everseiko/application/views/bForm.php
2020-01-02 23:02:57 +07:00

823 lines
26 KiB
PHP

<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="utf-8">
<title>Form Customer</title>
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<meta name="description" content="">
<meta name="author" content="">
<!-- Le styles -->
<link href="<?php echo base_url(); ?>asset/bootstrap/css/bootstrap.css" rel="stylesheet">
<link href="<?php echo base_url(); ?>asset/css/style.css" rel="stylesheet">
<style type="text/css">
body {
padding-top: 60px;
padding-bottom: 40px;
}
.sidebar-nav {
padding: 9px 0;
}
label.filebutton {
width:80px;
height:20px;
overflow:hidden;
position:relative;
}
.btn input {
opacity: 0;
filter: alpha(opacity = 0);
-ms-filter: "alpha(opacity=0)";
cursor: pointer;
_cursor: hand;
}
@media (max-width: 980px) {
/* Enable use of floated navbar text */
.navbar-text.pull-right {
float: none;
padding-left: 5px;
padding-right: 5px;
}
}
</style>
<link href="<?php echo base_url(); ?>asset/bootstrap/css/bootstrap-responsive.css" rel="stylesheet">
<!-- HTML5 shim, for IE6-8 support of HTML5 elements -->
<!--[if lt IE 9]>
<script src="../assets/js/html5shiv.js"></script>
<![endif]-->
</head>
<body data-spy="scroll" data-target=".sidebar">
<!--Navigation bar-->
<div class="navbar navbar-inverse navbar-fixed-top" >
<div class="navbar-inner">
<div class="container-fluid">
<button type="button" class="btn btn-navbar" data-toggle="collapse" data-target=".nav-collapse">
<span class="icon-bar"></span>
<span class="icon-bar"></span>
<span class="icon-bar"></span>
</button>
<a class="brand" href="#">Everseiko</a>
<div class="nav-collapse collapse">
<ul class="nav pull-right">
<li id="fat-menu" class="dropdown">
<a href="#" id="drop3" role="button" class="dropdown-toggle" data-toggle="dropdown" style="background-color:#fff;"><i class="icon-user"></i>
<?php echo $this->auth->CI->session->userdata('nama'); ?><b class="caret"></b></a>
<ul class="dropdown-menu" role="menu" aria-labelledby="drop3">
<li role="presentation"><a role="menuitem" tabindex="-1" href="<?php echo base_url(); ?>">
<i class="icon-tags"></i>
<?php echo $this->auth->CI->session->userdata('role'); ?></a></li>
<li role="presentation" class="divider"></li>
<li role="presentation"><a role="menuitem" tabindex="-1" href="<?php echo base_url(); ?>user/logout"><i class="icon-off"></i> Logout</a></li>
</ul>
</li>
</ul>
<!--
<ul class="nav">
<li class="active"><a href="#">Home</a></li>
<li><a href="#about">About</a></li>
<li><a href="#contact">Contact</a></li>
</ul>
-->
</div><!--/.nav-collapse -->
</div>
</div>
</div>
<!--Container-->
<div class="container-fluid">
<div class="row-fluid">
<!--sidebar-->
<div class="span3 sidebar">
<div class="well affix span3">
<ul class="nav nav-list">
<li class="active"><a href="#1">Contact Details</a></li>
<li class=""><a href="#2">Vehicles Details</a></li>
<li class=""><a href="#3">Types</a></li>
<li class=""><a href="#4">Tyre Usages</a></li>
<li class=""><a href="#5">Recommendation</a></li>
<li class=""><a href="#6">Upload Picture</a></li>
</ul>
</div><!--/.well -->
</div><!--/span3-->
<!--section-->
<div class="span7 offset1 well">
<!--
<div class="hero-unit">
<h1>Hello, world!</h1>
<p>This is a template for a simple marketing or informational website. It includes a large callout called the hero unit and three supporting pieces of content. Use it as a starting point to create something more unique.</p>
<p><a href="#" class="btn btn-primary btn-large">Learn more &raquo;</a></p>
</div>
-->
