CHANGE_LEAD_TYPE_3_MIXED_WITH_1_AND_2

This commit is contained in:
VENKATESHWARAN 2026-04-21 16:00:08 +05:30
parent 3e8b4dcd2d
commit 923c97c9cb
4 changed files with 199 additions and 130 deletions

View File

@ -196,14 +196,15 @@
<div class="form-group col-md-4">
<label for="issuer">Issuer<span class="text-danger">*</span></label>
<select class="form-control" id="issuer" name="issuer" required>
<option value="">Select Issuer</option>
<?php
<option value='2' selected>Nhance</option>;
<!-- <?php
if (isset($issuer) && count($issuer)) {
foreach ($issuer as $key => $value) {
echo "<option value=" . $key . ">" . $value . "</option>";
}
}
?>
?> -->
</select>
</div>
@ -229,14 +230,14 @@
<hr>
<div class="form-row">
<div class="form-group col-md-4 renewalFields" style="display: none;">
<div class="form-group col-md-4 renewalFields rolloverhide" style="display: none;">
<label for="client_id">Client<span class="text-danger">*</span></label>
<select class="form-control" id="client_id" name="client_id">
<option value="">Select Client</option>
</select>
</div>
<div class="form-group col-md-4 renewalFields" style="display: none;">
<div class="form-group col-md-4 renewalFields rolloverhide" style="display: none;">
<label for="client_branch_id">Branch<span class="text-danger">*</span></label>
<select class="form-control" id="client_branch_id" name="client_branch_id"
onchange="getBranchData(this,1)">
@ -343,7 +344,7 @@
placeholder="Enter Branch Code" required>
</div>
<div class="form-group col-md-4 renewalFields">
<div class="form-group col-md-4 renewalFields rolloverhide">
<label for="contact_person_summary">Contact Person<span class="text-danger">*</span></label>
<select class="form-control" name="contact_person_summary" id="contact_person_summary">
<option value="">Select a Contact</option>
@ -541,8 +542,8 @@
var lead_type = $(this).val();
var increment = 1; // Example increment value (modify as needed)
var start_date_id = (lead_type == "1" || lead_type == "3") ? `policy_start_date_${increment}` : "policy_start_date";
var end_date_id = (lead_type == "1" || lead_type == "3") ? `policy_end_date_${increment}` : "policy_end_date";
var start_date_id = (lead_type == "1") ? `policy_start_date_${increment}` : "policy_start_date";
var end_date_id = (lead_type == "1") ? `policy_end_date_${increment}` : "policy_end_date";
$(".policy_start_date").attr("id", start_date_id);
// $("label[for]").attr("for", start_date_id);
@ -553,7 +554,7 @@
// $('#leads_form_id')[0].reset();
// console.log("Updated ID:", newId);
if (lead_type == 1 || lead_type == 3) {
if (lead_type == 1) {
var policy_start_datePicker = flatpickr("#policy_start_date_" + increment, {
dateFormat: "d/m/Y",
@ -561,8 +562,7 @@
onChange: function(selectedDates) {
var policy_end_date = new Date(selectedDates[0]);
policy_end_date.setFullYear(policy_end_date.getFullYear() + 1);
policy_end_date.setDate(policy_end_date.getDate() -
1); // Set end date to last day of selected year
policy_end_date.setDate(policy_end_date.getDate() - 1); // Set end date to last day of selected year
policy_end_datePicker.setDate(policy_end_date);
// console.log('this object', this);
@ -585,7 +585,7 @@
// }
}
});
} else if (lead_type != 1 && lead_type != 3) {
} else if (lead_type == 2) {
$("#source_policy_id").prop("required", true);
$("#source_policy_start_date").prop("required", true);
$("#source_policy_end_date").prop("required", true);
@ -624,7 +624,7 @@
}
if (lead_type != 1 && lead_type != 3) {
if (lead_type != 1) {
dataIncrement = 1;
// updateRenewalFields(dataIncrement);
@ -744,12 +744,9 @@
leadTypeBsedHideAndShow(lead_type)
if (lead_type == 1 || lead_type == 3) {
if (lead_type == 1) {
$('.claim-row').hide();
} else {
$('.claim-row').show();
if (policy_type_id == 1) {
$('.gpaClaimFileds').show();
@ -757,50 +754,50 @@
} else if (policy_type_id == 6 || policy_type_id == 7) {
$('.gpaClaimFileds').hide();
$('.lifeClaimFields').show();
} else {
// updateRenewalFields(dataIncrement);
// let incurred_claim_date_id = 'incurred_claim_date_' + dataIncrement;
let incurred_claim_date_id = 'incurred_claim_date';
var incurred_claim_datepicker = flatpickr("#" + incurred_claim_date_id, {
dateFormat: "d/m/Y",
