<div class="page-content" >
    <div class="page-header">
        <h1>
            Customer registration
            <small class="red">
                <i class="ace-icon fa fa-angle-double-right"></i>
               Fill up all information
            </small>
        </h1>
    </div><!-- /.page-header -->

    <!-- /Content Section  -->
    <?php
    $message = $this->session->userdata('message');
    if (!empty($message)) {
        ?>
        <div class="alert alert-block alert-success">
            <h6 class="lighter arial green" style="text-align:center;"><b>
                    <?php
                    echo $message;
                    $this->session->unset_userdata('message');
                    ?>
                </b></h6>
        </div>
        <?php
    }
    $errormessage = $this->session->userdata('errormessage');
    if (!empty($errormessage)) {
        ?>
        <div class="alert alert-block alert-danger">
            <h6 class="lighter arial red" style="text-align:center;"><b>
                    <?php
                    echo $errormessage;
                    $this->session->unset_userdata('errormessage');
                    ?>
                </b></h6>
        </div>
        <?php
    }
    ?>
    <div class="row">

        <div class="col-xs-12 col-sm-12">

                <form  class="form-horizontal" action="<?php echo admin_url(); ?>/landcustomerRegistration/save_customer_info" method="post" enctype="multipart/form-data">

                    <div id="printDIV" class="col-xs-12 col-sm-12">
                        <div class="alert alert-block alert-info">
                            <h4 class="lighter arial red align-center"><b>Customer Information</b></h4>
                        </div>

                        <!-- PAGE CONTENT BEGINS -->
                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Customer ID * &nbsp; <?php echo form_error('data[customerId]', '<span style="color: rgb(255, 0, 0);" class="successMessage">', '</span>'); ?></label>
                             
                            <input type="text" name="data[customerId]"  autocomplete="off"  placeholder="Customer ID" disabled  class="col-xs-10 col-sm-12"/>
                        </div>
                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Plot Id * &nbsp; <?php echo form_error('data[kro_num]', '<span style="color: rgb(255, 0, 0);" class="successMessage">', '</span>'); ?></label>
                             <!-- <input type="hidden" name="data[kro_num]" autocomplete="off" value="<?php $id=getkro_num(); echo $id['id']+1; ?>"  placeholder=""   class="col-xs-10 col-sm-12" />  -->

                            <input type="text" name="data[kro_num]"  autocomplete="off"  placeholder="Plot Id (should unique)"   class="col-xs-10 col-sm-12" />
                        </div>
                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Date  &nbsp; <?php echo form_error('data[date]', '<span style="color: rgb(255, 0, 0);" class="successMessage">', '</span>'); ?></label>
                             <input class="form-control date-picker col-xs-10 col-sm-12" id="form-field-date" type="text"  name="data[date]" autocomplete="off" value="<?php echo set_value('data[date]', false); ?>" data-date-format="dd-mm-yyyy" placeholder="dd-mm-yyyy" />
                        </div>
                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Applicant Name  &nbsp; <?php echo form_error('data[applicant_name]', '<span style="color: rgb(255, 0, 0);" class="successMessage">', '</span>'); ?></label>
                            <input type="text" name="data[applicant_name]" autocomplete="off" value="<?php echo set_value('data[applicant_name]', false); ?>"  placeholder="Applicant Name"   class="col-xs-10 col-sm-12" />
                        </div>
                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Father's Name  &nbsp; <?php echo form_error('data[fatherName]', '<span style="color: rgb(255, 0, 0);" class="successMessage">', '</span>'); ?></label>
                            <input type="text" name="data[fatherName]" autocomplete="off" value="<?php echo set_value('data[fatherName]', false); ?>"  placeholder="Father's Name"   class="col-xs-10 col-sm-12" />
                        </div>
                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Mother's Name  &nbsp; <?php echo form_error('data[motherName]', '<span style="color: rgb(255, 0, 0);" class="successMessage">', '</span>'); ?></label>
                            <input type="text" name="data[motherName]" autocomplete="off" value="<?php echo set_value('data[motherName]', false); ?>"  placeholder="Mother's Name"   class="col-xs-10 col-sm-12" />
                        </div>
                         <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Hasbend/Wife Name  &nbsp; <?php echo form_error('data[husbant_wifeName]', '<span style="color: rgb(255, 0, 0);" class="successMessage">', '</span>'); ?></label>
                            <input type="text" name="data[husbant_wifeName]" autocomplete="off" value="<?php echo set_value('data[husbant_wifeName]', false); ?>"  placeholder="Hasbend/Wife Name"   class="col-xs-10 col-sm-12" />
                        </div>



