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<?php
session_start();
$se = $_SESSION["id"];
if (!isset($_SESSION['id'])) {
header("Location: login.php");
}
include("includes/config.php");;
?>
<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="utf-8">
<meta name="viewport" content="width=device-width, initial-scale=1">
<title> family Form Elements</title>
<!-- Google Font: Source Sans Pro -->
<link rel="stylesheet" href="https://fonts.googleapis.com/css?family=Source+Sans+Pro:300,400,400i,700&display=fallback">
<!-- Font Awesome -->
<link rel="stylesheet" href="plugins/fontawesome-free/css/all.min.css">
<!-- Theme style -->
<link rel="stylesheet" href="dist/css/adminlte.min.css">
</head>
<body class="hold-transition sidebar-mini">
<div class="wrapper">
<!-- Navbar -->
<?php require "includes/nav.php" ?>
<!-- /.navbar -->
<!-- Main Sidebar Container -->
<?php require "includes/sidebar.php" ?>
<!-- Content Wrapper. Contains page content -->
<div class="content-wrapper">
<!-- Content Header (Page header) -->
<section class="content-header">
<div class="container-fluid">
<div class="row mb-2">
<div class="col-sm-6">
<h1>Family Form</h1>
</div>
<div class="col-sm-6">
<ol class="breadcrumb float-sm-right">
<li class="breadcrumb-item"><a href="#">Home</a></li>
<li class="breadcrumb-item active">Family Form</li>
</ol>
</div>
</div>
</div><!-- /.container-fluid -->
</section>
<!-- Main content -->
<section class="content">
<div class="container-fluid">
<div class="row">
<!-- left column -->
<div class="col-md-12">
<!-- general form elements -->
<div class="card card-primary">
<div class="card-header">
<h3 class="card-title">Add Family</h3>
</div>
<!-- /.card-header -->
<!-- form start -->
<?php
if(isset($_SESSION['status']) && $_SESSION != ''){
?>
<div class="alert alert-warning alert-dismissible fade show" role="alert">
<strong>Hey!</strong> <?php echo $_SESSION['status']; ?>
<button type="button" class="btn-close" data-bs-dismiss="alert" aria-label="Close"></button>
</div>
<?php
unset($_SESSION['status']);
}
?>
<form action="add_family.php" method="post" enctype="multipart/form-data">
<div class="card-body">
<div class="row">
<div class="col-md-4">
<div class="form-group">
<label for="exampleInputPassword1">Family Id</label>
<input type="text" class="form-control" id="family_id" name="family_id" placeholder="Enter Family ID">
</div>
</div>
<div class="col-md-8">
<div class="form-group">
<label for="exampleInputPassword1">Address</label>
<input type="text" class="form-control" id="h_no" name="h_no" placeholder="Enter House No.">
</div>
</div>
</div>
<div class="row">
<div class="col-md-4">
<div class="form-group">
<label for="exampleInputPassword1">Proposer Name</label>
<input type="text" class="form-control" id="own_name" name="own_name" placeholder="Enter Family Owner Name">
</div>
</div>
<div class="col-md-4">
<div class="form-group">
<label for="exampleInputPassword1">Proposer Age</label>
<input type="text" class="form-control" id="own_age" name="own_age" placeholder="Enter Owner Age">
</div>
</div>
<div class="col-md-4">
<div class="form-group">
<label for="ownerGender">Proposer's Gender</label>
<select class="form-control" id="ownerGender" name="ownerGender">
<option value="">Select Gender</option>
<option value="male">Male</option>
<option value="female">Female</option>
<option value="other">Other</option>
</select>
</div>
</div>
<!-- </div> -->
<!-- </div> -->
</div>
<div class="row">
<!-- <div class="col-md-3">
<div class="form-group">
<label for="exampleInputPassword1">Owner'S Father Name</label>
<input type="text" class="form-control" id="own_fname" name="own_fname" placeholder="Enter Family Owner Name">
</div>
</div> -->
<!-- <div class="col-md-3">
<div class="form-group">
<label for="exampleInputPassword1">Owner'S Father Age</label>
<input type="text" class="form-control" id="own_fage" name="own_fage" placeholder="Enter Family Owner Name">
</div>
</div> -->
<div class="col-md-3">
<div class="form-group">
<label for="exampleInputPassword1">Wife Name</label>
<input type="text" class="form-control" id="wife_name" name="wife_name" placeholder="Enter Wife Name">
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<label for="exampleInputPassword1">Wife Age</label>
