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✏️ Editing: generatelead.php

<?php
ob_start();
session_start();
include("includes/inall.php");
if(isset($_POST['submitin']) && $_POST['submitin']=="Lead") {
	$d=date("Y-m-d");
	$fname=isset($_POST['fname'])?addslashes(trim($_POST['fname'])):'';
	$mname=isset($_POST['mname'])?addslashes(trim($_POST['mname'])):'';
	$lname=isset($_POST['lname'])?addslashes(trim($_POST['lname'])):'';
	$dob=isset($_POST['dob'])?addslashes(trim($_POST['dob'])):'';
	$gender=isset($_POST['gender'])?addslashes(trim($_POST['gender'])):'';
	$mstatus=isset($_POST['mstatus'])?addslashes(trim($_POST['mstatus'])):'';
	$education=isset($_POST['education'])?addslashes(trim($_POST['education'])):'';
	$mobile=isset($_POST['mobile'])?addslashes(trim($_POST['mobile'])):'';
	$amobile=isset($_POST['amobile'])?addslashes(trim($_POST['amobile'])):'';
	$email=isset($_POST['email'])?addslashes(trim($_POST['email'])):'';
	$address=isset($_POST['address'])?addslashes(trim($_POST['address'])):'';
	$district=isset($_POST['district'])?addslashes(trim($_POST['district'])):'';
	$state=isset($_POST['state'])?addslashes(trim($_POST['state'])):'';
	$pin=isset($_POST['pin'])?addslashes(trim($_POST['pin'])):'';
	$noofmembers=isset($_POST['noofmembers'])?addslashes(trim($_POST['noofmembers'])):'';
	$occupation=isset($_POST['occupation'])?addslashes(trim($_POST['occupation'])):'';
	$aincome=isset($_POST['aincome'])?addslashes(trim($_POST['aincome'])):'';
	$policytype=isset($_POST['policytype'])?addslashes(trim($_POST['policytype'])):'';
	$sumassured=isset($_POST['sumassured'])?addslashes(trim($_POST['sumassured'])):'';
	$premium=isset($_POST['premium'])?addslashes(trim($_POST['premium'])):'';
	$doyou=isset($_POST['doyou'])?addslashes(trim($_POST['doyou'])):'';
	$ifyes=isset($_POST['ifyes'])?addslashes(trim($_POST['ifyes'])):'';
	$nominee=isset($_POST['nominee'])?addslashes(trim($_POST['nominee'])):'';
	$ifothers=isset($_POST['ifothers'])?addslashes(trim($_POST['ifothers'])):'';
	$refname=isset($_POST['refname'])?addslashes(trim($_POST['refname'])):'';
	$age=isset($_POST['refname'])?addslashes(trim($_POST['refname'])):'';
	$relation=isset($_POST['relation'])?addslashes(trim($_POST['relation'])):'';
	$refcontact=isset($_POST['refcontact'])?addslashes(trim($_POST['refcontact'])):'';
	$insert_sql_data=array('date'=>$d,
	'doneby'=>$_SESSION['rid'],
	'fname'=>$fname,
	'mname'=>$mname,
	'lname'=>$lname,
	'dob'=>$dob,
	'gender'=>$gender,
	'mstatus'=>$mstatus,
	'education'=>$education,
	'mobile'=>$mobile,
	'amobile'=>$amobile,
	'email'=>$email,
	'address'=>$address,
	'district'=>$district,
	'state'=>$state,
	'pin'=>$pin,
	'noofmembers'=>$noofmembers,
	'occupation'=>$occupation,
	'aincome'=>$aincome,
	'policytype'=>$policytype,
	'sumassured'=>$sumassured,
	'premium'=>$premium,
	'doyou'=>$doyou,
	'ifyes'=>$ifyes,
	'nominee'=>$nominee,
	'ifothers'=>$ifothers,
	'refname'=>$refname,
	'age'=>$age,
	'relation'=>$relation,
	'refcontact'=>$refcontact,
	'status'=>'1'
	);
	$ins_query=tep_db_perform("leads",$insert_sql_data,"insert");
	if($ins_query) {
		$_SESSION['msg']="Lead is submitted successfully. Thank you.";
		header("location:generatelead.php");
		exit();
	} else {
		$_SESSION['msgerr']="Some error occured.";
		header("location:generatelead.php");
		exit();
	}
}
include("includes/headermain.php"); 
?>
<body class="body-bg">


