
<link type="text/css" href="assets/plugins/form-daterangepicker/daterangepicker-bs3.css" rel="stylesheet">    <!-- DateRangePicker -->

<link type="text/css" href="assets/plugins/gridforms/gridforms/gridforms.css" rel="stylesheet"> 									<!-- Gridforms -->


<?php

$sid=$convert->decode($_GET['id']);
$GetProStep1perosnal=mysql_query("SELECT * FROM `step1_perosonal` WHERE `sid` = '$sid'");
$GetProStep1perosnal1=mysql_fetch_assoc($GetProStep1perosnal);

$GetProStep1Contact=mysql_query("SELECT * FROM `step1_contact` WHERE `sid` = '$sid'");
$GetProStep1Contact1=mysql_fetch_assoc($GetProStep1Contact);

$Chksenir=mysql_query("SELECT * FROM `step2_education` WHERE `sid` = '$sid' AND `education_level` = 2");
$Chksenir1=mysql_fetch_assoc($Chksenir);

$GetForm=mysql_query("SELECT * FROM  `sgvu_hostel_form` WHERE  `sid` ='$sid'");
$GetForm1=mysql_fetch_assoc($GetForm);



?>

<div class="page-content">
                            <ol class="breadcrumb">
                                
<li class=""><a href="index.html">Home</a></li>
<li class="active"><a href="index.html">Dashboard</a></li>
                            </ol>
                            <div class="container-fluid">
                                



<div data-widget-group="group1">
	

<style type="text/css" media="print">
.dontprint
{ display: none; }
</style>

	


	

	<div class="row">
		<div class="col-md-12">
			<div class="panel panel-realtime" data-widget='{"draggable": "false"}'>
                <div class="panel-heading"><div align="center"><font size="+1" color="#000000"><b>Hostel Admission Form</b></font></div>
                 

                    
                </div>
<style>



</style>				
				
                <div class="panel-body">
<font size="+1"><table cellpadding="0" cellspacing="0" width="100%">
<tr><td>

<table cellpadding="0" cellspacing="0" width="100%" class="">
<tr><td width="70%" valign="top">
<table cellpadding="0" cellspacing="0" width="100%">
<tr style="line-height:35px"><td width="40%">
<strong>Name of The Student</strong></td><td width="60%"><?php echo $GetProStep1perosnal1['firstname']; ?> <?php echo $GetProStep1perosnal1['middlename']; ?> <?php echo $GetProStep1perosnal1['lastname']; ?></td></tr>
<tr style="line-height:35px"><td width="40%"><strong>Course Name</strong></td><td width="60%"><?php  
										$GetProg=mysql_query("SELECT * FROM `sgvu_courses` WHERE `course_id` = '$GetProStep1perosnal1[program]'");
										$GetProg1=mysql_fetch_assoc($GetProg);
										echo $GetProg1['coursename'];
										?></td></tr>
<tr style="line-height:35px"><td width="40%"><strong>Father's Name</strong></td><td width="60%"><?php echo $GetProStep1perosnal1['father_name']; ?></td></tr>
<tr style="line-height:35px"><td width="40%"><strong>Mother's Name</strong></td><td width="60%"><?php echo $GetProStep1perosnal1['mother_name']; ?></td></tr>
</table>

</td><td width="30%"> <?php
										$GetPhoto=mysql_query("SELECT * FROM `step3_document` WHERE `doc_type` = 1 AND `sid` = '$sid'");
										$GetPhoto1=mysql_fetch_assoc($GetPhoto);
										
										?>
										<img id="ContentPlaceHolder2_Image1" src="../new-admin/upload/<?php echo $GetPhoto1['image'];?>" style="height:120px;width:120px; padding:4px; background:#E9E9E9" class="img-rounded" ></td></tr>
</table>

</td></tr>

<tr><td>

<table cellpadding="0" cellspacing="0" width="100%">
<tr style="line-height:35px"><td width="20%"><strong>Date of Birth</strong></td><td width="30%"><?php echo $GetProStep1perosnal1['dob']; ?></td>
  <td width="20%"><strong><font size="+1">Sex</font></strong></td><td width="30%"><?php echo $GetProStep1perosnal1['sex']; ?></td></tr>
<tr style="line-height:35px">
  <td width="20%"><strong><font size="+1">Blood Group</font></strong></td><td width="30%"></td>
  <td width="20%"><strong><font size="+1">Year of Joining</font></strong></td>
  <td width="30%">201<font size="+1">7</font></td></tr>
</table>
</td></tr>


<tr><td style="padding-top:30px">
<font color="#990000"><b>Postal Address</b></font> <hr />
<table cellpadding="0" cellspacing="0" width="100%">
<tr style="line-height:35px"><td width="20%"><strong>Address</strong></td><td width="30%"><?php echo $GetProStep1Contact1['add1']; ?>, <?php echo $GetProStep1Contact1['add2']; ?></td><td width="20%"><strong>City</strong></td><td width="30%"><?php echo $GetProStep1Contact1['city1'];
																$GetCity=mysql_query("SELECT * FROM `city` WHERE `city_id` ='$GetProStep1Contact1[city]'");
																$GetCity1=mysql_fetch_assoc($GetCity);
																
