<!DOCTYPE html>
<!--
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and open the template in the editor.
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<html>
    <head>
        <title>Registration Form</title>
        <meta charset="UTF-8">
        <meta name="viewport" content="width=device-width, initial-scale=1.0">
        <link rel="stylesheet"  href="<?php echo base_url();?>form/style.css" type="text/css" media="screen"/>
        <script type="text/javascript">
            function printDiv1(divName) {
                var printContents = document.getElementById(divName).innerHTML;
                var originalContents = document.body.innerHTML;
                document.body.innerHTML = printContents;
                window.print();
                document.body.innerHTML = originalContents;
            }
        </script>
    </head>
    <body >
        <?php
                    $message = $this->session->userdata('message');
                    if (!empty($message)) {?>
        <table class="wrapper">
            <thead>
                <tr>
                    
                    <th style="width: 100%; height:70px; text-align:center;color:white;background-color:#ADD8E6;">
                        <?php
                        echo $message;
                        $this->session->unset_userdata('message');
                        ?>
                    </th>
                    
                </tr>
            </thead>
        </table>
        <?php } ?>

        <?php
            $errormessage = $this->session->userdata('errormessage');
            if (!empty($errormessage)) {?>
        <table class="wrapper">
            <thead>
                <tr>
                    
                    <th style="width: 100%; height:70px; text-align:center;color:white;background-color:#FFB6C1;">
                        <?php
                        echo $errormessage;
                        $this->session->unset_userdata('errormessage');
                        ?>
                    </th>
                    
