1203 lines
76 KiB
HTML
1203 lines
76 KiB
HTML
<!DOCTYPE html>
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<html lang="en">
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<head>
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<meta charset="UTF-8" />
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<meta http-equiv="X-UA-Compatible" content="IE=edge" />
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<meta name="viewport" content="width=device-width, initial-scale=1.0" />
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<title>Order Process</title>
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<link rel="stylesheet" href="css/bootstrap.min.css" />
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<link rel="stylesheet" href="css/fontawesome-all.min.css" />
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<link rel="stylesheet" href="css/style.css" />
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<script src="https://code.jquery.com/jquery-2.2.4.min.js"
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integrity="sha256-BbhdlvQf/xTY9gja0Dq3HiwQF8LaCRTXxZKRutelT44=" crossorigin="anonymous"></script>
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<script type="text/javascript"
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src="http://ajax.aspnetcdn.com/ajax/jquery.validate/1.13.1/jquery.validate.js"></script>
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<script type="text/javascript"
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src="http://ajax.aspnetcdn.com/ajax/jquery.validate/1.13.1/additional-methods.js"></script>
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</head>
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<body>
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<div class="benifits_wrapper">
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<div class="container">
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<div class="stepper_header d-flex flex-wrap">
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<div class="step d-flex flex-column align-items-center active">
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<img src="imgs/step_1_act.png" alt="1" />
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<div class="step_content">
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انشاء حساب
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</div>
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</div>
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<div class="step d-flex flex-column align-items-center active">
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<img src="imgs/step_2_act.png" alt="2" />
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<div class="step_content">
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تأكيد الحساب
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</div>
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</div>
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<div class="step d-flex flex-column align-items-center active">
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<img src="imgs/step_3_act.png" alt="3" />
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<div class="step_content">
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حدد شاراتك
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</div>
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</div>
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<div class="step d-flex flex-column align-items-center active">
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<img src="imgs/step_4_act.png" alt="4" />
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<div class="step_content">
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استكمال البيانات
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</div>
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</div>
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<div class="step d-flex flex-column align-items-center">
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<img src="imgs/step_5_inact.png" alt="5" />
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<div class="step_content">
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تم بنجاح
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</div>
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</div>
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</div>
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<div class="user_reg_form">
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<div class="code_wrapper">
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<form class="form-horizontal user_data_form" action="" method="POST" id="myform">
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<!-- first step data -->
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<fieldset id="first_step" class="step_field active">
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<legend>
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<div class="step_number">
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<span class="active"> 1 </span>
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من
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<span class="total"> 10 </span>
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</div>
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من فضلك قم بتعبئة (بيانات العائل الرئيسي )
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</legend>
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<div class="row">
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<div class="form-group col-lg-6">
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<label for="work" class="control-label">العمل</label>
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<div class="">
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<input type="text" class="form-control" id="work" name="work"
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placeholder="كما موضح في بطاقة الهوية" />
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="workPlace" class="control-label">مكان العمل </label>
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<div class="">
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<input type="text" class="form-control" id="workPlace" name="workPlace" />
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="indetity" class=" control-label">أرفق الهوية </label>
