<div class="col-lg-10 col-lg-offset-1">
	<section class="panel">
		<header class="panel-heading" style="min-height:120px">
			<div class="col-lg-3"> <span> &nbsp; </span> </div>
			<div class="col-lg-6">
				<h4 class="text-center"><i class="fa fa-user truck_icon"></i><br/> <b> <?php echo $view_type;?> Customer</b></h4>
			</div>
			<div class="col-lg-3"><span> &nbsp; </span></div>
		</header>
		<div class="clear"></div>
		<div class="panel-body">
			<form class="form-horizontal"method="post" action="<?php echo base_url();?>customer_ctrl/insert_customer/<?php if(isset($cl_data['cl_id'])){ echo $cl_data['cl_id'];}?>">
				<div class="col-lg-12">
					<?php
						if(isset($cl_data['cl_id'])){
					?>
							<div class="form-group col-md-6">
								<label class="col-lg-4 col-sm-4">Customer Code</label>
								<div class="col-lg-8">
									<input type="text" class="form-control" name="cl_code" value="<?php if(isset($cl_data['cl_code'])){ echo $cl_data['cl_code'];}?>" readonly required>
								</div>
							</div>
					<?php
						}
					?>
					<div class="form-group col-md-6">
						<label class="col-lg-4 col-sm-4">Customer Name</label>
						<div class="col-lg-8">
							<input type="text" class="form-control" name="cl_name" value="<?php if(isset($cl_data['cl_name'])){ echo $cl_data['cl_name'];}?>" required>
						</div>
					</div>
					<div class="form-group col-md-6">
						<label  class="col-lg-4 col-sm-4">Mobile Number</label>
						<div class="col-lg-8">
							<input type="text" class="form-control" name="cl_mobile" value="<?php if(isset($cl_data['cl_mobile'])){ echo $cl_data['cl_mobile'];}?>" required>
						</div>
					</div>
					<div class="form-group col-md-6">
						<label  class="col-lg-4 col-sm-4">Email id</label>
						<div class="col-lg-8">
							<input type="email" class="form-control" name="cl_email" value="<?php if(isset($cl_data['cl_email'])){ echo $cl_data['cl_email'];}?>" required>
						</div>
					</div>
					<div class="form-group col-md-6">
						<label class="col-lg-4 col-sm-4">Country</label>
						<div class="col-lg-8">
							<input type="text" class="form-control" name="cl_state" value="<?php if(isset($cl_data['cl_state'])){ echo $cl_data['cl_state'];}?>" required>
						</div>
					</div>
					<div class="form-group col-md-6">
						<label class="col-lg-4 col-sm-4 ">Province</label>
						<div class="col-lg-8">
							<input type="text" class="form-control" name="cl_district" value="<?php if(isset($cl_data['cl_district'])){ echo $cl_data['cl_district'];}?>" required>
						</div>
					</div>
					<div class="form-group col-md-6">
						<label class="col-lg-4 col-sm-4 ">Place</label>
						<div class="col-lg-8">
							<input type="text" class="form-control" name="cl_place" value="<?php if(isset($cl_data['cl_place'])){ echo $cl_data['cl_place'];}?>" required>
						</div>
					</div>
					<div class="form-group col-md-6">
						<label class="col-lg-4 col-sm-4 ">pincode</label>
						<div class="col-lg-8">
							<input type="text" class="form-control" name="cl_pincode" value="<?php if(isset($cl_data['cl_pincode'])){ echo $cl_data['cl_pincode'];}?>" required>
						</div>
					</div>
					<div class="form-group col-md-6">
						<label class="col-lg-4 col-sm-4 ">Address1</label>
						<div class="col-lg-8">
							<textarea rows="1" class="form-control"  name="cl_address" required> <?php if(isset($cl_data['cl_address'])){ echo $cl_data['cl_address'];}?> </textarea>
						</div>
					</div>

					<div class="form-group col-md-6">
						<label class="col-lg-4 col-sm-4 ">Address2</label>
						<div class="col-lg-8">
							<textarea rows="1" class="form-control"  name="cl_address2" required> <?php if(isset($cl_data['cl_address2'])){ echo $cl_data['cl_address2'];}?> </textarea>
						</div>
					</div>

					<div class="form-group col-md-6">
						<label class="col-lg-4 col-sm-4 ">Contact Person Name</label>
						<div class="col-lg-8">
							<input type="text" class="form-control" name="cl_co_name" value="<?php if(isset($cl_data['cl_co_name'])){ echo $cl_data['cl_co_name'];}?>" required>
						</div>
					</div>

					<div class="form-group col-md-6">
						<label class="col-lg-4 col-sm-4 ">Phone No.</label>
						<div class="col-lg-8">
							<input type="text" class="form-control" name="cl_phone" value="<?php if(isset($cl_data['cl_phone'])){ echo $cl_data['cl_phone'];}?>" required>
						</div>
					</div>

					<div class="col-md-12"></div>
					<div class="form-group col-md-6">
						<label class="col-lg-4 col-sm-4 ">TIN No</label>
						<div class="col-lg-8">
							<input type="text" class="form-control" name="cl_tin_no" value="<?php if(isset($cl_data['cl_tin_no'])){ echo $cl_data['cl_tin_no'];}?>" required>
						</div>
					</div>

					<div class="form-group col-md-6">
						<label class="col-lg-4 col-sm-4 ">VRN Np</label>
						<div class="col-lg-8">
							<input type="text" class="form-control" name="cl_vrn_np" value="<?php if(isset($cl_data['cl_vrn_np'])){ echo $cl_data['cl_vrn_np'];}?>" required>
						</div>
					</div>

					<div class="form-group col-md-12">
						<div class="col-lg-offset-10 col-lg-2">
                            <button type="submit" class="btn btn-success pull-right">Save</button>
                        </div>
					</div>
				</div>
				
			</form>
		</div>
	</section>
</div>