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<!DOCTYPE html>
<html lang="en">
<!-- Mirrored from preview.landinglayouts.com/templates/5652/shop.html by HTTrack Website Copier/3.x [XR&CO'2014], Sun, 03 Dec 2023 07:49:15 GMT -->
<head>
<meta charset="UTF-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<?php include "includes/title.php" ?>
<link rel="stylesheet" href="assets/css/bootstrap.min.css">
<link rel="stylesheet" href="assets/css/all.min.css">
<link rel="stylesheet" href="assets/css/font.css">
<link rel="stylesheet" href="assets/css/swiper.min.css">
<link rel="stylesheet" href="assets/css/style.css">
<link rel="shortcut icon" href="assets/imgs/favicon.png" type="image/x-icon">
</head>
<body>
<!-- pre loader start -->
<!-- <div class="ll-preloader">
<div class="ll-ellipsis">
<span></span>
<span></span>
<span></span>
</div>
</div> -->
<!-- pre loader end -->
<!-- main wrapper start -->
<div class="ll-main-wrapper">
<!-- top header start -->
<?php include "includes/header.php" ?>
<!-- top header end -->
<!-- main header start -->
<!-- main header end -->
<!-- breadcrumb start -->
<div class="ll-breadcrumb">
<div class="container-fluid">
<div class="ll-breadcrumb-box">
<h1>Signup</h1>
<ul>
<li><a href="index.php">Home</a></li>
<li>Signup</li>
</ul>
</div>
</div>
</div>
<!-- breadcrumb end -->
<!-- SERVICE start -->
<div class="ll-product">
<div class="container">
<div class="ll-heading">
<img src="assets/imgs/Ayurveda-01.png" alt="image" class="img-fluid"/>
<!-- <h1>Signup</h1> -->
<!-- <h2>We Provide you one of the best Services</h2> -->
</div>
<!-- signup start -->
<div>
<div>
<div>
<div class="modal-content">
<div class="modal-body">
<h1 class="ll-login-title">Signup</h1>
<form action="signup_submit.php" method="POST" id="frmRegister" enctype="multipart/form-data">
<div class="row">
<div class="col-lg-4 col-md-4 col-sm-4">
<div class="form-group">
<!-- <label>Name</label> -->
<input type="text" name="name" placeholder="Enter Name" required="" />
</div>
</div>
<div class="col-lg-4 col-md-4 col-sm-4">
<div class="form-group">
<!-- <label>Email</label> -->
<input type="email" name="email" placeholder="Enter Email" required="" />
</div>
</div>
<div class="col-lg-4 col-md-4 col-sm-4">
<div class="form-group">
<!-- <label>Password</label> -->
<input type="Password" name="password" placeholder="Enter Password " required="" />
</div>
</div>
<div class="col-lg-4 col-md-4 col-sm-4">
<div class="form-group">
<!-- <label>Age</label> -->
<input type="number" name="age" placeholder="Enter Age" required="" />
</div>
</div>
<div class="col-lg-4 col-md-4 col-sm-4">
<div class="form-group">
<!-- <label>Phone No</label> -->
<input type="text" name="phone" placeholder="Enter Phone No" required="" />
</div>
</div>
<div class="col-lg-4 col-md-4 col-sm-4">
<div class="form-group">
<!-- <label>Country</label> -->
<input type="text" name="country" placeholder="Enter Country " required="" />
</div>
</div>
<div class="col-lg-4 col-md-4 col-sm-4">
<div class="form-group">
<!-- <label>State</label> -->
<input type="text" name="state" placeholder="Enter State " required="" />
</div>
</div>
<div class="col-lg-4 col-md-4 col-sm-4">
<div class="form-group">
<!-- <label>City</label> -->
<input type="text" name="city" placeholder="Enter City " required=""/>
</div>
</div>
<div class="col-lg-4 col-md-4 col-sm-4">
<div class="form-group">
<!-- <label>Address</label> -->
<textarea name="address" required="" cols="38" rows="2" placeholder="Address"></textarea>
</div>
</div>
<div class="col-lg-4 col-md-4 col-sm-4">
<div class="form-group">
<!-- <label>ZIP Code/Postal Code</label> -->
<input type="text" name='zip_code' placeholder="Enter Zipcode " required="" />
</div>
</div>
<div class="col-lg-4 col-md-4 col-sm-4">
<!-- <label>Image</label> -->
<div class="form-group">
<input type="file" name="img" id="img" onchange="readThumb(this, 'thumb-error')" class="" accept="image/*" required="">
</div>
<div id="thumb" class="col-md-4"></div>
<div id="thumb-error" style="color: red; margin: 10px 0px 0 10px; display: none;">Please upload file having extensions .jpeg / .jpg / .png only.