<form id="fileupload" class="form-horizontal" action="http://10.10.10.14/everseiko/index.php/visit/addvisit/format/json" method="post" name="fo1">
<section id="1">
<fieldset>
<legend><strong>Contact Details</strong></legend>
</fieldset>
<!--form1-->
<table>
<tr height="50px">
<td colspan="3">
<strong>General Location</strong>
</td>
</tr>
<tr>
<td width="30%">
<input type="text" placeholder="Province" name="cdProvince">
</td>
<td width="30%">
<input type="text" placeholder="Kota" name="cdKota">
</td>
<td width="30%"></td>
</tr>
<tr height="50px">
<td colspan="3">
<strong>Company Details</strong>
</td>
</tr>
<tr>
<td>
<label class="radio inline">
<input type="radio" name="rbCd" value="By Appoinment">By Appoinment
</label>
</td>
<td>
<label class="radio inline">
<input type="radio" name="rbCd" value="Cold Call/go show">Cold Call/go show
</label>
</td>
<td>
<label class="radio inline">
<input type="radio" name="rbCd" value=""><input type="text" placeholder="Other" name="rbCd">
</label>
</td>
</tr>
<tr height="70px">
<td>
<input type="text" placeholder="Staff of Scene" name="cdSos">
</td>
<td>
<input type="text" placeholder="Customer Name" name="cdCusName">
</td>
</tr>
<tr>
<td>
<label class="radio inline">
<input type="radio" name="rbCd2" value="Company">Company
</label>
</td>
<td>
<label class="radio inline">
<input type="radio" name="rbCd2" value="Individual">Individual
</label>
</td>
</tr>
<tr height="50px">
<td colspan="3">
<button type="button" class="btn">Search</button>
</td>
</tr>
<tr>
<td colspan="3">
<hr>
</td>
</tr>
<tr>
<td colspan="3">
<strong>Address / Phone no</strong>
</td>
</tr>
<tr height="50px">
<td>
<input type="text" placeholder="Head Office" name="cdOffice">
</td>
<td>
<input type="text" id="" placeholder="Phone" name="cdTelp" onkeypress="return isNumberKey(event)">
</td>
</tr>
<tr height="50px">
<td>
<input type="text" id="" placeholder="Branch/Garrage" name="cdBranch">
</td>
<td>
<input type="text" id="" placeholder="Phone" name="cdTelp2" onkeypress="return isNumberKey(event)">
</td>
</tr>
<tr height="50px">
<td colspan="3">
<strong>Contact Person</strong>
</td>
</tr>
<tr>
<td>
<input type="text" placeholder="Name" name="cp_name">
</td>
<td>
<input type="text" id="" placeholder="Phone" name="cdcpphone" onkeypress="return isNumberKey(event)">
</td>
</tr>
<tr height="50px">
<td colspan="3">
<strong>Nature Business</strong>
</td>
</tr>
<tr height="20px">
<td>
<label class="checkbox">
<input type="checkbox" name="cdCb_1" value="Transportation">Transportation
</label>
</td>
<td>
<label class="checkbox">
<input type="checkbox" name="cdCb_2" value="Bus">Bus
</label>
</td>
<td>
<label class="checkbox">
<input type="checkbox" name="cdCb_3" value="Minning">Minning
</label>
</td>
</tr>
<tr height="20px">
<td>
<label class="checkbox">
<input type="checkbox" name="cdCb_4" value="Expedition/Courier">Expedition/Courier
</label>
</td>
<td>
<label class="checkbox">
<input type="checkbox" name="cdCb_5" value="">
<input type="text" placeholder="Other"name="cdCb_5">
</label>
</td>
</tr>
</table>
</section>
<br></br>
<section id="2">
<fieldset>
<legend><strong>Vehicles Details</strong></legend>
</fieldset>
<table>
<tr>
<td colspan="2"><strong>Number of vehicles owned</strong></td>
</tr>
<tr>
<td valign="top" width="50%">
<table>
<tr height="50px">
<td width="100px">Light Truck</td>
<td width="100px">QTY</td>
</tr>
<tr height="50px">
<td>4 wheels</td>
<td>
<input type="text" style="width:30px" name="vdTr4" maxlength="3" onkeypress="return isNumberKey(event)">
</td>
</tr>
<tr height="50px">
<td>6 wheels</td>
<td>
<input type="text" style="width:30px" name="vdTr6" maxlength="3" onkeypress="return isNumberKey(event)">
