@extends('layouts/microfin_layout') @section('title', '| Add Member') @section('content')
New Member for Opening Balance
{!! Form::open(array('name' => 'memberForm', 'url' => '', 'role' => 'form', 'id' => 'rootwizard', 'files' => 'true', 'class' => 'form-wizard validate', 'novalidate' => '')) !!}
Member
{!! Form::label('samity name', 'Samity Name:*', ['class' => 'control-label']) !!}
{!! Form::select('samityId', ($damageData['samities']), null, array('class'=>'form-control', 'id' => 'samityId', 'data-validate' => 'required')) !!}
{!! Form::label('member name', 'Member Name:*', ['class' => 'control-label']) !!}
{!! Form::text('name', $value = null, ['class' => 'form-control', 'id' => 'name', 'type' => 'text', 'data-validate' => 'required']) !!}
{!! Form::label('member surname', 'Member Surname:*', ['class' => 'control-label']) !!}
{!! Form::text('surName', $value = null, ['class' => 'form-control', 'id' => 'surName', 'type' => 'text']) !!}
{!! Form::label('admission date', 'Admission Date:*', ['class' => 'control-label']) !!}
{!! Form::text('admissionDate', $value = null, ['class' => 'form-control datepicker', 'id' => 'admissionDate', 'type' => 'text', 'readonly' => 'readonly', 'data-validate' => 'required']) !!}
{!! Form::label('primary product', 'Primary Product:*', ['class' => 'control-label']) !!}
{!! Form::select('primaryProductId', (array('' => 'Select') + $damageData['primaryProduct']), null, array('class'=>'form-control', 'id' => 'primaryProductId', 'data-validate' => 'required')) !!}
{!! Form::label('member code', 'Member Code:*', ['class' => 'control-label']) !!}
{!! Form::text('code', $value = null, ['class' => 'form-control', 'id' => 'code', 'type' => 'text', 'readonly' => 'readonly', 'data-validate' => 'required']) !!}
{!! Form::label('gender', 'Gender:*', ['class' => 'control-label']) !!}
{!! Form::select('gender', array('' => 'Select'), null, array('class'=>'form-control', 'id' => 'gender', 'data-validate' => 'required')) !!}
{!! Form::label('date of birth', 'Date of Birth:*', ['class' => 'control-label']) !!}
{!! Form::text('dob', $value = null, ['class' => 'form-control datepicker', 'id' => 'dob', 'type' => 'text', 'readonly' => 'readonly', 'data-validate' => 'required']) !!}
{!! Form::label('age', 'Age:*', ['class' => 'control-label']) !!}
{!! Form::text('age', $value = null, ['class' => 'form-control', 'id' => 'age', 'type' => 'text', 'data-validate' => 'required', 'readonly' => 'readonly' ]) !!}
{!! Form::label('marital status', 'Marital Status:*', ['class' => 'control-label']) !!}
{!! Form::select('maritalStatus', ($damageData['maritalStatus']), null, array('class'=>'form-control', 'id' => 'maritalStatus', 'data-validate' => 'required')) !!}
{!! Form::label('Father/Spouse Name', 'Father/Spouse Name:*', ['class' => 'control-label']) !!}
{!! Form::text('spouseName', $value = null, ['class' => 'form-control', 'id' => 'spouseFatherSonName', 'type' => 'text', 'data-validate' => 'required']) !!}
{!! Form::label('relationship', 'Relationship:*', ['class' => 'control-label']) !!}
{!! Form::select('relationship', ($damageData['relationship']), null, array('class'=>'form-control', 'id' => 'relationship', 'data-validate' => 'required')) !!}
{!! Form::label('admission fee', 'Admission Fee:', ['class' => 'control-label']) !!}
{!! Form::text('admissionFee', $value = null, ['class' => 'form-control', 'id' => 'admissionFee', 'type' => 'text']) !!}
{!! Form::label('admission no', 'Admission No:', ['class' => 'control-label']) !!}
{!! Form::text('admissionNo', $value = null, ['class' => 'form-control', 'id' => 'admissionNo', 'type' => 'text']) !!}
{!! Form::label('national ID', 'National ID:*', ['class' => 'control-label']) !!}
{!! Form::text('nID', $value = null, ['class' => 'form-control', 'id' => 'nID', 'type' => 'text', 'data-validate' => 'minlength[13]', 'autocomplete' => 'off']) !!}
{!! Form::label('birth registration no', 'Birth Registration No:', ['class' => 'control-label']) !!}
{!! Form::text('birthRegNo', $value = null, ['class' => 'form-control', 'id' => 'birthRegNo', 'type' => 'text', 'autocomplete' => 'off']) !!}
{!! Form::label('passport no', 'Passport No:', ['class' => 'control-label']) !!}
{!! Form::text('passportNo', $value = null, ['class' => 'form-control', 'id' => 'passportNo', 'type' => 'text', 'autocomplete' => 'off']) !!}
{!! Form::label('group', 'Group:', ['class' => 'control-label']) !!}
{!! Form::select('groupId', array('' => 'Select'), null, array('class'=>'form-control', 'id' => 'groupId')) !!}
{!! Form::label('sub group', 'Sub Group:', ['class' => 'control-label']) !!}
{!! Form::select('subGroupId', array('' => 'Select'), null, array('class'=>'form-control', 'id' => 'subGroupId')) !!}
{!! Form::label('education level', 'Education Level:', ['class' => 'control-label']) !!}
{!! Form::select('maxEducation', ($damageData['educationLevel']), null, array('class'=>'form-control', 'id' => 'maxEducation')) !!}
