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<div
  style="border:1px solid black;background-color:skyblue;height:35px;text-align:center"
>
  <h4><b>Personal Details</b></h4>
</div>

<div
  class=""
  style="border:1px solid black;padding-left:10px;width:100%;height:100%;"
>
  <br />
  <div>
    <h5>
      <span style="color: red;"
        >Applicants must avoid entering special characters (Eg: ' " # \ &) while
        entering the details.
      </span>
    </h5>
    <br />
  </div>
  <div>
    <div class="row mb40">
      <div class="col-md-3 mb5">
        Post Applied Category
      </div>
      <div class="col-md-4 mb5">
        <select class="form-control1" id="1S4" title="Category">
          <option value="">-Select-</option>
          <option>UR</option>
          <option>SC</option>
          <option>ST</option>
          <option>OBC</option>
          <option>EWS</option>
          <option>PWD(a)</option>
          <option>PWD(d/e)</option>
        </select>
      </div>
    </div>

    <div class="row mb40">
      <div class="col-md-3 mb5">
        Name(as per your matriculation certificate)
      </div>
      <div class="col-md-4 mb5">
        <input
          type="text"
          class="form-control1"
          id="T1"
          maxlength="100"
          title="Name"
          placeholder="Name"
        />
      </div>
    </div>
    <div class="row mb40">
      <div class="col-md-3 mb5">
        Father's Name
      </div>
      <div class="col-md-4 mb5">
        <input
          type="text"
          class="form-control1"
          id="T5"
          maxlength="100"
          title="Father's Name"
          placeholder="Father's Name"
        />
      </div>
    </div>

    <div class="row mb40">
      <div class="col-md-3 mb5">
        Mother's Name
      </div>
      <div class="col-md-4 mb5">
        <input
          type="text"
          class="form-control1"
          id="T6"
          maxlength="100"
          title="Mother's Name"
          placeholder="Mother's Name"
        />
      </div>
    </div>
    <div class="row mb40">
      <div class="col-md-3 mb5">
        Date of Birth
      </div>
      <div class="col-md-2 mb5">
        <input
          type="text"
          class="form-control1"
          id="T2"
          maxlength="10"
          onkeypress="return acceptNumbersOnlyForModule(event);"
          title='Date of Birth in "dd/mm/yyyy" Format'
          onchange="getage()"
          placeholder="DD/MM/YYYY"
          onkeyup="dmydateformat(event,this.id);"
        />
      </div>
    </div>

    <div class="row mb40">
      <div class="col-md-3 mb5">
        Age as on Closing Date of Advt.
      </div>
      <div class="col-md-1 mb3">
        <input
          type="text"
          class="form-control1"
          id="T3"
          maxlength="2"
          title="Age as on date of advertisement"
          disabled
          placeholder="Advertisement"
        />
      </div>
    </div>

    <div class="row mb40">
      <div class="col-md-3 mb5">
        Place of Birth
      </div>
      <div class="col-md-2 mb5">
        <input
          type="text"
          class="form-control1"
          id="T4"
          maxlength="20"
          title="Place of Birth"
          placeholder="Place of Birth"
        />
      </div>
    </div>

    <div class="row mb40">
      <div class="col-md-3 mb5">
        Religion
      </div>
      <div class="col-md-2 mb5">
        <input
          type="text"
          class="form-control1"
          id="T7"
          maxlength="10"
          title="Religion"
          placeholder="Religion"
        />
      </div>
    </div>

    <div class="row mb40">
      <div class="col-md-3 mb5">
        Nationality
      </div>
      <div class="col-md-2 mb5">
        <input
          type="text"
          class="form-control1"
          id="T8"
          maxlength="10"
          title="Nationality"
          placeholder="Nationality"
        />
      </div>
    </div>

    <div class="row mb40">
      <div class="col-md-3 mb5">
        Gender
      </div>
      <div class="col-md-2 mb5">
        <select class="form-control1" id="T9" title="Gender">
          <option value="Male">Male</option>
          <option value="Female">Female</option>
          <option value="Other">Other</option>
        </select>
      </div>
    </div>

    <div class="row mb40">
      <div class="col-md-3 mb5" style="margin-top:8px;">
        Category
      </div>
      <div class="col-md-2 mb5">
        <select
          class="form-control1"
          id="S3"
          title="Category"
          style="margin-top:8px;"
        ></select>
      </div>
    </div>

    <div class="row mb40">
      <div class="col-md-3 mb5">
        Marital Status
      </div>
      <div class="col-md-2 mb5">
        <select class="form-control1" id="T11" title="Martial Status">
          <option value="Unmarried">Unmarried</option>
          <option value="Married">Married</option>
          <option value="Widowed">Widowed</option>
          <option value="Diverse">Divorced</option>
        </select>
      </div>
    </div>

    <div class="row mb40">
      <div class="col-md-3 mb5">
        Whether PWD?
      </div>
      &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<input
        type="radio"
        name="fqualify"
        id="T12"
        title="physical challenged,indicate"
        onclick="enableappeared(this.id)"
        value="T"
        onclick="enableappeared(this.value)"
      />
      <td class="col-md-2 mb5">
        Yes &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
        <input
          type="radio"
          name="fqualify"
          id="T13"
          checked="checked"
          onclick="enableappeared(this.id)"
          value="F"
        />
        No
      </td>
    </div>