                </tr>
            </thead>
        </table>
        <?php } ?>
        <table class="wrapper" id="printDIV1">
            <thead>
                <tr>
                    <th><img src="<?php echo base_url();?>form/img/banner.png" alt="banner" style="width: 100%;"></th>
                </tr>
            </thead>
            <tbody>
                <tr>
                    <td>
                        <form action="<?php echo admin_url();?>/landcustomerRegistration/index" method="post">
                            <table class="child_wrapper">
                                <tbody>
                                    <tr>
                                        <td colspan="4" align="center"><p style="width: 200px; background:#990099; color: #ffffff; border-radius: 10px; padding: 10px; text-align: center;">প্লট বরাদ্দের আবেদন</p></td>
                                    </tr>
                                    <tr>
                                        <td width="19%" class="td_color" style="background-color: #cccccc">ক্রমিক নং</td>
                                        <td width="29%" style="background-color: #cccccc"><?php if(!empty($kro_num)){echo $kro_num;}?></td>
                                        <td width="26%" style="background-color: #cccccc">তারিখ <?php if(!empty($date)){echo $date;}?></td>
                                        <td width="26%" style="background-color: #cccccc">ছবি <input class="input_box_one" type="file" name="name"></td>
                                    </tr>
                                    <tr>
                                        <td width="25%" class="td_color" style="background-color: #cccccc">আবেদনকারীর নাম </td>
                                        <td colspan="3" style="background-color: #cccccc"><?php if(!empty($applicant_name)){echo $applicant_name;}?></td>
                                    </tr>
                                    <tr>
                                        <td class="td_color" style="background-color: #cccccc"> পরিচয় পত্রের নম্বর</td>
                                        <td colspan="3" style="background-color: #cccccc"><?php if(!empty($nationalid)){echo $nationalid;}?></td>
                                    </tr>
                                    <tr>
                                        <td class="td_color" style="background-color: #cccccc">পিতার নাম </td>
                                        <td colspan="3" style="background-color: #cccccc"><?php if(!empty($fatherName)){echo $fatherName;}?></td>
                                    </tr>
                                    <tr>
                                        <td class="td_color" style="background-color: #cccccc">মাতার নাম </td>
                                        <td colspan="3" style="background-color: #cccccc"><?php if(!empty($motherName)){echo $motherName;}?></td>
                                    </tr>
                                    <tr>
                                        <td class="td_color" style="background-color: #cccccc">স্বামী/স্ত্রী নাম &nbsp;</td>
                                        <td colspan="3" style="background-color: #cccccc"><?php if(!empty($husbant_wifeName)){echo $husbant_wifeName;}?></td>
                                    </tr>
                                    <tr>
                                        <td class="td_color" style="background-color: #cccccc">জন্ম তারিখ &nbsp;</td>
                                        <td style="background-color: #cccccc"><?php if(!empty($birthdate)){echo $birthdate;}?></td>
                                        <td style="background-color: #cccccc">পেশা  &nbsp;<?php if(!empty($occupation)){foreach(getOccupation() as $key=>$val){if($key==$occupation){echo $val;}}}?></td>
                                        <td style="background-color: #cccccc">জাতীয়তা &nbsp;<?php if(!empty($nationality)){echo $nationality;}?></td>
                                    </tr>
                                    <tr>
                                        <td class="td_color" style="background-color: #cccccc">বর্তমান ঠিকানা &nbsp;</td>
                                        <td colspan="3" style="background-color: #cccccc"><?php if(!empty($presentAddress)){echo $presentAddress;}?></td>
                                    </tr>
                                    <tr>
                                        <td class="td_color" style="background-color: #cccccc">স্থায়ী ঠিকানা&nbsp; </td>
                                        <td colspan="3" style="background-color: #cccccc"><?php if(!empty($permanentAddress)){echo $permanentAddress;}?></td>
                                    </tr>
                                    <tr>
                                        <td class="td_color" style="background-color: #cccccc">পাসপোর্ট নাম্বার (যদি থাকে) </td>
                                        <td colspan="3" style="background-color: #cccccc"><?php if(!empty($passportNumber)){echo $passportNumber;}?></td>
                                    </tr>
                                    <tr>
                                        <td class="td_color" style="background-color: #cccccc">ফোন &nbsp;</td>
                                        <td style="background-color: #cccccc"><?php if(!empty($phone)){echo $phone;}?></td>
                                        <td style="background-color: #cccccc">মোবইল &nbsp; <?php if(!empty($mobile)){echo $mobile;}?></td>
                                        <td style="background-color: #cccccc">ই-মেইল &nbsp;  <?php if(!empty($email)){echo $email;}?></td>
                                        <!--<td>অফিস    <input type="text" name="name"></td>-->
                                    </tr>
                                    <tr>
                                        <td class="td_color" style="background-color: #cccccc">ধর্ম &nbsp; </td>
                                        <td style="background-color: #cccccc"> <?php if(!empty($religion)){foreach(getReligion() as $key=>$val){if($key==$religion){echo $val;}}}?></td>
                                        <td colspan="2" style="background-color: #cccccc">টিন নম্বর (যদি থাকে) &nbsp; <?php if(!empty($tinNo)){echo $tinNo;}?></td>
                                    </tr>
                                    <tr>
                                        <td colspan="4"><p style=" background:#990099; color: #ffffff; text-align: center;">উত্তরাধিকারী (Nominee Information)</p></td>
                                    </tr>
                                    <tr>
                                        <td class="td_color" style="background-color: #cccccc">নাম &nbsp;</td>
                                        <td style="background-color: #cccccc"><?php if(!empty($nomineeName)){echo $nomineeName;}?></td>
                                        <td style="background-color: #cccccc">সম্পর্ক &nbsp; <?php if(!empty($relationship)){echo $relationship;}?></td>
                                        <td style="background-color: #cccccc">ছবি &nbsp;  </td>
                                        <!--<td>অফিস    <input type="text" name="name"></td>-->
                                    </tr>
                                    <tr>
                                        <td class="td_color" style="background-color: #cccccc">ঠিকানা &nbsp; </td>
                                        <td style="background-color: #cccccc"><?php if(!empty($address)){echo $address;}?></td>
                                        <td colspan="2" style="background-color: #cccccc">অংশ &nbsp; <?php if(!empty($part)){echo $part;}?></td>
                                    </tr>
                                    <tr>
                                        <td class="td_color" style="background-color: #cccccc">মোবাইল&nbsp;</td>
                                        <td style="background-color: #cccccc"><?php if(!empty($nominee_mobile)){echo $nominee_mobile;}?></td>
                                        <td style="background-color: #cccccc">ফোন &nbsp; <?php if(!empty($nominee_phone)){echo $nominee_phone;}?></td>
                                        <td style="background-color: #cccccc">ই-মেইল  &nbsp; <?php if(!empty($nominee_email)){echo $nominee_email;}?></td>
                                        <!--<td>অফিস    <input type="text" name="name"></td>-->
                                    </tr>
                                    <tr>
                                        <td colspan="4"><p style=" background:#990099; color: #ffffff; text-align: center;">প্রজেক্টের বিবরণ (Project Details)</p></td>
                                    </tr>
                                    <tr>
                                        <td class="td_color" style="background-color: #cccccc">ব্লক নম্বর &nbsp;</td>
                                        <td style="background-color: #cccccc"><?php if(!empty($projectBlockNo)){echo $projectBlockNo;}?></td>
                                        <td style="background-color: #cccccc">রোড নম্বর &nbsp; <?php if(!empty($roadNo)){echo $roadNo;}?></td>
                                        <td style="background-color: #cccccc">প্লট নম্বর  &nbsp; <?php if(!empty($plotNo)){echo $plotNo;}?></td>
                                        <!--<td>অফিস    <input type="text" name="name"></td>-->
                                    </tr>
                                    <tr>
                                        <td class="td_color" style="background-color: #cccccc">প্লট সাইজ  &nbsp;</td>
                                        <td style="background-color: #cccccc"> <?php if(!empty($plote_size)){echo $plote_size;}?></td>
                                        <td colspan="2" style="background-color: #cccccc">প্লট ফেইস &nbsp; <?php if(!empty($plote_face)){echo $plote_face;}?></td>
                                    </tr>
                                    <tr>
                                        <td class="td_color" style="background-color: #cccccc">পেমেন্টের ধরন &nbsp;</td>
                                        <td style="background-color: #cccccc"><?php if(!empty($payment_type)){foreach(getPaymentType() as $key=>$val){if($key==$payment_type){echo $val;}}}?></td>
                                        
