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 : 3.135.199.179
<div
style="border:1px solid black;background-color:skyblue;height:35px;text-align:center"
>
<h4><b>General 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;">Note: Special characters are not allowed</span>
</h5>
</div>
<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 (As per your matriculation certificate)
</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="0">--Select--</option>
<option value="Male">Male</option>
<option value="Female">Female</option>
<option value="Other">Other</option>
</select>
</div>
</div>
<br />
<div class="row mb40">
<div class="col-md-3 mb5">
Caste
</div>
<div class="col-md-2 mb5">
<input
type="text"
class="form-control1"
id="T905"
maxlength="100"
title="Caste"
placeholder="Caste"
/>
</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">
Do you belong to PWD category?
</div>
<input
type="radio"
name="PWD"
value="TRUE"
name="PWD"
id="T901"
onchange="getPWDdet()"
/>
<td class="col-md-2 mb5">
Yes
<input
type="radio"
onchange="getPWDdet()"
name="PWD"
checked
id="T902"
value="FALSE"
/>
No
</td>
</div>
<div class="row mb40" id="pwddet" style="display:none">
<div class="col-md-3 mb5">
PWD Type
</div>
<div class="col-md-2 mb5">
<select class="form-control1" id="T904" title="Martial Status">
<option value="">--Select--</option>
<option>PWD(A)</option>
<option>PWD(B)</option>
<option>PWD(C)</option>
<option>PWD(D)</option>
<option>PWD(E)</option>
</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="0">--Select--</option>
<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" >
Do you come under article 371(j)?
</div>
<input type="radio" checked value="TRUE" name = "371j" id="T903" />
<td class="col-md-2 mb5">
Yes
<input type="radio" name = "371j" id="T904" value="" disabled="disabled" />No
</td>
</div>
<div class="row mb40">
<div class="col-md-3 mb5" >
Are you Kannada Medium candidate?
</div>
<input type="radio" name="kan" value="TRUE" name = "kan" id="T901" />
<td class="col-md-2 mb5">Yes
<input type="radio" name="kan" checked id = "T902" value=""/>
No </td>
</div>
<div class="row mb40">
<div class="col-md-3 mb5" >
Are you Rural Candidate?
</div>
<input type="radio" value="TRUE" name = "rural" id="T907" />
<td class="col-md-2 mb5">Yes
<input type="radio" name = "rural" checked="checked" id="T908" value=""/>
No </td>
</div>
<div class="row mb40">
<div class="col-md-3 mb5" >
Are you Ex-Serviceman?
</div>
<input type="radio" value="TRUE" name = "ex" id="T909" />
<td class="col-md-2 mb5">Yes
<input type="radio" name = "ex" checked="checked" id="T910" value=""/>
No </td>
</div>
<div class="row mb40">
<div class="col-md-3 mb5" >
Are you Physically Disabled?
</div>
<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
<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"
onkeypress="singlequtes(this.id)"
title="Address for Correspondence 1"
style="width:280px; padding:2px;"
/><br />
<input
type="text"
onkeypress="singlequtes(this.id)"
maxlength="50"
id="T17"
title="Address for Correspondence 2"
style="width:280px; padding:2px;"
/><br />
<input
type="text"
onkeypress="singlequtes(this.id)"
maxlength="50"
id="T18"
title="Address for Correspondence 3"
style="width:280px; padding:2px;"
/><br />
<input
type="text"
onkeypress="singlequtes(this.id)"
maxlength="50"
id="T19"
title="Address for Correspondence 4"
style="width:280px; padding:2px;"
/><br />
</div>
</div>
<div class="row mb40">
<div class="col-md-3 mb5">
City
</div>
<div class="col-md-2 mb5">
<input
type="text"
maxlength="50"
id="T601"
onkeypress="singlequtes(this.id)"
title="Correspondence City"
style="width:280px; padding:2px;"
/><br />
</div>
</div>
<div class="row mb40">
<div class="col-md-3 mb5">
Pincode
</div>
<div class="col-md-2 mb5">
<input
type="text"
maxlength="50"
id="T602"
onkeypress="singlequtes(this.id)"
title="Correspondence Pincode"
style="width:280px; padding:2px;"
/><br />
<p>
Click on checkbox if your permanent address is same as Address for
Correspondence <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"
onkeypress="singlequtes(this.id)"
id="T20"
title="Permanent Address 1"
style="width:280px; padding:2px;"
/><br />
<input
type="text"
maxlength="50"
onkeypress="singlequtes(this.id)"
id="T21"
title="Permanent Address 2"
style="width:280px; padding:2px;"
/><br />
<input
type="text"
maxlength="50"
onkeypress="singlequtes(this.id)"
id="T22"
title="Permanent Address 3"
style="width:280px; padding:2px;"
/><br />
<input
type="text"
maxlength="50"
onkeypress="singlequtes(this.id)"
id="T23"
title="Permanent Address 4"
style="width:280px; padding:2px;"
/><br />
</div>
</div>
<div class="row mb40">
<div class="col-md-3 mb5">
City
</div>
<div class="col-md-2 mb5">
<input
type="text"
maxlength="50"
onkeypress="singlequtes(this.id)"
id="T603"
title="Permanent City"
style="width:280px; padding:2px;"
/><br />
</div>
</div>
<div class="row mb40">
<div class="col-md-3 mb5">
Pincode
</div>
<div class="col-md-2 mb5">
<input
type="text"
maxlength="50"
onkeypress="singlequtes(this.id)"
id="T604"
title="Permanent Pincode"
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-3 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-3 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>
<!-- <table>
<tr>
<td style="width: 20%;">
Kannada Medium
</td>
<td style="width: 10%;">
<input type="checkbox" value="TRUE" name = "kan" id="T901">
</td>
</tr>
<tr>
<td style="width: 20%;">
371J
</td>
<td style="width: 10%;">
<input type="checkbox" value="TRUE" name = "371j" id="T902">
</td>
</tr>
<tr>
<td style="width: 20%;">
Physically Disabled
</td>
<td style="width: 10%;">
<input type="checkbox" value="TRUE" name = "pd" id="T905">
</td>
</tr>
<tr>
<td style="width: 20%;">
Rural Candidate
</td>
<td style="width: 10%;">
<input type="checkbox" value="TRUE" name = "rural" id="T903">
</td>
</tr>
<tr>
<td style="width: 20%;">
Ex-Serviceman
</td>
<td style="width: 10%;">
<input type="checkbox" value="TRUE" name = "ex" id="T904">
</td>
</tr>
</table> -->
<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>
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