Linux ip-172-26-7-228 5.4.0-1103-aws #111~18.04.1-Ubuntu SMP Tue May 23 20:04:10 UTC 2023 x86_64
Your IP : 13.59.58.68
<div class="row clearfix" id="personal_det">
<div class="col-lg-12 col-md-12 col-sm-12 col-xs-12">
<div class="card">
<div class="header bg-blue" style="margin-top: 35px;">
<h2> Personal Details</h2>
</div>
<div class="body" id="idPerDet">
<div class="field">
<div class="col-md-6">
<div class="dz-message p-t-60">
<b
>Click to upload<br />
Photo <br />
<span style="color: red;"
>*</span
></b
>
</div>
</form>
<div
id="studphoto"
style="display: block; align-items: center; text-align: center;"
>
<img
id="studphoto_img"
style="
width: 160px;
height: 150px;
padding: 3px;
"
/>
<div class="fallback">
<input name="file" type="file" id="photo"/>
</div>
<center>
<button
id="idChangePhoto"
class="btn btn-success"
onclick="photoupload()"
>
Change
</button>
</center>
</div>
<div class="p-t-20">
<p id="photomsg1" style="text-align: justify;">
Upload clearly visible photo having a width of 2 inches and
height of 2 inches
</p>
<p id="photomsg2">Maximum size allowed is 100kb</p>
</div>
</div>
<div class="col-md-8">
<div class="form-group">
<div class="col-md-12">
<b>1. Name Of The Candidate<span style="color: red;">*</span>
</b>
<span class="fieldError">
Name is Required
</span>
</div>
<div class="form-line col-md-12">
<input type="text" id="fullname" class="form-control date" placeholder="Candidate Name" name="Student Name"
maxlength="60" onkeypress="return charKeydown(event);" autocomplete="off" required/>
</div>
<div class="col-md-12">
<b>2. Father Name<span style="color: red;">*</span>
</b>
<span class="fieldError">
Father Name is Required
</span>
</div>
<div class="form-line col-md-12">
<input type="text" id="fname" class="form-control date" placeholder="Father Name" name="Father Name"
maxlength="60" onkeypress="return charKeydown(event);" autocomplete="off" required/>
</div>
<div class="col-md-12">
<b>3. Mother Name<span style="color: red;">*</span>
</b>
<span class="fieldError">
Mother Name is Required
</span>
</div>
<div class="form-line col-md-12">
<input type="text" id="mname" class="form-control date" placeholder="Mother Name" name="Mother Name"
maxlength="60" onkeypress="return charKeydown(event);" autocomplete="off" required/>
</div>
</div>
</div>
<div class="col-md-8">
<b>4. Date of Birth
<span style="color: red;">*</span></b>
<div class="form-group">
<span class="fieldError" id="dob_err">
Date of Birth is required
</span>
<div class="form-line daterange">
<input type="text" id="dob" class="form-control date" name="Date of Birth" placeholder="dd/mm/yyyy"
autocomplete="off" />
</div>
</div>
</div>
<div class="col-md-8">
<b>5. Aadhar Number
<span style="color: red;">*</span></b>
<div class="form-group">
<span class="fieldError" id="dob_err">
Date of Birth is required
</span>
<div class="form-line daterange">
<input type="text" id="faadhar" class="form-control date" name="faadhar" placeholder="Aadhar Number"
autocomplete="off" />
</div>
</div>
</div>
<div class="col-md-12">
<b>6.Nationality<span style="color: red;">*</span>
</b>
<span class="fieldError">
Nationality is Required
</span>
</div>
<div class="form-line col-md-12">
<input type="text" id="nationality" class="form-control date" placeholder="Nationality" name="Nationality"
maxlength="60" onkeypress="return charKeydown(event);" autocomplete="off" required/>
</div>
<div class="col-md-12">
<b>7.Category<span style="color: red;">*</span>
</b>
<span class="fieldError">
Category is Required
</span>
</div>
<div class="form-line col-md-12">
<input type="text" id="category" class="form-control date" placeholder="Category" name="Category"
maxlength="60" onkeypress="return charKeydown(event);" autocomplete="off" required/>
</div>
<!-- <div class="form-group"> -->
<div class="col-md-12">
<b>8. Gender<span style="color: red;">*</span></b>
<div class="form-group">
<span class="fieldError" id="gender_err">
Select Gender
</span>
<div class="demo-radio-button" id="fgender" name="gender">
<input name="fgender" type="radio" value="M" id="radio_1" autocomplete="off"/>
<label for="radio_1">Male</label>
<input name="fgender" type="radio" id="radio_2" value="F" autocomplete="off" />
<label for="radio_2">Female</label>
<input name="fgender" type="radio" id="radio_3" value="T" autocomplete="off" />
<label for="radio_3">Other</label>
</div>
</div>
<script>
</script>
</div>
<div class="col-md-6">
<span class="fieldError">
Kalyana Karnataka (371J)
</span>
<b>9. Kalyana Karnataka<span style="color: red;">*</span></b>
<div class="focused">
