"></span>
</a>
</div>
<!-- /menu footer buttons -->
</div>
</div>
<!-- top navigation -->
<div class="top_nav">
<div class="nav_menu">
<nav>
<div class="nav toggle">
<a id="menu_toggle"><i class="fa fa-bars"></i></a>
</div>
<ul class="nav navbar-nav navbar-right">
<li class="">
<a href="javascript:;" class="user-profile dropdown-toggle" data-toggle="dropdown" aria-expanded="false">
<img src="build/images/admin_avatar.png" alt="">Admin
<span class=" fa fa-angle-down"></span>
</a>
<ul class="dropdown-menu dropdown-usermenu pull-right">
<li><a href="javascript:;"> Profile</a></li>
<li>
<a href="javascript:;">
<span class="badge bg-red pull-right">50%</span>
<span>Settings</span>
</a>
</li>
<li><a href="javascript:;">Help</a></li>
<li><a href="login.html"><i class="fa fa-sign-out pull-right"></i> Log Out</a></li>
</ul>
</li>
</ul>
</nav>
</div>
</div>
<!-- /top navigation -->
<!-- page content -->
<div class="right_col" role="main">
<div class="">
<div class="page-title">
<div class="title_left">
<h3>Customer Registration</h3>
</div>
<div class="title_right">
<div class="col-md-5 col-sm-5 col-xs-12 form-group pull-right top_search">
<div class="input-group">
<input type="text" class="form-control" placeholder="Search for...">
<span class="input-group-btn">
<button class="btn btn-default" type="button">Go!</button>
</span>
</div>
</div>
</div>
</div>
<div class="clearfix"></div>
<div class="row">
<div class="col-md-12 col-sm-12 col-xs-12">
<div class="x_panel">
<div class="x_title">
<h2>Registration Form<small>Only for new customers</small></h2>
<ul class="nav navbar-right panel_toolbox">
<li><a class="collapse-link"><i class="fa fa-chevron-up"></i></a>
</li>
<li class="dropdown">
<a href="#" class="dropdown-toggle" data-toggle="dropdown" role="button" aria-expanded="false"><i class="fa fa-wrench"></i></a>
<ul class="dropdown-menu" role="menu">
<li><a href="#">Settings 1</a>
</li>
<li><a href="#">Settings 2</a>
</li>
</ul>
</li>
<li><a class="close-link"><i class="fa fa-close"></i></a>
</li>
</ul>
<div class="clearfix"></div>
</div>
<div class="x_content">
<br />
<f id="demo-form2" data-parsley-validate class="form-horizontal form-label-left">
<div class="form-group">
<div class="col-md-4 col-sm-4 col-xs-12">
<label for="cusCategory" class="control-label">Customer Category<span class="required">*</span></label>
<select class="form-control" id="cusCategory" required="required">
<option>Choose option</option>
<option>Option one</option>
<option>Option two</option>
<option>Option three</option>
<option>Option four</option>
</select>
</div>
<div class="col-md-4 col-sm-4 col-xs-12">
<label class="control-label" for="cusSubCategory">Customer Sub Category<span class="required">*</span></label>
<select class="form-control" id="cusSubCategory" required="required">
<option>Choose option</option>
<option>Option one</option>
<option>Option two</option>
<option>Option three</option>
<option>Option four</option>
</select>
</div>
<div class="col-md-4 col-sm-4 col-xs-12">
<label for="cusCode" class="control-label">Customer Code</label>
<input type="text" id="cusCode" disabled="disabled" class="form-control">
</div>
</div>
<div class="form-group">
<div class="col-md-2 col-sm-4 col-xs-12">
<label class="control-label" for="officialNo">Official No<span class="required">*</span>
</label>
<input type="text" id="officialNo" required="required" class="form-control">
</div>
<div class="col-md-2 col-sm-4 col-xs-12">
<label class="control-label" for="cusTitle">Title<span class="required">*</span></label>
<select class="form-control" id="cusTitle" required="required">
<option>Choose</option>
<option>Mr</option>
<option>Mrs</option>
<option>Miss</option>
</select>
</div>
<div class="col-md-2 col-sm-4 col-xs-12">
<label class="control-label" for="cusRank">Rank<span class="required">*</span>
</label>
<select class="form-control" id="cusRank">
<option>Choose</option>
<option>Mr</option>
<option>Mrs</option>
<option>Miss</option>
</select>
</div>
<div class="col-md-6 col-sm-12 col-xs-12">
<label class="control-label" for="cusName">Customer Name<span class="required">*</span>
</label>
<input type="text" id="cusName" required="required" class="form-control">
</div>
</div>
<div class="form-group">
<div class="col-md-4 col-sm-4 col-xs-12">
