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  1. <!DOCTYPE html>
  2. <html lang="en" dir="">
  3. <html xmlns:th="http://www.thymeleaf.org">
  4. <head th:replace="~{fragments/modules/base/head :: head}"></head>
  5. <body>
  6. <div class="wrapper">
  7. <!-- header top menu Start -->
  8. <header th:replace="~{fragments/modules/base/header :: header}"></header>
  9. <!-- header top menu end -->
  10. <div class="page-wrap">
  11. <!--=============== Left Menu side Start ===================-->
  12. <div th:replace="~{fragments/modules/base/menu :: menu}"></div>
  13. <section class="vh-100 gradient-custom">
  14. <div class="container py-5 h-100">
  15. <div class="row justify-content-center align-items-center h-100">
  16. <div class="col-12 col-lg-9 col-xl-7">
  17. <div class="card shadow-2-strong card-registration"
  18. style="border-radius: 15px;">
  19. <div class="card-body p-4 p-md-5">
  20. <h3 class="mb-4 pb-2 pb-md-0 mb-md-5">Circular - New</h3>
  21. <hr>
  22. <form class="reduce-margin">
  23. <br>
  24. <div class="row">
  25. <div class="form-group">
  26. <h6 class="mb-2 pb-1">
  27. Document Category :
  28. <div class="form-check form-check-inline">
  29. <input class="form-check-input" type="radio"
  30. name="documentcategory" id="common" value="option1" /> <label
  31. class="form-check-label" for="common">Common</label>
  32. </div>
  33. <div class="form-check form-check-inline">
  34. <input class="form-check-input" type="radio"
  35. name="documentcategory" id="flood" value="option2" /> <label
  36. class="form-check-label" for="flood">Flood</label>
  37. </div>
  38. </h6>
  39. </div>
  40. </div>
  41. <br>
  42. <div class="row">
  43. <div class="form-group">
  44. <h6 class="mb-2 pb-1">
  45. Type :
  46. <div class="form-check form-check-inline">
  47. <input class="form-check-input" type="radio" name="type"
  48. id="circular" value="option1" /> <label
  49. class="form-check-label" for="circular">Circular</label>
  50. </div>
  51. <div class="form-check form-check-inline">
  52. <input class="form-check-input" type="radio" name="type"
  53. id="minutes" value="option2" /> <label
  54. class="form-check-label" for="minutes">Minutes</label>
  55. </div>
  56. <div class="form-check form-check-inline">
  57. <input class="form-check-input" type="radio" name="type"
  58. id="regularreport" value="option3" /> <label
  59. class="form-check-label" for="regularreport">Regular
  60. Report</label>
  61. </div>
  62. <div class="form-check form-check-inline">
  63. <input class="form-check-input" type="radio" name="type"
  64. id="rainfallreport" value="option4" /> <label
  65. class="form-check-label" for="rainfallreport">Rainfall
  66. Report</label>
  67. </div>
  68. </h6>
  69. </div>
  70. </div>
  71. <div class="row">
  72. <div class="col-md-6 mb-4">
  73. <div class="form-group">
  74. <label class="form-label" for="firstName">From
  75. Department :</label> <select class="form-control"
  76. id="exampleFormControlSelect1">
  77. <option>1</option>
  78. <option>2</option>
  79. <option>3</option>
  80. <option>4</option>
  81. <option>5</option>
  82. </select>
  83. </div>
  84. </div>
  85. <div class="col-md-6 mb-4">
  86. <div class="form-group">
  87. <label class="form-label" for="lastName">Date :</label> <input
  88. type="date" class="form-control" id="date" name="date"
  89. required>
  90. </div>
  91. </div>
  92. </div>
  93. <div class="row">
  94. <div class="col-md-6 mb-4 pb-2">
  95. <div class="form-group">
  96. <h6 class="mb-2 pb-1">
  97. SMS :
  98. <div class="form-check form-check-inline">
  99. <input class="form-check-input" type="radio" name="sms"
  100. id="send" value="option1" /> <label
  101. class="form-check-label" for="send">Send</label>
  102. </div>
  103. <div class="form-check form-check-inline">
  104. <input class="form-check-input" type="radio" name="sms"
  105. id="notsend" value="option2" /> <label
  106. class="form-check-label" for="notsend">Not Send</label>
  107. </div>
  108. </h6>
  109. </div>
  110. </div>
  111. </div>
  112. <div class="form-group">
  113. <label class="form-label" for="textarea1">SMS Subject :</label>
  114. <textarea class="form-control" id="textarea1" rows="1"></textarea>
  115. </div>
  116. <div class="form-group">
  117. <label for="textarea2">Subject :</label>
  118. <textarea class="form-control" id="textarea2" rows="1"></textarea>
  119. </div>
  120. <div class="form-group">
  121. <label for="file" class="col-form-label">Select File :</label>
  122. <div class="custom-file">
  123. <input type="file" class="custom-file-input" id="file"
  124. name="file" required> <label
  125. class="custom-file-label" for="file">Choose file</label>
  126. </div>
  127. </div>
  128. <div class="mt-4 pt-2">
  129. <input class="btn btn-primary btn-lg" type="submit"
  130. value="Submit" />
  131. </div>
  132. </form>
  133. </div>
  134. </div>
  135. </div>
  136. </div>
  137. </div>
  138. </section>
  139. </div>
  140. </div>
  141. <!-- Optional JavaScript -->
  142. <!-- jQuery first, then Popper.js, then Bootstrap JS -->
  143. <script src="https://code.jquery.com/jquery-3.2.1.slim.min.js"
  144. integrity="sha384-KJ3o2DKtIkvYIK3UENzmM7KCkRr/rE9/Qpg6aAZGJwFDMVNA/GpGFF93hXpG5KkN"
  145. crossorigin="anonymous"></script>
  146. <script
  147. src="https://cdn.jsdelivr.net/npm/popper.js@1.12.9/dist/umd/popper.min.js"
  148. integrity="sha384-ApNbgh9B+Y1QKtv3Rn7W3mgPxhU9K/ScQsAP7hUibX39j7fakFPskvXusvfa0b4Q"
  149. crossorigin="anonymous"></script>
  150. <script
  151. src="https://cdn.jsdelivr.net/npm/bootstrap@4.0.0/dist/js/bootstrap.min.js"
  152. integrity="sha384-JZR6Spejh4U02d8jOt6vLEHfe/JQGiRRSQQxSfFWpi1MquVdAyjUar5+76PVCmYl"
  153. crossorigin="anonymous"></script>
  154. </body>
  155. </html>