ok
Mini Shell
<?php
include "header.php";
$ids=$_REQUEST['ids'];
?>
<!-- login section start -->
<section class="form-section px-15 section-b-space">
<div class="row"
style="margin-top: 50px;">
<div class="col-12 col-sm-12">
<center><h1>Alliances Register Form</h1></center>
</div>
</div>
<form id="profile_verification">
<div id="religious_info">
<center><h3><b>Religious Info</b></h3></center><br>
<div class="form-floating mb-4">
<select name="religion" id="religion" class="form-control" >
<option value="">Select Religion</option>
<option value="Hindu">Hindu</option>
<option value="Muslim">Muslim</option>
<option value="Christian">Christian</option>
</select>
<label for="one">Religion</label>
</div>
<div class="form-floating mb-4">
<select name="mother_tongue" id="mother_tongue" class="form-control" >
<option value="">Select Mother Tongue</option>
<option value="Tamil">Tamil</option>
<option value="English">English</option>
</select>
<label for="one">Mother Tongue</label>
</div>
<div class="form-floating mb-4">
<select name="caste" id="caste" class="form-control" >
<option value="">Select Caste</option>
</select>
<label for="one">Caste</label>
</div>
</div><br>
<div id="horoscope_info">
<center><h3><b>Horoscope Info</b></h3></center><br>
<div class="form-floating mb-4">
<input type="text" class="form-control" name="horoscope_name" id="horoscope_name" placeholder="Name" />
<label for="age">Applicant's Name</label>
</div>
<div class="form-floating mb-4">
<select name="horoscope_gender" id="horoscope_gender" class="form-control" >
<option value="">Select Gender</option>
<option value="Male">Male</option>
<option value="Female">Female</option>
</select>
<label for="one">Gender</label>
</div>
<div class="form-floating mb-4">
<input type="date" class="form-control" name="horoscope_dob" id="horoscope_dob"/>
<label for="age">Date Of Birth</label>
</div>
<div class="row mb-4">
<p style="color:orange;">Time Of Birth</p>
<div class="col-4">
<select name="birth_hour" id="birth_hour" class="form-control" >
<option value="">Hour</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
</select>
</div>
<div class="col-4">
<select name="birth_min" id="birth_min" class="form-control" >
<option value="">Min</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
</select>
</div>
<div class="col-4">
<select name="birth_sn" id="birth_sn" class="form-control" >
<option value="Am">Am</option>
<option value="Pm">Pm</option>
</select>
</div>
</div>
<div class="form-floating mb-4">
<input type="text" class="form-control" name="birth_place" id="birth_place"/>
<label for="age">Place of Birth</label>
</div>
<div class="form-floating mb-4">
<select name="zodiac_signs_star" id="zodiac_signs_star" class="form-control" >
<option value="">Select Zodiac Signs / Star</option>
<option value="no">No Star</option>
</select>
<label for="age">Zodiac Signs / Star</label>
</div>
<div class="form-floating mb-4">
<select name="dhosam" id="dhosam" class="form-control" >
<option value="">Select Dhosam</option>
<option value="no">No Zodiac</option>
</select>
<label for="age">Dosham</label>
</div><br>
</div>
<div id="verification_proof">
<center><h3><b>Verification Proof</b></h3></center><br>
<label for="age">Profile Photos</label>
<div class="row mb-4" style="padding:10px;">
<div class="col-12" style="border:1px solid gray;padding:10px;border-radius:10px;">
<div class="row">
<div class="col-8"><img src="images/icon/star.png" style="margin-bottom:10px;">Choose the Your Profile Photos from your <span style="color:blue;">computer / phone's gallery</span><br><img src="images/icon/star.png" style="margin-bottom:10px;">Take a Your Profile Photos using <span style="color:blue;">mobile camera.</span></div>
