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<?php
header("Cache-Control: no-cache, must-revalidate");
include 'dbconnect.php';
?>
<!doctype html>
<html lang="en">
<head>
<meta charset="utf-8">
<meta name="viewport" content="width=device-width, initial-scale=1">
<title>Account Open Form</title>
<link href="css/bootstrap.min.css" rel="stylesheet">
<!-- Font Awesome Icons -->
<link rel="stylesheet" href="css/fontawesome-free-6.6.0-web/css/all.min.css">
<link rel="stylesheet" href="css/style.css">
<link href="https://cdn.jsdelivr.net/npm/select2@4.1.0-rc.0/dist/css/select2.min.css" rel="stylesheet" />
<script src="https://cdn.jsdelivr.net/npm/select2@4.1.0-rc.0/dist/js/select2.min.js"></script>
</head>
<body>
<div class="card-container">
<div class="card ac_open_container">
<div class="card-header text-center">FSIB Account Opening Request Form</div>
<div class="card-body">
<form action="form-api.php" method="post" enctype="multipart/form-data">
<div class="mb-2">
<label class="form-subheading">Customer Information :</label>
</div>
<div class="input_group">
<label class="form-label">A/C Type :</label>
<select class="form-select" id="ac_type" name="ac_type" required>
<option disabled selected>Choose Account Type</option>
<option value="161">FCA WAGE EARNERS US DOLLAR</option>
<option value="162">FCA WAGE EARNERS EURO</option>
<option value="163">FCA WAGE EARNERS GBP</option>
<option value="111">Al-Wadiah Current Deposit Account</option>
<option value="122">Mudarabah Savings Deposit Account</option>
<option value="131">Mudarabah Special Notice Deposit Account (SND)</option>
<option value="143">Mudarabah FSIBL Smart Account</option>
</select>
</div>
<?php
// $sql_br = "SELECT * FROM `branch` ORDER BY `branch`.`branch_name` ASC";
// $sql_br_execute = $conn->query($sql_br);
// $branch = $sql_br_execute->fetch_assoc();
?>
<div class="input_group">
<label class="form-label">A/C Open Br :</label>
<select class="form-select" id="ac_open_br" name="ac_open_br" required>
<option disabled selected>First Select A/C Type</option>
</select>
</div>
<div class="input_group">
<label class="form-label">Account Holder Name :</label>
<input type="text" name="cus_name" id="cus_name" class="form-control" required>
</div>
<div class="input_group">
<label class="form-label" style="margin-right:15px">Gender :</label>
<select class="form-select" id="gender" name="gender">
<option disabled selected>Choose...</option>
<option value="male">Male</option>
<option value="female">Female</option>
<option value="others">Other</option>
</select>
</div>
<div class="input_group">
<label class="form-label">Father's Name :</label>
<input type="text" name="father_name" id="father_name" class="form-control" required>
</div>
<div class="input_group">
<label class="form-label">Mother's Name :</label>
<input type="text" name="mother_name" id="mother_name" class="form-control" required>
</div>
<div class="input_group">
<label class="form-label">Date of Birth :</label>
<input type="date" name="dob" id="dob" class="form-control" placeholder="mm/dd/yyyy" required>
</div>
<div class="input_group">
<label class="form-label">Occupation :</label>
<select class="form-select" id="occupation" name="occupation" required>
<option disabled selected>Choose...</option>
<option value="service_holder">SERVICE HOLDER</option>
<option value="teacher_school_college">TEACHER-SCHOOL/COLLEGE</option>
<option value="doctor">DOCTOR</option>
<option value="self_employed_professional">SELF-EMPLOYED PROFESSIONAL</option>
<option value="student">STUDENT</option>
<option value="housewife">HOUSEWIFE</option>
<option value="professor">PROFESSOR</option>
<option value="engineer">ENGINEER</option>
<option value="lawyer">LAWYER</option>
<option value="business">BUSINESS</option>
<option value="other">OTHER</option>
</select>
</div>
<div class="input_group">
<label class="form-label">Mobile(Whatsapp/BOTIM enable no) :</label>
<div class="d-flex justify-content-center gap-5">
<select class="form-select" id="cc" name="cc" required>
<option disabled selected>Country Code</option>
<?php
$sql_cc = "SELECT * FROM `country_code` ORDER BY `Country_name`";
$sql_cc_execute = $conn->query($sql_cc);