</div>
</div>
<div class="col-lg-4 col-md-4 col-sm-4">
<div class="form-group">
<!-- <label>Gender</label> -->
<select name="gender" id="gender" class="form-control" required="">
<option >Select Gender</option>
<option value="Male">Male</option>
<option value="FeMale">FeMale</option>
<option value="other">Other</option>
</select>
</div>
</div>
<div class="col-lg-2 col-md-4 col-sm-4">
<div class="ll-login-btn">
<!-- <label>Gender</label> -->
<input type="submit" name="regi_submit" class="ll-btn" value="Register"/>
</div>
</div>
<div class="col-lg-8 col-md-8 col-sm-8">
<div>
<p>Already have an account? <a href="login.php">Login</a></p>
</div>
</div>
</div>
</form>
<!-- <form>
<div class="ll-login-form container">
<div class="row">
<div class="col-md-4">
<input type="text" placeholder="Username">
</div>
<div class="col-md-4">
<input type="text" placeholder="Email">
</div>
<div class="col-md-4">
<input type="password" placeholder="Password">
</div>
<div class="col-md-4">
<input type="text" placeholder="Age">
</div>
<div class="col-md-4">
<div class="form-group">
<select name="gender" id="gender" class="form-control" required="" style="">
<option value="Male">Male</option>
<option value="FeMale">Female</option>
<option value="FeMale">Other</option>
</select>
</div>
</div>
<div class="col-md-4">
<input type="text" placeholder="Phone No">
</div>
<div class="col-md-4">
<input type="text" placeholder="Country">
</div>
<div class="col-md-4">
<input type="password" placeholder="State">
</div>
<div class="col-md-4">
<input type="text" placeholder="City">
</div>
<div class="col-md-4">
<input type="text" placeholder="Zip Code">
</div>
<div class="col-md-4">
<input type="file" placeholder="Image">
</div>
</div>
<div class="col-md-4">
<textarea name="address" id="" cols="60" rows="2" placeholder="address"></textarea>
</div>
<div class="ll-login-btn">
<button class="ll-btn">Sign up</button>
<p>Already have an account? <a href="login.php">Login</a></p>
</div>
</div>
</form> -->
</div>
</div>
</div>
</div>
</div>
<!-- signup end -->
</div>
</div>
<!-- product end -->
<!-- footer start -->
<?php include "includes/footer.php" ?>
<!-- copyright end -->
</div>
<!-- main wrapper end -->
<script src="assets/js/jquery.min.js"></script>
<script src="assets/js/bootstrap.min.js"></script>
<script src="assets/js/SmoothScroll.min.js"></script>
<script src="assets/js/swiper.min.js"></script>
<script src="assets/js/custom.js"></script>
<!-- <script src="assets/js/register.js"></script> -->
<!-- <script type="text/javascript">
function readThumb(input, error) {
document.getElementById(error).style.display = "none";
var filePath = input.value;
var allowedExtensions = /(\.jpg|\.jpeg|\.png)$/i;
if(!allowedExtensions.exec(filePath)){
document.getElementById(error).style.display = "block";
input.value = '';
document.getElementById("thumb").innerHTML = "";
return false;
} else if(input.files && input.files[0]) {
document.getElementById("thumb").innerHTML = "";
var total = input.files.length;
for(i=0; i<total; i++ ) {
var reader = new FileReader();
reader.onload = function(e) {
var newimg = document.createElement("img");
newimg.setAttribute("src", e.target.result);
newimg.setAttribute("height", "70px");
document.getElementById("thumb").appendChild(newimg);
}
reader.readAsDataURL(input.files[i]);
}
}
}
</script>
<script type="text/javascript">
function readImages(input, errorClass) {
document.getElementById(errorClass).style.display = "none";
var len = input.files.length;
var error = false;
for(var i=0; i<len; i++) {
var filePath = input.files[i].name;
var allowedExtensions = /(\.jpg|\.jpeg|\.png)$/i;
if(!allowedExtensions.exec(filePath)){
document.getElementById(errorClass).style.display = "block";
input.value = '';
document.getElementById("img-container").innerHTML = "";
error = true;
break;
}
}
if(error == true) {
return false;
} else if(input.files && input.files[0]) {
document.getElementById("img-container").innerHTML = "";
var total = input.files.length;
for(i=0; i<total; i++ ) {
var reader = new FileReader();
reader.onload = function(e) {
var newimg = document.createElement("img");
newimg.setAttribute("src", e.target.result);
newimg.setAttribute("height", "50px");
document.getElementById("img-container").appendChild(newimg);
}
reader.readAsDataURL(input.files[i]);
}
}
}
</script> -->
</body>
<!-- Mirrored from preview.landinglayouts.com/templates/5652/shop.html by HTTrack Website Copier/3.x [XR&CO'2014], Sun, 03 Dec 2023 07:49:15 GMT -->
</html>