-
Notifications
You must be signed in to change notification settings - Fork 0
/
Copy pathform.html
319 lines (305 loc) · 12.8 KB
/
form.html
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
<!DOCTYPE html>
<!--[if IE 9]><html class="no-js lt-ie10" lang="en">
<![endif]-->
<!--[if gt IE 9]><!-->
<html>
<head>
<meta charset="utf-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0, maximum-scale=1.0, user-scalable=no">
<title>Seme AdminHTML</title>
<meta name="description" content="Created By Seme Framework. The light weight framework that fit your needs with automation generated model.">
<meta name="keyword" content="Seme AdminCMS"/>
<meta name="author" content="Seme AdminCMS">
<meta name="robots" content="INDEX,FOLLOW" />
<link rel="apple-touch-icon" sizes="180x180" href="apple-touch-icon.png">
<link rel="icon" type="image/png" sizes="32x32" href="favicon-32x32.png">
<link rel="icon" type="image/png" sizes="16x16" href="favicon-16x16.png">
<link rel="stylesheet" href="dist/css/app.css" />
<link rel="manifest" href="site.webmanifest">
</head>
<body>
<header class="seme-header seme-header-image">
<div class="container">
<div class="row">
<div class="col-md-6 col-sm-6 col-xs-6">
<a href="">
<img src="src/assets/images/logo.png" class="img-responsive seme-header-logo" />
</a>
</div>
<div class="col-md-6 col-sm-6 col-xs-6">
<div class="row">
<div class="col-md-10 col-sm-8 col-xs-6 ">
</div>
<div class="col-md-2 col-sm-4 col-xs-6 ">
<a href="#">
<img src="dist/images/daeng.jpg" class="seme-avatar" />
</a>
</div>
</div>
</div>
</div>
</div>
</header>
<div id="page-container" class="sidebar-visible">
<div id="sidebar">
<div class="sidebar-wrapper">
<div class="sidebar-content">
<ul class="sidebar-nav">
<li class="active">
<a href="index.html"><i class="fa fa-dashboard sidebar-nav-icon"></i><span class="sidebar-nav-mini-hide">Home</span></a>
</li>
<li>
<a href="datatable.html"><i class="fa fa-bank sidebar-nav-icon"></i><span class="sidebar-nav-mini-hide">Datatable</span></a>
</li>
<li>
<a href="graph.html"><i class="fa fa-bar-chart sidebar-nav-icon"></i><span class="sidebar-nav-mini-hide">Graph</span></a>
</li>
<li>
<a href="form.html"><i class="fa fa-edit sidebar-nav-icon"></i><span class="sidebar-nav-mini-hide">Form</span></a>
</li>
</ul>
</div>
</div>
</div>
<div id="main-container">
<nav class="navbar navbar-default">
<div class="container-fluid">
<!-- Brand and toggle get grouped for better mobile display -->
<div class="navbar-header">
<button type="button" class="navbar-toggle" data-toggle="collapse" data-target="#navbar" aria-expanded="true" aria-controls="navbar">
<span class="sr-only">Toggle navigation</span>
<span class="icon-bar"></span>
<span class="icon-bar"></span>
<span class="icon-bar"></span>
</button>
</div>
<!-- Collect the nav links, forms, and other content for toggling -->
<div id="navbar" class="collapse navbar-collapse" >
<ul class="nav navbar-nav">
<li class="active">
<a href="#" class="btn-sidebar-toggle"><i class="fa fa-list"></i></a>
</li>
</ul>
<form class="navbar-form navbar-left">
<div class="form-group">
<input type="text" class="form-control" placeholder="Search">
</div>
<button type="submit" class="btn btn-default">Submit</button>
</form>
<ul class="nav navbar-nav navbar-right">
<li><a href="#">Link</a></li>
<li class="dropdown">
<a href="#" class="dropdown-toggle" data-toggle="dropdown" role="button" aria-haspopup="true" aria-expanded="false">Dr Djan Crocovich <span class="caret"></span></a>
<ul class="dropdown-menu">
<li><a href="#">Action</a></li>
<li><a href="#">Another action</a></li>
<li><a href="#">Something else here</a></li>
<li role="separator" class="divider"></li>
<li><a href="#">Separated link</a></li>
</ul>
</li>
</ul>
</div><!-- /.navbar-collapse -->
</div><!-- /.container-fluid -->