                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Mobile  &nbsp; <?php echo form_error('data[mobile]', '<span style="color: rgb(255, 0, 0);" class="successMessage">', '</span>'); ?></label>
                            <input type="text" name="data[mobile]" autocomplete="off" value="<?php echo set_value('data[mobile]', false); ?>"  placeholder="mobile"   class="col-xs-10 col-sm-12" />
                        </div>
                         <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Email  &nbsp; <?php echo form_error('data[email]', '<span class="successMessage">', '</span>'); ?></label>
                            <input type="email" name="data[email]" autocomplete="off" value="<?php echo set_value('data[email]', false); ?>"  placeholder="email"   class="col-xs-10 col-sm-12" />
                        </div>

                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">National Id &nbsp; <?php echo form_error('data[nationalid]', '<span class="successMessage">', '</span>'); ?></label>
                            <input type="text" name="data[nationalid]" autocomplete="off" value="<?php echo set_value('data[nationalid]', false); ?>"  placeholder="nationalid"   class="col-xs-10 col-sm-12" />
                        </div>


                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Gender  &nbsp; <?php echo form_error('data[gender]', '<span class="successMessage">', '</span>'); ?></label>

                            <select name="data[gender]" class="form-control col-xs-10 col-sm-12" id="form-field-select-1">

                                    <?php foreach (getGender() as $key => $value) { ?>
                                        <option value="<?php echo $key ?>" <?php echo set_select('data[gender]', $key, FALSE); ?>>
                                            <?php echo $value; ?>
                                        </option>
                                    <?php } ?>
                            </select>
                        </div>

                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Religion  &nbsp; <?php echo form_error('data[religion]', '<span class="successMessage">', '</span>'); ?></label>

                            <select name="data[religion]" class="form-control col-xs-10 col-sm-12" id="form-field-select-1">

                                    <?php foreach (getReligion() as $key => $value) { ?>
                                        <option value="<?php echo $key ?>" <?php echo set_select('data[religion]', $key, FALSE); ?>>
                                            <?php echo $value; ?>
                                        </option>
                                    <?php } ?>
                                </select>

                        </div>

                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Occupation  &nbsp; <?php echo form_error('data[occupation]', '<span class="successMessage">', '</span>'); ?></label>

                            <select name="data[occupation]" class="form-control col-xs-10 col-sm-12" id="form-field-select-1">

                                    <?php foreach (getOccupation() as $key => $value) { ?>
                                        <option value="<?php echo $key ?>" <?php echo set_select('data[occupation]', $key, FALSE); ?>>
                                            <?php echo $value; ?>
                                        </option>
                                    <?php } ?>
                                </select>

                        </div>

                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Birthdate  &nbsp; <?php echo form_error('data[birthdate]', '<span class="successMessage">', '</span>'); ?></label>
                            <input class="form-control date-picker col-xs-10 col-sm-12" id="form-field-date" type="text"  name="data[birthdate]" autocomplete="off" value="<?php echo set_value('data[birthdate]', false); ?>" data-date-format="dd-mm-yyyy" placeholder="dd-mm-yyyy" />
                        </div>

                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Nationality  &nbsp; <?php echo form_error('data[nationality]', '<span class="successMessage">', '</span>'); ?></label>
                             <input type="text" name="data[nationality]" autocomplete="off" value="<?php echo set_value('data[nationality]', false); ?>"  placeholder="nationality"   class="col-xs-10 col-sm-12" />
                        </div>


                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Present Address &nbsp; <?php echo form_error('data[presentAddress]', '<span style="color: rgb(255, 0, 0);" class="successMessage">', '</span>'); ?></label>

                              <textarea rows='3' cols="3" name="data[presentAddress]" class="col-xs-10 col-sm-12" ><?php echo set_value('data[presentAddress]', false); ?></textarea>
                        </div>


                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Parmanent Address &nbsp; <?php echo form_error('data[permanentAddress]', '<span style="color: rgb(255, 0, 0);" class="successMessage">', '</span>'); ?></label>

                              <textarea rows='3' cols="3" name="data[permanentAddress]" class="col-xs-10 col-sm-12" ><?php echo set_value('data[permanentAddress]', false); ?></textarea>
                        </div>

                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Office  &nbsp; <?php echo form_error('data[office]', '<span class="successMessage">', '</span>'); ?></label>

                              <textarea rows='3' cols="3" name="data[office]" class="col-xs-10 col-sm-12" ><?php echo set_value('data[office]', false); ?></textarea>
                        </div>

