<?php include 'header1f.php';?>
  <div class="content-page">
    <div class="content">
      <div class="container">
	  <div class="row">
          <div class="col-sm-12">
            <div class="page-header-title">
            <button type="button" class="btn btn-dark waves-effect waves-light" onclick="location.href='qtn_status.php'">BACK </button>
              <div class="clearfix"></div>
            </div>
          </div>
        </div>
	  
	<form name="frmdetail" action="insert_accounts.php" method="post">
		<input type="hidden" value="<? echo $_REQUEST['created_dept']?>" name="created_dept">
<input name="app_db" id="app_db" value="" type="hidden">


<? include('sahavas_dropdown_function.php');?>

<input name="type" id="type" value="1" type="hidden">
<input name="jsmenu" id="jsmenu" value="0" type="hidden">
                    <div class="row">
                        <div class="col-sm-12">
                            <div class="panel panel-primary">
                                <div class="panel-heading">
                                    <h3 class="panel-title">Add Transport </h3></div>
                                <div class="panel-body">
                                    <div class="row">
                                                    <div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>Customer ID</label>
                                                          <input class="form-control" name="customer_id" type="text" id="name1"  required>
                                                    </div>
													</div>
													
												
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>Account  Name</label>
                                                         <input class="form-control" name="customer_name"  type="text"id="name">
                                                    </div>
													</div>
													
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>Company Type</label>
                                                            <select class="form-control" name="comptype" id="comptype" required>
									        <option selected="selected"></option>
											<option value="Direct"> Direct</option>
											<option value="3rd Party agents">3rd Party agents </option>
											
											
									      </select>
                                                    </div>
													</div>
													
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>PAN No</label>
                                                          <input class="form-control" name="pan_no" id="pan_no" type="text">
                                                    </div>
													</div>
													
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>Assign to</label>
                                                         <select name="assigned_to" id="assigned_to" class="form-control" >
							 
										 <?php $query1 = "select * from users  ORDER BY username asc";
		                 $result1 = mysql_query($query1,$conn);		?>
						 
			<option selected="selected" value="">Select Assigned to</option>
			<?php
													  while($row=mysql_fetch_array($result1))
	                                              	{
													  $full_name = $row['full_name'];
													  $id = $row['id'];
													  ?>
			 <option value="<?php echo $id ?>"><?php echo $full_name ?></option>
			 
                                                      <?php
														
														 } ?>
														 
                  </select>
                                                    </div>
													</div>
													
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>Credit Time (in Days)</label>
                                                          <input class="form-control" name="credittime" id="credittime" type="text">
                                                    </div>
													</div>
													
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>Amt (in <span id="basecur">INR</span>)</label>
                                           <input class="form-control" name="creditlimit" style="text-align:right;background-color:#FFFFFF;" id="creditlimit" onBlur="isnumericf('creditlimit');" type="text">
                                                  <script>
    								document.getElementById('basecur').innerHTML='INR';
									</script>	  </div>
													</div>
													
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>Turn Over</label>
                                                           <input class="form-control" name="turnover" id="turnover" type="text">
                                                    </div>
													</div>
													
                                                    
                                                    
                                        
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
					
					
					<div class="row">
                        <div class="col-sm-12">
                            <div class="panel panel-primary">
                                <div class="panel-heading">
                                    <h3 class="panel-title">Billing Address Information</h3></div>
                                <div class="panel-body">
                                    <div class="row">
                                                    <div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>Address</label>
                                                         <textarea class="form-control" rows="4" style="resize:vertical;" name="baddrl1" id="baddrl1" maxlength="250" required></textarea>
                                                    </div>
													</div>
													
												<input name="accbcountry" id="accbcountry" value="" type="hidden">
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>Country</label>
                                                     <select class="form-control" name="bcountry" id="bcountry" onChange="acttypefun();">
									            	<option value=""></option>
										          	
													<? echo country(); ?>
													
													
												</select>
                                                    </div>
													</div>
													
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>State</label>
                                                           
														<select style="" class="form-control" name="bstate" id="bstate" onChange="getDistrict('0');" required>
															<option value=""></option>
									                 		<? echo state(); ?>
														</select>
														
