@extends('layouts.app')
@section('title')
All Brands
@endsection
@section('content')

<div class="card card-white">
    <div class="formwizard">
        <div class="form-header d-flex mb-4"> <span class="stepIndicator finish">Registration</span> <span class="stepIndicator active">Application</span> <span class="stepIndicator">Payment</span> </div>
    </div>
    <div class="card-header py-3 d-flex flex-row align-items-center justify-content-between">
        <h6 class="m-0 font-weight-normal text-head-color"> Personal Details</h6>
    </div>
    <div class="card-body"> 
        <form id="personalDetailsForm" method="post">            
            <div class="row">
                <div class="col-sm-6">
                    <label class="">Aadhar No <span class="astric-sign">*</span>:</label>
                    <div class="form-group">
                        <input type="text" class="form-control form-control-sm" placeholder="Enter Aadhar No" name="AadharNumber" id="AadharNumber">
                    </div>
                </div>
                <div class="col-sm-6">
                    <label class="">Father Name <span class="astric-sign">*</span>:</label>
                    <div class="form-group">
                        <input type="text" class="form-control form-control-sm" placeholder="Enter Father Name" name="FatherNumber" id="FatherNumber">
                    </div>
                </div>
                <div class="col-sm-6">
                    <label class="">Mother Name <span class="astric-sign">*</span>:</label>
                    <div class="form-group">
                        <input type="text" class="form-control form-control-sm" placeholder="Enter Mother Name" name="MotherName" id="MotherName">
                    </div>
                </div>
                <div class="col-sm-6">
                    <label class="">Gender <span class="astric-sign">*</span>:</label>
                    <div class="form-group">
                        <select class="form-select form-select-sm" aria-label=".form-select-sm example" name="Gender" id="Gender">
                            <option selected="">---Select---</option>
                            <option value="1">Male</option>
                            <option value="2">Female</option>
                            <option value="3">Third Gender</option>
                        </select>
                    </div>
                </div>
                <div class="col-sm-6">
                    <label class="">Marital Status <span class="astric-sign">*</span>:</label>
                    <div class="form-group">
                        <select class="form-select form-select-sm" aria-label=".form-select-sm example" name="MaritalStatus" id="MaritalStatus">
                            <option selected="">---Select---</option>
                            <option value="1">Married</option>
                            <option value="2">UnMarried </option>
                        </select>
                    </div>
                </div>
                <div class="col-sm-6">
                    <label class="">Religion <span class="astric-sign">*</span>:</label>
                    <div class="form-group">
                        <select class="form-select form-select-sm" aria-label=".form-select-sm example" name="Religion" id="Religion">
                            <option selected="">---Select---</option>
                            <option value="1">HINDU</option>
                            <option value="2">MUSLIM</option>
                            <option value="3">SIKH</option>
                            <option value="4">CHRISTIAN</option>
                            <option value="5">BUDDHIST</option>
                            <option value="6">PARSI</option>
                            <option value="7">JAIN</option>
                        </select>
                    </div>
                </div>
                <div class="col-sm-6">
                    <label class="">1<sup>st</sup> Choice For Exam City <span class="astric-sign">*</span>:</label>
                    <div class="form-group">
                        <select class="form-select form-select-sm" aria-label=".form-select-sm example" id="FstChoiceForExamState">
                            <option value="">--Select State--</option>
                            <option value="4">ASSAM</option>
                            <option value="19">Manipur</option>
                            <option value="20">Meghalaya</option>
                            <option value="21">Mizoram</option>
                            <option value="1023">ARUNACHAL PRADESH</option>
                            <option value="3032">Nagaland</option>
                            <option value="3037">Sikkim</option>
                            <option value="3040">Tripura</option>
                            <option value="3041">West Bengal</option>
                        </select>
                    </div>
                </div>
                <div class="col-sm-6">
                    <label class="mt-3"></label>
                    <div class="form-group mt-1">
                        <select class="form-select form-select-sm" aria-label=".form-select-sm example" id="FstChoiceForExamCity">
                            <option value="">--Select City--</option>
                            <option value="30">Guwahati</option>
                            <option value="31">Jorhat</option>
                            <option value="32">Silchar(Assam)</option>
                            <option value="33">Tezpur</option>
                        </select>
                    </div>
                </div>
                <div class="col-sm-6">
                    <label class="">2<sup>nd</sup> Choice For Exam City <span class="astric-sign">*</span>:</label>
                    <div class="form-group">
                        <select class="form-select form-select-sm" aria-label=".form-select-sm example" id="sndChoiceForExamState">
                            <option value="">--Select State--</option>
                            <option value="4">ASSAM</option>
                            <option value="19">Manipur</option>
                            <option value="20">Meghalaya</option>
                            <option value="21">Mizoram</option>
                            <option value="1023">ARUNACHAL PRADESH</option>
                            <option value="3032">Nagaland</option>
                            <option value="3037">Sikkim</option>
                            <option value="3040">Tripura</option>
                            <option value="3041">West Bengal</option>
                        </select>
                    </div>
                </div>
                <div class="col-sm-6">
                    <label class="mt-3"></label>
                    <div class="form-group mt-1">
                        <select class="form-select form-select-sm" aria-label=".form-select-sm example" id="SndChoiceForExamCity">
                            <option value="">--Select City--</option>
                            <option value="30">Guwahati</option>
                            <option value="31">Jorhat</option>
                            <option value="32">Silchar(Assam)</option>
                            <option value="33">Tezpur</option>
                        </select>
                    </div>
                </div>
                 <div class="col-sm-6">
                    <label class="">3<sup>rd</sup> Choice For Exam City <span class="astric-sign">*</span>:</label>
                    <div class="form-group">
                        <select class="form-select form-select-sm" aria-label=".form-select-sm example" id="ThrdChoiceForExamState">
                            <option value="">--Select State--</option>
                            <option value="4">ASSAM</option>
                            <option value="19">Manipur</option>
                            <option value="20">Meghalaya</option>
                            <option value="21">Mizoram</option>
                            <option value="1023">ARUNACHAL PRADESH</option>
                            <option value="3032">Nagaland</option>
                            <option value="3037">Sikkim</option>
                            <option value="3040">Tripura</option>
                            <option value="3041">West Bengal</option>
                        </select>
                    </div>
                </div>
                <div class="col-sm-6">
                    <label class="mt-3"></label>
                    <div class="form-group mt-1">
                        <select class="form-select form-select-sm" aria-label=".form-select-sm example" id="ThrdChoiceForExamCity">
                            <option value="">--Select City--</option>
                            <option value="30">Guwahati</option>
                            <option value="31">Jorhat</option>
                            <option value="32">Silchar(Assam)</option>
                            <option value="33">Tezpur</option>
                        </select>
                    </div>
                </div>
            </div>
            <br>
            <div class="row mb-3 justify-content-center">
                <div class="col-sm-3 text-center">
                    <button  type="submit" id="personalDetailsSubmitBtn" class="btn btn-warning btn-sm">Next <i class="ri-arrow-right-circle-line float-end ms-1"></i></button>
                </div>
            </div>
        </form>
    </div>
</div>

</div>

@endsection

@push('scripts')


@endpush