<input type="text" class="form-control" id="wife_age" name="wife_age" placeholder="Enter Wife Age">
</div>
</div>
<!-- <div class="col-md-3">-->
<!-- <div class="form-group">-->
<!-- <label for="exampleInputPassword1">Wife Gender</label>-->
<!-- <input type="text" class="form-control" id="wife_gender" name="wife_gender" placeholder="Enter Wife Age">-->
<!-- </div>-->
<!--</div>-->
<div class="col-md-3">
<div class="form-group">
<label for="ownerGender">Wife Gender</label>
<select class="form-control" id="wife_gender" name="wife_gender">
<option value="">Select Gender</option>
<option value="male">Male</option>
<option value="female">Female</option>
<option value="other">Other</option>
</select>
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<label for="exampleInputPassword1">Wife Relation</label>
<input type="text" class="form-control" id="wife_relation" name="wife_relation" placeholder="Enter Wife Age">
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<label for="exampleInputPassword1">Child 1</label>
<input type="text" class="form-control" id="child1" name="child1" placeholder="Enter Child 1">
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<label for="exampleInputPassword1">Child 1 Age</label>
<input type="text" class="form-control" id="child1age" name="child1age" placeholder="Enter Child 1 Age">
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<label for="ownerGender">Child 1's Gender</label>
<select class="form-control" id="child1Gender" name="child1Gender">
<option value="">Select Gender</option>
<option value="male">Male</option>
<option value="female">Female</option>
<option value="other">Other</option>
</select>
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<label for="exampleInputPassword1">Child 1 Relation</label>
<input type="text" class="form-control" id="rchild1" name="rchild1" placeholder="Enter Child 1">
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<label for="exampleInputPassword1">Child 2</label>
<input type="text" class="form-control" id="child2" name="child2" placeholder="Enter Child 2">
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<label for="exampleInputPassword1">Child 2 Age</label>
<input type="text" class="form-control" id="child2age" name="child2age" placeholder="Child 2 Age">
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<label for="ownerGender">Child 2's Gender</label>
<select class="form-control" id="child2Gender" name="child2Gender">
<option value="">Select Gender</option>
<option value="male">Male</option>
<option value="female">Female</option>
<option value="other">Other</option>
</select>
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<label for="exampleInputPassword1">Child 2 Relation</label>
<input type="text" class="form-control" id="rchild2" name="rchild2" placeholder="Enter Child 1">
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<label for="exampleInputPassword1">Child 3</label>
<input type="text" class="form-control" id="child3" name="child3" placeholder="Enter Child 3">
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<label for="exampleInputPassword1">Child 3 Age</label>
<input type="text" class="form-control" id="child3age" name="child3age" placeholder="Child 3 Age">
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<label for="ownerGender">Child 3's Gender</label>
<select class="form-control" id="child3Gender" name="child3Gender">
<option value="">Select Gender</option>
<option value="male">Male</option>
<option value="female">Female</option>
<option value="other">Other</option>
</select>
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<label for="exampleInputPassword1">Child 3 Relation</label>
<input type="text" class="form-control" id="rchild3" name="rchild3" placeholder="Enter Child 1">
</div>
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
<label for="exampleInputPassword1">Family Member 1</label>
<input type="text" class="form-control" id="fm1" name="fm1" placeholder="Enter Family Member 1">
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<label for="exampleInputPassword1">Family Member 1 Age</label>
<input type="text" class="form-control" id="fm1age" name="fm1age" placeholder="Family Member 1 Age">
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<label for="ownerGender">Family Member 1's Gender</label>
