
<?php
include"alertandmark.php";
?>
<div class="content-wrapper">
    <!-- Content Header (Page header) -->
    <section class="content-header">
      <div class="container-fluid">
        <div class="row mb-2">
          <div class="col-sm-6">
            <h1>Add New Repair</h1>
          </div>
          <div class="col-sm-6">
            <ol class="breadcrumb float-sm-right">
              <li class="breadcrumb-item"><a href="#">Home</a></li>
              <li class="breadcrumb-item active">Repair Form</li>
            </ol>
          </div>
        </div>
      </div><!-- /.container-fluid -->
	   <div class="card card-info">
              <div class="card-header">
                <h3 class="card-title"> Repair</h3>
              </div>
              <!-- /.card-header -->
              <!-- form start -->
              <form action='repairaction.php' method='POST'>
                <div class="card-body">
                  <div class="form-group">
                    <label for="exampleInputEmail1">Customer Name <?php  echo $mandatory_star; ?> </label>
                    <input type="text" class="form-control" id="exampleInputEmail1" placeholder="Enter CustomerName" name='CustomerName'  required>
                  </div>
				  
				
				    <div class="form-group">
                    <label for="exampleInputEmail1">Problem/Fault <?php  echo $mandatory_star; ?> </label>
                    <input type="text" class="form-control" id="exampleInputEmail1" placeholder="Problem" name='Problem'  required>
                  </div>
		
		
					<div class="form-group">
                    <label for="exampleInputEmail1">Submission Date <?php  echo $mandatory_star; ?> </label>
                    <input type="date" class="form-control" id="exampleInputEmail1" name='SubmissionDate' required>
                  </div>
				  
				    <div class="form-group">
                    <label for="exampleInputEmail1">Discharge Date <?php  echo $mandatory_star; ?> </label>
                    <input type="date" class="form-control" id="exampleInputEmail1"  name='DischargeDate' value=''>
                  </div>

				    <div class="form-group">
                    <label for="exampleInputEmail1">Repair Status <?php  echo $mandatory_star; ?> </label>
					<SELECT class="form-control" id="exampleInputEmail1" name='RepairStatus'>
					 <OPTION>Submited</OPTION>
					 <OPTION>UnderDiagonsis</OPTION>
					 <OPTION>Fixed</OPTION>
					 <OPTION>Dispatch</OPTION>
					 <OPTION>BeyondRepair</OPTION>
					 </SELECT>
                  </div>
				  
				  
				  
				  
				    <div class="form-group">
                    <label for="exampleInputEmail1">Service Charge <?php  echo $mandatory_star; ?> </label>
                    <input type="text" class="form-control" id="exampleInputEmail1" placeholder="Amount" name='ServiceCharge'  required>
                  </div>
				  
				     <div class="form-group">
                    <label for="exampleInputEmail1">MODEL <?php  echo $mandatory_star; ?> </label>
					<SELECT class="form-control" id="exampleInputEmail1" name='Model'>
					 <OPTION>CRDB TPS</OPTION>
					 <OPTION>CRDB NEXGO</OPTION>
					 <OPTION>NMB TPS</OPTION>
					 <OPTION>MADINI</OPTION>
					 <OPTION>TRAFIC</OPTION>
					 </SELECT>
                  </div>
				  
				  <div class="form-group">
                    <label for="exampleInputEmail1">Description <?php  echo $mandatory_star; ?> </label>
                    <input type="text" class="form-control" id="exampleInputEmail1" placeholder="Serila Number" name='Description'  required>
                  </div>
				  
				  <div class="form-group">
                    <label for="exampleInputEmail1">Serial Number <?php  echo $mandatory_star; ?> </label>
                    <input type="text" class="form-control" id="exampleInputEmail1" placeholder="Serila Number" name='SerialNumber'  required>
                  </div>
				  
				  <div class="form-group">
                    <label for="exampleInputEmail1">Tag Number <?php  echo $mandatory_star; ?> </label>
                    <input type="text" class="form-control" id="exampleInputEmail1" placeholder="Tag Nunber" name='TagNumber'  required>
                  </div>
				  
				  
				 <div class="form-group">
                    <label for="exampleInputEmail1">Scanned Photos (Pdf) <?php  echo $mandatory_star; ?> </label>
                    <input type="file" class="form-control" id="exampleInputEmail1" placeholder="Amount" name='File' required>
                  </div>
				 	  
					
					  
                  <div class="form-group">
                
                    <div class="input-group">
                    
                    
                    </div>
                  </div>
                 
                </div>
                <!-- /.card-body -->

                <div class="card-footer">
                  <button type="submit" class="btn btn-primary">Submit</button>
                </div>
				
				
				

              </form>
            </div>
	</div>
    </section>
	           