</td>
</tr>
<tr height="50px">
<td>10 wheels</td>
<td>
<input type="text" style="width:30px" name="vdTr10" maxlength="3" onkeypress="return isNumberKey(event)">
</td>
</tr>
</table>
</td>
<td width="50%">
<table>
<tr height="50px">
<td width="70x">Truck</td>
<td>QTY</td>
</tr>
<tr height="50px">
<td>6 wheels</td>
<td>
<input type="text" style="width:30px" name="vdLt6" maxlength="3" onkeypress="return isNumberKey(event)">
</td>
</tr>
<tr height="50px">
<td>8 wheels</td>
<td>
<input type="text" style="width:30px" name="vdLt8" maxlength="3" onkeypress="return isNumberKey(event)">
</td>
</tr>
<tr height="50px">
<td>10 wheels</td>
<td>
<input type="text" style="width:30px" name="vdLt10" maxlength="3" onkeypress="return isNumberKey(event)">
</td>
</tr>
<tr height="50px">
<td>12 wheels</td>
<td>
<input type="text" style="width:30px" name="vdLt12" maxlength="3" onkeypress="return isNumberKey(event)">
</td>
</tr>
<tr height="50px">
<td>14 wheels</td>
<td>
<input type="text" style="width:30px" name="vdLt14" maxlength="3" onkeypress="return isNumberKey(event)">
</td>
</tr>
<tr height="50px">
<td>18 wheels</td>
<td>
<input type="text" style="width:30px" name="vdLt18" maxlength="3" onkeypress="return isNumberKey(event)">
</td>
</tr>
<tr height="50px">
<td>Other</td>
<td>
<input type="text" style="width:30px" name="vdLtot" maxlength="3" onkeypress="return isNumberKey(event)">
</td>
</tr>
</table>
</td>
</tr>
<tr>
<td colspan="2">QTR</td>
</tr>
<tr>
<td><input class="span10" id="appendedInput" type="text" placeholder="type" name="vdQtrType"></td>
<td>
<input class="span5" id="appendedInput" type="text" placeholder="Qty" name="vdQtrQty" maxlength="3" onkeypress="return isNumberKey(event)">
<input class="span5" id="appendedInput" type="text" placeholder="Total tyre" name="vdQtrTyre" maxlength="3" onkeypress="return isNumberKey(event)"></td>
</tr>
<tr>
<td><input class="span10" id="appendedInput" type="text" placeholder="type" name="vdQtrType2"></td>
<td>
<input class="span5" id="appendedInput" type="text" placeholder="Qty" name="vdQtrQty2" maxlength="3" onkeypress="return isNumberKey(event)">
<input class="span5" id="appendedInput" type="text" placeholder="Total tyre" name="vdQtrTyre2" maxlength="3" onkeypress="return isNumberKey(event)"></td>
</tr>
</table>
<hr>
<table>
<tr height="30px">
<td colspan="3"><strong>Load and Speed Details</strong></td>
</tr>
<tr height="30px">
<td colspan="3">Type of Load</td>
</tr>
<tr height="30px">
<td width="150px">
<label class="checkbox">
<input type="checkbox" name="vdCb_1" value="Materials">Materials</label>
</td>
<td width="150px">
<label class="checkbox">
<input type="checkbox" name="vdCb_2" value="Passenger">Passenger</label>
</td>
<td width="150px">
<label class="checkbox">
<input type="checkbox" name="vdCb_3" value="Goods">Goods</label>
</td>
</tr>
<tr height="30px">
<td>
<label class="checkbox">
<input type="checkbox" name="vdCb_4" value="Soil">Soil</label>
</td>
<td>
<label class="checkbox">
<input type="checkbox" name="vdCb_5" value="General Cargo">General Cargo</label>
</td>
<td>
<label class="checkbox">
<input type="checkbox" name="vdCb_6" value="">
<input type="text" style="width:100px" placeholder="Other" name="vdCb_6"></label>
</td>
</tr>
<tr height="30px">
<td colspan="3">Average Weight of Loads</td>
</tr>
<tr>
<td valign="top" width="50%">
<table>
<tr height="50px">
<td width="100px">Truck</td>
<td width="100px">Wt</td>
</tr>
<tr height="50px">
<td>4 wheels</td>
<td>
<input type="text" style="width:30px" name="vdTr4wt" maxlength="3" onkeypress="return isNumberKey(event)">
