

<form id="" action="" method="POST" enctype="multipart/form-data" autocomplete="off">
  <br><br> 
    <div class="row">
    <div class="col-md-1"></div>
    <div class="col-md-10" style="background-image: url(../img/placeholders/inner-texture-bg.png); border-radius: 8px;">
      <div style='border-radius: 8px;border: 2px solid #7E9350;width:100%;margin-top:1%;margin-bottom:1%;'>
        <br/>
        <center>
           <b style="font-family: century gothic;font-size: 23px;"><i class="fa fa-user"></i> New User.</b>
        </center>
        <br/>      

        <div class="form-group row">                
            <label class="col-form-label col-2 col-lg-2 form-label text-lg-right">First Name<span class="required" style="color:red">*</span></label>
            <div class="col-3 col-lg-3">
               <input type="text" class="form-control" id="" name="firstname" placeholder="First Name" required>
            </div>

            <label class="col-form-label col-2 col-lg-2 form-label text-lg-right">Last Name</label>
            <div class="col-3 col-lg-3">
               <input type="text" class="form-control" id="" name="lastname" placeholder="Last Name" required>
            </div>
        </div>
            
        <div class="form-group row">              
            <label class="col-form-label col-2 col-lg-2 form-label text-lg-right">Rank<span class="required" style="color:red">*</span></label>
            <div class="col-3 col-lg-3">                  
                <select class="show-tick ms select2" name="rank_name" style="width: 100%" data-placeholder="~select rank~" required>
                    <option></option>
			        <?php
			            $selectrank= $conn->prepare("SELECT * FROM tbl_rank ");
                        $selectrank->execute();
                        while($row_1rank = $selectrank->fetch()) { ?>
                        
                            <option value = <?php echo $row_1rank['rank_id']; ?>><?php echo $row_1rank['rank_name']; ?></option>
                        <?php
                        }
			        ?>
                </select>
            </div>

            <label class="col-form-label col-2 col-lg-2 form-label text-lg-right">Phone<span class="required" style="color:red">*</span></label>
            <div class="col-3 col-lg-3">                  
            <input type="number" class="form-control" id="" name="phone" placeholder="tel: 07..." required>
            </div>
        </div>

        <div class="form-group row">    
            <label class="col-form-label col-2 col-lg-2 form-label text-lg-right">Email<span class="required" style="color:red">*</span></label>
            <div class="col-3 col-lg-3">                  
                <input type="email" class="form-control" id="" name="email" placeholder="example@example.com">
            </div>

            <label class="col-form-label col-2 col-lg-2 form-label text-lg-right">Department<span class="required" style="color:red">*</span></label>
            <div class="col-3 col-lg-3">                  
                <select class="show-tick ms select2" name="role" id="dept" style="width: 100%" data-placeholder="~department~"  onchange="getappoint(this.value)" required>
                    <option></option>
			        <?php
			            $select= $conn->prepare("SELECT * FROM tbl_role");
                        $select->execute();
                        while($row_1 = $select->fetch()) { ?>
                        
                            <option value = <?php echo $row_1['role_id']; ?>><?php echo $row_1['role_name']; ?></option>
                        <?php
                        }
			        ?>
			    </select>
            </div>
        </div>

        <div class="form-group row">    
            <label class="col-form-label col-2 col-lg-2 form-label text-lg-right">Appointment<span class="required" style="color:red">*</span></label>
            <div class="col-3 col-lg-3">                  
                <select class="show-tick ms select2" name="title_name" id="appointid" style="width: 100%" data-placeholder="~title~">
                    <option></option>
		
			    </select>
            </div>

            <label class="col-form-label col-2 col-lg-2 form-label text-lg-right">User privilege<span class="required" style="color:red">*</span></label>
            <div class="col-3 col-lg-3">                  
                <select class=" show-tick ms select2" name="privilege" style="width: 100%" data-placeholder="~Privilege~">
                    <option></option>
			        <?php
			            $select1= $conn->prepare("SELECT * FROM tbl_privilege");
                        $select1->execute();
                        while($row_11 = $select1->fetch()) { ?>
                        
                            <option value = <?php echo $row_11['privilege_id']; ?>><?php echo $row_11['privilege']; ?></option>
                        <?php
                        }
			        ?>
			    </select>
            </div>
        </div>

        <div class="form-group row">    
            <label class="col-form-label col-2 col-lg-2 form-label text-lg-right">Gender<span class="required" style="color:red">*</span></label>
            <div class="col-3 col-lg-3">                  
                <select class="show-tick ms select2" name="gender" style="width: 100%" data-placeholder="-Gender-">
                    <option></option>
                    <option value = "M" >Male</option>
                    <option value = "F" >Female</option>
			    </select>
            </div>

      </div>

        <hr>
        <center>
            <button type="reset" class="btn btn-default btn-sm" style="border-radius: 4px;">Reset</button>
            <button class="btn btn-primary btn-sm" name="btn-save" style="border-radius: 4px;" type="submit" id="">Submit</button>
        </center>
        <br>
    </div> <!--border -->
    </div>
  </div>
</form>


