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divthird.php
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<div class="col-md-12">
<!-- process timeline -->
<div class="col-md-12">
<div class="col-md-3" align="center">
<div class="icon-box ">
<a class="icon icon-gray icon-circled icon-border-effect effect-circled" title="Creditaintial">
<i class="fas fa-sign-in-alt"></i>
</a><br>
</div>
</div>
<div class="col-md-2" align="center">
<div class="icon-box ">
<a class="icon icon-gray icon-circled icon-border-effect effect-circled" title="Personal Information">
<i class="fas fa-user-tie"></i>
</a>
</div>
</div>
<div class="col-md-2" align="center">
<div class="icon-box iconbox-theme-colored2">
<a class="icon icon-dark icon-circled icon-border-effect effect-circled" title="Parent Information">
<i class="fas fa-users"></i>
</a><br>
<i class="fas fa-chevron-down" style="font-size: 20px;"></i>
</div>
</div>
<div class="col-md-2" align="center">
<div class="icon-box">
<a class="icon icon-gray icon-circled icon-border-effect effect-circled"title="Course Selection">
<i class="fas fa-book-open"></i>
</a>
</div>
</div>
<div class="col-md-3" align="center">
<div class="icon-box">
<a class="icon icon-gray icon-circled icon-border-effect effect-circled" title="Qualification">
<i class="fas fa-user-graduate"></i>
</a>
</div>
</div>
</div>
<!-- end process timeline -->
<h2 class="text-theme-colored2 font-25">Parent Information</h2>
</div>
<?php
include 'connection.php';
$result = mysqli_query($conn,"SELECT MAX(uid) FROM registration1");
$row = mysqli_fetch_row($result);
$highest_id = $row[0];
?>
<form method="post">
<div class="col-md-12">
<div class="form-group">
<input type="text" readonly="true" class="form-control" style="border-style: solid; border-color: #828182; border-width:2px;" id="txtuid3" name="txtuid3" value="<?php echo $highest_id; ?>">
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<input type="text" class="form-control" style="border-style: solid; border-color: #828182; border-width:2px;" id="txtfathername" name="txtfathername" placeholder="Enter Father Name">
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<input type="text" class="form-control" style="border-style: solid; border-color: #828182; border-width:2px;" id="txtmothername" name="txtmothername" placeholder="Enter Mother Name">
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<input type="number" class="form-control" style="border-style: solid; border-color: #828182; border-width:2px;" id="txtfmno" name="txtfmno" placeholder="Enter Father Mobile Number">
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<input type="number" class="form-control" style="border-style: solid; border-color: #828182; border-width:2px;" id="txtmmno" name="txtmmno" placeholder="Enter Mother Mobile Number">
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<input type="email" class="form-control" style="border-style: solid; border-color: #828182; border-width:2px;" id="txtfemail" name="txtfemail" placeholder="Enter Father Email Id">
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<input type="email" class="form-control" style="border-style: solid; border-color: #828182; border-width:2px;" id="txtmemail" name="txtmemail" placeholder="Enter Mother Email Id">
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<input type="text" class="form-control" style="border-style: solid; border-color: #828182; border-width:2px;" id="txtfoccu" name="txtfoccu" placeholder="Enter Father Occupation">
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<input type="text" class="form-control" style="border-style: solid; border-color: #828182; border-width:2px;" id="txtmoccu" name="txtmoccu" placeholder="Enter Mother Occupation">
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<input type="text" class="form-control" style="border-style: solid; border-color: #828182; border-width:2px;" id="txtfdesi" name="txtfdesi" placeholder="Enter Father Designation">
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<input type="text" class="form-control" style="border-style: solid; border-color: #828182; border-width:2px;" id="txtmdesi" name="txtmdesi" placeholder="Enter Mother Designation">
</div>
</div>
<div class="col-md-12">
<div class="form-group">
<input type="number" class="form-control" style="border-style: solid; border-color: #828182; border-width:2px;" id="txtaincome" name="txtaincome" placeholder="Total Annual Income">
</div>
</div>