allowInput: false,
onChange: function(selectedDates) {
console.log('Flatpickr instance:', this);
console.log('ID of this element:', this.input.id);
// Extract the increment value from the element's ID
let increment = this.input.id.split('_').pop();
console.log('Extracted increment:', increment);
let lead_type = $('#lead_type').val();
var policyStartDate = $("#source_policy_start_date");
if (lead_type == 3) {
policyStartDate = $("#policy_start_date");
}
console.log('Selected Dates:', selectedDates);
console.log('policy start date instance', policyStartDate)
console.log('Policy Start Date:', policyStartDate.val());
// Recalculate policy_run_days if policy start date is already selected
// if (policyStartDate.val()) {
// calculatePolicyRunDays(increment);
// }
}
});
// var premium_date_datepicker = flatpickr("#" + premium_date_id, {
// dateFormat: "d/m/Y",
// allowInput: false
// });
$('#proposed_insurer_' + dataIncrement).select2();
$('#proposed_tpa_' + dataIncrement).select2();
}
}
if (lead_type != 1 && policy_type_id != 1 && policy_type_id != 6 && policy_type_id != 7) {
// updateRenewalFields(dataIncrement);
// let incurred_claim_date_id = 'incurred_claim_date_' + dataIncrement;
let incurred_claim_date_id = 'incurred_claim_date';
var incurred_claim_datepicker = flatpickr("#" + incurred_claim_date_id, {
dateFormat: "d/m/Y",
allowInput: false,
onChange: function(selectedDates) {
console.log('Flatpickr instance:', this);
console.log('ID of this element:', this.input.id);
// Extract the increment value from the element's ID
let increment = this.input.id.split('_').pop();
console.log('Extracted increment:', increment);
let lead_type = $('#lead_type').val();
var policyStartDate = $("#source_policy_start_date");
if (lead_type == 3) {
policyStartDate = $("#policy_start_date");
}
console.log('Selected Dates:', selectedDates);
console.log('policy start date instance', policyStartDate)
console.log('Policy Start Date:', policyStartDate.val());
// Recalculate policy_run_days if policy start date is already selected
// if (policyStartDate.val()) {
// calculatePolicyRunDays(increment);
// }
}
});
// var premium_date_datepicker = flatpickr("#" + premium_date_id, {
// dateFormat: "d/m/Y",
// allowInput: false
// });
$('#proposed_insurer_' + dataIncrement).select2();
$('#proposed_tpa_' + dataIncrement).select2();
}
hide_list_show_add();
pageTitle = 'Edit Opportunities - (EB)';
@ -1131,12 +1128,9 @@
leadTypeBsedHideAndShow(lead_type)
if (lead_type == 1 || lead_type == 3) {
if (lead_type == 1) {
$('.claim-row').hide();
} else {
$('.claim-row').show();
if (policy_type_id == 1) {
@ -1145,47 +1139,47 @@
} else if (policy_type_id == 6 || policy_type_id == 7) {
$('.gpaClaimFileds').hide();
$('.lifeClaimFields').show();
} else {
if (lead_type == 1 || lead_type == 3) {
updateRenewalFields(dataIncrement);
}
// let incurred_claim_date_id = 'incurred_claim_date_' + dataIncrement;
let incurred_claim_date_id = 'incurred_claim_date';
var incurred_claim_datepicker = flatpickr("#" + incurred_claim_date_id, {
dateFormat: "d/m/Y",
allowInput: false,
onChange: function(selectedDates) {
console.log('Flatpickr instance:', this);
console.log('ID of this element:', this.input.id);
// Extract the increment value from the element's ID
let increment = this.input.id.split('_').pop();
console.log('Extracted increment:', increment);
var policyStartDate = $("#source_policy_start_date");
if (lead_type == 3) {
policyStartDate = $("#policy_start_date");
}
console.log('Selected Dates:', selectedDates);
console.log('policy start date instance', policyStartDate)
console.log('Policy Start Date:', policyStartDate.val());
// Recalculate policy_run_days if policy start date is already selected
// if (policyStartDate.val()) {
// calculatePolicyRunDays(increment);
// }
}
});
$('#proposed_insurer_' + dataIncrement).select2();
$('#proposed_tpa_' + dataIncrement).select2();
}
}
if (lead_type != 1 && policy_type_id != 1 && policy_type_id != 6 && policy_type_id != 7) {
if (lead_type == 1) {
updateRenewalFields(dataIncrement);
}
// let incurred_claim_date_id = 'incurred_claim_date_' + dataIncrement;
let incurred_claim_date_id = 'incurred_claim_date';
