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<section class="wrapper">
    <div class="row">
        <div class="col-lg-12">
            <h3 class="page-header">
                <i class="icon_document_alt"></i>Seller
            </h3>
            <ol class="breadcrumb">
                <li><i class="fa fa-home"></i><a
                        href="${rc.contextPath}/dashboard">Home</a></li>
                <li><i class="icon_document_alt"></i>Supplier Form</li>
            </ol>
        </div>
    </div>
    <form id="new-supplier-create-form">
        <div class="form-row">
            <div class="form-group col-md-6">
                <label for="name">Name</label>
                <input type="text" class="form-control" id="name" name="inputName" placeholder="Name">
            </div>

            <div class="form-group col-md-6">
                <label for="phone">Phone</label>
                <input type="number" class="form-control" id="phone" name="inputPhone" placeholder="Phone">
            </div>

            <div class="form-group col-md-6">
                <label for="gst">GSTIN</label>
                <input type="text" class="form-control" id="gst" name="inputGst" placeholder="GST">
            </div>
            <div class="form-group col-md-6">
                <label for="panNumber">PAN</label>
                <input type="text" class="form-control" id="panNumber" name="inputPan" placeholder="pan">
            </div>
            <div class="form-group col-md-6">
                <label for="Fax">Fax</label>
                <input type="text" class="form-control" id="Fax" name="inputFax" placeholder="Fax">
            </div>
            <div class="form-group col-md-6">
                <label for="headName">Head Name</label>
                <input type="text" class="form-control" id="headName" name="inputHeadName" placeholder="Head Name">
            </div>

            <div class="form-group col-md-6">
                <label for="headDesig">Head Designation</label>
                <input type="text" class="form-control" id="headDesig" name="inputHeadDesig"
                       placeholder="Head Designation">
            </div>
            <div class="form-group col-md-6">
                <label for="headEmail">Head Email</label>
                <input type="email" class="form-control" id="headEmail" name="inputHeadEmail" placeholder="Head Email">
            </div>
            <div class="form-group col-md-6">
                <label for="contactPerson">Contact Person</label>
                <input type="text" class="form-control" id="contactPerson" name="inputContactPerson"
                       placeholder="Contact Person">
                       </div>
            <div class="form-group col-md-6">
             <label for="contactPhone">Contact Phone</label>
              <input type="number" class="form-control" id="contactPhone" name="inputContactPhone"
               placeholder="Contact Phone" >
             </div>

            <div class="form-group col-md-6">
                <label for="contactEmail">Contact Email</label>
                <input type="email" class="form-control" id="contactEmail" name="inputContactEmail"
                       placeholder="Contact Email">
            </div>
            <div class="form-group col-md-6">
                            <label for="document">Document</label>
                            <input type="file" id="document" name="inputDocument">

             </div>
            <div class="form-group col-md-6">
                <label for="contactFax">Contact Fax</label>
                <input type="text" class="form-control" id="contactFax" name="inputContactFax"
                       placeholder="Contact Fax">
            </div>

            <div class="form-group col-md-6">
                <label for="registeredAddress">Registered Address</label>
                <input type="text" class="form-control" id="registeredAddress" name="inputRegisteredAddress"
                       placeholder="Registered Address">
            </div>
            <div class="form-group col-md-6">
                <label for="communicationAddress">Communication Address</label>
                <input type="text" class="form-control" id="communicationAddress" name="inputCommunicationAddress"
                       placeholder="Communication Address">
            </div>
            <div class="form-group col-md-6">
                <label for="terms&Conditions">Terms & Conditions</label>
                <input type="text" class="form-control" id="terms&Conditions" name="inputTermConditions"
                       placeholder="Terms & Conditions">
            </div>
            <div class="form-group col-md-6">
                                 #if($warehouseCheckboxMap.get($wh.getId()).isWarehouse())

                                     <input type="checkbox" id="warehouseCheckbox" name="warehouseCheckbox" value="" checked>
                                        <label for="warehouseCheckbox">Internal Warehouse</label><br>

                                   #else
                                   <input type="checkbox" id="warehouseCheckbox" name="warehouseCheckbox" value="">
                                        <label for="warehouseCheckbox">Internal Warehouse</label><br>

                                 #end



            </div>
            <div class="form-group col-md-6">
                                        <label for="warehouse">Warehouse Name</label>
                                        <select disabled class="form-control input-sm" id="warehouseId" name="warehouseId" placeholder="Warehouse Name">

                                            <option value="" disabled selected>Warehouse Name</option>
                                            #foreach($warehouseEntry in $warehouseMap.entrySet())
                                            <option value="$warehouseEntry.getKey()">$warehouseEntry.getValue()</option>
                                            #end
                                        </select>
                                    </div>


            <div class="form-group col-md-6">
                <label for="warehouseLocation">Warehouse Location</label>
                <select class="chosen-select" id="warehouseLocation" name="inputWarehouseLocation"
                        data-placeholder="Warehouse Location" multiple style="width:500px;" tabindex="4">
                    #foreach($warehouseIdAndState in $warehouseIdAndState.entrySet())
                        <option value="$warehouseIdAndState.getKey()">$warehouseIdAndState.getValue().getPrefix()
                            ($warehouseIdAndState.getValue().getStateName())
                        </option>
                    #end
                </select>
            </div>

            <div class="form-group col-md-6">
                <label for="state">State</label>
                <select class="form-control input-sm" id="stateId" name="stateId" placeholder="State"
                        >
                    <option value="" disabled selected>State</option>
                    #foreach($stateName in $state)
                        <option value="$stateName.getId()">$stateName.getName()</option>
                    #end
                </select>
            </div>

            <div class="form-group col-md-6">
                <label for="pOValidityLimit">PO Validity Days Limit</label>
                <input type="number" class="form-control" id="pOValidityLimit" name="inputPOValidityLimit"
                       placeholder="PO Validity Days Limit">
            </div>

            <div class="form-group col-md-6">
                <button type="button" class="btn btn-primary create-supplier-submit" style="margin: 20px;">Submit
                </button>

            </div>
        </div>
    </form>
</section>

<script>

    $(document).ready(function () {
        $('.chosen-select').chosen({
            search_contains: true

        });
    });

</script>