<?php include 'header1f.php';?>

  <div class="content-page">
    <div class="content">
      <div class="container">
        
        <div class="row">
          <div class="col-sm-12">
            <div class="page-header-title">
            <button type="button" class="btn btn-dark waves-effect waves-light" onclick="location.href='index.php'">BACK </button>
              <div class="clearfix"></div>
            </div>
          </div>
        </div>
        
		
        <div class="row">
          <div class="col-md-6">
            <div class="panel panel-primary">
			
              <div class="panel-heading">
                <h3 class="panel-title">Whatsapp <?php echo $company_name?> <?php echo $final_quotation_no?></h3>
              </div>	
		
			
              <div class="panel-body">
                                    <div class="row"> 

               <form name="frm_add_category"  id="frm_add_category" action="update_casestudy_form.php" method="POST" enctype="multipart/form-data" >			
  <input type="hidden" name="appointment"  value="<? echo $_REQUEST['appointment'];?>" /> 
		                       <input type="hidden" name="call_follow_up_id"  value="<? echo $_REQUEST['call_follow_up_id'];?>" />  
							     <input type="hidden" name="tablename"  value="<? echo $_REQUEST['tablename'];?>" />  
								 <input type="hidden" name="program_id"  value="<? echo $_REQUEST['program_id'];?>" />  
								 <input type="hidden" name="registration_id"  value="<? echo $_REQUEST['registration_id'];?>" />  
								 
								 
							   
 
                        <div class="box-body">
						<div class="control-group"> 
						
							<div class="col-sm-12 col-xs-12">
                                            <div class="m-t-20">
							<div class="form-group">

                                <label for="Video Name">Mobile Number<sup class="mandatory">*</sup></label>

                                <input type="text" name="mobile_nob" class="form-control" value="<? echo $_REQUEST['mobile_no'];?>" required>

                            </div></div></div>
							
							<div class="col-sm-12 col-xs-12">
<div class="form-group">
<label><b>Case Form</b></label>
<select  class="form-control select2" data-style="py-0" name="case_form"  required>
<option value="" selected="selected">Select Case Form</option>
<?php 
$querynp = "select * from  case_form_master where status='1' ORDER BY case_form ASC";
$resultmp = mysqli_query($conn,$querynp);
while($row=mysqli_fetch_array($resultmp))
{
$case_form = $row['case_form'];
?>
<option value="<?php echo $case_form ?>"><?php echo $case_form ?> </option>
<?php 	}?>
</select></div>
</div>
						
							
</div><div class="col-sm-12 col-xs-12">
                                           
                                            <div class="m-t-20">
                                                    <div class="form-group">
                                                        <div>
                                                            <button type="submit" class="btn btn-primary waves-effect waves-light" style="float:right"> Submit </button>
							
															
                                                           
                                                        </div>
                                                    </div>
                                               
                                            </div>
                                        </div>
                    </form></div></div>
									
                   </div>						
                                                    
                                        
                              </div>
            </div>
          </div>
        </div>
        
      </div>
    </div>
	<?php include 'footer1.php';?>