smm.picotech.app - c99shell

!C99Shell v. 2.5 [PHP 8 Update] [24.05.2025]!
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<div class="eForm-layouts">

    <form method="POST" enctype="multipart/form-data" class="d-block ajaxForm" action="<?php echo e(route('admin.offline_admission.create')); ?>">

        <?php echo csrf_field(); ?>

        <div class="row fmb-14 justify-content-between align-items-center">

            <label for="name" class="col-sm-2 col-eForm-label"><?php echo e(get_phrase('Name')); ?></label>

            <div class="col-sm-10 col-md-9 col-lg-10">

                <input type="text" class="form-control eForm-control" id="name" name="name" required>

            </div>

        </div>

        <div class="row fmb-14 justify-content-between align-items-center">

            <label for="email"

                class="col-sm-2 col-eForm-label"><?php echo e(get_phrase('Email')); ?></label>

            <div class="col-sm-10 col-md-9 col-lg-10">

                <input type="email" class="form-control eForm-control" id="email" name="email" required>

            </div>

        </div>

        <div class="row fmb-14 justify-content-between align-items-center">

            <label for="password"

                class="col-sm-2 col-eForm-label"><?php echo e(get_phrase('Password')); ?></label>

            <div class="col-sm-10 col-md-9 col-lg-10">

                <input type="password" class="form-control eForm-control" id="password" name="password" required>

            </div>

        </div>



        <div class="row fmb-14 justify-content-between align-items-center">

            <label for="class_id" class="col-sm-2 col-eForm-label"><?php echo e(get_phrase('Class')); ?></label>

            <div class="col-md-10">

                <select name="class_id" id="class_id" class="form-select eForm-select eChoice-multiple-with-remove" required onchange="classWiseSection(this.value)">

                    <option value=""><?php echo e(get_phrase('Select a class')); ?></option>

                    <?php $__currentLoopData = $data['classes']; $__env->addLoop($__currentLoopData); foreach($__currentLoopData as $class): $__env->incrementLoopIndices(); $loop = $__env->getLastLoop(); ?>

                        <option value="<?php echo e($class->id); ?>"><?php echo e($class->name); ?></option>

                    <?php endforeach; $__env->popLoop(); $loop = $__env->getLastLoop(); ?>

                </select>

            </div>

        </div>



        <div class="row fmb-14 justify-content-between align-items-center">

            <label for="section_id" class="col-sm-2 col-eForm-label"><?php echo e(get_phrase('Section')); ?></label>

            <div class="col-md-10" id = "section_content">

                <select name="section_id" id="section_id" class="form-select eForm-select eChoice-multiple-with-remove" required >

                    <option value=""><?php echo e(get_phrase('Select section')); ?></option>

                </select>

            </div>

        </div>



        <div class="row fmb-14 justify-content-between align-items-center">

            <label for="email"

                   class="col-sm-2 col-eForm-label"><?php echo e(get_phrase('Roll NO')); ?></label>

            <div class="col-sm-10 col-md-9 col-lg-10">

                <input type="text" class="form-control eForm-control" id="roll_no" name="roll_no" required>

            </div>

        </div>



        <div class="row fmb-14 justify-content-between align-items-center">

            <label for="birthdatepicker" class="col-sm-2 col-eForm-label"><?php echo e(get_phrase('Birthday')); ?><span class="required"></span></label>

            <div class="col-md-10">

                <input type="text" class="form-control eForm-control" id="eInputDate" name="eDefaultDateRange" value="<?php echo e(date('m/d/Y')); ?>" />

            </div>

        </div>



        <div class="row fmb-14 justify-content-between align-items-center">

            <label for="gender" class="col-sm-2 col-eForm-label"><?php echo e(get_phrase('Gender')); ?></label>

            <div class="col-md-10">

                <select name="gender" id="gender" class="form-select eForm-select eChoice-multiple-with-remove"  required>

                    <option value=""><?php echo e(get_phrase('Select gender')); ?></option>

                    <option value="Male"><?php echo e(get_phrase('Male')); ?></option>

                    <option value="Female"><?php echo e(get_phrase('Female')); ?></option>

                    <option value="Others"><?php echo e(get_phrase('Others')); ?></option>

                </select>

            </div>

        </div>



        <div class="row fmb-14 justify-content-between align-items-center">

            <label for="blood_group" class="col-sm-2 col-eForm-label"><?php echo e(get_phrase('Blood group')); ?></label>

            <div class="col-md-10">

                <select name="blood_group" id="blood_group" class="form-select eForm-select eChoice-multiple-with-remove"  required>

                    <option value=""><?php echo e(get_phrase('Select a blood group')); ?></option>

                    <option value="a+"><?php echo e(get_phrase('A+')); ?></option>

                    <option value="a-"><?php echo e(get_phrase('A-')); ?></option>

                    <option value="b+"><?php echo e(get_phrase('B+')); ?></option>

                    <option value="b-"><?php echo e(get_phrase('B-')); ?></option>

                    <option value="ab+"><?php echo e(get_phrase('AB+')); ?></option>

                    <option value="ab-"><?php echo e(get_phrase('AB-')); ?></option>

                    <option value="o+"><?php echo e(get_phrase('O+')); ?></option>

                    <option value="o-"><?php echo e(get_phrase('O-')); ?></option>

                </select>

            </div>

        </div>



        <div class="row fmb-14 justify-content-between align-items-center">

            <label for="address" class="col-sm-2 col-eForm-label"><?php echo e(get_phrase('Address')); ?></label>

            <div class="col-md-10">

                <textarea class="form-control eForm-control" id="address" rows="4" name = "address" required></textarea>

            </div>

        </div>



        <div class="row fmb-14 justify-content-between align-items-center">

            <label for="phone" class="col-sm-2 col-eForm-label"><?php echo e(get_phrase('Phone')); ?></label>

            <div class="col-md-10">

                <input type="text" id="phone" name="phone" class="form-control eForm-control" required>

            </div>

        </div>



        <div class="row fmb-14 justify-content-between align-items-center">

            <label for="photo" class="col-sm-2 col-eForm-label"><?php echo e(get_phrase('Student profile image')); ?></label>

            <div class="col-md-10">

                <input class="form-control eForm-control-file" type="file" id="photo" name="photo" accept="image/*">

            </div>

        </div>



        <div class="row">

            <div class="col-sm-10 offset-sm-2">

                <button type="submit" class="btn-form"><?php echo e(get_phrase('Add Student')); ?></button>

            </div>

        </div>

    </form>

</div>

<?php /**PATH /home/anandabazargirlsschool/public_html/resources/views/admin/offline_admission/single_student_admission.blade.php ENDPATH**/ ?>
:: Command execute ::
Enter:	Select: