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Current File : /home2/imyrqtmy/public_html/wellcare/admin/update-family.php
<?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">Update 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']);
                      }
                ?>


                <?php
                    $id = $_GET['id'];
                    $query = "SELECT * FROM families WHERE id='$id'";
                    $query_run =mysqli_query($conn, $query);
                    if(mysqli_num_rows($query_run) > 0){
                    foreach($query_run as $row){
                ?>


                  
              <form action="add_family.php" method="post" enctype="multipart/form-data">
              <input type="hidden" name="id" value="<?php echo $row['id']; ?>">
                <div class="card-body">

                <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" value="<?php echo $row['family_id']; ?>" readonly>
                    </div>
                  </div>
                
                 <div class="row">

                
                  <div class="col-md-4">
                    <div class="form-group">
                      <label for="exampleInputPassword1">Address</label>
                      <input type="text" class="form-control" id="h_no" name="h_no" value="<?php echo $row['h_no']; ?>">
                    </div>
                  </div>

                  <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" value="<?php echo $row['own_name']; ?>">
                    </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=""><?php echo $row['ownerGender']; ?></option>-->
                <!--            <option value="male">Male</option>-->
                <!--            <option value="female">Female</option>-->
                <!--            <option value="other">Other</option>-->
                <!--        </select>-->
                <!--    </div>-->
                <!--</div>-->
                
                  <div class="col-md-4">
                        <div class="form-group">
                            <label for="child1Gender">Proposer's Gender</label>
                            <select class="form-control" id="ownerGender" name="ownerGender">
                                <!-- Default value for the option is set to the value from the database -->
                                <option value="" <?php echo ($row['ownerGender'] == '') ? 'selected' : ''; ?>>Select Gender</option>
                                <option value="male" <?php echo ($row['ownerGender'] == 'male') ? 'selected' : ''; ?>>Male</option>
                                <option value="female" <?php echo ($row['ownerGender'] == 'female') ? 'selected' : ''; ?>>Female</option>
                                <option value="other" <?php echo ($row['ownerGender'] == 'other') ? 'selected' : ''; ?>>Other</option>
                            </select>
                        </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"  value="<?php echo $row['own_age']; ?>">
                    </div>
                  </div>

                  <!--<div class="col-md-4">-->
                  <!--  <div class="form-group">-->
                  <!--    <label for="exampleInputPassword1">Owner'S Father Name</label>-->
                  <!--    <input type="text" class="form-control" id="own_fname" name="own_fname" value="<?php echo $row['own_fname']; ?>">-->
                  <!--  </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" value="<?php echo $row['own_fage']; ?>">-->
                  <!--  </div>-->
                  <!--</div>-->
                 
                 </div>

                 <div class="row">

                 <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" value="<?php echo $row['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" value="<?php echo $row['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"  value="<?php echo $row['wife_gender']; ?>">-->
                  <!--  </div>-->
                  <!--</div>-->
                  
                  <div class="col-md-3">
                        <div class="form-group">
                            <label for="child1Gender">Wife Gender</label>
                            <select class="form-control" id="wife_gender" name="wife_gender">
                                <!-- Default value for the option is set to the value from the database -->
                                <option value="" <?php echo ($row['wife_gender'] == '') ? 'selected' : ''; ?>>Select Gender</option>
                                <option value="male" <?php echo ($row['wife_gender'] == 'male') ? 'selected' : ''; ?>>Male</option>
                                <option value="female" <?php echo ($row['wife_gender'] == 'female') ? 'selected' : ''; ?>>Female</option>
                                <option value="other" <?php echo ($row['wife_gender'] == 'other') ? 'selected' : ''; ?>>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"  value="<?php echo $row['wife_relation']; ?>">
                    </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" value="<?php echo $row['child1']; ?>">
                    </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" value="<?php echo $row['child1age']; ?>">
                    </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=""><?php echo $row['child1Gender']; ?></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="child1Gender">Child 1's Gender</label>
                            <select class="form-control" id="child1Gender" name="child1Gender">
                                <!-- Default value for the option is set to the value from the database -->
                                <option value="" <?php echo ($row['child1Gender'] == '') ? 'selected' : ''; ?>>Select Gender</option>
                                <option value="male" <?php echo ($row['child1Gender'] == 'male') ? 'selected' : ''; ?>>Male</option>
                                <option value="female" <?php echo ($row['child1Gender'] == 'female') ? 'selected' : ''; ?>>Female</option>
                                <option value="other" <?php echo ($row['child1Gender'] == 'other') ? 'selected' : ''; ?>>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" value="<?php echo $row['rchild1']; ?>">
                    </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" value="<?php echo $row['child2']; ?>">
                    </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" value="<?php echo $row['child2age']; ?>">
                    </div>
                  </div>
                  
                     <div class="col-md-3">
                        <div class="form-group">
                            <label for="child1Gender">Child 2's Gender</label>
                            <select class="form-control" id="child2Gender" name="child2Gender">
                                <!-- Default value for the option is set to the value from the database -->
                                <option value="" <?php echo ($row['child2Gender'] == '') ? 'selected' : ''; ?>>Select Gender</option>
                                <option value="male" <?php echo ($row['child2Gender'] == 'male') ? 'selected' : ''; ?>>Male</option>
                                <option value="female" <?php echo ($row['child2Gender'] == 'female') ? 'selected' : ''; ?>>Female</option>
                                <option value="other" <?php echo ($row['child2Gender'] == 'other') ? 'selected' : ''; ?>>Other</option>
                            </select>
                        </div>
                    </div>


