<?php include "layouts/menu.php"; ?>    
 <script>
function add3()
{
var x = document.getElementById("1").value;
var y = document.getElementById("bba").value;
document.getElementById("1").value =(x*1)+(y*1);
}
</script>

  <script>
function add()
{
var x = document.getElementById("txt1").value;
var y = document.getElementById("txt2").value;
document.getElementById("tot").value =(x*1)+(y*1);
}
</script>
<script>
function add1()
{
var x1 = document.getElementById("1").value;
var y1 = document.getElementById("2").value;
document.getElementById("txt2").value =(x1*1)*(y1/100);
}
</script>
<script>
function add2()
{
var x1 = document.getElementById("1").value;
var y1 = document.getElementById("3").value;
document.getElementById("txt1").value =parseInt((x1*1)/(y1*1));
}
</script>
  <!--  page-wrapper -->
         <div class="right_col" role="main">
            <div class="row">
                 <!-- page header -->
                <div class="col-lg-12">
                    <h1 class="page-header  alert alert-danger">Update Columns</h1>
                </div>
                <!--end page header -->
            </div>
            <div class="row">
                <div class="col-lg-12">
                    <!-- Form Elements -->
                    <div class="panel panel-default">
                        <div class="panel-heading">
                            Fill the form
                        </div>
                        <div class="panel-body">
                            <div class="row">
                                <div class="col-lg-6">
                                   
   <form role="form" name="form1" method="post" action="pen.php" enctype="multipart/form-data">
   <div class="form-group has-success has-feedback">
    <label for="inputPassword3" >Vehicle No</label>
      <input type="checkbox" class="form-control" id="inputPassword3" name="vno" value="1" placeholder="" required>
<span class="glyphicon glyphicon-user form-control-feedback"></span> 
 </div>
  <div class="form-group has-success has-feedback">
    <label for="inputEmail3" >Vehicle Name</label>
      <input type="checkbox" class="form-control" id="inputEmail3" name="vname" value="1" placeholder="E.g TN 21 S 2676">
  <span class="glyphicon glyphicon-shopping-cart form-control-feedback"></span>
  </div>
   
  <div class="form-group has-success has-feedback">
    <label for="inputPassword3" >	H.P Amount</label>
      <input type="checkbox" class="form-control" id="inputPassword3" name="hpamount" value="1" placeholder="Vehicle Model">
   <span class="glyphicon glyphicon-time form-control-feedback"></span>
  </div>
    <div class="form-group has-success has-feedback">
    <label for="inputPassword3" >Address</label>
      <input type="checkbox" class="form-control" id="inputPassword3" name="address" value="1" placeholder="Broker Name">
    <span class="glyphicon glyphicon-cloud-download form-control-feedback"></span>
  </div>
  
 
	  
  </div>
                                <div class="col-lg-6">  
								 
  
    <div class="form-group has-warning has-feedback">
    <label for="inputPassword3" >Insurance Date</label>
      <input type="checkbox" class="form-control" id="datepicker2" name="idate" value="1" placeholder="Insurance Date">
  <span class="glyphicon glyphicon-calendar form-control-feedback"></span>
  </div>
  <div class="form-group has-warning has-feedback">
    <label for="inputPassword3" >FC Date</label>
      <input type="checkbox" class="form-control" id="datepicker8" name="uname" value="1" placeholder="Fc Date" >
   <span class="glyphicon glyphicon-calendar form-control-feedback"></span> 
  </div>
  <div class="form-group has-warning has-feedback">
    <label for="inputPassword3" >Tax Date</label>
      <input type="checkbox" class="form-control" id="datepicker9" name="pwd" value="1" placeholder="Tax Dtae">
  <span class="glyphicon glyphicon-calendar form-control-feedback"></span>
  </div>
   <div class="form-group has-warning has-feedback">
    <label for="inputPassword3" >Permit Date</label>
      <input type="checkbox" class="form-control" id="datepicker9" name="pwd" value="1" placeholder="Tax Dtae">
  <span class="glyphicon glyphicon-calendar form-control-feedback"></span>
  </div>
  <div class="form-group">
   
      <button type="submit" class="btn btn-success btn-lg btn-block" name="s2">Register</button>

</div>
      <div class="alert alert-success">
	<?php
							if(isset($_POST['s2']))
							{
									extract($_POST);
								header("Location:pend5.php?vno=$vno&vname=$vname&hpamount=$hpamount&address=$address&idate=$idate&uname=$uname&pwd=$pwd");	
								
							}
?>
	  </div>
</form>
  </div>
 
 
</div>
</div></div>
</div></div></div> <?php include "layouts/footer.php"; ?></body></html>