                                        <td style="background-color: #cccccc" colspan="2">কিস্তি &nbsp;  <?php if(!empty($installment_step)){echo $installment_step;}?></td>
                                        <!--<td>অফিস    <input type="text" name="name"></td>-->
                                    </tr>
                                    <tr>
                                        <td class="td_color" style="background-color: #cccccc">মোট মুল্য</td>
                                        <td style="background-color: #cccccc"><?php if(!empty($total_cost)){echo $total_cost;}?></td>
                                        <td  style="background-color: #cccccc">ডাউন পেমেন্ট &nbsp; <?php if(!empty($down_payment)){echo $down_payment;}?> </td>
                                        <td  style="background-color: #cccccc">Dues &nbsp; <?php if(!empty($dues)){echo $dues;}?> </td>
                                        <!--<td>অফিস    <input type="text" name="name"></td>-->
                                    </tr>
                                    <tr>
                                        <td colspan="4" style="background-color: #cccccc" align="center">
                                            <input type="button" name="send" value="Print" onclick="javascript:printDiv1('printDIV1')" style="width:100px;height:30px;color:rgb(255, 255, 255);background-color:#990099; border:1px solid #990099;font-family:Arial,Helvetica,sans-serif;font-size:12px;font-weight:bold;text-align:center;text-transform:none;border-radius:4px;"/>&nbsp;&nbsp;
                                            <input type="submit" name="btn"  value="Back" style="width:100px;height:30px;color:rgb(255, 255, 255);background-color:#990099; border:1px solid #990099;font-family:Arial,Helvetica,sans-serif;font-size:12px;font-weight:bold;text-align:center;text-transform:none;border-radius:4px;"/>
                                        </td>
                                    </tr>
                                    
                                </tbody>
                            </table>
                        </form>
                    </td>
                </tr>
            </tbody>
        </table>
    </body>
</html>
