File: //var/www/html/qcr24/app/application/views/admin/odometer/view.php
<!-- ! Main -->
<main class="main users job-role-page" id="">
<div class="container">
<!-- <h2 class="main-title">Job Role</h2> -->
<div class="row mrg15B justify-content-between">
<div class="col-auto">
<h2 class="app-page-title mb-0">View Drivers / Customers</h2>
</div>
<div class="col-auto">
<div class="page-utilities">
<div class="row">
<div class="col-auto">
<a class="btn app-btn-primary" href="driver-management-list.html">
VIEW ALL Driver / Customer
</a>
</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<div class="white-block view_page_input">
<form action="" class="row">
<div class="col-lg-6 col-md-12 ">
<div class="form-group">
<label for="" class="">First Name <span class="asterisk"> *</span></label>
<input type="text" class="form-control" name="" value="First Name" required="required" readonly>
</div>
</div>
<div class="col-lg-6 col-md-12 ">
<div class="form-group">
<label for="" class="">Middle Name <span class="asterisk"> </span></label>
<input type="text" class="form-control" name="" value="Middle Name" required="" readonly >
</div>
</div>
<div class="col-lg-6 col-md-12 ">
<div class="form-group">
<label for="" class="">Last Name <span class="asterisk"> *</span></label>
<input type="text" class="form-control" name="" value="Last Name" required="required" readonly>
</div>
</div>
<div class="col-md-12"><hr>
<h3>Address</h3>
<hr>
</div>
<div class="col-lg-6 col-md-12 ">
<div class="form-group">
<label for="" class="">Unit/Flat No. <span class="asterisk"> *</span></label>
<input type="text" class="form-control" name="" value="Unit/Flat No." required="required" readonly>
</div>
</div>
<div class="col-lg-6 col-md-12 ">
<div class="form-group">
<label for="" class="">Street No. <span class="asterisk"> *</span></label>
<input type="text" class="form-control" name="" value="Street No." required="required" readonly>
</div>
</div>
<div class="col-lg-6 col-md-12 ">
<div class="form-group">
<label for="" class="">Street Name <span class="asterisk"> *</span></label>
<input type="text" class="form-control" name="" value="Street Name" required="required" readonly>
</div>
</div>
<div class="col-lg-6 col-md-12 ">
<div class="form-group">
<label for="" class="">Suburb <span class="asterisk"> *</span></label>
<input type="text" class="form-control" name="" value="Suburb" required="required" readonly>
</div>
</div>
<div class="col-lg-6 col-md-12 ">
<div class="form-group">
<label for="" class="">Post Code <span class="asterisk"> *</span></label>
<input type="text" class="form-control" name="" value="Post Code" required="required" readonly>
</div>
</div>
<div class="col-md-12"><hr></div>
<div class="col-lg-6 col-md-12 ">
<div class="form-group">
<label for="" class="">Email ID <span class="asterisk"> *</span></label>
<input type="text" class="form-control" name="" value="" required="required" readonly>
</div>
</div>
<div class="col-lg-6 col-md-12 ">
<div class="form-group">
<label for="" class="">Mobile No. <span class="asterisk"> *</span></label>
<input type="text" class="form-control" name="" value="Mobile No." required="required" readonly>
</div>
</div>
<div class="col-lg-6 col-md-12 ">
<div class="form-group">
<label for="" class="">Date of Birth <span class="asterisk"> *</span></label>
<input type="text" class="form-control" name="" value="20/03/2022" required="required" id="datepicker" readonly>
</div>
</div>
<div class="col-md-12"><hr></div>
<div class="col-lg-6 col-md-12 ">
<div class="form-group">
<label for="" class="">Driver LIC No. <span class="asterisk"> *</span></label>
<input type="text" class="form-control" name="" value="K654231" required="" readonly>
<img src="assets/img/driver-lic.jpg" alt="" width="100px" class="mrg15T">
</div>
</div>
<div class="col-md-12"><hr></div>
<div class="col-lg-6 col-md-12 ">
<div class="form-group">
<label for="" class="">Driver Expire <span class="asterisk"> *</span></label>
<input type="text" class="form-control" name="" value="25/09/2022" required="" id="datepicker1" readonly>
<img src="assets/img/driver-lic.jpg" alt="" width="100px" class="mrg15T">
</div>
</div>
<div class="col-md-12"><hr></div>
<div class="col-lg-12 col-md-12">
<div class="form-group">
<label for="" class="mrg20R">Australian Licence </label>
<div class=" form-check-inline ">
<span>Yes</span>
</div>
</div>
</div>
<div class="col-md-12">
<div class="row">
<div class="col-lg-6 col-md-12 ">
<div class="form-group">
<label for="" class="">Passport No. <span class="asterisk"> *</span></label>
<input type="text" class="form-control" name="" value="H986M2200" required="" readonly><img src="assets/img/passport.jpg" alt="" width="100px" class="mrg15T">
</div>
</div>
<div class="col-md-12">
<hr>
</div>
<div class="col-lg-6 col-md-12 ">
<div class="form-group">
<label for="" class="">Passport Expire <span class="asterisk"> *</span> <small>(Upload passport address page)</small></label>
<input type="text" class="form-control" name="" value="20/06/2023" required="" readonly>
<img src="assets/img/passport.jpg" alt="" width="100px" class="mrg15T mrg10R">
</div>
</div>
<div class="col-lg-6 col-md-12 ">