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<div class="attach_wrapper">
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<input type="file" class="form-control" id="indetity" name="indetity" />
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<input type="text" class="form-control" />
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<img src="imgs/attatch.png" alt="attach" />
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="identity_date" class=" control-label"> تاريخ انتهاء الهوية </label>
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<div class="">
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<input type="date" class="form-control" id="identity_date" name="identity_date">
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="myCity" class=" control-label"> الحالة الاجتماعية </label>
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<select id="myCity" class="custom-select">
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<option selected>اعزب</option>
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<option value="1">متزوج </option>
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</select>
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</div>
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<div class="form-group col-lg-6">
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<label for="bank" class=" control-label"> اسم البنك </label>
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<div class="">
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<input type="text" class="form-control" id="bank" name="bank">
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="" class=" control-label"> ارفاق شهادة لحساب البنك </label>
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<div class="attach_wrapper">
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<input type="file" class="form-control" id="" name="">
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<input type="text" />
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<img src="imgs/attatch.png" alt="attach">
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="" class=" control-label"> رقم ايبان البنك </label>
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<div class="">
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<input type="text" class="form-control" id="" name="">
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="" class=" control-label"> اسم المستفيد في البنك</label>
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<div class="">
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<input type="text" class="form-control" id="" name="">
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="" class=" control-label"> ترميز رقم الملف </label>
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<div class="">
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<input type="text" class="form-control" id="" name="">
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="" class=" control-label"> عدد التابعين داخل المنزل </label>
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<div class="">
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<input type="text" class="form-control" id="" name="">
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="" class=" control-label"> عدد التابعين خارج المنزل </label>
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<div class="">
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<input type="text" class="form-control" id="" name="">
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="" class=" control-label"> صك الاعانة </label>
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<div class="">
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<input type="text" class="form-control" id="" name="">
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="" class=" control-label">ارفاق صك الاعانة </label>
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<div class="attach_wrapper">
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<input type="file" class="form-control" id="" name="">
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<input type="text" />
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<img src="imgs/attatch.png" alt="attach">
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</div>
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</div>
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</div>
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<p><a class="btn btn-primary next">التالي</a></p>
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</fieldset>
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<!-- Home information -->
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<fieldset id="home_information" class="step_field ">
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<legend>
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<div class="step_number">
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<span class="active"> 2 </span>
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من
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<span class="total"> 10 </span>
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</div>
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من فضلك قم بتعبئة (بيانات السكن )
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</legend>
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<div class="row">
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<div class="form-group col-lg-6">
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<label for="work" class="control-label">المدينة</label>
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<div class="">
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<select id="city" class="custom-select">
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<option selected="selected">1</option>
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<option value="1">2 </option>
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</select>
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="place" class="control-label"> الحي </label>
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<div class="">
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<select id="place" class="custom-select">
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<option selected="selected">1</option>
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<option value="1">2 </option>