</nav>
<div id="page-content">
<!-- Static Layout Header -->
<div class="content-header">
<div class="row">
<div class="col-md-12">
<div class="btn-group">
<a id="aback" href="index.html" class="btn btn-default"><i class="fa fa-chevron-left"></i> Kembali</a>
</div>
</div>
</div>
</div>
<ul class="breadcrumb breadcrumb-top">
<li>Admin</li>
<li>Akun</li>
<li>Pelanggan</li>
<li>Baru</li>
</ul>
<!-- END Static Layout Header -->
<!-- Content -->
<form id="ftambah" action="form.html" method="post" enctype="multipart/form-data" class="" onsubmit="return false;">
<div class="block full row">
<div class="block-title">
<h4><strong>Data Utama</strong></h4>
</div>
<div class="form-group">
<div class="col-md-12">
<label class="control-label" for="ifnama">Nama *</label>
<input id="ifnama" type="text" name="fnama" class="form-control" minlength="1" placeholder="Nama Pelanggan" required="">
</div>
<div class="col-md-3">
<label for="ia_company_id" class="control-label">Perusahaan *</label>
<select id="ia_company_id" name="a_company_id" class="form-control select2-hidden-accessible" required="" data-select2-id="ia_company_id" tabindex="-1" aria-hidden="true">
<option value="NULL" data-select2-id="2">-</option>
</select><span class="select2 select2-container select2-container--default" dir="ltr" data-select2-id="1" style="width: 233.5px;"><span class="selection"><span class="select2-selection select2-selection--single" role="combobox" aria-haspopup="true" aria-expanded="false" tabindex="0" aria-disabled="false" aria-labelledby="select2-ia_company_id-container"><span class="select2-selection__rendered" id="select2-ia_company_id-container" role="textbox" aria-readonly="true" title="-">-</span><span class="select2-selection__arrow" role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper" aria-hidden="true"></span></span>
</div>
<div class="col-md-3">
<label for="ia_jabatan_id" class="control-label">Jabatan *</label>
<select id="ia_jabatan_id" name="a_jabatan_id" class="form-control select2-hidden-accessible" required="" data-select2-id="ia_jabatan_id" tabindex="-1" aria-hidden="true">
<option value="NULL" data-select2-id="4">-</option>
</select><span class="select2 select2-container select2-container--default" dir="ltr" data-select2-id="3" style="width: 233.5px;"><span class="selection"><span class="select2-selection select2-selection--single" role="combobox" aria-haspopup="true" aria-expanded="false" tabindex="0" aria-disabled="false" aria-labelledby="select2-ia_jabatan_id-container"><span class="select2-selection__rendered" id="select2-ia_jabatan_id-container" role="textbox" aria-readonly="true" title="-">-</span><span class="select2-selection__arrow" role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper" aria-hidden="true"></span></span>
</div>
</div>
</div>
<div class="block full row">
<div class="block-title">
<h4><strong>Biodata</strong></h4>
</div>
<div class="form-group">
<div class="form-group">
<div class="col-md-4">
<label class="control-label" for="ikelamin">Jenis Kelamin</label>
<select id="ikelamin" name="kelamin" class="form-control">
<option value="1">Pria</option>
<option value="0">Wanita</option>
</select>
</div>
</div>
<div class="form-group">
<div class="col-md-4">
<label class="control-label" for="itlahir">Tempat Lahir</label>
<input id="ibplace" name="bplace" type="text" class="form-control" value="" placeholder="Tempat lahir">
</div>
</div>
<div class="form-group">
<div class="col-md-4">
<label class="control-label" for="ibdate">Tgl Lahir</label>
<input id="ibdate" name="bdate" type="text" class="form-control input-datepicker" data-date-format="yyyy-mm-dd" minlength="1" value="1970-01-01" required="">
</div>
</div>
<div class="form-group">
<div class="col-md-4">
</div>
</div>
</div>
</div>
