123 lines
4.5 KiB
Plaintext
123 lines
4.5 KiB
Plaintext
<div class="col-lg-4 col-md-4 col-sm-4">
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<%= simple_form_for @crm_customer,:url => crm_customers_path, :method => :post do |f| %>
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<span class="patch_method"></span>
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<%= f.hidden_field :id, :class => "form-control col-md-6 " %>
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<div class="form-group <%= (flash["errors"]) ? "has-error" : "" %>">
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<%= f.input :card_no, :class => "form-control col-md-6 card_no"%>
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<% flash.each do |name, msg| %>
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<% str="[\"#{msg['name']}\"]"
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str.gsub!('["', '')
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str.gsub!('"]', '') %>
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<span class="help-block" style="margin-top:-10px"><%= str %></span>
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<% end -%>
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</div>
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<div class="form-group">
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<label>Salutation :</label><br>
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<label>
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<input type="radio" value="Mr" name="salutation" class="salutation mr" style="width: 30px">Mr
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</label>
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<label>
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<input type="radio" value="Miss" name="salutation" class="salutation miss" style="width: 30px">Miss
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</label>
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<label>
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<input type="radio" value="Mrs" name="salutation" class="salutation mrs" style="width: 30px">Mrs
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</label>
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<label>
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<input type="radio" value="Mdm" name="salutation" class="salutation mdm" style="width: 30px">Mdm
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</label>
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</div>
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<div class="form-group <%= (flash["errors"]) ? "has-error" : "" %>">
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<%= f.input :name, :class => "form-control col-md-6 name", :required => true %>
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<% flash.each do |name, msg| %>
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<% str="[\"#{msg['name']}\"]"
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str.gsub!('["', '')
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str.gsub!('"]', '') %>
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<span class="help-block" style="margin-top:-10px"><%= str %></span>
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<% end -%>
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</div>
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<div class="form-group">
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<label>Gender :</label><br>
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<label>
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<input type="radio" value="Male" name="gender" class="gender male" style="width:30px;">Male
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</label>
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<label>
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<input type="radio" value="Female" name="gender" class="gender female" style="width:30px;">Female
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</label>
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</div>
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<div class="form-group">
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<%= f.input :nrc_no, :class => "form-control nrc_no" %>
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</div>
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<div class="form-group">
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<%= f.input :company, :class => "form-control col-md-6 company",:required => true%>
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<% flash.each do |name, msg| %>
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<% str="[\"#{msg['company']}\"]"
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str.gsub!('["', '')
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str.gsub!('"]', '') %>
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<span class="help-block" style="margin-top:-10px"><%= str %></span>
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<% end -%>
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</div>
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<div class="form-group <%= (flash["errors"]) ? "has-error" : "" %>">
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<%= f.input :contact_no, :class => "form-control col-md-6 contact_no" ,:required => true%>
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<% flash.each do |name, msg| %>
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<% str="[\"#{msg['contact_no']}\"]"
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str.gsub!('["', '')
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str.gsub!('"]', '') %>
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<span class="help-block" style="margin-top:-10px"><%= str %></span>
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<% end -%>
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</div>
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<div class="form-group <%= (flash["errors"]) ? "has-error" : "" %>">
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<%= f.input :email, :class => "form-control col-md-6 email" ,:required => true%>
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<% flash.each do |name, msg| %>
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<% str="[\"#{msg['contact_no']}\"]"
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str.gsub!('["', '')
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str.gsub!('"]', '') %>
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<span class="help-block" style="margin-top:-10px"><%= str %></span>
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<% end -%>
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</div>
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<div class="form-group">
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<%= f.input :address, :class => "form-control col-md-6 address" %>
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</div>
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<div class="form-group">
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<label>Sr.No</label>
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<input type="text" name="" value="<%=@count_customer%>" class="form-control" readonly="true">
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</div>
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<div class="form-group">
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<label>Date Of Birth</label>
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<%= f.text_field :date_of_birth,:value=>"01-01-1990",:class=>"form-control datepicker"%>
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</div>
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<div class="form-group">
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<label>Select Member Group</label>
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<select class="selectpicker form-control col-md-12" name="member_group_id" style="height: 40px" >
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<option value="">Select Membership Group</option>
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<% Lookup.where("lookup_type = ?", "member_group_type" ).each do |member| %>
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<option value="<%= member.value %>">
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<%= member.name %></option>
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<%end %>
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</select>
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</div>
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<div class="form-group">
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<%= f.button :submit, "Submit",:class => 'btn btn-primary ', :id => 'submit_customer' %>
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<%= f.button :submit, "Update",:class => 'btn btn-primary ', :disabled =>'', :id => 'update_customer' %>
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<%= f.button :button, "Reset",:class => 'btn btn-danger ', :id => 'reset' %>
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</div>
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<%end%>
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</div> |