</td>
</tr>
<tr height="50px">
<td>6 wheels</td>
<td>
<input type="text" style="width:30px" name="vdTr6wt" maxlength="3" onkeypress="return isNumberKey(event)">
</td>
</tr>
<tr height="50px">
<td>10 wheels</td>
<td>
<input type="text" style="width:30px" name="vdTr10wt" maxlength="3" onkeypress="return isNumberKey(event)">
</td>
</tr>
</table>
</td>
<td width="50%">
<table>
<tr height="50px">
<td width="70x">Light Tr</td><td>Wt</td>
</tr>
<tr height="50px">
<td>6 wheels</td>
<td>
<input type="text" style="width:30px" name="vdLt6wt" maxlength="3" onkeypress="return isNumberKey(event)">
</td>
</tr>
<tr height="50px">
<td>8 wheels</td>
<td>
<input type="text" style="width:30px" name="vdLt8wt" maxlength="3" onkeypress="return isNumberKey(event)">
</td>
</tr>
<tr height="50px">
<td>10 wheels</td>
<td>
<input type="text" style="width:30px" name="vdLt10wt" maxlength="3" onkeypress="return isNumberKey(event)">
</td>
</tr>
<tr height="50px">
<td>12 wheels</td>
<td>
<input type="text" style="width:30px" name="vdLt12wt" maxlength="3" onkeypress="return isNumberKey(event)">
</td>
</tr>
<tr height="50px">
<td>14 wheels</td>
<td>
<input type="text" style="width:30px" name="vdLt14wt" maxlength="3" onkeypress="return isNumberKey(event)">
</td>
</tr>
<tr height="50px">
<td>18 wheels</td>
<td>
<input type="text" style="width:30px" name="vdLt18wt" maxlength="3" onkeypress="return isNumberKey(event)">
</td>
</tr>
<tr height="50px">
<td>Other</td>
<td>
<input type="text" style="width:30px" name="vdLtotwt" maxlength="3" onkeypress="return isNumberKey(event)">
</td>
</tr>
</table>
</td>
</tr>
<tr height="50px">
<td colspan="2">Points of Origin Destination <input type="text" name="vdDest"></td>
</tr>
<tr height="30px">
<td colspan="2">Driving Condition</td>
</tr>
<tr>
<td colspan="2">
<div class="input-append">
<input id="appendedInput" type="text" placeholder="Good Roads" name="vdgoro">
<span class="add-on">%</span>
</div>
<div class="input-append">
<input id="appendedInput" type="text" placeholder="Toll Roads" name="vdtoro">
<span class="add-on">%</span>
</div>
</td>
</tr>
<tr>
<td colspan="2">
<div class="input-append">
<input id="appendedInput" type="text" placeholder="Bad Roads" name="vdbaro">
<span class="add-on">%</span>
</div>
<div class="input-append">
<input id="appendedInput" type="text" placeholder="Others" name="vdothers">
<span class="add-on">%</span>
</div>
</td>
</tr>
</table>
</section>
<br></br>
<section id="3">
<fieldset>
<legend><strong>Types</strong></legend>
</fieldset>
<table>
<tr height="50px">
<td colspan="3">
<strong>Tyre Brands and Type</strong>
</td>
</tr>
<tr>
<td width="150px">
<label class="checkbox">
<input type="checkbox" name="tpCb_1" value="MRF">MRF</label>
</td>
<td width="150px">
<label class="checkbox">
<input type="checkbox" name="tpCb_2" value="Goodyear">Goodyear</label>
</td>
<td width="150px">
<label class="checkbox">
<input type="checkbox" name="tpCb_3" value="Bridgestone">Bridgestone</label>
</td>
<td width="150px">
<label class="checkbox">
<input type="checkbox" name="tpCb_4" value="GT">GT</label>
</td>
</tr>
<tr>
<td>
<label class="checkbox">
<input type="checkbox" name="tpCb_5" value="Dunlop">Dunlop</label>
</td>
<td>
<label class="checkbox">
<input type="checkbox" name="tpCb_6" value="Chinese">Chinese</label>
</td>
<td>
<label class="checkbox">
<input type="checkbox" name="tpCb_7" value="Kumho">Kumho</label>
</td>
<td>
<label class="checkbox">
<input type="checkbox" name="tpCb_8" value="Hankook">Hankook</label>
</td>
</tr>
<tr>
<td>
<label class="checkbox">