<select id="kalyana_karnataka" class="form-control" name="Kalyana Karnataka" value="">
<option value="">--Select--</option>
<option value="yes">Yes</option>
<option value="no">No</option>
</select>
</div>
</div>
<div class="col-md-6">
<span class="fieldError">
Physically Challenged
</span>
<b>10. Physically Challenged<span style="color: red;">*</span></b>
<div class="focused">
<select id="pc" class="form-control" name="Kalyana Karnataka" value="">
<option value="">--Select--</option>
<option value="yes">Yes</option>
<option value="no">No</option>
</select>
</div>
</div>
<div class="col-md-6">
<b
>11. Permanent Address<span style="color: red;"
>*</span
></b
>
<div class="form-group p-b-10" style="padding-top: 12px;">
<span class="fieldError" id="padd1_err">
All fields in Address are required
</span>
<div class="form-line">
<input
type="text"
id="fpermadd1"
name="Permanent Address Line - 1"
class="form-control"
placeholder="Address Line - 1"
maxlength="40"
autocomplete="off"
/>
</div>
</div>
<div class="form-group p-b-10">
<div class="form-line">
<input
type="text"
id="fpermadd2"
name="Permanent Address Line - 2"
class="form-control"
placeholder="Address Line - 2"
maxlength="40"
autocomplete="off"
/>
</div>
</div>
<div class="form-group p-b-10">
<div class="form-line">
<input
type="text"
name="Permanent Address Line - 3"
id="fpermadd3"
class="form-control"
placeholder="Address Line - 3"
maxlength="40"
autocomplete="off"
/>
</div>
</div>
<div class="form-group p-b-10 m-l--15 col-md-6">
<div class="form-line">
<input
type="text"
name="Permanent District"
id="fpermdist"
class="form-control"
placeholder="District"
maxlength="30"
onkeypress="return charKeydown(event);"
autocomplete="off"
/>
</div>
</div>
<div class="form-group pull-right m-r--15 col-md-6">
<div class="form-line">
<input
type="text"
id="fpermpin"
name="Permanent Pincode"
class="form-control"
placeholder="Pincode"
onkeypress="return acceptNumbersOnlyForModule(event);"
maxlength="6"
autocomplete="off"
/>
</div>
</div>
<div class="form-group">
<div class="form-line p-b-10">
<input
type="text"
id="fpermstate"
class="form-control"
placeholder="State"
maxlength="30"
onkeypress="return charKeydown(event);"
autocomplete="off"
/>
</div>
</div>
</div>
<div class="col-md-6 p-r-30">
<b
>12. Communication Address <span style="color: red;"
>*   </span
>
</b>
<input
type="checkbox"
id="basic_checkbox_1"
onclick="autoFillAddr()"
autocomplete="off"
/>
<label for="basic_checkbox_1" style="font-size: 10px !important;"
>Same as Perm. Add.?</label
>
<div class="form-group p-b-10">
<span class="fieldError" id="cadd1_err">
All fields in Address are required
</span>
<div class="form-line">
<input
type="text"
id="fcurradd1"
class="form-control"
name="Communication Address Line - 1"
placeholder="Address Line - 1"
maxlength="40"
autocomplete="off"
/>
</div>
</div>
<div class="form-group p-b-10">
<div class="form-line">
<input
type="text"
id="fcurradd2"
name="Communication Address Line - 2"
class="form-control"
placeholder="Address Line - 2"
maxlength="40"
autocomplete="off"
/>
</div>
</div>
<div class="form-group p-b-10">
<div class="form-line">
<input
type="text"
id="fcurradd3"
name="Communication Address Line - 3"
class="form-control"
placeholder="Address Line - 3"
maxlength="40"
autocomplete="off"
/>
</div>
</div>
<div class="form-group p-b-10 m-l--15 col-md-6">
<div class="form-line">
<input
type="text"
id="fcurrdist"
name="Communication District"
class="form-control"
placeholder="District"
maxlength="30"
onkeypress="return charKeydown(event);"
autocomplete="off"
/>
</div>
</div>
<div class="form-group pull-right m-r--15 col-md-6">
<div class="form-line">
<input
type="text"
id="fcurrpin"
name="Communication Pincode"
class="form-control"
placeholder="Pincode"
onkeypress="return acceptNumbersOnlyForModule(event);"
maxlength="6"
autocomplete="off"
/>
</div>
</div>
<div class="form-group">
<div class="form-line p-b-10">
<input
type="text"
id="fcurrstate"
name="Communication State"
class="form-control"
placeholder="State"
maxlength="30"
onkeypress="return charKeydown(event);"
autocomplete="off"
value="Karnataka"
/>
</div>
</div>
</div>
</div>
</div>
<div class="clearfix"></div>
</div>
<center>
<button
type="button"
style="font-weight: 600; font-size: 16px; margin-bottom:17px;"
class="btn btn-warning waves-effect btn-lg"
onclick="personaldetails()"
>
Save
</button>
</center>
</div>
<div class="form-group">
<div class="form-line p-b-10">
<input
type="hidden"
id="photopath"
name="photopath"
class="form-control"
/>
</div>
</div>
</div>
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