-
Notifications
You must be signed in to change notification settings - Fork 0
/
Copy pathnewCust.php
80 lines (73 loc) · 4.06 KB
/
newCust.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
<!DOCTYPE html>
<html lang="en" dir="ltr">
<head>
<meta charset="UTF-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<meta http-equiv="X-UA-Compatible" content="ie=edge">
<title>Pulse Electronics</title>
<link rel="stylesheet" href="https://maxcdn.bootstrapcdn.com/bootstrap/4.3.1/css/bootstrap.min.css">
<script src="https://ajax.googleapis.com/ajax/libs/jquery/3.4.1/jquery.min.js"></script>
<script src="https://cdnjs.cloudflare.com/ajax/libs/popper.js/1.14.7/umd/popper.min.js"></script>
<script src="https://maxcdn.bootstrapcdn.com/bootstrap/4.3.1/js/bootstrap.min.js"></script>
<link rel="stylesheet" href="css/newCustomer.css">
<link rel="icon" type="images/png" href="images/logo.png">
</head>
<body>
<?php echo "HELLO WORLD" ?>
<div class="container">
<form class="was-validated" action="">
<div class="form-group">
<label for="fname">First Name<span style="color: red">*</span></label> :
<input type="text" class="form-control" name="fname" placeholder="First name" required>
<div class="invalid-feedback">The first name cannot be empty.</div>
<div class="valid-feedback"></div>
</div>
<div class="form-group">
<label for="lname">Last Name<span style="color: red">*</span></label> :
<input type="text" class="form-control" name="lname" placeholder="Last name" required>
<div class="invalid-feedback">The last name cannot be empty.</div>
<div class="valid-feedback"></div>
</div>
<div class="form-group">
<label for="mailid">Email ID<span style="color: red">*</span></label> :
<input type="email" class="form-control" name="mailid" placeholder="Email ID" required>
<div class="invalid-feedback">The Email ID cannot be empty.</div>
<div class="valid-feedback"></div>
</div>
<div class="form-group">
<label for="addressl1">Address Line 1<span style="color: red">*</span></label> :
<input type="text" class="form-control" name="addressl1"
placeholder="Address line 1 (Flat no., House No,Building,etc)" style="width: 400px" required>
<div class="invalid-feedback">The address cannot be empty.</div>
<div class="valid-feedback"></div>
</div>
<div class="form-group">
<label for="addressl2">Address Line 2<span style="color: red">*</span></label> :
<input type="text" class="form-control" name="addressl2" placeholder="Address line 2 (Locality)"
style="width: 400px" required>
<div class="invalid-feedback">The address cannot be empty.</div>
</div>
<div class="from-group">
<label for="addressl3">Address Line 3<span style="color: red">*</span></label> :
<input type="text" class="form-control" name="addressl3" placeholder="Address line 3 (city)"
style="width: 400px" required>
<div class="invalid-feedback">The address cannot be empty.</div>
</div>
<div class="form-group">
<label for="city">City<span style="color: red">*</span></label> :
<input type="text" class="form-control" name="city" required>
<div class="invalid-feedback">The city name cannot be empty.</div>
</div>
<div class="form-group form-check">
<label class="form-check-label">
<input class="form-check-input" type="checkbox" name="remember" required> I agree to the terms and
conditions.
<div class="valid-feedback"></div>
<div class="invalid-feedback">Check this checkbox to continue.</div>
</label>
</div>
<button type="submit" class="btn btn-primary">Submit</button>
</form>
</div>
</body>
</html>