                <!--  <div class="col-md-3">-->
                <!--    <div class="form-group">-->
                <!--        <label for="ownerGender">Child 2's Gender</label>-->
                <!--        <select class="form-control" id="child1Gender" name="child2Gender">-->
                <!--            <option value=""><?php echo $row['child2Gender']; ?></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" value="<?php echo $row['rchild2']; ?>">
                    </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" value="<?php echo $row['child3']; ?>">
                    </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" value="<?php echo $row['child3age']; ?>">
                    </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=""><?php echo $row['child3Gender']; ?></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="child1Gender">Child 3's Gender</label>
                            <select class="form-control" id="child3Gender" name="child3Gender">
                                <!-- Default value for the option is set to the value from the database -->
                                <option value="" <?php echo ($row['child3Gender'] == '') ? 'selected' : ''; ?>>Select Gender</option>
                                <option value="male" <?php echo ($row['child3Gender'] == 'male') ? 'selected' : ''; ?>>Male</option>
                                <option value="female" <?php echo ($row['child3Gender'] == 'female') ? 'selected' : ''; ?>>Female</option>
                                <option value="other" <?php echo ($row['child3Gender'] == 'other') ? 'selected' : ''; ?>>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" value="<?php echo $row['rchild3']; ?>">
                    </div>
                  </div>

                  
                 </div>

                 <div class="row">
                 <div class="col-md-3">
                    <div class="form-group">
                      <label for="exampleInputPassword1">Visit</label>
                      <input type="number" class="form-control" id="visit" name="visit" value="<?php echo $row['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" value="<?php echo $row['phone']; ?>">
                    </div>
                  </div>
                  
                  <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" value="<?php echo $row['fm1']; ?>">
                    </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" value="<?php echo $row['fm1age']; ?>">
                    </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=""><?php echo $row['fm1Gender']; ?></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="child1Gender">Family Member 1's Gender</label>
                            <select class="form-control" id="fm1Gender" name="fm1Gender">
                                <!-- Default value for the option is set to the value from the database -->
                                <option value="" <?php echo ($row['fm1Gender'] == '') ? 'selected' : ''; ?>>Select Gender</option>
                                <option value="male" <?php echo ($row['fm1Gender'] == 'male') ? 'selected' : ''; ?>>Male</option>
                                <option value="female" <?php echo ($row['fm1Gender'] == 'female') ? 'selected' : ''; ?>>Female</option>
                                <option value="other" <?php echo ($row['fm1Gender'] == 'other') ? 'selected' : ''; ?>>Other</option>
                            </select>
                        </div>
                    </div>

                <div class="col-md-3">
                    <div class="form-group">
                      <label for="exampleInputPassword1">Family Member 1 Relation</label>
                      <input type="text" class="form-control" id="rfm1" name="rfm1" value="<?php echo $row['rfm1']; ?>">
                    </div>
                  </div>

                  
                  <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" value="<?php echo $row['fm2']; ?>">
                    </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" value="<?php echo $row['fm2age']; ?>">
                    </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=""><?php echo $row['fm2Gender']; ?></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="child1Gender">Family Member 2's Gender</label>
                            <select class="form-control" id="fm2Gender" name="fm2Gender">
                                <!-- Default value for the option is set to the value from the database -->
                                <option value="" <?php echo ($row['fm2Gender'] == '') ? 'selected' : ''; ?>>Select Gender</option>
                                <option value="male" <?php echo ($row['fm2Gender'] == 'male') ? 'selected' : ''; ?>>Male</option>
                                <option value="female" <?php echo ($row['fm2Gender'] == 'female') ? 'selected' : ''; ?>>Female</option>
                                <option value="other" <?php echo ($row['fm2Gender'] == 'other') ? 'selected' : ''; ?>>Other</option>
                            </select>
                        </div>
                    </div>

                <div class="col-md-3">
                    <div class="form-group">
                      <label for="exampleInputPassword1">Family Member 2 Relation</label>
                      <input type="text" class="form-control" id="rfm2" name="rfm2" value="<?php echo $row['rfm2']; ?>">
                    </div>
                  </div>
               
                </div>
                 <div class="row">
                 <div class="col-md-6">
                    <div class="form-group">
                      <label for="exampleInputPassword1">Visit Date</label>
                      <input type="rext" class="form-control" id="visit_date" name="visit_date" value="<?php echo $row['visit_date']; ?>">
                    </div>
                  </div>


                 </div>

                <div class="card-footer">
                <button type="submit" name="update_family" class="btn btn-primary">Update</button>
                  <!-- <button type="submit" class="btn btn-primary">Submit</button> -->
                </div>
              </form>


              <?php }} ?>
            </div>
            <!-- /.card -->

         

        
       
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        </div>
      </div>
    </section>
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    <div class="float-right d-none d-sm-block">
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    </div>
    <strong>Copyright &copy; 2014-2021 <a href="https://adminlte.io">AdminLTE.io</a>.</strong> All rights reserved.
  </footer> -->

  <?php require "includes/footer.php" ?>

  <!-- Control Sidebar -->
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    <!-- Control sidebar content goes here -->
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</div>
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