                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Passport Number &nbsp; <?php echo form_error('data[passportNumber]', '<span class="successMessage">', '</span>'); ?></label>
                            <input type="text" name="data[passportNumber]" autocomplete="off" value="<?php echo set_value('data[passportNumber]', false); ?>"  placeholder="passportNumber"   class="col-xs-10 col-sm-12" />
                        </div>

                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Tin No  &nbsp; <?php echo form_error('data[tinNo]', '<span class="successMessage">', '</span>'); ?></label>
                            <input type="text" name="data[tinNo]" autocomplete="off" value="<?php echo set_value('data[tinNo]', false); ?>"  placeholder="tinNo"   class="col-xs-10 col-sm-12" />
                        </div>
                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Upload Image  &nbsp; <?php echo form_error('photo', '<span style="color: rgb(255, 0, 0);" class="successMessage">', '</span>'); ?></label>
                           <input name="photo" class="small" value="<?php echo set_value("photo", false); ?>" type="file" id="id-input-file-2" />
                           <label style="color:red">Maximum 1 MB, 300pxX300px, .jpg/.png/.jpeg</label>
                        </div>

                            <div class="clearfix"></div>
                            <div class="alert alert-block alert-info">
                                <h4 class="lighter arial red" style="text-align:center;"><b>Nominee's Information</b></h4>
                            </div>

                            <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Nominee's Name  &nbsp; <?php echo form_error('data[nomineeName]', '<span style="color: rgb(255, 0, 0);" class="successMessage">', '</span>'); ?></label>
                            <input type="text" name="data[nomineeName]" autocomplete="off" value="<?php echo set_value('data[nomineeName]', false); ?>"  placeholder="nomineeName"   class="col-xs-10 col-sm-12" />
                        </div>
                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Relation  &nbsp; <?php echo form_error('data[relationship]', '<span style="color: rgb(255, 0, 0);" class="successMessage">', '</span>'); ?></label>
                            <input type="text" name="data[relationship]" autocomplete="off" value="<?php echo set_value('data[relationship]', false); ?>"  placeholder="relationship"   class="col-xs-10 col-sm-12" />
                        </div>
                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Part  &nbsp; <?php echo form_error('data[part]', '<span style="color: rgb(255, 0, 0);" class="successMessage">', '</span>'); ?></label>
                            <input type="text" name="data[part]" autocomplete="off" value="<?php echo set_value('data[part]', false); ?>"  placeholder="part"   class="col-xs-10 col-sm-12" />
                        </div>

                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1"> Nominee's Email  &nbsp; <?php echo form_error('data[nominee_email]', '<span style="color: rgb(255, 0, 0);" class="successMessage">', '</span>'); ?></label>
                            <input type="text" name="data[nominee_email]" autocomplete="off" value="<?php echo set_value('data[nominee_email]', false); ?>"  placeholder="nominee_email"   class="col-xs-10 col-sm-12" />
                        </div>
                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Mobile  &nbsp; <?php echo form_error('data[nominee_mobile]', '<span style="color: rgb(255, 0, 0);" class="successMessage">', '</span>'); ?></label>
                            <input type="text" name="data[nominee_mobile]" autocomplete="off" value="<?php echo set_value('data[nominee_mobile]', false); ?>"  placeholder="nominee_mobile"   class="col-xs-10 col-sm-12" />
                        </div>

                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Nominee's phone   &nbsp; <?php echo form_error('data[nominee_phone]', '<span style="color: rgb(255, 0, 0);" class="successMessage">', '</span>'); ?></label>
                            <input type="text" name="data[nominee_phone]" autocomplete="off" value="<?php echo set_value('data[nominee_phone]', false); ?>"  placeholder="nominee_phone"   class="col-xs-10 col-sm-12" />
                        </div>
                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1"> Address  &nbsp; <?php echo form_error('data[address]', '<span class="successMessage">', '</span>'); ?></label>

                              <textarea rows='3' cols="3" name="data[address]" class="col-xs-10 col-sm-12" ><?php echo set_value('data[address]', false); ?></textarea>
                        </div>

                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Upload Nominee Photo  &nbsp; <?php echo form_error('nominee_photo', '<span style="color: rgb(255, 0, 0);" class="successMessage">', '</span>'); ?></label>
                           <input name="nominee_photo" class="small" value="<?php echo set_value("nominee_photo", false); ?>" type="file" id="id-input-file-2" />
                           <label style="color:red">Maximum 1 MB, 300pxX300px, .jpg/.png/.jpeg</label>
                        </div>