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</select>
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="street" class=" control-label"> الشارع</label>
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<div class="">
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<input type="text" class="form-control" id="street" name="bank">
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="status" class=" control-label"> حالة السكن </label>
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<div class="">
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<select id="status" name="status" class="custom-select">
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<option selected="selected">1</option>
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<option value="1">2 </option>
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</select>
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="floor" class=" control-label"> الدور </label>
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<div class="">
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<select id="floor" name="status" class="custom-select">
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<option selected="selected">1</option>
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<option value="1">2 </option>
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</select>
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="flat_number" class=" control-label"> رقم الوحدة السكنية </label>
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<select id="flat_number" class="custom-select">
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<option selected>اعزب</option>
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<option value="1">متزوج </option>
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</select>
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</div>
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<div class="form-group col-lg-6">
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<label for="bank" class=" control-label"> الموقع على الخريطة </label>
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<div class="">
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<input type="text" class="form-control" id="bank" name="bank">
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="" class=" control-label"> ارفاق صورة السكن </label>
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<div class="attach_wrapper">
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<input type="file" class="form-control" id="" name="">
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<input type="text" />
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<img src="imgs/attatch.png" alt="attach">
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="home_type" class=" control-label"> نوع السكن </label>
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<div class="">
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<select id="home_type" class="custom-select">
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<option selected>1</option>
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<option value="1">2 </option>
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</select>
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="owner_type" class=" control-label"> نوع الملكية </label>
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<div class="">
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<select id="owner_type" class="custom-select">
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<option selected>1</option>
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<option value="1">2 </option>
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</select>
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="" class=" control-label"> رقم حساب فاتورة المياه </label>
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<div class="">
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<input type="text" class="form-control" id="" name="">
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="water_bill" class=" control-label">ارفاق فاتورة المياه </label>
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<div class="attach_wrapper">
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<input type="file" class="form-control" id="" name="">
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<input type="text" />
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<img src="imgs/attatch.png" alt="attach">
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="" class=" control-label"> رقم حساب فاتورة الكهرباء </label>
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<div class="">
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<input type="text" class="form-control" id="" name="">
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="elect_bill" class=" control-label">ارفاق فاتورة الكهرباء </label>
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<div class="attach_wrapper">
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<input type="file" class="form-control" id="" name="">
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<input type="text" />
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<img src="imgs/attatch.png" alt="attach">
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="owner_type" class=" control-label"> ملائمة عدد الغرف لعدد الأفراد
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</label>
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<div class="">
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<select id="owner_type" class="custom-select">
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<option selected>1</option>
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<option value="1">2 </option>
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</select>
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="" class=" control-label"> مساحة الغرفة </label>
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<div class="">
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<input type="text" class="form-control" id="" name="">
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="owner_type" class=" control-label"> حالة الغرفة </label>
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<div class="">
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<select id="owner_type" class="custom-select">
