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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 >																																						
		<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" >
				Are you physicaly challenged? 
			</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 = '2' 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%;">Spoken</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 Fileds +</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>