/home/hdwebsolution/www/try/sareensurgicals/app/Views/front/profile.php
<div class="ttm-page-title-row text-center">
<div class="section-overlay"></div>
<div class="title-box text-center">
<div class="container">
<div class="page-title-heading">
<h1 class="title">Profile Information</h1>
</div>
<div class="breadcrumb-wrapper">
<div class="container">
<span><a title="Homepage" href="<?=base_url();?>"><i class="fa fa-home"></i> Home</a></span>
<span class="ttm-bread-sep ttm-textcolor-white"> ⁄ </span>
<span class="ttm-textcolor-white">Profile Information</span>
</div>
</div>
</div>
</div>
</div>
<div class="site-main">
<!-- checkout-section -->
<section class="ttm-row checkout-section ttm-bgcolor-grey break-991-colum clearfix">
<div class="container">
<!-- row -->
<div class="row">
<div class="col-lg-12">
<div class="coupon_toggle">
<div class="coupon_code">
Profile information
</div>
</div>
<form name="checkout" method="post" class="checkout row box-shadow1" action="<?=base_url('profile');?>">
<div class="col-lg-12">
<div class="billing-fields">
<h3>Basic information</h3>
<div class="row">
<div class="col-sm-6">
<p class="checkout-form">
<label>FIRST NAME<abbr class="required" title="required">*</abbr></label>
<input type="text" required="" class="input-tex" name="f_name" placeholder="FIRST NAME" value="">
</p>
</div>
<div class="col-sm-6">
<p class="checkout-form">
<label>LAST NAME <abbr class="required" title="required">*</abbr></label>
<input required="" type="text" class="input-text " name="l_name" placeholder="LAST NAME" value="">
</p>
</div>
<div class="col-sm-6">
<p class="checkout-form">
<label>GENDER <abbr class="required" title="required">*</abbr></label>
<select name="gender" class="country_to_state country_select" tabindex="-1" aria-hidden="true">
<option value="">Choose one…</option>
<option value="Male">Male</option>
<option value="Female">Female</option>
</select>
</p>
</div>
<div class="col-sm-6">
<p class="checkout-form">
<label>EMAIL <abbr class="required" title="required">*</abbr></label>
<input required="" type="email" class="input-text" name="email" placeholder="EMAIL" value="">
</p>
</div>
<div class="col-sm-6">
<p class="checkout-form">
<label>DATE OF BIRTH <abbr class="required" title="required">*</abbr></label>
<input type="date" class="input-text" name="dob" placeholder="EMAIL" value="">
</p>
</div>
<div class="col-sm-6">
<p class="checkout-form">
<label>MARITAL STATUS <abbr class="required" title="required">*</abbr></label>
<select name="marital_status" class="country_to_state country_select" tabindex="-1" aria-hidden="true">
<option value="">Choose one…</option>
<option value="Never Married">Never Married</option>
<option value="Married">Married</option>
<option value="Divorced ">Divorced </option>
<option value="Widowed">Widowed</option>
</select>
</p>
</div>
<div class="col-sm-6">
<p class="checkout-form">
<label>NUMBER OF CHILDREN <abbr class="required" title="required">*</abbr></label>
<input type="text" class="input-text" name="number_children" placeholder="NUMBER OF CHILDREN" value="">
</p>
</div>
<div class="col-sm-6">
<p class="checkout-form">
<label>AREA <abbr class="required" title="required">*</abbr></label>
<input type="text" class="input-text" name="area" placeholder="AREA" value="">
</p>
</div>
<div class="col-sm-6">
<p class="checkout-form">
<label>ON BEHALF <abbr class="required" title="required">*</abbr></label>
<select name="behalf" class="country_to_state country_select" tabindex="-1" aria-hidden="true">
<option value="">Choose one…</option>
<option value="Self">Self</option>
<option value="Daughter/Son">Daughter/Son</option>
<option value="Sister">Sister </option>
<option value="Brother">Brother</option>
<option value="Friend">Friend</option>
</select>
</p>
</div>
<div class="col-sm-6">
<p class="checkout-form">
<label>MOBILE <abbr class="required" title="required">*</abbr></label>
<input type="text" class="input-text" required="" name="mobile" placeholder="MOBILE" value="">
</p>
</div>
<div class="col-sm-6">
<p class="checkout-form">
<label>MARRIAGE BUDGET <abbr class="required" title="required">*</abbr></label>
<input type="number" class="input-text" name="budget" placeholder="budget " value="">
</p>
</div>
<div class="col-sm-6">
<p class="checkout-form">
<label>FAMILY ANNUAL INCOME <abbr class="required" title="required">*</abbr></label>
<input type="number" class="input-text" name="family_annual_income" placeholder="FAMILY ANNUAL INCOME " value="">
</p>
</div>
<div class="col-sm-6">
<p class="checkout-form">
<label>ANNUAL INCOME (BRIDE/GROOM) <abbr class="required" title="required">*</abbr></label>
<input type="number" class="input-text" name="annual_income_bride_groom" placeholder="ANNUAL INCOME (BRIDE/GROOM)" value="">
</p>
</div>
<div class="col-sm-6">
<p class="checkout-form">
<label>Profession <abbr class="required" title="required">*</abbr></label>
<select name="behalf" class="country_to_state country_select" id="profession1" tabindex="-1" aria-hidden="true">
<option value="">Choose one…</option>
<option value="Self">DOCTOR</option>
<option value="ENGINEER">ENGINEER</option>
<option value="TEACHER ">TEACHER </option>
<option value="PILOT">PILOT</option>
<option value="BANKER">BANKER</option>
<option value="ACCOUNTANT">ACCOUNTANT</option>
<option value="ARMY_OFFICER">ARMY OFFICER</option>
<option value="LAWYER">LAWYER</option>
<option value="BUSINESMAN">BUSINESMAN</option>
<option value="OTHER">OTHER</option>
</select>
</p>
</div>
<!--<div class="col-sm-12" id="profession_other1" style="display:none;">
<p class="checkout-form">
<label>Other <abbr class="required" title="required">*</abbr></label>
<input type="text" class="input-text" name="profession_other1" placeholder="Profession Other" value="">
</p>
</div>-->
</div>
</div>
</div>
</div>
<div class="col-md-12 text-center">
<button class="ttm-btn ttm-btn-size-md ttm-btn-shape-round ttm-btn-style-fill ttm-btn-color-black mt-50" type="submit">Next</button></div>
</form>
</div>
</div>
</section></div>