<div class="form-group">
<label for="" class="">Utility Bill <span class="asterisk"> *</span> <small>(Upload eg mobile , electricity , gas)</small></label>
<input type="text" class="form-control" name="" value="20/06/2023" required="" readonly>
<img src="assets/img/passport.jpg" alt="" width="100px" class="mrg15T">
</div>
</div>
</div>
</div>
<div class="col-md-12">
<hr>
<h3>Bank Account Details</h3>
<hr>
</div>
<div class="col-lg-6 col-md-12 ">
<div class="form-group">
<label for="" class="">Account Name <span class="asterisk"> *</span></label>
<input type="text" class="form-control" name="" value="Account Name" required="required" readonly>
</div>
</div>
<div class="col-lg-6 col-md-12 ">
<div class="form-group">
<label for="" class="">BSB <span class="asterisk"> *</span></label>
<input type="text" class="form-control" name="" value="BSB" required="required" placeholder="" readonly>
</div>
</div>
<div class="col-lg-6 col-md-12 ">
<div class="form-group">
<label for="" class="">Account No. <span class="asterisk"> *</span></label>
<input type="text" class="form-control" name="" value="Account No." required="required" placeholder="" readonly>
</div>
</div>
<div class="col-md-12">
<hr>
<h3>Accident History Last 5 Years</h3>
<hr>
</div>
<div class="col-lg-6 col-md-12">
<div class="form-group">
<label for="" class="mrg20R">No of At Fault Accidents</label>
<span class="orm-control">3</span>
</div>
</div>
<div class="col-lg-6 col-md-12">
<div class="form-group">
<label for="" class="mrg20R">No of Not At Fault Accidents</label>
<span class="orm-control">2</span>
</div>
</div>
<div class="col-md-12 ">
<div class="form-group">
<label class="form-checkbox-wrapper">
<input class="form-checkbox" type="checkbox" required="">
<span class="form-checkbox-label">Car to be used in area max of 200 km from melbourne cbd</span>
</label>
</div>
<div class="form-group">
<label class="form-checkbox-wrapper">
<input class="form-checkbox" type="checkbox" required="">
<span class="form-checkbox-label">I will check water and engine oil every day</span>
</label>
</div>
<div class="form-group">
<label class="form-checkbox-wrapper">
<input class="form-checkbox" type="checkbox" required="">
<span class="form-checkbox-label">I will report every accident on the day</span>
</label>
</div>
<div class="form-group">
<label class="form-checkbox-wrapper">
<input class="form-checkbox" type="checkbox" required="">
<span class="form-checkbox-label">I will send service sticker and speedo meter photo every week</span>
</label>
</div>
<div class="form-group">
<label class="form-checkbox-wrapper">
<input class="form-checkbox" type="checkbox" required="">
<span class="form-checkbox-label">I will pay $10 per nomination for any late toll invoices</span>
</label>
</div>
<div class="form-group">
<label class="form-checkbox-wrapper">
<input class="form-checkbox" type="checkbox" required="">
<span class="form-checkbox-label">I will give 2 weeks notice when returing the car / van</span>
</label>
</div>
<div class="form-group">
<label class="form-checkbox-wrapper">
<input class="form-checkbox" type="checkbox" required="">
<span class="form-checkbox-label">I agree to terms and conditions listed on car rental website</span>
</label>
</div>
<div class="form-group">
<label class="form-checkbox-wrapper">
<input class="form-checkbox" type="checkbox" required="">
<span class="form-checkbox-label">All information provided is true and correct</span>
</label>
</div>
<div class="form-group">
<label class="form-checkbox-wrapper">
<input class="form-checkbox" type="checkbox" required="">
<span class="form-checkbox-label">Agree to <a href="terms-and-conditions.html">Terms and Conditions</a></span>
</label>
</div>
</div>
<div class="col-md-12">
<hr>
<h3>Bond Setup</h3>
<hr>
</div>
<div class="col-lg-6">
<div class="form-group">
<label for="" class="">Bond Amount <span class="asterisk"> *</span></label>
<input type="text" class="form-control" name="" value="Bond Amount" required="required" placeholder="" maxlength="15">
</div>
</div>
<div class="col-lg-6">
<div class="form-group">
<label for="" class="">Date <span class="asterisk"> *</span></label>
<input type="text" class="form-control" name="" value="27/09/2022" >
</div>
</div>
<div class="col-lg-6">
<div class="form-group">
<label for="" class="">Payment Method <span class="asterisk"> *</span></label>
<span class="form-control">Cash</span>
</div>
</div>
<div class="col-lg-6">
<div class="form-group">
<label for="" class="">Refarence Number <span class="asterisk"> </span></label>
<input type="text" class="form-control" name="" value="Refarence Number" placeholder="">
</div>
</div>
<div class="col-md-12">
<hr>
<h3>Admin Notes</h3>
<hr>
</div>
<div class="col-md-12">
<div class="form-group">
<label for="" class="">Notes <span class="asterisk"> </span></label>
<span class="form-control">Enter Your Notes</span>
</div>
</div>
<div class="col-md-12"><hr></div>
<div class="col-md-12">
<div class="form-group">
<a href="driver-management-edit.html" class="btn btn-primary mrg15R" href="">Edit</a>
<a class="btn btn-danger" href="">CANCEL</a>
</div>
</div>
</form>
</div>
</div>
</div>
</div>
</main>