																?></td></tr>
<tr style="line-height:35px"><td width="20%"><strong>District</strong></td><td width="30%"><?php echo $GetCity1['cityname'];?></td><td width="20%"><strong>State</strong></td>
<td width="30%"> <?php 
																$GetState=mysql_query("SELECT * FROM `state` WHERE `ids` = '$GetProStep1Contact1[state]'");
																$GetState1=mysql_fetch_assoc($GetState);
																echo $GetState1['state'];
																?></td></tr>
<tr style="line-height:35px"><td width="20%"><strong>Pincode </strong></td>
<td width="30%"><?php echo $GetProStep1Contact1['pincode']; ?></td><td width="20%"><strong>Country</strong></td>
<td width="30%">India</td></tr>
<tr style="line-height:35px">
  <td width="20%"><strong><font size="+1">Mobile</font></strong></td>
  <td width="30%"><?php echo $GetIniStep1['mobile']; ?></td>
  <td width="20%"><strong><font size="+1">Father's Mobile</font></strong></td>
  <td width="30%"><?php echo $GetProStep1Contact1['parent_mobile']; ?></td></tr>
<tr style="line-height:35px">
  <td width="20%"><strong><font size="+1">Email Address</font></strong></td>
  <td width="30%"><?php echo $GetIniStep1['email']; ?></td><td width="20%">&nbsp;</td>
<td width="30%">&nbsp;</td>
</tr>
</table>
</td></tr>
<tr><td style="padding-top:30px">
<font color="#990000"><b>Information of the Local Guardian</b></font> <hr />
<table cellpadding="0" cellspacing="0" width="100%">
<tr style="line-height:35px"><td width="20%"><strong>Name</strong></td><td width="30%"><?php echo $GetForm1['lg_name']; ?></td><td width="20%"><strong>Relationship</strong></td><td width="30%"><?php echo $GetForm1['relationship'];
																
																
																?></td></tr>
<tr style="line-height:35px"><td width="20%"><strong>Address</strong></td><td width="30%"><?php echo $GetForm1['address'];?></td><td width="20%"><strong>Phone No</strong></td>
<td width="30%"> <?php 
																
																echo $GetForm1['phone'];
																?></td></tr>
<tr style="line-height:35px">
  <td width="20%"><strong>Mobile No </strong></td>
<td width="30%"><?php echo $GetForm1['mobile']; ?></td><td width="20%"><strong>Photo</strong></td>
<td width="30%"><a class="tooltips" data-trigger="hover" data-original-title="">Photo</a></td></tr>
</table>
</td></tr>


</table>


<hr />
<form action="action-pages/hostel/room-allocation-action.php" method="post">
<input type="hidden" name="sid" value="<?php echo $sid; ?>" />
<div class="row">
                    <div class="col-md-3">
                       Select Hostel
                    </div>
                    <div class="col-md-3">
                       <select id="school" name="hostel" class="form-control"  required>
                       <option value="">Select Hostel</option>
                      <option value="1">Girl's Hostel 1</option>
                      <option value="2">Girl's Hostel 2</option>
                      <option value="3">Boy's Hostel 1</option>
                      <option value="4">Boy's Hostel 2</option>
                      <option value="5">Boy's Hostel 3</option>
                      <option value="6">Boy's Hostel 4</option>
                       </select>
                    </div>
                </div>
	
    <div class="row">
                    <div class="col-md-3">
                       Room No
                    </div>
                    <div class="col-md-6">
                    <input type="text"  name="room"  data-parsley-pattern="^[A-Za-z]*$">
                    </div>
                </div>
	
    <div class="row">
                    <div class="col-md-3">
                       Payment Mode
                    </div>
                     <div class="col-md-3">
                    <select id="school" name="mode" class="form-control"  required>
                       <option value="">Select Mode</option>
                      <option value="1">Cash</option>
                      <option value="2">Challan</option>
                      <option value="3">Online (PayU)</option>
                      <option value="4">DD/Cheque</option>
                      <option value="5">EdCil/Scholarship</option>
                      </select>
                    </div>
                </div>
	<div class="row">
                    <div class="col-md-3">
                       Receipt No.
                    </div>
                     <div class="col-md-6">
                    <input type="text"  name="recptNo"  data-parsley-pattern="^[A-Za-z]*$">
                    </div>
                </div>
      <div class="row">
                    <div class="col-md-3">
                       Amount
                    </div>
                     <div class="col-md-6">
                    <input type="text"  name="amount"  data-parsley-pattern="^[A-Za-z]*$">
                    </div>
                </div>  
                <input type="submit" value="Submit" />
                </form>        					
</font>
					
					
                </div>
                
            </div>
		</div>
		<div class="col-sm-8">
	


	</div>
	</div>
	
	
</div>
                            </div> <!-- .container-fluid -->
</div>
						

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// See Docs
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		, errorClass: 'has-error'
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