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<option selected>1</option>
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<option value="1">2 </option>
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</select>
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="owner_type" class=" control-label"> الموجودات </label>
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<div class="">
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<select id="owner_type" class="custom-select">
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<option selected>1</option>
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<option value="1">2 </option>
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</select>
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</div>
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</div>
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</div>
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<p><a class="btn btn-primary next">التالي</a></p>
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</fieldset>
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<!-- the benefits information -->
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<fieldset id="step_3" class="step_field">
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<legend>
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<div class="step_number">
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<span class="active"> 3 </span>
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من
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<span class="total"> 10 </span>
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</div>
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من فضلك قم بتعبئة ( بيانات التابع للمستفيد)
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</legend>
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<div class="row">
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<div class="form-group col-lg-6">
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<label for="work" class="control-label">اسم التابع</label>
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<div class="">
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<input type="text" name="" id="">
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="place" class="control-label"> نوع التابع </label>
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<div class="">
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<select id="place" class="custom-select">
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<option selected="selected">1</option>
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<option value="1">2 </option>
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</select>
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="name"> الجنس </label>
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<div class="gender d-flex">
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<div class="mail d-flex align-items-center">
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<input class="d-inline-block w-auto" type="radio" checked name="gender"
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value="mail" id="mail">
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<label class="mb-0"> ذكر </label>
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</div>
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<div class="femail d-flex align-items-center">
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<input class="d-inline-block w-auto" type="radio" name="gender"
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value="femail" id="femail">
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<label class="mb-0"> انثى </label>
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</div>
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="status" class=" control-label"> تاريخ الميلاد </label>
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<div class="">
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<input type="date" name="" id="">
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="floor" class=" control-label"> الراتب </label>
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<div class="">
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<select id="floor" name="status" class="custom-select">
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<option selected="selected">1</option>
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<option value="1">2 </option>
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</select>
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="flat_number" class=" control-label"> نوع الراتب</label>
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<select id="flat_number" class="custom-select">
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<option selected>اعزب</option>
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<option value="1">متزوج </option>
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</select>
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</div>
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<div class="form-group col-lg-6">
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<label for="bank" class=" control-label"> قيمة الراتب </label>
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<div class="">
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<input type="text" class="form-control" id="bank" name="bank">
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="" class=" control-label"> ارفاق ثابت الراتب </label>
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<div class="attach_wrapper">
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<input type="file" class="form-control" id="" name="">
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<input type="text" />
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<img src="imgs/attatch.png" alt="attach">
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="name"> هل يسكن مع العائلة ؟ </label>
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<div class="gender d-flex">
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<div class="mail d-flex align-items-center">
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<input class="d-inline-block w-auto" type="radio" checked name="gender"
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value="mail" id="mail">