    <div id="TDISABILITY" class="row mb40">
      <div class="col-md-3 mb5">
        If yes, enter type of disability
      </div>
      <div class="col-md-3 mb6">
        <input
          type="text"
          class="form-control1"
          id="T14"
          title="Type of Disability"
          placeholder=""
        />
      </div>
    </div>

    <div id="PDISABILITY" class="row mb40">
      <div class="col-md-3 mb5">
        Percentage of disability
      </div>
      <div class="col-md-2 mb5">
        <input
          type="text"
          class="form-control1"
          id="T15"
          style="width:80px;"
          title="Percentage of Disability"
          onkeypress="return acceptNumbersOnlyForModule(event);"
          maxlength="3"
          placeholder=""
        />
        %
      </div>
    </div>

    <div class="row mb40">
      <div class="col-md-3 mb5">
        Address for Correspondence
      </div>
      <div class="col-md-2 mb5">
        <input
          type="text"
          maxlength="50"
          id="T16"
          title="Address for Correspondence"
          style="width:280px; padding:2px;"
        /><br />
        <input
          type="text"
          maxlength="50"
          id="T17"
          title="Address for Correspondence"
          style="width:280px; padding:2px;"
        /><br />
        <input
          type="text"
          maxlength="50"
          id="T18"
          title="Address for Correspondence"
          style="width:280px; padding:2px;"
        /><br />
        <input
          type="text"
          maxlength="50"
          id="T19"
          title="Address for Correspondence"
          style="width:280px; padding:2px;"
        /><br />
        <p>
          Click on checkbox if your permanent address is same as Address for
          Correspondence &nbsp;&nbsp;&nbsp;<input
            type="checkbox"
            onclick="getaddress()"
            style='"display: inline-block;vertical-align: middle;cursor: pointer;background: #fff;border: 1px solid #888;padding: 1px;height: 20px;width: 20px;"'
          />
        </p>
      </div>
    </div>
    <div class="row mb40">
      <div class="col-md-3 mb5">
        Permanent Address
      </div>
      <div class="col-md-2 mb5">
        <input
          type="text"
          maxlength="50"
          id="T20"
          title="Permanent Address"
          style="width:280px; padding:2px;"
        /><br />
        <input
          type="text"
          maxlength="50"
          id="T21"
          title="Permanent Address"
          style="width:280px; padding:2px;"
        /><br />
        <input
          type="text"
          maxlength="50"
          id="T22"
          title="Permanent Address"
          style="width:280px; padding:2px;"
        /><br />
        <input
          type="text"
          maxlength="50"
          id="T23"
          title="Permanent Address"
          style="width:280px; padding:2px;"
        /><br />
      </div>
    </div>

    <div class="row mb40">
      <div class="col-md-3 mb5">
        Email Id
      </div>
      <div class="col-md-4 mb5">
        <input
          type="text"
          class="form-control1"
          id="T24"
          title="Email Id"
          maxlength="50"
          placeholder="Email Id"
        />
      </div>
    </div>

    <div class="row mb40">
      <div class="col-md-3 mb5">
        Aadhar No.
      </div>
      <div class="col-md-4 mb5">
        <input
          type="text"
          class="form-control1"
          id="T90"
          title="Aadhar No."
          onkeypress="return acceptNumbersOnlyForModule(event);"
          maxlength="12"
          placeholder="Aadhar No."
        />
      </div>
    </div>

    <div class="row mb40">
      <div class="col-md-3 mb5">
        Phone No.
      </div>
      <div class="col-md-3 mb5">
        <input
          type="text"
          class="form-control1"
          id="T25"
          title="Phone No."
          onkeypress="return acceptNumbersOnlyForModule(event);"
          maxlength="15"
          placeholder="Phone No."
        />
      </div>
    </div>

    <div class="row mb40">
      <div class="col-md-3 mb5">
        Mobile No.
      </div>
      <div class="col-md-3 mb5">
        <input
          type="text"
          class="form-control1"
          id="T26"
          title="Mobile No."
          onkeypress="return acceptNumbersOnlyForModule(event);"
          maxlength="12"
          placeholder="Mobile No."
        />
      </div>
    </div>

    <div style="margin-left:2px;" class="row mb40">
      <div>
        <h5>Languages Known</h5>
      </div>
      <table
        class="table table-bordered"
        id="languageknowntable"
        style="width:50%"
      >
        <thead>
          <tr>
            <th style="width: 30%;">Language</th>
            <th style="width: 10%;">Read</th>
            <th style="width: 10%;">Write</th>
            <th style="width: 10%;">Speak</th>
            <th style="width: 5%;">Del.</th>
          </tr>
        </thead>

        <tbody id="lanknown">
          <tr>
            <td>
              <input
                type="text"
                id="1HT1"
                class="form-control1"
                name="language"
              />
            </td>
            <td><input type="checkbox" id="1HT2" class="form-control1" /></td>
            <td><input type="checkbox" id="1HT3" class="form-control1" /></td>
            <td><input type="checkbox" id="1HT4" class="form-control1" /></td>
            <td><input type="hidden" id="1HT5" class="form-control1" /></td>
          </tr>
        </tbody>
      </table>
      <div style="margin-left:">
        <button onclick="addlanguagesdet()" class="btn btn_3 btn-lg btn-info">
          Click to add more language Fields +
        </button>
      </div>
    </div>

    <div class="row mb40">
      <div class="col-md-10 mb5">
        <center>
          <button
            type="submit"
            class="btn btn_3 btn-lg btn-info"
            onclick="savepersonaldetails()"
          >
            Submit
          </button>
        </center>
      </div>
    </div>
  </div>
</div>