@extends('frontend.app')
<!-- Main Container  --> 
@section('content') 
<div class="position-relative">
    <div id="carouselExampleIndicators" class="carousel slide" data-pause="false" data-ride="carousel">
        <div class="carousel-inner">
            <div class="carousel-item active innerHeaderimg">
                <img src="/assets/frontend/images/inner-about.jpg" />
                <div class="carousel-caption innertopHEadcaption">
                    <div class="container">
                        <div class="row">
                            <div class="col-md-5">
                                <div class="capbg">
                                    <p>
										Home <i class="fa fa-angle-right mx-2"></i>
                                    </p>
                                    <div class="heading-seperator innerseperatorspace">
                                        <span></span>
                                    </div>
                                    <h4>Apply New Connection</h4>
                                </div>
                            </div>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
</div>
<section>
    <div class="container">
        <div class="row">
            <div class="col-md-12 py-3 py-sm-5">
                <div class="innerabout-content">
                    <h2 class="f-20">MNGL <strong>New Connection Application</strong>
                    </h2>
                    <ul class="mt-3">
                        <li>Applicant residing in a particular building should have a gas supply</li>
                        <li>Payments can be made through online transaction only.</li>
                        <li>As per safety standards, in case, the applicant's residence is found to be technically not feasible, MNGL will refund the amount paid by the applicant in full.</li>
                        <li>Applicant should be the owner of the flat for which new connection is requested. Incase of any dispute w.r.t. ownership arising in future, the security deposit against the connection stands forfeited.</li>
                        <li>Online Scheme1 not applicable to those customers who have surrender the connection before the installment plan.</li>
                    </ul>
                    <hr class="mt-4">
                    <div class="tab-content mt-5">
                        <div class="tab-pane active" role="tabpanel" id="step1">
                            <div class="row mb-5">
                                <div class="col-md-12 application-step">
									@include('frontend.apply-new-connection.partials.links')
                                </div>
                            </div>
                            <h2 class="f-18 mb-4">
                                <b>Step 3 </b> - Personal Information
                            </h2>
							<form role="form" action="/online-connection/personal-information" method="post">
								<input type="hidden" name="_token" value="{{ csrf_token() }}">
                                <input type="hidden" name="online_connection_id" value="{{$onlineConnection->id}}">
								<div class="row">
                                    <div class="col-md-3 form-group">
                                        <select class="form-control" id="">
                                            <option selected>Title</option>
                                            <option>Mr.</option>
                                            <option>Ms.</option>
                                        </select>
                                    </div>
                                    <div class="col-md-3 form-group">
                                        <input type="text" class="form-control" placeholder="First Name">
                                    </div>
                                    <div class="col-md-3 form-group">
                                        <input type="text" class="form-control" placeholder="Middle Name">
                                    </div>
                                    <div class="col-md-3 form-group">
                                        <input type="text" class="form-control" placeholder="Surname">
                                    </div>
                                    <div class="col-md-4 form-group">
                                        <input type="date" class="form-control" placeholder="Surname">
                                    </div>
                                    <div class="col-md-4 form-group">
                                        <input type="text" class="form-control" placeholder="Mobile No">
                                    </div>
                                    <div class="col-md-4 form-group">
                                        <input type="text" class="form-control" placeholder="Email">
                                    </div>
                                    <div class="col-md-4 form-group">
                                        <input type="text" class="form-control" placeholder="Aadhar No">
                                    </div>
                                    <div class="col-md-4 form-group">
                                        <input type="text" class="form-control" placeholder="Tel (Res)">
                                    </div>
                                    <div class="col-md-4 form-group">
                                        <input type="text" class="form-control" placeholder="Tel (Off)">
                                    </div>
                                </div>
                                <div class="row">
                                    <div class="col-md-4 form-group">
                                        <label>Do You Have a LPG connection in Youre name?</label>
                                        <select class="form-control">
                                            <option selected>Select</option>
                                            <option>Yes</option>
                                            <option>No</option>
                                        </select>
                                    </div>
                                </div>
                                <div class="row">
                                    <div class="col-md-4 form-group">
                                        <select class="form-control" id="">
                                            <option selected>Please Select LPG Company</option>
                                            <option>Indian Gas(Indian Oil)</option>
                                            <option>HP Gas (Hindustan Gas)</option>
                                            <option>Bharat Gas (Bharat Petroleum)</option>
                                        </select>
                                    </div>
                                    <div class="col-md-4 form-group">
                                        <input type="text" class="form-control" placeholder="Name of the LPG Distributor">
                                    </div>
                                    <div class="col-md-4 form-group">
                                        <input type="text" class="form-control" placeholder="LPG Consumer No.">
                                    </div>
                                </div>
                                <button type="button" data-toggle="tab" data-target="#step2" class="btn mr-2 btn-outline-secondary mt-4">
                                    <i class="fa ml-1 fa-arrow-circle-left"></i> Previous 
                                </button>
                                <button type="button" data-toggle="tab" data-target="#step4" class="btn btn-primary mt-4">
                                    Save and Next  <i class="fa ml-2 fa-arrow-circle-right"></i>
                                </button>
							</form>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
</section> 
@endsection @section('styles') @endsection @section('scripts') @parent @endsection