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<label class="mb-0"> نعم </label>
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</div>
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<div class="femail d-flex align-items-center">
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<input class="d-inline-block w-auto" type="radio" name="gender"
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value="femail" id="femail">
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<label class="mb-0"> لا </label>
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</div>
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="name"> هل هو مستفيد من جمعيات اخرى ؟ </label>
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<div class="gender d-flex">
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<div class="mail d-flex align-items-center">
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<input class="d-inline-block w-auto" type="radio" checked name="gender"
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value="mail" id="mail">
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<label class="mb-0"> نعم </label>
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</div>
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<div class="femail d-flex align-items-center">
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<input class="d-inline-block w-auto" type="radio" name="gender"
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value="femail" id="femail">
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<label class="mb-0"> لا </label>
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</div>
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="home_type" class=" control-label"> اسم الجمعية </label>
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<div class="">
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<input type="text" name="" id="">
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</div>
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</div>
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<div class="form-group col-lg-6">
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<label for="owner_type" class=" control-label"> نوع الدعم </label>
|
|
<div class="">
|
|
<select id="owner_type" class="custom-select">
|
|
<option selected>1</option>
|
|
<option value="1">2 </option>
|
|
</select>
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="" class=" control-label"> قيمة الدعم </label>
|
|
<div class="">
|
|
<input type="text" class="form-control" id="" name="">
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="water_bill" class=" control-label">شرح الدعم </label>
|
|
<div class="">
|
|
<input type="text" class="form-control" id="" name="water_bill">
|
|
</div>
|
|
</div>
|
|
</div>
|
|
<p><a class="btn btn-primary next">التالي</a></p>
|
|
</fieldset>
|
|
<!-- the funds information -->
|
|
<fieldset id="step_4" class="step_field ">
|
|
<legend>
|
|
<div class="step_number">
|
|
<span class="active"> 4 </span>
|
|
من
|
|
<span class="total"> 10 </span>
|
|
|
|
</div>
|
|
من فضلك قم بتعبئة ( بيانات المصروفات )
|
|
</legend>
|
|
<div class="row">
|
|
<div class="form-group col-lg-6">
|
|
<label for="work" class="control-label"> نوع المصروف </label>
|
|
<div class="d-flex add_wrapper ">
|
|
<select style="margin-inline-end:8px" id="place" class="custom-select">
|
|
<option selected="selected">1</option>
|
|
<option value="1">2 </option>
|
|
</select>
|
|
<button type="button" class="btn btn-primary" data-toggle="modal"
|
|
data-target="#exampleModal">
|
|
<img src="imgs/Icon awesome-plus.png" alt="">
|
|
</button>
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="place" class="control-label"> الاعتماد </label>
|
|
<div class="">
|
|
<select id="place" class="custom-select">
|
|
<option selected="selected">1</option>
|
|
<option value="1">2 </option>
|
|
</select>
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="name"> نوع الرسوم </label>
|
|
<div class="">
|
|
<input type="text" name="" id="">
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="status" class=" control-label"> قيمة الرسوم </label>
|
|
<div class="">
|
|
<input type="text" name="" id="">
|
|
</div>
|
|
</div>
|
|
<legend>
|
|
|
|
من فضلك قم بتعبئة ( بيانات المصروفات العلاجية)
|
|
</legend>
|
|
<div class="form-group col-lg-6">
|
|
<label for="work" class="control-label"> نوع المصروف </label>
|
|
<div class="d-flex add_wrapper ">
|
|
<select style="margin-inline-end:8px" id="place" class="custom-select">
|
|
<option selected="selected">1</option>
|
|
<option value="1">2 </option>
|
|
</select>
|
|
<button type="button" class="btn btn-primary" data-toggle="modal"
|
|
data-target="#exampleModal">
|
|
<img src="imgs/Icon awesome-plus.png" alt="">
|
|
</button>
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="place" class="control-label"> الاعتماد </label>
|
|
<div class="">
|
|
<select id="place" class="custom-select">
|
|
<option selected="selected">1</option>
|
|
<option value="1">2 </option>
|
|
</select>
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-12">
|
|
<label for="" class="control-label"> نوع الدواء </label>
|
|
<input type="text" name="" id="">
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="" class="control-label"> المرض </label>
|
|
<input type="text" name="" id="">
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="" class="control-label"> قيمة الرسوم </label>
|
|
<input type="text" name="" id="">
|
|
</div>
|
|
|
|
</div>
|
|
<p><a class="btn btn-primary next">التالي</a></p>
|
|
</fieldset>
|
|
|
|
<!-- transport funds -->
|
|
<fieldset id="step_5" class="step_field ">
|
|
<legend>
|
|
<div class="step_number">
|
|
<span class="active"> 5 </span>
|
|
من
|
|
<span class="total"> 10 </span>
|
|
|
|
</div>
|
|
من فضلك قم بتعبئة ( بيانات مصروفات المواصلات )
|
|
</legend>
|
|
<div class="row">
|
|
<div class="form-group col-lg-6">
|
|
<label for="work" class="control-label"> نوع المصروف </label>
|
|
<div class="d-flex add_wrapper ">
|
|
<select style="margin-inline-end:8px" id="place" class="custom-select">
|
|
<option selected="selected">1</option>
|
|
<option value="1">2 </option>
|
|
</select>
|
|
<button type="button" class="btn btn-primary" data-toggle="modal"
|
|
data-target="#exampleModal">
|
|
<img src="imgs/Icon awesome-plus.png" alt="">
|
|
</button>
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="place" class="control-label"> الاعتماد </label>
|
|
<div class="">
