@extends('admin.layouts.index')



@section('content')
   <style>
    .form-control {
    width: 95%!important;
    }
   </style>
<!--main content start-->
<section id="main-content">
	<section class="wrapper">
	<div class="form-w3layouts">
        <!-- page start-->
        <!-- page start-->
        <div class="row">
        <div class="col-lg-12">
            <h2 style="margin:12px;">New Student Admission</h2>
</div>
            
           
        </div>
        
        <div class="col-lg-12">
                <section class="panel">
                <header class="panel-heading">
                            Personal Information
                        </header>
                    <div class="panel-body">
                        <div class="position-center">
                            <form    method="POST" action="application/store" class="form-horizontal shadow p-12" enctype="multipart/form-data">
                                 @csrf
                            <div class="row">

<div class="form-group col-lg-4">
<label for="form_no">FORM NO<span class="strick">*</span></label>
<input type="text" class="form-control" id="form_no" placeholder="FORM NO" name="form_no" required="">
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<div class="form-group col-lg-4">
<label for="admission_number">ADMISSION NUMBER<span class="strick">*</span></label>
<input type="text" class="form-control" id="admission_number" placeholder="ADMISSION NUMBER" name="admission_number" required="">
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<div class="form-group col-lg-4">
<label for="admission_date">ADMISSION DATE<span class="strick">*</span></label>
<input type="date" class="form-control" id="admission_date" placeholder="ADMISSION DATE" name="admission_date" required="">
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<div class="form-group col-lg-4">
<label for="assign_class">ASSIGN CLASS<span class="strick">*</span></label>
{{-- <input type="text" class="form-control" id="assign_class" placeholder="ASSIGN CLASS" name="assign_class" required=""> --}}
<select class="form-control" style="" name="assign_class" required="">
                    <option selected disabled>Select Class</option>
                     @foreach ($classes as $cla)
                     <option value="{{ $cla->id	}}">{{ $cla->name	}}</option>
                     @endforeach
                  </select>
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<div class="form-group col-lg-4">
<label for="assign_section">ASSIGN SECTION<span class="strick">*</span></label>
{{-- <input type="text" class="form-control" id="assign_section" placeholder="ASSIGN SECTION" name="assign_section" required=""> --}}
<select class="form-control" style="margin-right:10px;"  name="assign_section" required="">
                    <option selected disabled>Select Section</option>
                     @foreach ($section as $cla)
                     <option value="{{ $cla->id	}}">{{ $cla->name	}}</option>
                     @endforeach
                  </select>
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<div class="form-group col-lg-4">
<label for="first_name"> NAME<span class="strick">*</span></label>
<input type="text" class="form-control" id="first_name" placeholder="FIRST NAME" name="first_name" required="">
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<div class="form-group col-lg-4">
<label for="father_name">FATHER NAME<span class="strick">*</span></label>
<input type="text" class="form-control" id="father_name" placeholder="FATHER NAME" name="father_name" required="">
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<div class="form-group col-lg-4">
<label for="father_ocupation">FATHER OCUPATION<span class="strick">*</span></label>
<input type="text" class="form-control" id="father_ocupation" placeholder="FATHER OCUPATION" name="father_ocupation" required="">
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<div class="form-group col-lg-4">
<label for="father_aadhaar_no">FATHER UID/ PASSPORT ID<span class="strick">*</span></label>
<input type="text" class="form-control" id="father_aadhaar_no" placeholder="FATHER UID/ PASSPORT ID" name="father_aadhaar_no" required="">
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<div class="form-group col-lg-4">
<label for="mother_name">MOTHER NAME<span class="strick">*</span></label>
<input type="text" class="form-control" id="mother_name" placeholder="MOTHER NAME" name="mother_name" required="">
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<div class="form-group col-lg-4">
<label for="mother_adhar_no">MOTHER UID/ PASSPORT ID<span class="strick">*</span></label>
<input type="text" class="form-control" id="mother_aadhaar_no" placeholder="MOTHER UID/ PASSPORT ID" name="mother_adhar_no" required="">
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<div class="form-group col-lg-4">
<label for="gender">GENDER<span class="strick">*</span></label>
{{-- <input type="text" class="form-control" id="gender" placeholder="GENDER" name="gender" required=""> --}}
<select class="form-control" name="gender" required="">
    <option value="male">Male</option>
    <option value="female">Female</option>
    <option value="other">Other</option>
</select>
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<div class="form-group col-lg-4">
<label for="date_of_birth">DATE OF BIRTH<span class="strick">*</span></label>
<input type="date" class="form-control" id="date_of_birth" placeholder="DATE OF BIRTH" name="date_of_birth" required="">
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<div class="form-group col-lg-4">
<label for="blood_group">BLOOD GROUP<span class="strick">*</span></label>
<input type="text" class="form-control" id="blood_group" placeholder="BLOOD GROUP" name="blood_group" required="">
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<div class="form-group col-lg-4">
<label for="category">CATEGORY<span class="strick">*</span></label>
{{-- <input type="text" class="form-control" id="category" placeholder="CATEGORY" name="category" required=""> --}}
<select class="form-control" name="category" required="">
    <option value="general">General</option>
    <option value="obc">OBC</option>
    <option value="sc">SC</option>
    <option value="st">ST</option>
</select>
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<div class="form-group col-lg-4">
<label for="religion">RELIGION<span class="strick">*</span></label>
<input type="text" class="form-control" id="religion" placeholder="RELIGION" name="religion" required="">
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<div class="form-group col-lg-4">
<label for="phone">PHONE<span class="strick">*</span></label>
<input type="number" class="form-control" id="phone" placeholder="PHONE" name="phone" required="">
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<div class="form-group col-lg-4">
<label for="whatsapp_no">WHATSAPP NO</label>
<input type="number" class="form-control" id="whatsapp_no" placeholder="WHATSAPP NO" name="whatsapp_no" >
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<div class="form-group col-lg-4">
<label for="email">EMAIL<span class="strick">*</span></label>
<input type="email" class="form-control" id="email" placeholder="EMAIL" name="email" required="">
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<div class="form-group col-lg-4">
<label for="residence_address"> ADDRESS<span class="strick">*</span></label>
<input type="text" class="form-control" id="residence_address" placeholder="RESIDENCE ADDRESS" name="residence_address" required="">
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<div class="form-group col-lg-4">
<label for="state_of_residence">STATE<span class="strick">*</span></label>
<input type="text" class="form-control" id="state_of_residence" placeholder="STATE OF RESIDENCE" name="state_of_residence" required="">
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>