{!! Form::label('mobile no', 'Mobile No:*', ['class' => 'control-label']) !!}
{!! Form::text('mobileNo', $value = null, ['class' => 'form-control', 'id' => 'mobileNo', 'type' => 'text']) !!} {{-- {!! Form::text('mobileNo', $value = null, ['class' => 'form-control', 'id' => 'mobileNo', 'type' => 'text', 'data-validate' => 'required, minlength[11], maxlength[11]']) !!} --}}
{!! Form::label('form applicatin no', 'Form Applicatin No:', ['class' => 'control-label']) !!}
{!! Form::text('formApplicationNo', $value = null, ['class' => 'form-control', 'id' => 'formApplicationNo', 'type' => 'text']) !!}
{!! Form::label('nationality', 'Nationality:', ['class' => 'control-label']) !!}
{!! Form::select('nationality', ($damageData['country']), null, array('class'=>'form-control', 'id' => 'nationality')) !!}
{!! Form::label('smart Card', 'Smart Card:*', ['class' => 'control-label']) !!}
{!! Form::text('smartCardNo', $value = null, ['class' => 'form-control', 'id' => 'smartCardNo', 'type' => 'text', 'data-validate' => 'minlength[10], maxlength[10]', 'autocomplete' => 'off']) !!}
{!! Form::label('father Name', 'Father Name:*', ['class' => 'control-label']) !!}
{!! Form::text('fatherName', $value = null, ['class' => 'form-control', 'id' => 'fatherName', 'type' => 'text', 'autocomplete' => 'off']) !!}
{!! Form::label('mother Name', 'Mother Name:*', ['class' => 'control-label']) !!}
{!! Form::text('motherName', $value = null, ['class' => 'form-control', 'id' => 'motherName', 'type' => 'text', 'autocomplete' => 'off']) !!}
Contact Details
Present Address
{!! Form::label('village / ward', 'Village / Ward:*:', ['class' => 'control-label']) !!}
{!! Form::textarea('curVillageWard', $value = null, ['class' => 'form-control', 'id' => 'curVillageWard', 'type' => 'textarea', 'rows' => '3', 'cols' => '50', 'readonly' => 'readonly']) !!}
{!! Form::label('family / home contact no', 'Family / Home Contact No:', ['class' => 'control-label']) !!}
{!! Form::text('curFamilyHomeMobileNo', $value = null, ['class' => 'form-control', 'id' => 'curFamilyHomeMobileNo', 'type' => 'text']) !!}
Permanent Address
{!! Form::label('same as present address', 'Same as present address:', ['class' => 'control-label']) !!}
{!! Form::checkbox('sameAsPresentAddress', 1, false, array('class' => 'cbr', 'id' => 'sameAsPresentAddress')) !!}
{!! Form::label('village / ward', 'Village / Ward:*:', ['class' => 'control-label']) !!}
{!! Form::textarea('permVillageWard', $value = null, ['class' => 'form-control', 'id' => 'permVillageWard', 'type' => 'textarea', 'rows' => '3', 'cols' => '50']) !!}
{!! Form::label('family / home contact no', 'Family / Home Contact No:', ['class' => 'control-label']) !!}
{!! Form::text('permFamilyHomeMobileNo', $value = null, ['class' => 'form-control', 'id' => 'permFamilyHomeMobileNo', 'type' => 'text']) !!}
{{-- savings --}}
Savings
{!! Form::label('product', 'Product:*', ['class' => 'control-label']) !!}
{!! Form::select('savingsProductId', ($damageData['mandatorySavingsProduct']), null, array('class'=>'form-control', 'id' => 'savingsProductId', 'data-validate' => 'required')) !!}
{!! Form::label('deposit type', 'Deposit Type:', ['class' => 'control-label']) !!}
{!! Form::text('depositTypeId', $value = null, ['class' => 'form-control', 'id' => 'depositTypeId', 'type' => 'text', 'readonly' => 'readonly']) !!}
{!! Form::label('interest rate', 'Interest Rate:', ['class' => 'control-label']) !!}
{!! Form::text('savingsInterestRate', $value = null, ['class' => 'form-control', 'id' => 'savingsInterestRate', 'type' => 'text', 'readonly' => 'readonly']) !!}
%
{!! Form::label('saving code', 'Saving Code:*', ['class' => 'control-label']) !!}
{!! Form::text('savingsCode', $value = null, ['class' => 'form-control', 'id' => 'savingsCode', 'type' => 'text', 'data-validate' => 'required', 'readonly' => 'readonly']) !!}
{!! Form::label('auto process amount', 'Auto Process Amount:', ['class' => 'control-label']) !!}
{!! Form::text('savingsAmount', $value = null, ['class' => 'form-control', 'id' => 'savingsAmount', 'type' => 'text', 'data-validate' => 'required,minlength[1]']) !!}
{{-- end of savings --}}
Upload Photo
{!! Form::label('profile picture', 'Profile Picture:', ['class' => 'control-label']) !!}
{!! Form::file('profileImage', array('class' => 'profileImage', 'onchange' => 'loadProfileImageFile(event)')) !!}
{!! Form::label('regular signature', 'Regular Signature:', ['class' => 'control-label']) !!}
{!! Form::file('regularSignatureImage', array('class' => 'signature', 'onchange' => 'loadRegularSignatureImageFile(event)')) !!}
{!! Form::label('national id signature', 'National ID Signature:', ['class' => 'control-label']) !!}
{!! Form::file('nIDSignatureImage', array('class' => 'signature', 'onchange' => 'loadnIDSignatureImageFile(event)')) !!}
{!! Form::close() !!}
@endsection