|
|
<select id="place" class="custom-select">
|
|
<option selected="selected">1</option>
|
|
<option value="1">2 </option>
|
|
</select>
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="name">نوع التنقلات</label>
|
|
<div class="">
|
|
<input type="text" name="" id="">
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="status" class=" control-label"> قيمة المصروف </label>
|
|
<div class="">
|
|
<input type="text" name="" id="">
|
|
</div>
|
|
</div>
|
|
<legend>
|
|
|
|
من فضلك قم بتعبئة (بيانات مصروفات الديون)
|
|
</legend>
|
|
<div class="form-group col-lg-6">
|
|
<label for="work" class="control-label"> نوع المصروف </label>
|
|
<div class="d-flex add_wrapper ">
|
|
<select style="margin-inline-end:8px" id="place" class="custom-select">
|
|
<option selected="selected">1</option>
|
|
<option value="1">2 </option>
|
|
</select>
|
|
<button type="button" class="btn btn-primary" data-toggle="modal"
|
|
data-target="#exampleModal">
|
|
<img src="imgs/Icon awesome-plus.png" alt="">
|
|
</button>
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="place" class="control-label"> الاعتماد </label>
|
|
<div class="">
|
|
<select id="place" class="custom-select">
|
|
<option selected="selected">1</option>
|
|
<option value="1">2 </option>
|
|
</select>
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="" class="control-label"> سبب الدين </label>
|
|
<input type="text" name="" id="">
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="" class="control-label"> قيمة الدين </label>
|
|
<input type="text" name="" id="">
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="" class="control-label"> نوع الدين </label>
|
|
<div class="">
|
|
<select id="place" class="custom-select">
|
|
<option selected="selected">1</option>
|
|
<option value="1">2 </option>
|
|
</select>
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="" class="control-label"> الوقت </label>
|
|
<input type="text" name="" id="">
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="" class="control-label"> التقسيط </label>
|
|
<input type="text" name="" id="">
|
|
</div>
|
|
|
|
<div class="form-group col-lg-6">
|
|
<label for="indetity" class=" control-label">إرفاق مستند اثبات الدين</label>
|
|
<div class="attach_wrapper">
|
|
<input type="file" class="form-control" id="indetity" name="indetity" />
|
|
<input type="text" class="form-control" />
|
|
<img src="imgs/attatch.png" alt="attach" />
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-12">
|
|
<label for="" class="control-label"> شرح الدين </label>
|
|
<input type="text" name="" id="">
|
|
</div>
|
|
</div>
|
|
<p><a class="btn btn-primary next">التالي</a></p>
|
|
</fieldset>
|
|
<!-- funds -->
|
|
<fieldset id="step_6" class="step_field">
|
|
<legend>
|
|
<div class="step_number">
|
|
<span class="active"> 6 </span>
|
|
من
|
|
<span class="total"> 10 </span>
|
|
|
|
</div>
|
|
من فضلك قم بتعبئة (بيانات مصروفات الجوائح )
|
|
</legend>
|
|
<div class="row">
|
|
<div class="form-group col-lg-6">
|
|
<label for="work" class="control-label"> نوع المصروف </label>
|
|
<div class="d-flex add_wrapper ">
|
|
<select style="margin-inline-end:8px" id="place" class="custom-select">
|
|
<option selected="selected">1</option>
|
|
<option value="1">2 </option>
|
|
</select>
|
|
<button type="button" class="btn btn-primary" data-toggle="modal"
|
|
data-target="#exampleModal">
|
|
<img src="imgs/Icon awesome-plus.png" alt="">
|
|
</button>
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="place" class="control-label"> الاعتماد </label>
|
|
<div class="">
|
|
<select id="place" class="custom-select">
|
|
<option selected="selected">1</option>
|
|
<option value="1">2 </option>
|
|
</select>
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="name">نوع الجائحة </label>
|
|
<div class="">
|
|
<input type="text" name="" id="">
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="status" class=" control-label"> القيمة </label>
|
|
<div class="">
|
|
<input type="text" name="" id="">
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="work" class="control-label">شرح الجائحة </label>
|
|
<div class="">
|
|
<input type="text" name="" id="">
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="indetity" class=" control-label"> إرفاق مستند اثبات الجائحة</label>
|
|
<div class="attach_wrapper">
|
|
<input type="file" class="form-control" id="indetity" name="indetity" />
|
|
<input type="text" class="form-control" />
|
|
<img src="imgs/attatch.png" alt="attach" />
|
|
</div>
|
|
</div>
|
|
<legend>
|
|
من فضلك قم بتعبئة (بيانات مصروفات المعيشية )
|
|
</legend>
|
|
<div class="form-group col-lg-6">
|
|
<label for="work" class="control-label"> نوع المصروف </label>
|
|
<div class="d-flex add_wrapper ">
|
|
<select style="margin-inline-end:8px" id="place" class="custom-select">
|
|
<option selected="selected">1</option>
|
|
<option value="1">2 </option>
|
|
</select>
|
|
<button type="button" class="btn btn-primary" data-toggle="modal"
|
|
data-target="#exampleModal">
|
|
<img src="imgs/Icon awesome-plus.png" alt="">
|
|
</button>
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="place" class="control-label"> الاعتماد </label>
|
|
<div class="">
|
|
<select id="place" class="custom-select">
|
|
<option selected="selected">1</option>
|
|
<option value="1">2 </option>
|
|
</select>
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="name"> هل له طعام او لباس خاص ؟</label>
|
|
<div class="gender d-flex">
|
|
<div class="mail d-flex align-items-center">
|
|
<input class="d-inline-block w-auto" type="radio" checked name="gender"
|
|
value="mail" id="mail">
|
|
<label class="mb-0"> نعم </label>
|
|
</div>
|
|
<div class="femail d-flex align-items-center">
|
|
<input class="d-inline-block w-auto" type="radio" name="gender"
|
|
value="femail" id="femail">
|
|
<label class="mb-0"> لا </label>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="place" class="control-label"> نوع المصروف </label>
|
|
<div class="">
|
|
<input type="text" name="" id="">
|
|
</div>
|
|
</div>
|
|
</div>
|
|
<p><a class="btn btn-primary next">التالي</a></p>
|
|
</fieldset>
|
|
<!-- العائل الرئيسي -->
|
|
<fieldset id="step_7" class="step_field ">
|
|
<legend>
|
|
<div class="step_number">
|
|
<span class="active"> 7</span>
|
|
من
|
|
<span class="total"> 10 </span>
|
|
|
|
</div>
|
|
من فضلك قم بتعبئة (بيانات مصروفات الجوائح )
|
|
</legend>
|
|
<div class="row">
|
|
<div class="form-group col-lg-12">
|
|
<label for="name"> هل المستفيد متعلم ؟</label>