<label class="control-label" for="dateofbirth">Date Of Birth <span class="required">*</span>
</label>
<input type="date" class="form-control" placeholder="Date Of Birth" id="dateofbirth">
</div>
<div class="col-md-8 col-sm-8 col-xs-12">
<label class="control-label" for="cusAddress">Address</label>
<input type="text" id="cusAddress" class="form-control">
</div>
</div>
<div class="form-group">
<div class="col-md-6 col-sm-6 col-xs-12">
<label class="control-label" for="telephone">Telephone</label>
<input type="number" id="telephone" class="form-control">
</div>
<div class="col-md-6 col-sm-6 col-xs-12">
<label class="control-label" for="mobile">Mobile<span class="required">*</span>
</label>
<input type="number" id="mobile" required="required" class="form-control">
</div>
</div>
<div class="form-group">
<div class="col-md-6 col-sm-6 col-xs-12">
<label class="control-label" for="fax">Fax</label>
<input type="number" id="fax" class="form-control">
</div>
<div class="col-md-6 col-sm-6 col-xs-12">
<label class="control-label" for="cusEmail">Email</label>
<input type="text" id="cusEmail" class="form-control">
</div>
</div>
<div class="form-group">
<div class="col-md-6 col-sm-6 col-xs-12">
<label class="control-label" for="referenceNo">Reference No<span class="required">*</span>
</label>
<input type="number" id="referenceNo" required="required" class="form-control" placeholder="NIC / Passport / Driving License etc..">
</div>
<div class="col-md-6 col-sm-6 col-xs-12">
<label class="control-label" for="reference1">Reference 1</label>
<input type="number" id="reference1" class="form-control" placeholder="Reference 1">
</div>
<div class="form-group">
<div class="col-md-6 col-sm-6 col-xs-12">
<label class="control-label" for="reference1">Reference 2</label>
<input type="number" id="reference2" class="form-control" placeholder="Reference 2">
</div>
<div class="col-md-6 col-sm-16 col-xs-12">
<label class="control-label" for="remarks">Remarks</label>
<textarea id="remarks" class="form-control" placeholder="Remarks"></textarea>
</div>
</div>
<div class="ln_solid"></div>
<div class="form-group">
<div class="col-md-6 col-sm-6 col-xs-12 col-md-offset-3">
<button class="btn btn-primary" type="button">Cancel</button>
<button class="btn btn-primary" type="reset">Reset</button>
<button type="submit" class="btn btn-success">Submit</button>
</div>
</div>
</form>
</div>
</div>
</div>
</div>
</div>
</div>
<!-- /page content -->
<!-- footer content -->
<footer>
<div class="pull-right">
Developed by <a href="https://www.etwinklesolutions.com">eTwinkle Solutions</a>
</div>
<div class="clearfix"></div>
</footer>
<!-- /footer content -->
</div>
</div>
<!-- jQuery -->
<script src="../vendors/jquery/dist/jquery.min.js"></script>
<!-- Bootstrap -->
<script src="../vendors/bootstrap/dist/js/bootstrap.min.js"></script>
<!-- FastClick -->
<script src="../vendors/fastclick/lib/fastclick.js"></script>
<!-- NProgress -->
<script src="vendors/nprogress/nprogress.js"></script>
<!-- bootstrap-progressbar -->
<script src="vendors/bootstrap-progressbar/bootstrap-progressbar.min.js"></script>
<!-- iCheck -->
<script src="vendors/iCheck/icheck.min.js"></script>
<!-- bootstrap-daterangepicker -->
<script src="vendors/moment/min/moment.min.js"></script>
<script src="../vendors/bootstrap-daterangepicker/daterangepicker.js"></script>
<!-- bootstrap-wysiwyg -->
<script src="vendors/bootstrap-wysiwyg/js/bootstrap-wysiwyg.min.js"></script>
<script src="vendors/jquery.hotkeys/jquery.hotkeys.js"></script>
<script src="vendors/google-code-prettify/src/prettify.js"></script>
<!-- jQuery Tags Input -->
<script src="vendors/jquery.tagsinput/src/jquery.tagsinput.js"></script>
<!-- Switchery -->
<script src="vendors/switchery/dist/switchery.min.js"></script>
<!-- Select2 -->
<script src="vendors/select2/dist/js/select2.full.min.js"></script>
<!-- Parsley -->
<script src="vendors/parsleyjs/dist/parsley.min.js"></script>
<!-- Autosize -->
<script src="vendors/autosize/dist/autosize.min.js"></script>
<!-- jQuery autocomplete -->
<script src="vendors/devbridge-autocomplete/dist/jquery.autocomplete.min.js"></script>
<!-- starrr -->
<script src="vendors/starrr/dist/starrr.js"></script>
<!-- Custom Theme Scripts -->
<script src="build/js/custom.min.js"></script>
</body>
</html>