<?php
include('include/header.php');
?>
<div class="container">
<h1 class="well text-center"> Member Registration Form</h1>
<div class="col-lg-8 well">
<div class="row">
<?php if(isset($_SESSION['err_msg'])) echo $_SESSION['err_msg'];?>
<form action="user_reg_succ.php" method="post" enctype="multipart/form-data">
<div class="col-sm-12 ">
<div class="form-group">
<label>Profile picture</label>
<input type="file" name="photo" />
</div>
<div class="form-group">
<label>Member Id</label>
<input type="text" name="member_id" value="<?php echo isset($_SESSION['POST']['member_id']) ? $_SESSION['POST'] ['member_id']: '';?>"placeholder="Enter Member Id Here.." class="form-control">
</div>
<div class="row">
<div class="col-sm-12 form-group">
<label>Member Name</label>
<input type="text" name="member_name" value="<?php echo isset($_SESSION['POST']['member_name']) ? $_SESSION['POST']['member_name'] : '';?>"placeholder="Enter First Name Here.." class="form-control"/>
</div>
</div>
<div class="form-group">
<label>Father's Name</label>
<input type="text" value="<?php echo isset($_SESSION['POST']['fa_name']) ? $_SESSION['POST']['fa_name']:'';?>"placeholder="Enter Your Father's Name.." name="fa_name"class="form-control input"/>
</div>
<div class="form-group">
<label>Mother's Name</label>
<input type="text" name="mo_name" value="<?php echo isset($_SESSION['POST']['mo_name']) ? $_SESSION['POST']['mo_name']:'';?>" placeholder="Enter Mother's Name .." class="form-control input"/>
</div>
<div class="form-group">
<label>Address</label>
<textarea placeholder="Enter Address Here.." rows="3" name="address" value="" class="form-control input"><?php echo isset($_SESSION['POST']['address']) ? $_SESSION ['POST']['address']:'';?></textarea>
</div>
<div class="form-group">
<label>Email </label>
<input type="text" name="email" value="<?php echo isset($_SESSION['POST']['email']) ? $_SESSION['POST']['email']:'';?>" placeholder="Enter Email Address Here.." class="form-control">
</div>
<div class="form-group">
<label>Phone Number</label>
<input type="text" name ="phone_num" value="<?php echo isset($_SESSION['POST']['phone_num']) ? $_SESSION['POST']['phone_num']:'';?>" placeholder="Enter Phone Number Here.." class="form-control">
</div>
<div class="form-group" >
<label>Date of birth</label>
<input type="date" name="da_birth" value="<?php echo isset($_SESSION['POST']['da_birth']) ? $_SESSION['POST']['da_birth']:'';?>" class="form-control"/>
</div>
<div class="form-group">
<label>National Id</label>
<input type="number" name ="n_id" value="<?php echo isset($_SESSION['POST']['n_id']) ? $_SESSION['POST']['n_id']:'';?>" placeholder="Enter Nid Number Here.." class="form-control">
</div>
<div class="form-group ">
<label>Gender</label>
<input type="radio" name="sex" value="male"<?php if(isset($_SESSION['POST']['sex']) && $_SESSION['POST']['sex']=='male') echo 'checked';?> />Male
<input type="radio" name="sex" value="female" <?php if(isset($_SESSION['POST']['sex']) && $_SESSION['POST']['sex']=='female') echo 'checked';?> />Female
</div>
<div class="form-group ">
<label>Zone</label>
<input type="radio" name="area" value="mir-bazar"<?php if (isset($_SESSION['POST']['area']) && $_SESSION['POST']['area']=='mir-bazar') echo 'checked';?> />Mirer bazar
<input type="radio" name="area" value="mazu-khan"<?php if (isset($_SESSION['POST']['area']) && $_SESSION['POST']['area']=='mazu-khan') echo 'checked';?>/>Mazu khan
</div>
<button type="submit" value="submit" name="submit" class="btn btn-lg btn-info">Submit</button>
</div>
</form>
</div>
</div>
<div class="col-lg-4 well" >
<div class="row">
<div class="col-sm-12 text-center for-text">
<h4>Terms and Conditions</h4><br />
<h6>Please read carefully.</h6>
<p >..
</p></div>
</div>
</div>
</div>
<?php
include('include/footer.php');
unset($_SESSION['err_msg']);
unset($_SESSION['POST']);
?> */
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