                            <div class="clearfix"></div>
                            <div class="alert alert-block alert-info">
                                <h4 class="lighter arial red" style="text-align:center;"><b>Plot Details</b></h4>
                            </div>

                        <div class=" col-xs-10 col-sm-4">  
                            <label class="control-label">Project Name </label>
                            <?php echo form_error('data[projectCategory]', '<div style="color: rgb(255, 0, 0);">', '</div>'); ?>
                            <select name="data[projectCategory]" class="form-control col-xs-10 col-sm-12">
                                    <option value=""> Select Project Name.....</option>>
                                <?php foreach($records as $value){?>
                                    <option value="<?php if(!empty($value['project_id'])){echo $value['project_id'];}?>" <?php echo set_select('data[projectCategory]',$value['project_id'],FALSE);?>>
                                    <?php if(!empty($value['project_name'])){echo $value['project_name'];}?>
                                    </option>
                                <?php }?>
                            </select>
                        </div>                        

                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Block No  &nbsp; <?php echo form_error('data[projectBlockNo]', '<span style="color: rgb(255, 0, 0);" class="successMessage">', '</span>'); ?></label>
                            <input type="text" name="data[projectBlockNo]" autocomplete="off" value="<?php echo set_value('data[projectBlockNo]', false); ?>"  placeholder="BlockNo"   class="col-xs-10 col-sm-12" />
                        </div>
                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Road No  &nbsp; <?php echo form_error('data[roadNo]', '<span style="color: rgb(255, 0, 0);" class="successMessage">', '</span>'); ?></label>
                            <input type="text" name="data[roadNo]" autocomplete="off" value="<?php echo set_value('data[roadNo]', false); ?>"  placeholder="roadNo"   class="col-xs-10 col-sm-12" />
                        </div>
                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Plot No  &nbsp; <?php echo form_error('data[plotNo]', '<span style="color: rgb(255, 0, 0);" class="successMessage">', '</span>'); ?></label>
                            <input type="text" name="data[plotNo]" autocomplete="off" value="<?php echo set_value('data[plotNo]', false); ?>"  placeholder="plotNo"   class="col-xs-10 col-sm-12" />
                        </div>

                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Plot Size  &nbsp; <?php echo form_error('data[plote_size]', '<span style="color: rgb(255, 0, 0);" class="successMessage">', '</span>'); ?></label>
                            <input type="text" name="data[plote_size]" autocomplete="off" value="<?php echo set_value('data[plote_size]', false); ?>"  placeholder="plote_size"   class="col-xs-10 col-sm-12" />
                        </div>
                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Plot Face  &nbsp; <?php echo form_error('data[plote_face]', '<span class="successMessage">', '</span>'); ?></label>

                            <select name="data[plote_face]" class="form-control col-xs-10 col-sm-12" id="form-field-select-1">

                                    <?php foreach (getPlotface() as $key => $value) { ?>
                                        <option value="<?php echo $key ?>" <?php echo set_select('data[plote_face]', $key, FALSE); ?>>
                                            <?php echo $value; ?>
                                        </option>
                                    <?php } ?>
                                </select>

                        </div>
                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Payment Type  &nbsp; <?php echo form_error('data[payment_type]', '<span class="successMessage">', '</span>'); ?></label>

                            <select name="data[payment_type]" class="form-control col-xs-10 col-sm-12" id="form-field-select-1">

                                    <?php foreach (getPaymentType() as $key => $value) { ?>
                                        <option value="<?php echo $key ?>" <?php echo set_select('data[payment_type]', $key, FALSE); ?>>
                                            <?php echo $value; ?>
                                        </option>
                                    <?php } ?>
                                </select>

                        </div>

                        <div class="col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Installment step  &nbsp; <?php echo form_error('data[installment_step]', '<span class="successMessage">', '</span>'); ?></label>

                            <select name="data[installment_step]" class="form-control col-xs-10 col-sm-12" id="form-field-select-1">
                                    <option value="1">--</option>
                                    <option value="24">24</option>
                                    <option value="36">36</option>
                                    <option value="48">48</option>
                                    <option value="60">60</option>
                                    <option value="72">72</option>
                                    <option value="84">84</option>
                                    <?php //foreach (getPaymentType() as $key => $value) { ?>
                                        <!--<option value="<?php //echo $key ?>" <?php //echo set_select('data[payment_type]', $key, FALSE); ?>>
                                            <?php //echo $value; ?>
                                        </option>-->
                                    <?php //} ?>
                                </select>