<div class="col-2" style="text-align:center;align-items:center;"><img src="images/icon/no-img.png" style="width:100%;height:30px;"></div>
<div class="col-2" style="text-align:center;align-items:center;"><img src="images/icon/no-camera.png" style="width:100%;height:30px;"></div>
<!--testing-->
<div class="col-md-3">
<label for="proof_first" class="form-label">Proof 1</label>
<input type="file" class="form-control" <?=$input_style?> name="proof_first" id="proof_first" onchange="displaySelectedImage(this, 'blah_bus_one');" />
<input type="hidden" name="oldfileInput_first" value="" class="form-control tip" id="oldfileInput_first" />
<center><img id="blah_bus_one" src="" style="width: 150px; padding: 10px;"></center>
</div>
<!--Testing end-->
</div>
</div>
</div>
<div class="form-floating mb-4">
<input type="text" class="form-control" name="verified_aadhar_name" id="verified_aadhar_name" placeholder="Enter Aadhar No"/>
<label for="age">Enter Applicant's Aadhar Name</label>
</div>
<div class="form-floating mb-4">
<input type="text" class="form-control" name="verified_aadhar_no" id="verified_aadhar_no" placeholder="Enter Aadhar No"/>
<label for="age">Enter Applicant's Aadhar No</label>
</div>
<div class="form-floating mb-4">
<input type="text" class="form-control" name="verified_aadhar_mobile_no" id="verified_aadhar_mobile_no" />
<label for="age">Enter Applicant's Aadhar Mobile No</label>
</div>
<div class="row mb-4" style="padding:10px;">
<div class="col-12" style="border:1px solid gray;padding:10px;border-radius:10px;">
<div class="row">
<div class="col-8"><img src="images/icon/star.png" style="margin-bottom:10px;">Choose the image of Aadhaar card from your <span style="color:blue;">computer / phone's gallery</span><br><img src="images/icon/star.png" style="margin-bottom:10px;">Take a image of Aadhaar card using<span style="color:blue;">mobile camera.</span></div>
<div class="col-2" style="text-align:center;align-items:center;"><img src="images/icon/no-img.png" style="width:100%;height:30px;"></div>
<div class="col-2" style="text-align:center;align-items:center;"><img src="images/icon/no-camera.png" style="width:100%;height:30px;"></div>
<!--testing-->
<!-- <div class="col-md-3">-->
<!-- <label for="proof_zero" class="form-label">Proof 0</label>-->
<!-- <input type="file" class="form-control" <?=$input_style?> name="proof_zero" id="proof_zero" onchange="displaySelectedImage(this, 'blah_bus_zero');" />-->
<!-- <input type="hidden" name="oldfileInput_zero" value="" class="form-control tip" id="oldfileInput_zero" />-->
<!-- <center><img id="blah_bus_zero" src="" style="width: 150px; padding: 10px;"></center>-->
<!--</div>-->
<!--Testing end-->
</div>
</div>
</div>
<div class="form-floating mb-4">
<input type="text" class="form-control" name="birth_certificatenumber" id="birth_certificatenumber" />
<label for="age">Birth Certificate Number</label>
</div>
<div class="row mb-4" style="padding:10px;">
<div class="col-12" style="border:1px solid gray;padding:10px;border-radius:10px;">
<div class="row">
<div class="col-8"><img src="images/icon/star.png" style="margin-bottom:10px;">Choose the image of Birth Certificate from your <span style="color:blue;">computer / phone's gallery</span><br><img src="images/icon/star.png" style="margin-bottom:10px;">Take a image of Aadhaar card using<span style="color:blue;">mobile camera.</span></div>
<div class="col-2" style="text-align:center;align-items:center;"><img src="images/icon/no-img.png" style="width:100%;height:30px;"></div>
<div class="col-2" style="text-align:center;align-items:center;"><img src="images/icon/no-camera.png" style="width:100%;height:30px;"></div>
<!--testing-->
<div class="col-md-3">
<label for="proof_two" class="form-label">Proof 2</label>
