Subversion Repositories SmartDukaan

<section class="wrapper">
    <div class="row">
        <div class="col-lg-12">
            <h3 class="page-header" style="text-align: center ;color:#d3181f">LOI Update Form</h3>
            <ol class="breadcrumb">
                <li><i class="fa fa-home"></i><a href="${rc.contextPath}/dashboard">#springMessage(
                    "reportdailycollection.home")</a></li>
                <li><i class="icon_document_alt"></i>LOI Update Form</li>
            </ol>
        </div>
    </div>
    <div>
        <form name="LoiUpdate" id="LoiUpdate" method="post" style="margin-top:40px;">
            <div>
                <h4>Personal Details</h4>
            </div>
            <div class="row">
                <div class="col-md-4">
                    <!-- Owner Name -->
                    <div class="form-group">
                        <label>First Name </label><span
                            style="color:red ;font-size: 140%">*</span>
                        <input type="text" class="form-control" required name="firstName"
                               placeholder="Enter first name" value="$loiForm.getFirstName()">
                    </div>
                </div>
                <div class="col-md-4">
                    <!-- Owner Name -->
                    <div class="form-group">
                        <label>Last Name </label><span
                            style="color:red ;font-size: 140%">*</span>
                        <input type="text" class="form-control" required name="lastName"
                               placeholder="Enter last name" value="$loiForm.getLastName()">
                    </div>
                </div>
                <div class="col-md-4">
                    <!-- Mobile No -->
                    <div class="form-group">
                        <label>Mobile No. </label><span
                            style="color:red ;font-size: 140%">*</span>

                        <input type="tel" class="form-control" required name="mobile"
                               placeholder="10-digit Mobile"
                               maxlength="10"
                               minlength="10"
                               value=$loiForm.getMobile()>
                    </div>
                </div>
            </div>
            <div class="row">
                <div class="col-md-4">
                    <!-- Landline No -->
                    <div class="form-group">
                        <label>Alternative Mobile No.</label>
                        <input type="tel" class="form-control" name="landline"
                               maxlength="10"
                               minlength="10"
                               placeholder="Enter Alternative mobile"
                               value="$loiForm.getLandline()">


                    </div>
                </div>
                <div class="col-lg-4"><!-- Email ID -->
                    <div class="form-group">
                        <label>Email ID </label>
                        <span
                                style="color:red ;font-size: 140%">*</span>

                        <input type="email" class="form-control" required name="email" placeholder="Enter Email"
                               value="$loiForm.getEmail()">

                    </div>
                </div>
                <div class="col-lg-4"> <!-- DOB -->
                    <div class="form-group">
                        <label>DOB </label>
                        <span
                                style="color:red ;font-size: 140%">*</span>

                        <input type="date" class="form-control" required name="dob" placeholder="Enter DOB"
                               value="$loiForm.getDob()">

                    </div>
                </div>
            </div>
            <div class="row">
                <div class="col-lg-4"> <!-- PAN No-->
                    <div class="form-group">
                        <label>PAN No</label><span
                            style="color:red ;font-size: 140%">*</span>
                        <input type="text" class="form-control" required name="panNo" placeholder="enter Pan No"
                               minlength="10"
                               maxlength="10"
                               value="$loiForm.getPanNo()"
                        >
                    </div>
                </div>
                <div class="col-lg-4"> <!-- Aadhar No-->
                    <div class="form-group">
                        <label>Aadhar No</label><span
                            style="color:red ;font-size: 140%">*</span>
                        <input type="tel" class="form-control" required name="adharNo"
                               value="$loiForm.getAdharNo()"
                               placeholder="Adhar Number"
                               maxlength="12"
                               minlength="12"
                               pattern="[0-9]{12}">
                    </div>
                </div>
            </div>
            <div class="form-group" style="text-align: center; margin-bottom:2px;">
                <button type="button"
                        class="btn btn-primary text-white font-semibold py-1 px-4 rounded background-red updateLoiFormDataButton"
                        style="box-shadow:none;margin-bottom:2px;" data-loiid="$loiForm.getId()">
                    <span>Update</span>
                </button>
            </div>
        </form>
    </div>
</section>