<div id="preloader">
	<div class="loader"></div>
</div>


<div class="horizontal-main-wrapper">
	<?php include("includes/header.php"); ?>
	
	<div class="main-content">
	 	<div class="main-content-inner">
			
			<div> 
				<div class="col-lg-12 mt-5">
					<div class="card">
						<div class="card-body">
							<h4 class="header-title">Generate Lead</h4>
							<form action="#" method="post" name="rform" enctype="multipart/form-data">
								<input type="hidden" name="submitin" value="Lead">
								<?php if($_SESSION['msgerr']) { ?><span class="redtxt"><?php print $_SESSION['msgerr']; $_SESSION['msgerr']=""; ?></span><div class="cleaner h10"></div><?php } ?>
								<?php if($_SESSION['msg']) { ?><span class="grtxt"><?php print $_SESSION['msg']; $_SESSION['msg']=""; ?></span><div class="cleaner h10"></div><?php } ?>
								<div class="form-group col-3 floatleft">
									<label for="example-text-input" class="col-form-label"><span>*</span>First Name</label>
									<input class="form-control" type="text" name="fname" id="fname" required>
								</div>
								<div class="form-group col-3 floatleft">
									<label for="example-text-input" class="col-form-label"><span>*</span>Middle Name</label>
									<input class="form-control" type="text" name="mname" id="mname">
								</div>
								<div class="form-group col-3 floatleft">
									<label for="example-text-input" class="col-form-label"><span>*</span>Last Name</label>
									<input class="form-control" type="text" name="lname" id="lname" required>
								</div>
								<div class="form-group col-3 floatleft">
									<label for="example-text-input" class="col-form-label"><span>*</span>DOB</label>
									<input class="form-control" type="date" name="dob" id="dob" required>
								</div>
								<div class="cleaner"></div>
								<div class="cleaner"></div>
								<div class="form-group col-4 floatleft">
									<label for="example-text-input" class="col-form-label"><span>*</span>Gender</label>
									<select class="form-control" name="gender" id="gender" required>
										<option value="">Select
										<option value="Male">Male
										<option value="Female">Female
										<option value="Other">Other
									</select>
								</div>
								<div class="form-group col-4 floatleft">
									<label for="example-text-input" class="col-form-label"><span>*</span>Marital Status</label>
									<select class="form-control" name="mstatus" id="mstatus" required>
										<option value="">Select
										<option value="Married">Married
										<option value="Unmarried">Unmarried
										<option value="Widow">Widow
									</select>
								</div>
								<div class="form-group col-4 floatleft">
									<label for="example-text-input" class="col-form-label"><span>*</span>Highest Education</label>
									<input class="form-control" type="text" name="education" id="education" required>
								</div>
								<div class="cleaner"></div>
								<div class="form-group col-4 floatleft">
									<label for="example-text-input" class="col-form-label"><span>*</span>Mobile No.</label>
									<input class="form-control" type="number" name="mobile" id="mobile" required>
								</div>
								<div class="form-group col-4 floatleft">
									<label for="example-text-input" class="col-form-label"><span>*</span>Alternate Mobile No.</label>
									<input class="form-control" type="number" name="amobile" id="amobile" required>
								</div>
								<div class="form-group col-4 floatleft">
									<label for="example-text-input" class="col-form-label"><span>*</span>Email ID</label>
									<input class="form-control" type="email" name="email" id="email" required>
								</div>
								
