Wednesday, November 15, 2017

form validation on submit button

<html lang="en">
<head>
  <title>Jagran Form</title>
 
 
  <link href="https://maxcdn.bootstrapcdn.com/bootstrap/3.3.7/css/bootstrap.min.css" rel="stylesheet"></link>
  <script src="https://ajax.googleapis.com/ajax/libs/jquery/3.2.1/jquery.min.js"></script>
  <script src="https://maxcdn.bootstrapcdn.com/bootstrap/3.3.7/js/bootstrap.min.js"></script>
  <script>
   function ValidateMob(inputText,adhar_no) 
{
    var inputText = inputText.value;
    var adhar_no = adhar_no.value;
   //alert(inputText);
   //alert(adhar_no);
//var mailformat = /^\w+([\.-]?\w+)*@\w+([\.-]?\w+)*(\.\w{2,3})+$/; 
if(isNaN(parseInt(inputText))) 
{ 
document.form1.mobile_no.focus(); 
alert("You have entered an Wrong Mobile Number!"); 
return false; 
} 
else if(!(inputText.length == 10))
{ 
alert("You have entered an Wrong Mobile Number!"); 
document.form1.mobile_no.focus();
//alert("length");
return false; 
} 

else if(isNaN(parseInt(adhar_no))) 
{ 
document.form1.adhar_no.focus(); 
alert("You have entered an Wrong Aadhar Number!"); 
return false; 
} 
else if(!(adhar_no.length == 12))
{ 
alert("You have entered an Wrong Aadhar Number!"); 
document.form1.adhar_no.focus();
//alert("length");
return false; 
} 
else {
   return true;
}
}

</script>
</head>
<body>

    <div class="row" style="background-color: #e8ecf2; padding: 10px 10px 10px 10px;">
    <div class="col-sm-1">
     
    </div>
<div class="col-sm-4">
      <img height="57px" src="image/jamajamoffer.png" style="align: left;" width="100px" />
      <h2 style="border-left: 1px solid #000; display: inline-block; font-size: 24px; font-weight: normal; margin: 22px 0 0 10px; padding: 7px 20px 0; vertical-align: bottom;">
 Insurance Data Details </h2>
</div>
<div class="col-sm-2">
       <a href="https://www.blogger.com/logout.php" style="border-left: 1px solid #000; display: inline-block; font-size: 18px; font-weight: normal; margin: 22px 0 0 10px; padding: 7px 20px 0; vertical-align: bottom;">LOGOUT</a>
    </div>
</div>
<div class="container">
 
  <div class="row">
    <div class="col-sm-3">
     
    </div>
<div class="col-sm-6" style="border-left: 1px solid #cedbef; padding-bottom: 20px; padding-top: 20px;">
         
         
            <div class="alert alert-success">
  <strong>Success!</strong> Data successful saved.
</div>
<div class="alert alert-danger">
                <strong>Error!</strong> Duplicate Data.
            </div>
<form action="saveindb.php" method="POST" name="form1" onsubmit="return ValidateMob(document.form1.mobile_no,document.form1.adhar_no) ">
  <div class="form-group">
    <label for="email">सब्सक्राइबर का नाम -</label>
    <input class="form-control" name="sub_name" required="required" type="text" />
  </div>
<div class="form-group">
    <label for="email">सब्सक्राइबर का पता -</label>
    <input class="form-control" name="sub_address" required="required" type="text" />
  </div>
<div class="form-group">
    <label for="email">शहर का नाम - </label>
    <input class="form-control" name="city" required="required" type="text" />
  </div>
<div class="form-group">
    <label for="email">जिले का नाम - </label>
    <input class="form-control" name="district" required="required" type="text" />
  </div>
<div class="form-group">
    <label for="email">जन्म तिथि -</label>
    <input class="form-control" name="dob" required="required" type="date" />
  </div>
<div class="form-group">
    <label for="email">व्यवसाय / कारोबार - </label>
    <input class="form-control" name="business" required="required" type="text" />
  </div>
<div class="form-group">
    <label for="email">नॉमिनी का नाम -</label>
    <input class="form-control" name="nomini_name" required="required" type="text" />
  </div>
<div class="form-group">
        <label for="email">आधार क्रमांक संख्या - </label>
        <input class="form-control" name="adhar_no" required="required" type="text" />
    </div>
<div class="form-group">
        <label for="email">मोबाइल नंबर -  </label>
        <input class="form-control" mobile="" name="mobile_no" type="text" value="&lt;?php echo $_SESSION[" />" readonly&gt;
        <input divn="" name="divn" type="hidden" value="&lt;?php echo $_SESSION[" />" &gt;
    </div>
<div class="checkbox">
         <label><input required="required" type="checkbox" value="" />I declare that the above answers are true to the best of my knowledge and belief,
  that I have desclosed all particulars affecting assessment of the risk. I agree that this is the basic of the contract between me and this Company.
  </label>
</div>
<input name="submit" type="submit" value="Submit" />
</form>
</div>
<div class="col-sm-3">
   
    </div>
</div>
</div>
<div class="row" style="background-color: #999999; border: 1px solid #99999; padding: 10px 10px 10px 10px;">
    <div class="col-sm-1">
     
    </div>
<div class="col-sm-4">
        <img height="30px" src="image/jagran-logo.png" style="align: left;" width="50px" /> &nbsp; Copyright Jagran Prakashan Limited. All Rights Reserved
    </div>
</div>
</body>
</html>

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