|
|
<div class="gender d-flex">
|
|
<div class="mail d-flex align-items-center">
|
|
<input class="d-inline-block w-auto" type="radio" checked name="gender"
|
|
value="mail" id="mail">
|
|
<label class="mb-0"> نعم </label>
|
|
</div>
|
|
<div class="femail d-flex align-items-center">
|
|
<input class="d-inline-block w-auto" type="radio" name="gender"
|
|
value="femail" id="femail">
|
|
<label class="mb-0"> لا </label>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-12">
|
|
<label for="work" class="control-label"> نوع المصروف </label>
|
|
<div class="d-flex add_wrapper ">
|
|
<select style="margin-inline-end:8px" id="place" class="custom-select">
|
|
<option selected="selected">1</option>
|
|
<option value="1">2 </option>
|
|
</select>
|
|
<button type="button" class="btn btn-primary" data-toggle="modal"
|
|
data-target="#exampleModal">
|
|
<img src="imgs/Icon awesome-plus.png" alt="">
|
|
</button>
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="place" class="control-label"> الاعتماد </label>
|
|
<div class="">
|
|
<select id="place" class="custom-select">
|
|
<option selected="selected">غير معتمد </option>
|
|
<option value="1">2 </option>
|
|
</select>
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="place" class="control-label"> مدة تكرار المصروف </label>
|
|
<div class="">
|
|
<select id="place" class="custom-select">
|
|
<option selected="selected">شهري</option>
|
|
<option value="1">2 </option>
|
|
</select>
|
|
</div>
|
|
</div>
|
|
<legend>
|
|
من فضلك قم بتعبئة ( بياناتك بالجهة التعليمية )
|
|
</legend>
|
|
<div class="form-group col-lg-6">
|
|
<label for="place" class="control-label"> المرحلة </label>
|
|
<div class="">
|
|
<select id="place" class="custom-select">
|
|
<option selected="selected">1</option>
|
|
<option value="1">2 </option>
|
|
</select>
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="place" class="control-label"> الصف الدراسي </label>
|
|
<div class="">
|
|
<input type="text" value="2" name="" id="">
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="place" class="control-label"> معلومات الجهة التعليمية </label>
|
|
<div class="">
|
|
<input type="text" value="2" name="" id="">
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="indetity" class=" control-label">تقاريرالجهة التعليمية </label>
|
|
<div class="attach_wrapper">
|
|
<input type="file" class="form-control" id="indetity" name="indetity" />
|
|
<input type="text" class="form-control" />
|
|
<img src="imgs/attatch.png" alt="attach" />
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="work" class="control-label"> التخصص التعليمي </label>
|
|
<div class="d-flex add_wrapper ">
|
|
<select style="margin-inline-end:8px" id="place" class="custom-select">
|
|
<option selected="selected">1</option>
|
|
<option value="1">2 </option>
|
|
</select>
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="indetity" class=" control-label"> إرفاق مستند الدراسة </label>
|
|
<div class="attach_wrapper">
|
|
<input type="file" class="form-control" id="indetity" name="indetity" />
|
|
<input type="text" class="form-control" />
|
|
<img src="imgs/attatch.png" alt="attach" />
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="place" class="control-label"> حالة الدراسة </label>
|
|
<div class="">
|
|
<select id="place" class="custom-select">
|
|
<option selected="selected">1</option>
|
|
<option value="1">2 </option>
|
|
</select>
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="place" class="control-label"> حالة التخرج </label>
|
|
<div class="">
|
|
<input type="text" name="" id="">
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="place" class="control-label"> تاريخ التخرج </label>
|
|
<div class="">
|
|
<input type="text" name="" id="">
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="place" class="control-label"> تاريخ الانقطاع </label>
|
|
<div class="">
|
|
<input type="text" name="" id="">
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="place" class="control-label"> اسباب الانقطاع </label>
|
|
<div class="">
|
|
<input type="text" name="" id="">
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="indetity" class=" control-label"> السجل الأكاديمي </label>
|
|
<div class="attach_wrapper">
|
|
<input type="file" class="form-control" id="indetity" name="indetity" />
|
|
<input type="text" class="form-control" />
|
|
<img src="imgs/attatch.png" alt="attach" />
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="indetity" class=" control-label"> كشف الدرجات </label>
|
|
<div class="attach_wrapper">
|
|
<input type="file" class="form-control" id="indetity" name="indetity" />
|
|
<input type="text" class="form-control" />
|
|
<img src="imgs/attatch.png" alt="attach" />
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="place" class="control-label"> المعدل </label>
|
|
<div class="">
|
|
<input type="text" name="" id="">
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="name"> هل ملحق بجهات تحفيظ قرآن ؟</label>
|
|
<div class="gender d-flex">
|
|
<div class="mail d-flex align-items-center">
|
|
<input class="d-inline-block w-auto" type="radio" checked name="gender"
|
|
value="mail" id="mail">
|
|
<label class="mb-0"> نعم </label>
|
|
</div>
|
|
<div class="femail d-flex align-items-center">
|
|
<input class="d-inline-block w-auto" type="radio" name="gender"
|
|
value="femail" id="femail">
|
|
<label class="mb-0"> لا </label>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="place" class="control-label"> اسم الجهة </label>
|
|
<div class="">
|
|
<input type="text" name="" id="">
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="place" class="control-label"> عدد أجزاء الحفظ </label>
|
|
<div class="">
|
|
<input type="text" name="" id="">
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="name"> برامج علمية اخرى ؟</label>
|
|
<div class="gender d-flex">
|
|
<div class="mail d-flex align-items-center">
|
|
<input class="d-inline-block w-auto" type="radio" checked name="gender"
|
|
value="mail" id="mail">
|
|
<label class="mb-0"> نعم </label>
|
|
</div>
|
|
<div class="femail d-flex align-items-center">
|
|
<input class="d-inline-block w-auto" type="radio" name="gender"
|
|
value="femail" id="femail">
|
|
<label class="mb-0"> لا </label>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-12">
|
|
<label for="place" class="control-label"> المجال او التخصص </label>
|
|
<div class="">
|
|
<select id="place" class="custom-select">
|
|
<option selected="selected">1</option>
|
|
<option value="1">2 </option>