<select class="form-control" id="fm1Gender" name="fm1Gender">
<option value="">Select Gender</option>
<option value="male">Male</option>
<option value="female">Female</option>
<option value="other">Other</option>
</select>
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<label for="exampleInputPassword1">Family Member 1's Relation</label>
<input type="text" class="form-control" id="rfm1" name="rfm1" placeholder="Enter Relation">
</div>
</div>
</div>
<div class="row">
<div class="col-md-3">
<div class="form-group">
<label for="exampleInputPassword1">Family Member 2</label>
<input type="text" class="form-control" id="fm2" name="fm2" placeholder="Enter Family Member 2">
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<label for="exampleInputPassword1">Family Member 2 Age</label>
<input type="text" class="form-control" id="fm2age" name="fm2age" placeholder="Family Member 2 Age">
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<label for="ownerGender">Family Member 2's Gender</label>
<select class="form-control" id="fm2Gender" name="fm2Gender">
<option value="">Select Gender</option>
<option value="male">Male</option>
<option value="female">Female</option>
<option value="other">Other</option>
</select>
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<label for="exampleInputPassword1">Family Member 2's Relation</label>
<input type="text" class="form-control" id="rfm2" name="rfm2" placeholder="Enter Relation">
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<label for="exampleInputPassword1">Visit</label>
<input type="number" class="form-control" id="visit" name="visit" placeholder="Enter visit">
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<label for="exampleInputPassword1">Mobile No.</label>
<input type="text" class="form-control" id="phone" name="phone" placeholder="Enter Mobile">
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<label for="exampleInputPassword1">Visit Date</label>
<input type="rext" class="form-control" id="visit_date" name="visit_date" placeholder="Enter visit Date">
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<label for="register_date">Register Date</label>
<input type="date" class="form-control" id="register_date" name="register_date" readonly>
</div>
</div>
<div class="col-md-3">
<div class="form-group">
<label for="expire_date">Expiry Date</label>
<input type="date" class="form-control" id="expire_date" name="expire_date" readonly>
</div>
</div>
</div>
<div class="card-footer">
<button type="submit" name="add_family" class="btn btn-primary">Add</button>
<!-- <button type="submit" class="btn btn-primary">Submit</button> -->
</div>
</form>
</div>
</div>
</div>
</div>
</section>
<!-- /.content -->
</div>
<!-- /.content-wrapper -->
<!-- <footer class="main-footer">
<div class="float-right d-none d-sm-block">
<b>Version</b> 3.2.0
</div>
<strong>Copyright © 2014-2021 <a href="https://adminlte.io">AdminLTE.io</a>.</strong> All rights reserved.
</footer> -->
<?php require "includes/footer.php" ?>
<script>
document.addEventListener("DOMContentLoaded", function() {
// Get today's date
const today = new Date();
// Format today's date as YYYY-MM-DD
const todayDate = today.toISOString().split('T')[0];
document.getElementById('register_date').value = todayDate;
// Calculate expiry date (1 year later)
const nextYear = new Date(today);
nextYear.setFullYear(today.getFullYear() + 1);
// Format expiry date as YYYY-MM-DD
const expiryDate = nextYear.toISOString().split('T')[0];
document.getElementById('expire_date').value = expiryDate;
});
</script>
<!-- Control Sidebar -->
<aside class="control-sidebar control-sidebar-dark">
<!-- Control sidebar content goes here -->
</aside>
<!-- /.control-sidebar -->
</div>
<!-- ./wrapper -->
<!-- jQuery -->
<script src="plugins/jquery/jquery.min.js"></script>
<!-- Bootstrap 4 -->
<script src="plugins/bootstrap/js/bootstrap.bundle.min.js"></script>
<!-- bs-custom-file-input -->
<script src="plugins/bs-custom-file-input/bs-custom-file-input.min.js"></script>
<!-- AdminLTE App -->
<script src="dist/js/adminlte.min.js"></script>
<!-- AdminLTE for demo purposes -->
<script src="dist/js/demo.js"></script>
<!-- Page specific script -->
<script>
$(function () {
bsCustomFileInput.init();
});
</script>
</body>
</html>