<div class="col-md-12">
<div class="form-group">
<input type="number" class="form-control" style="border-style: solid; border-color: #828182; border-width:2px;" id="txtecno" name="txtecno" placeholder="Enter Emergency Contact No">
</div>
</div>
<div class="col-md-12">
<div class="form-group">
<textarea class="form-control" style="border-style: solid; border-color: #828182; border-width:2px;" cols="30" rows="10" id="txtadd" name="txtadd" placeholder="Enter Address"></textarea>
</div>
</div>
<div class="col-md-12">
<div class="form-group">
<?php
$sql = "SELECT Name FROM city";
$result = mysqli_query($conn,$sql);
echo '<select name="city" id="city" style="margin-top:20px" class="form-control" style="border-style: solid; border-color: #828182; border-width:2px;">';
while ($row = mysqli_fetch_array($result)) {
echo "<option value='" . $row['Name'] ."'>" . $row['Name'] ."</option>";
}
echo "</select>";
?>
</div>
</div>
<div class="col-md-12">
<div class="form-group">
<?php
$sql = "SELECT Name FROM states";
$result = mysqli_query($conn,$sql);
echo '<select name="state" id="state" style="margin-top:20px" class="form-control" style="border-style: solid; border-color: #828182; border-width:2px;">';
while ($row = mysqli_fetch_array($result)) {
echo "<option value='" . $row['Name'] ."'>" . $row['Name'] ."</option>";
}
echo "</select>";
?>
</div>
</div>
<div class="col-md-12">
<div class="form-group">
<select class="form-control" style="border-style: solid; border-color: #828182; border-width:2px;" id="country" name="country">
<option value="Select Country">Select Country</option>
<option value="India">India</option>
</select>
</div>
</div>
<div class="col-md-12">
<div class="form-group">
<input type="number" class="form-control" style="border-style: solid; border-color: #828182; border-width:2px;" id="txtpcode" name="txtpcode" placeholder="Enter Pincode">
</div>
</div>
<div class="col-md-12">
<div class="form-group">
<input type="text" class="form-control" style="border-style: solid; border-color: #828182; border-width:2px;" id="txtfsignature" name="txtfsignature" placeholder="Enter Father Signature">
</div>
</div>
<div class="col-md-12">
<div class="form-group">
<input type="text" class="form-control" style="border-style: solid; border-color: #828182; border-width:2px;" id="txtmsignature" name="txtmsignature" placeholder="Enter Mother Signature">
</div>
</div>
<div class="col-md-12">
<label> Family Background</label>
<table class="table" width="100%">
<tr>
<th>Relatives</th>
<th cellpadding="50px">Name</th>
<th>Age</th>
<th cellpadding="75px">Eduction</th>
</tr>
<tr>
<td>Brother 1</td>
<td cellpadding="50px"><input type="text" class="form-control" id="txtb1name" name="txtb1name" placeholder="Enter Details (Optional)"></td>
<td><input type="text" class="form-control" placeholder="Enter Details (Optional)" id="txtb1age" name="txtb1age"></td>
<td cellpadding="75px"><input type="text" class="form-control" id="txtb1edu" name="txtb1edu" placeholder="Enter Details (Optional)"></td>
</tr>
<tr>
<td>Sister 1</td>
<td cellpadding="50px"><input type="text" class="form-control" id="txtsis1name" name="txtsis1name" placeholder="Enter Details (Optional)"></td>
<td><input type="text" class="form-control" placeholder="Enter Details (Optional)" id="txtsis1age" name="txtsis1age"></td>
<td cellpadding="75px"><input type="text" id="txtsis1edu" name="txtsis1edu" class="form-control" placeholder="Enter Details (Optional)"></td>
</tr>
<tr>
<td>Brother 2</td>
<td cellpadding="50px"><input type="text" class="form-control" id="txtbro2name" name="txtbro2name" placeholder="Enter Details (Optional)"></td>
<td><input type="text" class="form-control" id="txtbro2age" name="txtbro2age" placeholder="Enter Details (Optional)"></td>
<td cellpadding="75px"><input type="text" class="form-control" id="txtbro2edu" name="txtbro2edu" placeholder="Enter Details (Optional)"></td>
</tr>
<tr>
<td>Sister 2</td>
<td cellpadding="50px"><input type="text" class="form-control" placeholder="Enter Details (Optional)" id="txtsis2name" name="txtsis2name"></td>
<td><input type="text" class="form-control" id="txtsis2age" name="txtsis2age" placeholder="Enter Details (Optional)"></td>
<td cellpadding="75px"><input type="text" class="form-control" id="txtsis2edu" name="txtsis2edu" placeholder="Enter Details (Optional)"></td>
</tr>
</table>
<input type="submit" value="Submit" class="btn btn-dark btn-theme-colored2" id="btnsubmit3" name="btnsubmit3" >
</form>