|
|
</select>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
<p><a class="btn btn-primary next">التالي</a></p>
|
|
</fieldset>
|
|
<!-- funds -->
|
|
<fieldset id="step_8" class="step_field ">
|
|
<legend>
|
|
<div class="step_number">
|
|
<span class="active"> 8 </span>
|
|
من
|
|
<span class="total"> 10 </span>
|
|
|
|
</div>
|
|
من فضلك قم بتعبئة ( بيانات مصروفات الملابس )
|
|
</legend>
|
|
<div class="row">
|
|
<div class="form-group col-lg-6">
|
|
<label for="work" class="control-label"> نوع المصروف </label>
|
|
<div class="d-flex add_wrapper ">
|
|
<select style="margin-inline-end:8px" id="place" class="custom-select">
|
|
<option selected="selected">1</option>
|
|
<option value="1">2 </option>
|
|
</select>
|
|
<button type="button" class="btn btn-primary" data-toggle="modal"
|
|
data-target="#exampleModal">
|
|
<img src="imgs/Icon awesome-plus.png" alt="">
|
|
</button>
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="place" class="control-label"> الاعتماد </label>
|
|
<div class="">
|
|
<select id="place" class="custom-select">
|
|
<option selected="selected">1</option>
|
|
<option value="1">2 </option>
|
|
</select>
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-12">
|
|
<label for="place" class="control-label"> مدة تكرار المصروف </label>
|
|
<div class="">
|
|
<select id="place" class="custom-select">
|
|
<option selected="selected">1</option>
|
|
<option value="1">2 </option>
|
|
</select>
|
|
</div>
|
|
</div>
|
|
|
|
<legend>
|
|
من فضلك قم بتعبئة ( بيانات مقاسات الملابس والاحذية )
|
|
</legend>
|
|
<div class="form-group col-lg-6">
|
|
<label for="work" class="control-label"> نوع الملابس </label>
|
|
<div class="d-flex add_wrapper ">
|
|
<select style="margin-inline-end:8px" id="place" class="custom-select">
|
|
<option selected="selected">1</option>
|
|
<option value="1">2 </option>
|
|
</select>
|
|
<button type="button" class="btn btn-primary" data-toggle="modal"
|
|
data-target="#exampleModal">
|
|
<img src="imgs/Icon awesome-plus.png" alt="">
|
|
</button>
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="place" class="control-label"> المقاس </label>
|
|
<div class="">
|
|
<select id="place" class="custom-select">
|
|
<option selected="selected">1</option>
|
|
<option value="1">2 </option>
|
|
</select>
|
|
</div>
|
|
</div>
|
|
<legend>
|
|
من فضلك قم بتعبئة ( البيانات الصحية )
|
|
</legend>
|
|
|
|
<div class="form-group col-lg-6">
|
|
<label for="name"> هل لديه أمراض ؟</label>
|
|
<div class="gender d-flex">
|
|
<div class="mail d-flex align-items-center">
|
|
<input class="d-inline-block w-auto" type="radio" checked name="gender"
|
|
value="mail" id="mail">
|
|
<label class="mb-0"> نعم </label>
|
|
</div>
|
|
<div class="femail d-flex align-items-center">
|
|
<input class="d-inline-block w-auto" type="radio" name="gender"
|
|
value="femail" id="femail">
|
|
<label class="mb-0"> لا </label>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="place" class="control-label"> نوع المرض </label>
|
|
<div class="">
|
|
<select id="place" class="custom-select">
|
|
<option selected="selected">1</option>
|
|
<option value="1">2 </option>
|
|
</select>
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="place" class="control-label">العلاج المستخدم</label>
|
|
<div class="">
|
|
<input type="text" name="" id="">
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="place" class="control-label"> التكلفة</label>
|
|
<div class="">
|
|
<input type="text" name="" id="">
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="name"> هل يصرف من الدولة ؟</label>
|
|
<div class="gender d-flex">
|
|
<div class="mail d-flex align-items-center">
|
|
<input class="d-inline-block w-auto" type="radio" checked name="gender"
|
|
value="mail" id="mail">
|
|
<label class="mb-0"> نعم </label>
|
|
</div>
|
|
<div class="femail d-flex align-items-center">
|
|
<input class="d-inline-block w-auto" type="radio" name="gender"
|
|
value="femail" id="femail">
|
|
<label class="mb-0"> لا </label>
|
|
</div>
|
|
</div>
|
|
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="place" class="control-label"> الكمية في الشهر</label>
|
|
<div class="">
|
|
<input type="text" name="" id="">
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="place" class="control-label"> شرح</label>
|
|
<div class="">
|
|
<input type="text" name="" id="">
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="" class=" control-label"> إرفاق مستند اثبات المرض</label>
|
|
<div class="attach_wrapper">
|
|
<input type="file" class="form-control" id="" name="">
|
|
<input type="text" />
|
|
<img src="imgs/attatch.png" alt="attach">
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="name"> هل لديه إعاقة ؟</label>
|
|
<div class="gender d-flex">
|
|
<div class="mail d-flex align-items-center">
|
|
<input class="d-inline-block w-auto" type="radio" checked name="gender"
|
|
value="mail" id="mail">
|
|
<label class="mb-0"> نعم </label>
|
|
</div>
|
|
<div class="femail d-flex align-items-center">
|
|
<input class="d-inline-block w-auto" type="radio" name="gender"
|
|
value="femail" id="femail">
|
|
<label class="mb-0"> لا </label>
|
|
</div>
|
|
</div>
|
|
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="place" class="control-label"> نوع الإعاقة </label>
|
|
<div class="">
|
|
<select id="place" class="custom-select">
|
|
<option selected="selected">1</option>
|
|
<option value="1">2 </option>
|
|
</select>
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="place" class="control-label"> المستلزمات الخاصة </label>
|
|
<div class="">
|
|
<input type="text" name="" id="">
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-6">
|
|
<label for="" class=" control-label"> إرفاق ملف المعاق في الجهات الحكومية</label>
|
|
<div class="attach_wrapper">
|
|
<input type="file" class="form-control" id="" name="">
|
|
<input type="text" />
|
|
<img src="imgs/attatch.png" alt="attach">
|
|
</div>
|
|
</div>
|
|
<div class="form-group col-lg-12">
|
|
<label for="place" class="control-label"> الدعم الذي يتلقاه من الدولة</label>
|
|
<div class="">
|
|
<input type="text" name="" id="">
|
|
</div>
|
|
</div>
|
|
</div>
|
|
<p><a class="btn btn-primary next">التالي</a></p>
|
|
</fieldset>
|
|
|
|
</form>
|
|
</div>
|
|
</div>
|
|
|
|
|
|
</div>
|
|
</div>
|
|
|
|
<script src="js/popper.min.js"></script>
|
|
<script src="js/bootstrap.min.js"></script>
|
|
<script src="js/stepper.js"></script>
|
|
<script src="js/main.js"></script>
|
|
</body>
|
|
|
|
</html> |