<input type="file" class="form-control" <?=$input_style?> name="proof_two" id="proof_two" onchange="displaySelectedImage(this, 'blah_bus_two');" />
<input type="hidden" name="oldfileInput_two" value="" class="form-control tip" id="oldfileInput_two" />
<center><img id="blah_bus_two" src="" style="width: 150px; padding: 10px;"></center>
</div>
<!--Testing end-->
</div>
</div>
</div>
<div class="form-floating mb-4">
<input type="text" class="form-control" name="communication_certificate" id="communication_certificate" />
<label for="age">Communication Certificate</label>
</div>
<div class="row mb-4" style="padding:10px;">
<div class="col-12" style="border:1px solid gray;padding:10px;border-radius:10px;">
<div class="row">
<div class="col-8"><img src="images/icon/star.png" style="margin-bottom:10px;">Choose the image of Communication from your <span style="color:blue;">computer / phone's gallery</span><br><img src="images/icon/star.png" style="margin-bottom:10px;">Take a image of Aadhaar card using<span style="color:blue;">mobile camera.</span></div>
<div class="col-2" style="text-align:center;align-items:center;"><img src="images/icon/no-img.png" style="width:100%;height:30px;"></div>
<div class="col-2" style="text-align:center;align-items:center;"><img src="images/icon/no-camera.png" style="width:100%;height:30px;"></div>
<!--testing-->
<div class="col-md-3">
<label for="proof_two" class="form-label">Proof 2</label>
<input type="file" class="form-control" <?=$input_style?> name="proof_three" id="proof_three" onchange="displaySelectedImage(this, 'blah_bus_three');" />
<input type="hidden" name="oldfileInput_three" value="" class="form-control tip" id="oldfileInput_three" />
<center><img id="blah_bus_three" src="" style="width: 150px; padding: 10px;"></center>
</div>
<input type="hidden" name="ids" value="<?=$ids?>" />
<!--Testing end-->
</div>
</div>
</div>
<b>Agreement :</b><br
<input type="checkbox" name="agreement" id="agreement"><span>I have read and agree to comply with and/or be bound by the <span style="color:violet">Weddinfo</span> Alliance <span style="color:violet">Terms & Conditions.</span> </span><br>
</div>
<!--<a href="#" class="btn btn-solid w-100">Sign UP </a>-->
<button class="btn btn-solid w-100"> Sign UP</button>
<!--<a href="#" class="btn btn-solid w-100">Sign UP </a>-->
</form>
</section>
<!-- login section end -->
<!-- panel space start -->
<section class="panel-space"></section>
<!-- panel space end -->
<script>
var input = document.querySelector("#mobile_no");
window.intlTelInput(input, {
separateDialCode: true,
excludeCountries: ["il"],
preferredCountries: ["in"]
});
var alter_input = document.querySelector("#alter_mobile_no");
window.intlTelInput(alter_input, {
separateDialCode: true,
excludeCountries: ["il"],
preferredCountries: ["in"]
});
</script>
<script>
function displaySelectedImage(input, imgId) {
const imgElement = document.getElementById(imgId);
if (input.files && input.files[0]) {
const reader = new FileReader();
reader.onload = function(e) {
imgElement.src = e.target.result;
};
reader.readAsDataURL(input.files[0]);
} else {
imgElement.src = '';
}
}
</script>
<script>
$(document).ready(function() {
$('#profile_verification').submit(function(e) {
e.preventDefault();
alert('hello');
var formData = new FormData(this);
formData.append('type', 'horoscope');
console.log(formData);
$.ajax({
url: 'api/profile_add.php',
type: 'post',
dataType: 'json',
data: formData,
cache: false,
contentType: false,
processData: false,
success: function(response) {
console.log(response);
if (response['status'] == 200) {
alert(response['message']);
$(this).trigger("reset");
} else {
alert(response['message']);
}
}
});
});
});
</script>
<?php
include "footer2.php"; ?>
Zerion Mini Shell 1.0