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Rev 28494 Rev 32349
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<section class="wrapper">
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    <div class="row">
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        <div class="col-lg-12">
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            <h3 class="page-header">
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                <i class="icon_document_alt"></i>Seller
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            </h3>
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            <ol class="breadcrumb">
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                <li><i class="fa fa-home"></i><a
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                        href="${rc.contextPath}/dashboard">Home</a></li>
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                <li><i class="icon_document_alt"></i>Supplier Form</li>
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            </ol>
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        </div>
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    </div>
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    <form id="new-supplier-create-form">
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        <div class="form-row">
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            <div class="form-group col-md-6">
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                <label for="name">Name</label>
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                <input type="text" class="form-control" id="name" name="inputName" placeholder="Name">
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            </div>
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  <section class="wrapper">
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            <div class="form-group col-md-6">
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	<div class="row">
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                <label for="phone">Phone</label>
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		<div class="col-lg-12">
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                <input type="number" class="form-control" id="phone" name="inputPhone" placeholder="Phone">
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			<h3 class="page-header">
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            </div>
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				<i class="icon_document_alt"></i>Seller
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			</h3>
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            <div class="form-group col-md-6">
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			<ol class="breadcrumb">
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                <label for="gst">GSTIN</label>
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				<li><i class="fa fa-home"></i><a
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                <input type="text" class="form-control" id="gst" name="inputGst" placeholder="GST">
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					href="${rc.contextPath}/dashboard">Home</a></li>
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            </div>
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				<li><i class="icon_document_alt"></i>Supplier Form</li>
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            <div class="form-group col-md-6">
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			</ol>
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                <label for="panNumber">PAN</label>
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		</div>
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                <input type="text" class="form-control" id="panNumber" name="inputPan" placeholder="pan">
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	</div>
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            </div>
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              <form id="new-supplier-create-form">
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            <div class="form-group col-md-6">
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                            <div class="form-row">
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                <label for="Fax">Fax</label>
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                               <div class="form-group col-md-6">
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                <input type="text" class="form-control" id="Fax" name="inputFax" placeholder="Fax">
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                                    <label for="name">Name</label>
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            </div>
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                                    <input type="text" class="form-control" id="name"  name="inputName"  placeholder="Name">
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            <div class="form-group col-md-6">
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                                </div>
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                <label for="headName">Head Name</label>
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                <input type="text" class="form-control" id="headName" name="inputHeadName" placeholder="Head Name">
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                                <div class="form-group col-md-6">
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            </div>
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                                    <label for="phone">Phone</label>
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                                    <input type="number" class="form-control" id="phone"  name="inputPhone"  placeholder="Phone">
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            <div class="form-group col-md-6">
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                                </div>
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                <label for="headDesig">Head Designation</label>
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                <input type="text" class="form-control" id="headDesig" name="inputHeadDesig"
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                                 <div class="form-group col-md-6">
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                       placeholder="Head Designation">
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                                    <label for="gst">GSTIN</label>
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            </div>
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                                    <input type="text" class="form-control" id="gst"  name="inputGst"  placeholder="GST">
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            <div class="form-group col-md-6">
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                                </div>
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                <label for="headEmail">Head Email</label>
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                                 <div class="form-group col-md-6">
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                <input type="email" class="form-control" id="headEmail" name="inputHeadEmail" placeholder="Head Email">
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                                    <label for="panNumber">PAN</label>
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            </div>
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                                    <input type="text" class="form-control" id="panNumber"  name="inputPan"  placeholder="pan">
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            <div class="form-group col-md-6">
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                                </div>
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                <label for="contactPerson">Contact Person</label>
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                                 <div class="form-group col-md-6">
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                <input type="text" class="form-control" id="contactPerson" name="inputContactPerson"
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                                    <label for="Fax">Fax</label>
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                       placeholder="Contact Person">
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                                    <input type="text" class="form-control" id="Fax"  name="inputFax"  placeholder="Fax">
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            </div>
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                                </div>
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            <div class="form-group col-md-6">
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                                 <div class="form-group col-md-6">
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                <label for="contactEmail">Contact Email</label>
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                                    <label for="headName">Head Name</label>
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                <input type="email" class="form-control" id="contactEmail" name="inputContactEmail"
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                                    <input type="text" class="form-control" id="headName"  name="inputHeadName"  placeholder="Head Name">
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                       placeholder="Contact Email">
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                                </div>
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            </div>
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            <div class="form-group col-md-6">
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                                 <div class="form-group col-md-6">
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                <label for="contactFax">Contact Fax</label>
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                                    <label for="headDesig">Head Designation</label>
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                <input type="text" class="form-control" id="contactFax" name="inputContactFax"
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                                    <input type="text" class="form-control" id="headDesig"  name="inputHeadDesig"  placeholder="Head Designation">
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                       placeholder="Contact Fax">
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                                </div>
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            </div>
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                                 <div class="form-group col-md-6">
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                                    <label for="headEmail">Head Email</label>
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            <div class="form-group col-md-6">
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                                    <input type="email" class="form-control" id="headEmail"  name="inputHeadEmail"  placeholder="Head Email">
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                <label for="registeredAddress">Registered Address</label>
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                                </div>
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                <input type="text" class="form-control" id="registeredAddress" name="inputRegisteredAddress"
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                                 <div class="form-group col-md-6">