<input type="checkbox" name="tpCb_9" value="Coat">Coat</label>
</td>
<td>
<label class="checkbox">
<input type="checkbox" name="tpCb_10" value="Thai">Thai</label>
</td>
<td>
<label class="checkbox">
<input type="checkbox" name="tpCb_11" value="Maxxis">Maxxis</label>
</td>
<td>
<label class="checkbox">
<input type="checkbox" name="tpCb_12" value="Chengsin">Chengsin</label>
</td>
</tr>
<tr>
<td>
<label class="checkbox">
<input type="checkbox" name="tpCb_13" value="Epco">Epco</label>
</td>
<td>
<label class="checkbox">
<input type="checkbox" name="tpCb_14" value="Swallow">Swallow</label>
</td>
<td>
<label class="checkbox">
<input type="checkbox" name="tpCb_15" value="Chao Yang">Chao Yang</label>
</td>
</tr>
<tr height="50px">
<td colspan="3"><strong>Type of Purchase</strong></td>
</tr>
<tr>
<td>
<label class="checkbox">
<input type="checkbox" name="tpCb2_1" value="New Tyres">New Tyres</label>
</td>
<td>
<label class="checkbox">
<input type="checkbox" name="tpCb2_2" value="Retreads">Retreads</label>
</td>
</tr>
<tr height="50px">
<td colspan="3"><strong>Type</strong></td>
</tr>
<tr>
<td>
<label class="checkbox">
<input type="checkbox" name="tpCb3_1" value="Rib">Rib</label>
</td>
<td>
<label class="checkbox">
<input type="checkbox" name="tpCb3_2" value="Lug">Lug</label>
</td>
<td>
<label class="checkbox">
<input type="checkbox" name="tpCb3_3" value="Bias">Bias</label>
</td>
<td>
<label class="checkbox">
<input type="checkbox" name="tpCb3_4" value="Radial">Radial</label>
</td>
</tr>
</table>
</section>
<br></br>
<section id="4">
<fieldset>
<legend><strong>Tyre Usages</strong></legend>
</fieldset>
<div class="container-fluid">
<div class="row-fluid">
<div class="span4">
<strong>Milleage</strong><br></br>
<label class="radio inline">
<input type="radio" name="trRb" value="Estimates">Estimates</label>
<label class="radio inline">
<input type="radio" name="trRb" value="Actual">Actual</label>
<br></br>
<div class="input-append">
<input class="span9" id="appendedInput" type="text" placeholder="Front" name="trmfront">
<span class="add-on">Km</span>
</div><br></br>
<div class="input-append">
<input class="span9" id="appendedInput" type="text" placeholder="Rear" name="trmrear">
<span class="add-on">Km</span>
</div><br></br>
<label>Details</label>
<textarea rows="3" name="trmdetails"></textarea>
</div>
<div class="span4 offset1">
<strong>New Tyre Purchase per Month</strong><br></br>
<label class="radio inline">
<input type="radio" name="trRb2" value="Estimates">Estimates</label>
<label class="radio inline">
<input type="radio" name="trRb2" value="Actual">Actual</label>
<br></br>
</div>
</div><hr>
<div class="row-fluid">
<div class="span4">
<strong>Front Tyre</strong><br></br>
<input class="span9" id="appendedInput" type="text" placeholder="psi" name="trfpsi"><br></br>
<label class="checkbox inline">
<input type="checkbox" name="cb31" value="Estimates">New Tyre</label>&nbsp&nbsp
<label class="checkbox inline">
<input type="checkbox" name="cb3" value="Actual">Retreads</label>
</div>
<div class="span4 offset1">
<strong>Rear Tyre</strong><br></br>
<input class="span9" id="appendedInput" type="text" placeholder="psi" name="trrpsi"><br></br>
<label class="checkbox inline">
<input type="checkbox" name="cb31" value="Estimates">New Tyre</label>&nbsp&nbsp
<label class="checkbox inline">
<input type="checkbox" name="cb3" value="Actual">Retreads</label>
</div>
</div><br></br>
<div class="row-fluid">
<input class="span9" id="appendedInput" type="text" placeholder="OTR" name='trotr'><br></br>
<textarea class="span9" rows="5" placeholder="Problem faced with current type" name="trproblem"></textarea>