														<input style="display: none;" class="form-control" id="ostate" name="ostate" type="text">
                                                    </div>
													</div>
													
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>District</label>
                                                         <input class="form-control" name="bdistrict" id="bdistrict" value="" type="text">
                                                    </div>
													</div>
													
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>City</label>
                                                        	<input class="form-control" name="bcity" id="bcity" value="" type="text" required>
                                                    </div>
													</div>
													
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>Credit Time (in Days)</label>
                                                          <input class="form-control" name="credittime" id="credittime" type="text">
                                                    </div>
													</div>
													
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>State Code</label>
                                           <input class="form-control" id="bpin" name="bstate_code" value="" onChange="isnumericbpin('bpin');" type="text" > </div>
													</div>
													
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>Pin Code</label>
                                                         <input class="form-control" id="bpin" name="bpin" value="" onChange="isnumericbpin('bpin');" type="text" required>
                                                    </div>
													</div>
												
												
												<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>Email</label>
                                                         <input class="form-control" id="bemail" name="bemail" value="" onChange="getFieldValues('bemail');" type="text">
                                                    </div>
													</div>
													
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>Phone No</label>
                                                        	<input class="form-control" id="bphone" name="bphone" value="" onChange="getFieldValues('bphone');" type="text">
                                                    </div>
													</div>
													
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>Fax No</label>
                                                       <input class="form-control" id="bfax" name="bfax" value="" onChange="getFieldValues('bfax');" type="text">
                                                    </div>
													</div>
													
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>GST No.</label>
                                                         <input class="form-control" id="bgst_no" name="bgst_no" value="" onChange="getFieldValues('bgst_no');" type="text">
                                                    </div>
													</div>	
                                                    
                                                    
                                        
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
					
					
					
					<div class="row">
                        <div class="col-sm-12">
                            <div class="panel panel-primary">
                                <div class="panel-heading">
                                    <h3 class="panel-title">Shipping Address Information</h3></div>
                                <div class="panel-body">
                                    <div class="row">
                                                    <div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>Address</label>
                                                         <textarea class="form-control" rows="4" style="resize:vertical;" name="saddrl1" id="saddrl1" maxlength="250" required></textarea>
                                                    </div>
													</div>
													
												<input name="accbcountry" id="accbcountry" value="" type="hidden">
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>Country</label>
                                                     <select class="form-control" name="scountry" id="scountry" onChange="acttypefun();">
									            	<option value=""></option>
										          	
													<? echo country(); ?>
													
													
												</select>
                                                    </div>
													</div>
													
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>State</label>
                                                           
														<select style="" class="form-control" name="sstate" id="sstate" onChange="getDistrict('0');" required>
															<option value=""></option>
									                 		<? echo state(); ?>
														</select>
														
														<input style="display: none;" class="form-control" id="osstate" name="osstate" type="text">
                                                    </div>
													</div>
													
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>District</label>
                                                         <input class="form-control" name="sdistrict" id="sdistrict" value="" type="text">
														 <input style="display: none;" class="form-control" id="osdistrict" name="osdistrict" type="text">
                                                    </div>
													</div>
													
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>City</label>
                                                        	<input class="form-control" name="scity" id="scity" value="" type="text" required>
                                                    </div>
													</div>
													
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>Credit Time (in Days)</label>
                                                          <input class="form-control" name="credittime" id="credittime" type="text">
                                                    </div>
													</div>
													
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>State Code</label>
                                           <input class="form-control" id="bpin" name="sstate_code" value="" onChange="isnumericbpin('spin');" type="text" > </div>
													</div>
													
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>Pin Code</label>
                                                         <input class="form-control" id="spin" name="spin" value="" onChange="isnumericbpin('spin');" type="text" required>
                                                    </div>
													</div>
												
												
												<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>Email</label>
                                                         <input class="form-control" id="semail" name="semail" value="" onChange="getFieldValues('semail');" type="text">
                                                    </div>
													</div>
													
