
<div class="page-content" >   
<div class="row">
    <div class="col-sm-12">
        <div class="widget-box">
            <div class="widget-header" style="height:70px;">
                <h4  style="text-align:center; color:green;"><b> Customer Call Entry</b> </h4>
            </div>
<?php //echo print_r($callInfoById); ?>
<?php foreach ($callInfoById as $value){ ?>
            <div class="widget-body">

                <div class="widget-main no-padding">
                    <form action="<?php echo admin_url()?>/customerCalls/insert_call " method="post">
                        <!-- <legend>Form</legend> -->
                        
                        <fieldset class="col-xs-12 col-sm-12">
                            <div class="col-xs-2 col-sm-2"><label>Select Customer</label></div>
                            <?php echo form_error('data[customerId]', '<div style="color: rgb(255, 0, 0);">', '</div>'); ?>
                             <div class="col-xs-4 col-sm-4">
                             <select name="data[customerId]"  class="chosen-select" id="form-field-select-3" data-placeholder="Choose a State...">
                                 <option value=""> Select Customer Id......  </option>
                                 <?php if(!empty($allCustomerId)){
                                        foreach($allCustomerId as $value){
                                    ?>
                                    <option value="<?php echo $value['customerId'];?>" <?php echo set_select('data[customerId]',$value['customerId'],FALSE);?>>
                                        <?php 
                                            echo $value['customerId']; $app_name=getlandCustomerNameById($value['customerId']); echo "(".$app_name['applicant_name'].")";

                                        ?>
                                    </option>
                                    <?php }
                                        }
                                    ?>
                            </select>
                            </div>
                         </fieldset>
                         
                        <fieldset class="col-xs-12 col-sm-12">
                                <div class="col-xs-2 col-sm-2"><label>Contact Date</label></div>
                                <?php echo form_error('data[call_date]', '<div style="color: rgb(255, 0, 0);">', '</div>'); ?>
                                <div class="input-group col-xs-4 col-sm-4">
                                    <input class="form-control date-picker" id="id-date-picker-1" type="text" name="data[date]" value="<?php echo date('d-m-Y'); echo set_value('data[call_date]',false); ?>" data-date-format="dd-mm-yyyy" />
                                    <span class="input-group-addon">
                                        <i class="fa fa-calendar bigger-110"></i>
                                    </span>
                                </div>
                        </fieldset>

                        <fieldset class="col-xs-12 col-sm-12">
                            <label class="col-xs-2 col-sm-2"> Call Details </label>
                            <?php echo form_error('data[description]', '<div style="color: rgb(255, 0, 0);">', '</div>'); ?>
                            <textarea name="data[description]" autocomplete="off" class="col-xs-4 col-sm-4" placeholder="Description...."><?php echo $value['description']?></textarea>
                          
                        </fieldset>

                <?php } ?>
                        <div class="clearfix"></div>

                        <div class="form-actions center">
                            <button type="submit" class="btn btn-sm btn-success">
                                 <i class="ace-icon fa fa-check bigger-110"></i>
                                Submit
                                
                            </button>
                            
                            
                        </div>
                    </form>
                </div>
            </div>
        </div>
    </div></div></div>

    <script>
function myFunction() {
    var x = document.getElementById("mySelect").value;
    if(x==2 || x==3  || x==4){
    document.getElementById("demo").innerHTML = "<label class='col-xs-2 col-sm-2'>Check/PayOrder/DD No </label><input type='text' name='pay_order_ddNo' autocomplete='off' value='<?php echo set_value('pay_order_ddNo',false); ?>' placeholder='Check/Pay Order/DD No' class='col-xs-4 col-sm-4' />";
    }
    else
    {
    document.getElementById("demo").innerHTML = " ";
    }
}
</script>



    
    
    