</div>
</div>
</section>
<br></br>
<section id="5">
<fieldset>
<legend><strong>Recommendation</strong></legend>
</fieldset>
<div class="container-fluid">
<input type="text" value="" name="id_user">
<input type="text" value="" name="id_customer">
</div>
</section>
<br></br>
<section id="6">
<fieldset>
<legend><strong>Upload Picture</strong></legend>
</fieldset>
<div class="container-fluid">
<label class="filebutton btn btn-success" id="input_field">
<i class="icon-plus icon-white"></i> Add Files
<input type="file" multiple="true" id="files" onkeydown="return false;" onchange="upload_img()" name="uploadFile"/>
</label>
<br></br>
<div id="images" style="background-color:#C0C0C0;border:ridge"></div>
<br></br>
<button class="btn btn-warning" type="button" onclick="clearFileInputField('input_field')" style="display:none" id="clear">
Clear
</button>
</div>
</section>
<div class="pull-right">
<a href="<?php echo base_url(); ?>"><button type="button" class="btn" name="save">Discard</button></a>
<button type="submit" value="Submit" class="btn btn-primary" name="send" >Save</button>
</div>
</form>
</div><!--/span-->
</div><!--/row-->
<hr>
<!--
<footer>
<p>&copy; Company 2013</p>
</footer>
-->
</div><!--/.fluid-container-->
<!--javascript-->
<script src="<?php echo base_url(); ?>asset/bootstrap/js/jquery.js"></script>
<script src="<?php echo base_url(); ?>asset/bootstrap/js/bootstrap-alert.js"></script>
<script src="<?php echo base_url(); ?>asset/bootstrap/js/bootstrap-dropdown.js"></script>
<script src="<?php echo base_url(); ?>asset/bootstrap/js/bootstrap-scrollspy.js"></script>
<script src="<?php echo base_url(); ?>asset/bootstrap/js/bootstrap-button.js"></script>
<script src="<?php echo base_url(); ?>asset/bootstrap/js/bootstrap-collapse.js"></script>
<script src="<?php echo base_url(); ?>asset/bootstrap/js/bootstrap-typeahead.js"></script>
<script>
function isNumberKey(evt){
var charCode = (evt.which) ? evt.which : event.keyCode
if (charCode > 31 && (charCode < 48 || charCode > 57)){
alert('Number Only');
return false;}
return true;
}
</script>
<script type="text/javascript">
/*
function upload_img(input) {
if (input.files && input.files[0]) {
var reader = new FileReader();
reader.onload = function (e) {
$('#img_id').attr('src', e.target.result);
$('#img_id').css("display","block");
$('#myfile').css("display","none");
$('.filebutton').css("border","none");
}
reader.readAsDataURL(input.files[0]);
}
}
*/
var reader = new FileReader(),
i=0,
numFiles = 0,
imageFiles;
// use the FileReader to read image i
function readFile() {
reader.readAsDataURL(imageFiles[i])
}
// define function to be run when the File
// reader has finished reading the file
reader.onload = function(e) {
// make an image and append it to the div
var image = $('<img>').attr({'src': e.target.result,'width':'150px'});
var a = "<br>";
var filename = $('input[type=file]').val();
$(image).css({
'margin-right':'20px',
'border' : 'single'
});
$(image).appendTo('#images');
//$(a).appendTo('#images');
$(filename).appendTo('#images');
// if there are more files run the file reader again
if (i < numFiles) {
i++;
readFile();
};
};
function upload_img() {
imageFiles = document.getElementById('files').files
// get the number of files
numFiles = imageFiles.length;
readFile();
$('#clear').show();
$('#input_field').hide();
};
function clearFileInputField(tagId) {
document.getElementById(tagId).innerHTML =
document.getElementById(tagId).innerHTML;
$('#images').html('');
$('#clear').hide();
$('#input_field').show();
}
</script>
</body>
</html>