<div class="form-group col-lg-4">
<label for="city">CITY<span class="strick">*</span></label>
<input type="text" class="form-control" id="city" placeholder="CITY" name="city" required="">
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<div class="form-group col-lg-4">
<label for="pin_code">PIN CODE<span class="strick">*</span></label>
<input type="number" class="form-control" id="pin_code" placeholder="PIN CODE" name="pin_code" required="">
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<div class="form-group col-lg-4">
<label for="discount_quote">DISCOUNT QUOTE<span class="strick">*</span></label>
<input type="number" class="form-control" id="discount_quote" placeholder="DISCOUNT QUOTE" name="discount_quote" required="" value="0">
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<div class="form-group col-lg-4 d-none">
<label for="last_name">LAST NAME<span class="strick">*</span></label>
<input type="text" value='none' class="form-control" id="last_name" placeholder="LAST NAME" name="last_name" required="">
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<div class="form-group col-lg-4 d-none">
<label for="other_names">OTHER NAMES<span class="strick">*</span></label>
<input type="text" class="form-control" id="other_names" value='non' placeholder="OTHER NAMES" name="other_names" required="">
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<div class="form-group col-lg-4 d-none">
<label for="local_council">LOCAL COUNCIL<span class="strick">*</span></label>
<input type="text" class="form-control" id="local_council" placeholder="LOCAL COUNCIL" name="local_council" required="" value="non">
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>

<div class="form-group col-lg-4 d-none">
<label for="country_of_residence">COUNTRY OF RESIDENCE<span class="strick">*</span></label>
<input type="text" class="form-control" id="country_of_residence" value='india' placeholder="COUNTRY OF RESIDENCE" name="country_of_residence" required="">
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<div class="form-group col-lg-4 d-none">
<label for="nationality">NATIONALITY<span class="strick">*</span></label>
<input type="text" class="form-control" id="nationality" placeholder="NATIONALITY" name="nationality" required="" value="india">
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<div class="form-group col-lg-4 d-none">
<label for="admission_year">ADMISSION YEAR<span class="strick">*</span></label>
<input type="text" class="form-control" id="admission_year" placeholder="ADMISSION YEAR" name="admission_year" required="" value="2026">
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<div class="form-group col-lg-4 d-none">
<label for="assign_parent">ASSIGN PARENT<span class="strick">*</span></label>
<input type="text" class="form-control" id="assign_parent" placeholder="ASSIGN PARENT" name="assign_parent" required="" value='na'>
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<div class="form-group col-lg-4">
<label for="assign_session">ASSIGN SESSION<span class="strick">*</span></label>
{{-- <input type="text" class="form-control" id="assign_session" placeholder="ASSIGN SESSION" name="assign_session" required=""> --}}
<select class="form-control"  name="assign_session" required="">
                    <option selected disabled>Select session</option>
                     @foreach ($sessions as $cla)
                     <option value="{{ $cla->id	}}">{{ $cla->name	}}</option>
                     @endforeach
                  </select>
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<div class="form-group col-lg-4">
<label for="upload_photo">UPLOAD PHOTO<span class="strick">*</span></label>
<input type="file" class="form-control" id="upload_photo" placeholder="UPLOAD PHOTO" name="upload_photo" required="">
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<div class="form-group col-lg-4">
<label for="stype">Student TYPE<span class="strick">*</span></label>
{{-- <input type="text" class="form-control" id="stype" placeholder="STYPE" name="stype" required="">
 --}}
 <select class="form-control" name="stype" required="">
    <option value="new" selected>New</option>
    <option value="old">Old</option>
 </select>
<div class="valid-feedback">Valid.</div>
<div class="invalid-feedback">Please fill out this field.</div>
</div>
<!--form check aggree -->
 </div>
<!-- submit -->
<div class="row mt-4">
    <div class='col-md-12'>
<div class="form-group"> <div class="col-md-12 "> <button type="submit" class="btn btn-primary btn-block" name="SUBMIT" value="Sign up">Submit</button>
</div>
</div>
 </div>
</div>
                        </div>
                    </div>
                </section>    
            </div>

        </div>
        </div>

        


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@endsection