								<div class="form-group col-12 floatleft">
									<label for="example-text-input" class="col-form-label"><span>*</span>Address</label>
									<input class="form-control" type="text" name="address" id="address" required>
								</div>
								<div class="form-group col-4 floatleft">
									<label for="example-text-input" class="col-form-label"><span>*</span>District</label>
									<input class="form-control" type="text" name="district" id="district" required>
								</div>
								<div class="form-group col-4 floatleft">
									<label for="example-text-input" class="col-form-label"><span>*</span>State</label>
									<input class="form-control" type="text" name="state" id="state" required>
								</div>
								<div class="form-group col-4 floatleft">
									<label for="example-text-input" class="col-form-label"><span>*</span>PIN</label>
									<input class="form-control" type="text" name="pin" id="pin" required>
								</div>
								<div class="cleaner h40"></div>
								<div class="form-group col-4 floatleft">
									<label for="example-text-input" class="col-form-label"><span>*</span>No of Family Members</label>
									<input class="form-control" type="text" name="noofmembers" id="noofmembers" required>
								</div>
								<div class="form-group col-4 floatleft">
									<label for="example-text-input" class="col-form-label"><span>*</span>Occupation</label>
									<input class="form-control" type="text" name="occupation" id="occupation" required>
								</div>
								<div class="form-group col-4 floatleft">
									<label for="example-text-input" class="col-form-label"><span>*</span>Approx Income</label>
									<input class="form-control" type="text" name="aincome" id="aincome" required>
								</div>
								<div class="cleaner h40"></div>
								<div class="form-group col-4 floatleft">
									<label for="example-text-input" class="col-form-label"><span>*</span>Interest of Insurance Policy Type</label>
									<select class="form-control" name="policytype" id="policytype" required>
										<option value="">Select
										<option value="Life">Life
										<option value="General">General
										<option value="Health">Health
									</select>
								</div>
								<div class="form-group col-4 floatleft">
									<label for="example-text-input" class="col-form-label"><span>*</span>Required Sum Assured</label>
									<input class="form-control" type="text" name="sumassured" id="sumassured" required>
								</div>
								<div class="form-group col-4 floatleft">
									<label for="example-text-input" class="col-form-label"><span>*</span>Premium</label>
									<select class="form-control" name="premium" id="premium" required>
										<option value="">Select
										<option value="Yearly">Yearly
										<option value="Half Yearly">Half Yearly
										<option value="Monthly">Monthly
									</select>
								</div>
								<div class="cleaner"></div>
								<div class="form-group col-4 floatleft">
									<label for="example-text-input" class="col-form-label"><span>*</span>Smoking Habit</label>
									<select class="form-control" name="smkhabit" id="smkhabit" required>
										<option value="">Select
										<option value="Yes">Yes
										<option value="No">No
									</select>
								</div>
								<div class="cleaner h40"></div>
								<div class="form-group col-4 floatleft">
									<label for="example-text-input" class="col-form-label"><span>*</span>Do you hold any insurance policy?</label>
									<select class="form-control" name="doyou" id="doyou" required>
										<option value="">Select
										<option value="Yes">Yes
										<option value="No">No
									</select>
								</div>
								<div class="form-group col-8 floatleft">
									<label for="example-text-input" class="col-form-label">If Yes</label>
									<input class="form-control" type="text" name="ifyes" id="ifyes">
								</div>
								<div class="cleaner h40"></div>
								<div class="form-group col-4 floatleft">
									<label for="example-text-input" class="col-form-label"><span>*</span>Interested Nominee</label>
									<select class="form-control" name="nominee" id="nominee" required>
										<option value="">Select
										<option value="Spouse">Spouse            
										<option value="Child">Child
										<option value="Parents">Parents
										<option value="Others">Others
									</select>
								</div>
								<div class="form-group col-8 floatleft">
									<label for="example-text-input" class="col-form-label">If Others</label>
									<input class="form-control" type="text" name="ifothers" id="ifothers">
								</div>
								<div class="cleaner h40"></div>
								<div class="form-group col-3 floatleft">
									<label for="example-text-input" class="col-form-label"><span>*</span>Reference Name</label>
									<input class="form-control" type="text" name="refname" id="refname" required>
								</div>
								<div class="form-group col-3 floatleft">
									<label for="example-text-input" class="col-form-label"><span>*</span>Age</label>
									<input class="form-control" type="text" name="age" id="age" required>
								</div>
								<div class="form-group col-3 floatleft">
									<label for="example-text-input" class="col-form-label"><span>*</span>Relation</label>
									<input class="form-control" type="text" name="relation" id="relation" required>
								</div>
								<div class="form-group col-3 floatleft">
									<label for="example-text-input" class="col-form-label"><span>*</span>Reference Contact No.</label>
									<input class="form-control" type="text" name="refcontact" id="refcontact" required>
								</div>
								<div class="cleaner"></div>
								<button type="submit" class="btn btn-primary mt-4 pr-4 pl-4">Submit</button>
							</form>	
						</div>
					</div>
				</div>
			</div>
			
		</div>
	</div>
	
	<?php include("includes/footer.php"); ?>
</div>


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