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>Phone No</label>
                                                        	<input class="form-control" id="sphone" name="sphone" value="" onChange="getFieldValues('sphone');" type="text">
                                                    </div>
													</div>
													
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>Fax No</label>
                                                       <input class="form-control" id="sfax" name="sfax" value="" onChange="getFieldValues('Sfax');" type="text">
                                                    </div>
													</div>
													
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>GST No.</label>
                                                         <input class="form-control" id="sgst_no" name="sgst_no" value="" onChange="getFieldValues('sgst_no');" type="text">
                                                    </div>
													</div>	
                                                    
                                                    
                                        
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
					
					
					
					
					
					<div class="row">
                        <div class="col-sm-12">
                            <div class="panel panel-primary">
                                <div class="panel-heading">
                                    <h3 class="panel-title">Contact Details</h3></div>
                                <div class="panel-body">
                                    <div class="row">
                                                    <div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>Saul</label>
                                                      <select class="form-control" name="saul" id="saul" onChange="setGenderNew()">
																	    	<option selected="selected" value=""></option>
																	        <option value="Mr.">Mr.</option>
															                <option value="Ms.">Ms.</option>
															                <option value="Mrs.">Mrs.</option>
															                <option value="Dr.">Dr.</option>
															                <option value="Prof.">Prof.</option>
															                
															                
														                </select>
                                                    </div>
													</div>
													
											
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>Name</label>
                                                     <input class="form-control" id="name" name="name" type="text" >
                                                    </div>
													</div>
													
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>Gender</label>
                                                           
														<select class="form-control" id="gender" name="gender">
																		    	<option selected="selected" value=""></option>
																		         <option value="Male">Male</option>
																			     <option value="Female">Female</option>
															                </select>
                                                    </div>
													</div>
													
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>Department</label>
                                                        <input class="form-control" id="department" name="department" type="text">
                                                    </div>
													</div>
													
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>Designation</label>
                                                        	<input class="form-control" id="designation" name="designation" type="text">
                                                    </div>
													</div>
													
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>Contact Types</label>
                                                         <select class="form-control" name="contact_types" id="contact_types">
																    <option selected="selected"> </option>
													                
																	<option value="Decision Maker">Decision Maker</option>
																	
																	<option value="Influencer">Influencer</option>
																	
																	<option value="Recommender">Recommender</option>
																	
																	<option value="User">User</option>
																	
																	<option value="Purchase Officer">Purchase Officer</option>
																	
																 </select>
                                                    </div>
													</div>
													
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>Email</label>
                                          <input class="form-control" id="email" name="email" onChange="getFieldValuesContNew('cemail');ValidateEmail('cemail');" type="text"> </div>
													</div>
													
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>Office Phone</label>
                                                        <input class="form-control" id="office_phone" name="office_phone" onChange="getFieldValuesContNew('cphone');isnumericf('cphone')" type="text">
                                                    </div>
													</div>
												
												
												<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>Mobile No</label>
                                                        <input class="form-control" id="mobile_no" name="mobile_no" onChange="getFieldValuesContNew('mobile');isnumericf('mobile')" type="text">
                                                    </div>
													</div>
													
													<div class="col-sm-3 col-xs-12"><div class="form-group">
                                                        <label>B'day</label>
                                                        	<input type="text" id="datepicker" class="form-control date-picker" name="bday">
                                                    </div>
													</div>
													
													<div class="col-sm-6 col-xs-12"><div class="form-group">
                                                        <label>Remark</label>
                                                      	<textarea class="form-control" rows="2" id="remark" name="remark" style="resize: vertical;"></textarea>
                                                    </div>
													</div>
													
													<div class="col-sm-12 col-xs-12">
                                           
                                            <div class="m-t-20">
                                                    <div class="form-group">
                                                        <div>
                                                          <input class="btn btn-primary " type="submit" name="Submit" value="Save" >
						
															
                                                           
                                                        </div>
                                                    </div>
                                               
                                            </div>
                                        </div>
                                        
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
					
					
					
					
					</form>
        
        
      </div>
    </div>
   	<?php include 'footer1a.php';?>