                        </div>

                       <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Total Cost  &nbsp; <?php echo form_error('data[total_cost]', '<span style="color: rgb(255, 0, 0);" class="successMessage">', '</span>'); ?></label>
                            <input type="text" name="data[total_cost]" autocomplete="off" value="<?php echo set_value('data[total_cost]', false); ?>"  placeholder="total_cost"   class="col-xs-10 col-sm-12" />
                        </div>
                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Down Payment  &nbsp; <?php echo form_error('data[down_payment]', '<span style="color: rgb(255, 0, 0);" class="successMessage">', '</span>'); ?></label>
                            <input type="text" name="data[down_payment]" autocomplete="off" value="<?php echo set_value('data[down_payment]', false); ?>"  placeholder="down_payment"   class="col-xs-10 col-sm-12" />
                        </div>
                        <div class=" col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Dues / Instal Installment per month &nbsp; <?php echo form_error('data[dues]', '<span style="color: rgb(255, 0, 0);" class="successMessage">', '</span>'); ?></label>
                            <input type="text" name="data[dues]" autocomplete="off" value="<?php echo set_value('data[dues]', false); ?>"  placeholder="dues"   class="col-xs-10 col-sm-12" />
                        </div>

                        <!-- <div class=" col-xs-10 col-sm-4">   
                            <label class="control-label">Referrence </label>
                            <?php echo form_error('data[customer_ref]', '<div style="color: rgb(255, 0, 0);">', '</div>'); ?>
                            <select name="data[customer_ref]" class="form-control col-xs-10 col-sm-12">
                                    <option value=""> Select Referrence.....</option>>
                                <?php foreach($allrefs as $refs){?>
                                    <option value="<?php if(!empty($refs['userId'])){echo $refs['userId'];}?> - <?php if(!empty($refs['userName'])){echo $refs['userName'];}?>" <?php echo set_select('data[customer_ref]',$refs['userId'],FALSE);?>> 
                                    <?php if(!empty($refs['userId'])){echo $refs['userId'];}?> - <?php if(!empty($refs['userName'])){echo $refs['userName'];}?>
                                    </option>
                                <?php }?>
                            </select>
                        </div> -->

                        <!-- <div class=" col-xs-10 col-sm-4">   
                            <label class="control-label">Referrence Profile</label>
                            <?php echo form_error('data[customer_ref]', '<div style="color: rgb(255, 0, 0);">', '</div>'); ?>
                            <select name="data[ref_id]" class="form-control col-xs-10 col-sm-12">
                                    <option value=""> Select Referrence.....</option>>
                                <?php foreach($allrefs as $refs){?>
                                    <option value="<?php if(!empty($refs['userId'])){echo $refs['userId'];}?>" <?php echo set_select('data[customer_ref]',$refs['userId'],FALSE);?>> 
                                    <?php if(!empty($refs['userId'])){echo $refs['userId'];}?> - <?php if(!empty($refs['userName'])){echo $refs['userName'];}?>
                                    </option>
                                <?php }?>
                            </select>
                        </div> -->

                        <div class="col-xs-10 col-sm-4">
                            <label class="control-label" for="form-field-1">Reference Type  &nbsp; <?php echo form_error('data[installment_step]', '<span class="successMessage">', '</span>'); ?></label>
                            <select name="data[ref_type]" class="form-control col-xs-10 col-sm-12" id="ref_type" onchange="referenceUser();">
                                <option selected disabled>Select Reference Type</option>
                                <option value="2">User</option>
                            </select>
                        </div>

                        <div class="col-xs-10 col-sm-4" id="ref_name"></div>
                        <div class="col-xs-10 col-sm-4">
                            <input name="data[ref_id]"       type="hidden" class="form-control col-xs-10 col-sm-12" id="set_ref_id" value=""/>
                            <input name="data[customer_ref]" type="hidden" class="form-control col-xs-10 col-sm-12" id="set_ref_name" value=""/>
                        </div>

                        <!--Plot Details End-->

                    </div>
                    <div class="col-xs-12">
                        <div class="form-actions clearfix center">
                            <button type="submit" name="btnSave" class="btn btn-sm btn-success">
                                <i class="ace-icon fa fa-check bigger-110"></i>Submit
                            </button>
                            <button type="button"  onclick="javascript:printDiv('printDIV')" class="btn btn-sm btn-success">
                                <i class="ace-icon fa fa-check bigger-110"></i>PRINT
                            </button>
                        </div>
                    </div>
                </form>
            </div>
        </div>
    </div>