//$branch = $sql_br_execute->fetch_assoc();
while ($rowcc = $sql_cc_execute->fetch_assoc()) {
?>
<option value="<?php echo $rowcc["country_code"]; ?>"> <?php echo $rowcc["country_name"] . "(" . $rowcc["country_code"] . ")"; ?> </option>
<?php
}
?>
</select>
<input type="text" name="mobile" id="mobile" class="form-control" required>
</div>
</div>
<div class="input_group">
<label class="form-label">Email :</label>
<input type="email" name="email" id="email" class="form-control" required>
</div>
<div class="input_group">
<label class="form-label">Nationality :</label>
<input type="text" name="nationality" id="nationality" class="form-control" required>
</div>
<label class="form-subheading">Address :</label>
<br>
<div class="input_group">
<label class="form-label">Permenant Address :</label>
<input type="textarea" name="per_ad" id="per_ad" class="form-control" required>
</div>
<!--<div class="form-group">-->
<!-- <input type="checkbox" id="address_checkBox" onclick="autoFillAddress()"> Same as permanent address-->
<!--</div>-->
<div class="input_group">
<label class="form-label" style="margin-right:40px;">Present Address : </label>
<input type="checkbox" id="sameAsPermanent" onclick="copyAddress()">
<label for="sameAsPermanent" class="form-label">Same as Permanent Address</label>
<!--<input type="checkbox" name="homepostalcheck" id="homepostalcheck" style="margin-right:5px;"/>Same as above: </label>-->
<input type="textarea" name="pr_ad" id="pr_ad" class="form-control input_group" required>
</div>
<div class="input_group">
<label class="form-label">ID front(NID/Passport/Birth Certificate) :</label>
<input type="file" name="nid" id="nid" class="form-control" required>
</div>
<div class="input_group">
<label class="form-label">ID Back(NID/Passport/Birth Certificate) :</label>
<input type="file" name="nid_b" id="nid_b" class="form-control" required>
</div>
<div class="input_group">
<label class="form-label">Customer Photo :</label>
<input type="file" name="cus_photo" id="cus_photo" class="form-control" required>
</div>
<div class="input_group">
<label class="form-label">Customer Signature :</label>
<input type="file" name="cus_sign" id="cus_sign" class="form-control" required>
</div>
<div class="mb-2">
<label class="form-subheading">Nominee Information :</label>
</div>
<div class="input_group">
<label class="form-label">Name :</label>
<input type="text" name="nominee_name" id="nominee_name" class="form-control" required>
</div>
<div class="input_group">
<label class="form-label">Relation :</label>
<input type="text" name="nominee_relation" id="nominee_relation" class="form-control" required>
</div>
<div class="input_group">
<label class="form-label">Share :</label>
<input type="text" name="nominee_share" id="nominee_share" class="form-control" required>
</div>
<div class="input_group">
<label class="form-label">Nominee ID Front(NID/Passport) :</label>
<input type="file" name="nominee_nid" id="nominee_nid" class="form-control" required>
</div>
<div class="input_group">
<label class="form-label">Nominee ID Back(NID/Passport) :</label>
<input type="file" name="nominee_nid_b" id="nominee_nid_b" class="form-control" required>
</div>
<div class="d-flex justify-content-end">
<input type="submit" value="Submit" name="ac_open_form_submit" class="btn btn-success">
</div>
</form>
</div>
</div>
</div>
<script src="https://code.jquery.com/jquery-3.5.1.min.js"></script>
<script>
$(document).ready(function() {
$('#ac_type').on('change', function() {
product_id = $(this).val();
// alert(product_id);
$.ajax({
url: 'acc_type_api.php', // Specify your URL here
method: 'POST',
data: {
acc_TypeId: product_id
},
success: function(result) {
$('#ac_open_br').html(result);
}
});
});
});
</script>
<script>
$(function() {
$("#ac_open_br").select2();
});
function copyAddress() {
const permanentAddress = document.getElementById('per_ad').value;
const checkbox = document.getElementById('sameAsPermanent');
const presentAddress = document.getElementById('pr_ad');
if (checkbox.checked) {
presentAddress.value = permanentAddress;
} else {
presentAddress.value = '';
}
}
</script>
<script src="js/bootstrap.bundle.min.js"></script>
<script src="js/script.js"></script>
</body>
</html>