<div class="block full row">
<div class="block-title">
<h4><strong>Kontak</strong></h4>
</div>
<div class="form-group">
<div class="col-md-4">
<label for="iemail">Email *</label>
<input id="iemail" type="email" name="email" class="form-control" placeholder="email wajib" required="">
</div>
<div class="col-md-4">
<label class="control-label" for="itelp">Telp / No Hp *</label>
<input id="itelp" name="telp" type="text" class="form-control" minlength="1" required="">
</div>
<div class="col-md-4">
<label class="control-label" for="iealamat">Kab/Kota*</label>
<input id="ikabkota" name="kabkota" type="text" class="form-control" minlength="1" required="">
</div>
</div>
<div class="form-group">
<div class="col-md-12"><br></div>
</div>
<div class="form-group">
<div class="col-md-8">
<label class="control-label" for="iealamat">Alamat</label>
<input id="ialamat" name="alamat" type="text" class="form-control" minlength="1">
</div>
<div class="col-md-4">
<label class="control-label" for="itelp">Kodepos</label>
<input id="ikodepos" name="kodepos" type="text" class="form-control" minlength="4">
</div>
</div>
</div>
<div class="block full row">
<div class="block-title">
<h4><strong>Sosial Media</strong></h4>
</div>
<div class="form-group">
<div class="form-group">
<div class="col-md-4">
<label class="control-label" for="ifb">Facebook</label>
<div class="input-group">
<span id="" class="input-group-addon">
<i class="fa fa-facebook"></i>
</span>
<input id="ifb" name="fb" type="text" class="form-control" minlength="">
</div>
</div>
<div class="col-md-4">
<label class="control-label" for="iig">Instagram</label>
<div class="input-group">
<span id="" class="input-group-addon">
@
</span>
<input id="iig" name="ig" type="text" class="form-control" minlength="">
</div>
</div>
</div>
</div>
</div>
<div class="block full row">
<div class="block-title">
<h4><strong>Grup Pelanggan</strong></h4>
</div>
<div class="form-group">
<div class="col-md-3">
<label for="iadate">Tgl Mulai Langganan</label>
<input id="iadate" name="adate" type="text" class="form-control input-datepicker" value="2020-09-26" data-date-format="yyyy-mm-dd">
</div>
<div class="col-md-3">
<label for="iedate">Tgl Berakhir Langganan</label>
<input id="iedate" name="edate" type="text" class="form-control input-datepicker" value="2021-09-26" data-date-format="yyyy-mm-dd">
</div>
</div>
</div>
<div class="block full row">
<div class="block-title">
<h4><strong>Lain-lain</strong></h4>
</div>
<div class="form-group">
<div class="col-md-3">
<label for="iis_active">Aktif</label>
<select id="iis_active" name="is_active" class="form-control" required="">
<option value="1">Iya</option>
<option value="0">Tidak</option>
</select>
</div>
</div>
</div>
<div class="block full row">
<div class="block-title">
<h4><strong>Action</strong></h4>
</div>
<div class="row">
<div class="col-md-8"> </div>
<div class="col-md-4 text-right">
<div class="btn-group"><input type="submit" value="Simpan Data" class="btn btn-primary">
</div>
</div>
</div>
</div>
</form>
<!-- END Content -->
</div>
<footer class="clearfix">
<div class="pull-right">
Made with <i class="fa fa-heart text-danger"></i> by <a href="https://cenah.co.id/" target="_blank">Cenah</a>
</div>
<div class="pull-left">
Application Name - Administrator - version 1.0.0 © <span id="year-copy">2020</span>
</div>
</footer>
<script src="dist/js/app.js"></script>
<script defer>
$(document).ready(function(e){
$("body").on("click",".btn-sidebar-toggle",function(e){
e.preventDefault();
$("#page-container").toggleClass("sidebar-visible");
});
});
</script>
<script defer id="__bs_script__">
document.write("<script async src='http://HOST:3000/browser-sync/browser-sync-client.js?v=2.26.7'><\/script>".replace("HOST", location.hostname));
</script>
</body>
</html>