<?php
require("includes/check_auth_user.php");
require("includes/dbconnect.php");
include('includes/function.php');

$formname   = "Passport Zip";
$action     = "passzipreg_fr.php";

$admin      = $_SESSION["admin_" . $dbname];
$zdb        = $_SESSION["zdbyear_" . $dbname];

$zyear      = right($zdb, 4);
$mfrdate    = getzdates($zyear, 'S');
$mtodate    = getzdates($zyear, 'E');

$myyear     = $_SESSION[$myyear];

$usertype   = $_SESSION["usertype"];
$user       = $_SESSION['username_' . $dbname];
mysqli_select_db($conn,$zdb);

include("includes/linkshead.php");
?>
</head>
<body>
    <form action='<?= $action; ?>' method='POST'>
        <!-- Default box -->
        <div class="row" style="width:100%;">
            <div class="col-lg-4" style="float: none; margin: auto">
                <div class="panel panel-default">
                    <div class="panel-heading">
                        <h3 class="panel-title"><?php Echo $formname; ?></h3>
                        <div class="actions pull-right">
                            <i class="fa fa-chevron-down"></i>
                        </div>
                    </div>
                    <div class="panel-body">
                        <div class="row">
                            <div class="col-lg-3 col-sm-3 pad text-right">
                                <label class="label-control marg">Name</label>
                            </div>
                            <div class="col-lg-8 col-sm-8 pad">
                                <input type="text" class="form-control name" autofocus name="name">
                            </div>
                        </div>
                        <div class="row">
                            <div class="col-lg-3 col-sm-3 pad text-right">
                                <label class="label-control marg">Last Name</label>
                            </div>
                            <div class="col-lg-8 col-sm-8 pad">
                                <input type="text" class="form-control lastname" name="lastname">
                            </div>
                        </div>
<!--                        <div class="row">
                            <div class="col-lg-3 col-sm-3 pad text-right">
                                <label class="label-control marg">Passport No.</label>
                            </div>
                            <div class="col-lg-8 col-sm-8 pad">
                                <input type="text" class="form-control passno" name="passno">
                            </div>
                        </div>-->
                    </div>
                    <div class="panel-footer">
                        <div style="overflow: auto; ">
                            <table class="table-condensed" style="margin: 0 auto;">
                                <tr>
                                    <td class=" buttonform tooltip-bottom" id="ssubmit" style="display: <? Echo $savedisabled ?>" data-toggle="tooltip" data-placement="bottom" title="" data-original-title="View">
                                        <button id='view' type='submit' formtarget="_blank" name='view' class="btn btn-pad btn-square" style="background-color:#05B2EA; ">
                                            <i class="fa fa-television" style="color:#ffffff"></i>
                                        </button>
                                    </td>
                                    <td class=" buttonform tooltip-bottom" id="scancel" style="display: <? Echo $canceldisabled ?>" data-toggle="tooltip" data-placement="bottom" title="" data-original-title="Close">
                                        <button id='cancel' type="reset" class="btn btn-pad btn-square " style="background-color:red;" onclick="window.parent.location.href = 'menu.php'">
                                            <i class="fa fa-power-off" style="color:#ffffff"></i>
                                        </button>
                                    </td>
                                </tr>
                            </table>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </form>
    <?php include("includes/linksfoot.php"); ?>
</body>
</html>