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                       placeholder="Registered Address">
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                                    <label for="contactPerson">Contact Person</label>
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            </div>
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                                    <input type="text" class="form-control" id="contactPerson"  name="inputContactPerson"  placeholder="Contact Person">
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            <div class="form-group col-md-6">
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                                </div>
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                <label for="communicationAddress">Communication Address</label>
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                                 <div class="form-group col-md-6">
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                <input type="text" class="form-control" id="communicationAddress" name="inputCommunicationAddress"
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                                    <label for="contactEmail">Contact Email</label>
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                       placeholder="Communication Address">
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                                    <input type="email" class="form-control" id="contactEmail"  name="inputContactEmail"  placeholder="Contact Email">
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            </div>
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                                </div>
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            <div class="form-group col-md-6">
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                                 <div class="form-group col-md-6">
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                <label for="terms&Conditions">Terms & Conditions</label>
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                                    <label for="contactFax">Contact Fax</label>
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                <input type="text" class="form-control" id="terms&Conditions" name="inputTermConditions"
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                                    <input type="text" class="form-control" id="contactFax"  name="inputContactFax"  placeholder="Contact Fax">
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                       placeholder="Terms & Conditions">
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                                </div>
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            </div>
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                                <div class="form-group col-md-6">
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                                    <label for="registeredAddress">Registered Address</label>
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            <div class="form-group col-md-6">
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                                    <input type="text" class="form-control" id="registeredAddress"  name="inputRegisteredAddress"  placeholder="Registered Address">
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                <label for="warehouseLocation">Warehouse Location</label>
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                                </div>
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                <select class="chosen-select" id="warehouseLocation" name="inputWarehouseLocation"
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                                <div class="form-group col-md-6">
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                        data-placeholder="Warehouse Location" multiple style="width:500px;" tabindex="4">
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                                    <label for="communicationAddress">Communication Address</label>
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                    #foreach($warehouseIdAndState in $warehouseIdAndState.entrySet())
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                                    <input type="text" class="form-control" id="communicationAddress"  name="inputCommunicationAddress"  placeholder="Communication Address">
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                        <option value="$warehouseIdAndState.getKey()">$warehouseIdAndState.getValue().getPrefix()
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                                </div>
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                            ($warehouseIdAndState.getValue().getStateName())
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                                <div class="form-group col-md-6">
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                        </option>
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                                    <label for="terms&Conditions">Terms & Conditions</label>
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                    #end
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                                    <input type="text" class="form-control" id="terms&Conditions"  name="inputTermConditions"  placeholder="Terms & Conditions">
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                </select>
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                                </div>
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            </div>
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            <div class="form-group col-md-6">
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                                <div class="form-group col-md-6">
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                <label for="state">State</label>
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                                <label for="warehouseLocation">Warehouse Location</label>
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                <select class="form-control input-sm" id="stateId" name="stateId" placeholder="State"
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                         	   <select class="chosen-select" id="warehouseLocation"  name="inputWarehouseLocation" data-placeholder="Warehouse Location" multiple style="width:500px;" tabindex="4">
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                        style="height: 60px;">
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 		     				    #foreach($warehouseIdAndState in $warehouseIdAndState.entrySet())
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                    <option value="" disabled selected>State</option>
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		             		    <option value="$warehouseIdAndState.getKey()">$warehouseIdAndState.getValue().getPrefix()($warehouseIdAndState.getValue().getStateName())</option>
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                    #foreach($stateName in $state)
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		             		    #end
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                        <option value="$stateName.getId()">$stateName.getName()</option>
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		                       	</select>
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                    #end
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		                      	</div>
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                </select>
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            </div>
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                               <div class="form-group col-md-6">
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                                    <label for="state">State</label>
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            <div class="form-group col-md-6">
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                         	    <select class="form-control input-sm" id = "stateId" name="stateId" placeholder="State"  style="height: 60px;">
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                <label for="pOValidityLimit">PO Validity Days Limit</label>
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						        <option value="" disabled selected>State</option>
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                <input type="number" class="form-control" id="pOValidityLimit" name="inputPOValidityLimit"
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							    #foreach($stateName in $state)
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                       placeholder="PO Validity Days Limit">
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		             		    <option value="$stateName.getId()">$stateName.getName()</option>
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            </div>
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		             		    #end
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		                       	</select>
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            <div class="form-group col-md-6">
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		                      	</div>
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                <button type="button" class="btn btn-primary create-supplier-submit" style="margin: 20px;">Submit
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                </button>
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                                <div class="form-group col-md-6">
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                                    <label for="pOValidityLimit">PO Validity Days Limit</label>
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            </div>
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                                    <input type="number" class="form-control" id="pOValidityLimit"  name="inputPOValidityLimit"  placeholder="PO Validity Days Limit">
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        </div>
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                                </div>
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    </form>
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</section>
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                                <div class="form-group col-md-6">
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                                 <button type="button" class="btn btn-primary create-supplier-submit" style="margin: 20px;">Submit</button>
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<script>
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                                </div>
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    $(document).ready(function () {
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                          </div>
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        $('.chosen-select').chosen({
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                       </form>
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            search_contains: true
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           </section>
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        });
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 <script>
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    });
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    $(document).ready(function() {
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</script>
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	$('.chosen-select').chosen({
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			search_contains : true
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		});
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   });
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 </script>
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