var incurred_claim_datepicker = flatpickr("#" + incurred_claim_date_id, {
dateFormat: "d/m/Y",
allowInput: false,
onChange: function(selectedDates) {
console.log('Flatpickr instance:', this);
console.log('ID of this element:', this.input.id);
// Extract the increment value from the element's ID
let increment = this.input.id.split('_').pop();
console.log('Extracted increment:', increment);
var policyStartDate = $("#source_policy_start_date");
if (lead_type == 3) {
policyStartDate = $("#policy_start_date");
}
console.log('Selected Dates:', selectedDates);
console.log('policy start date instance', policyStartDate)
console.log('Policy Start Date:', policyStartDate.val());
// Recalculate policy_run_days if policy start date is already selected
// if (policyStartDate.val()) {
// calculatePolicyRunDays(increment);
// }
}
});
$('#proposed_insurer_' + dataIncrement).select2();
$('#proposed_tpa_' + dataIncrement).select2();
}
} else {
console.log(response.message, 'WARNING');
}
@ -1287,7 +1281,7 @@
<div class="form-group col-md-4">
<label for="policy_start_date">Date of Commencement <span class="text-danger">*</span></label>
<div class="input-icon">
<input type="text" class="form-control policy_start_date" id="policy_start_date_${increment}" name="policy_start_date[]" placeholder="Enter DOC" onchange="calculatePolicyMetrics(this)">
<input type="text" class="form-control policy_start_date" id="policy_start_date_${increment}" name="policy_start_date[]" placeholder="Enter DOC" onchange="calculatePolicyMetrics(this)" autocomplete="off" >
<i class="mdi mdi-calendar-blank-outline additional-icon"></i>
</div>
@ -1296,7 +1290,7 @@
<div class="form-group col-md-4">
<label for="policy_end_date">Date of Expiry <span class="text-danger">*</span></label>
<div class="input-icon">
<input type="text" class="form-control policy_end_date" id="policy_end_date_${increment}" name="policy_end_date[]" placeholder="Enter DOE">
<input type="text" class="form-control policy_end_date" id="policy_end_date_${increment}" name="policy_end_date[]" placeholder="Enter DOE" autocomplete="off">
<i class="mdi mdi-calendar-blank-outline additional-icon"></i>
</div>
</div>
@ -1351,7 +1345,7 @@
// $(".policy_end_date").attr("id", end_date_id);
// Initialize date pickers
if (lead_type == 1 || lead_type == 3) {
if (lead_type == 1) {
var policy_start_datePicker = flatpickr("#policy_start_date_" + increment, {
dateFormat: "d/m/Y",
@ -1565,7 +1559,7 @@
console.log('Lead Type:', lead_type);
let increment = input.id.split('_').pop(); // Extract increment
if (lead_type == 1 || lead_type == 3) {
if (lead_type == 1) {
return;
}
@ -1683,7 +1677,7 @@
var lead_type = $('#lead_type').val();
if (lead_type == 1 || lead_type == 3) {
if (lead_type == 1) {
let formRow = input.closest('.form-row');
@ -1924,6 +1918,7 @@
onChange: function(selectedDates) {
try {
let increment = this.input.id.split('_').pop();
console.log('Incurred claim date changed:', selectedDates);
let policyStartDate = $("#source_policy_start_date");
if (policyStartDate.val()) {
calculatePolicyRunDays(increment);
@ -2301,7 +2296,7 @@
function leadTypeBsedHideAndShow(value, resetValues = false) {
if (value == 1 || value == 3) {
if (value == 1) {
$('.btnDiv').show();
$('.claim-row').hide();
@ -2317,6 +2312,56 @@
// $('.proposed_div').hide().find('select, input').removeAttr('required');
if (resetValues) {
$('#gst').val('');
$('#pan').val('');
$('#branch_name').val('');
$('#branch_code').val('');
$('#contact_person_name').val('');
$('#contact_person_mobile').val('');
$('#contact_person_email').val('');
$('#client_type').val('');
$('#client_name').val('');
$('#client_short_name').val('');
$('#entity_type_id').val('');
}
$('#exixting_client').removeAttr('required');
} else if (value == 3) {
$('.btnDiv').hide();
$('.claim-row').show();
$('.emp_title_text').text('No of Employees at Inception')
$('.depnd_title_text').text(' No of Dependents at Inception')
$('.total_title_text').text('Total Lives at Inception')
$('.freshFields').find('select, input').attr('required', 'required');
$('.freshFields').show();
$('.rolloOverFields').find('select, input').attr('required', 'required');
$('.renewalFields').show();
$('#source_policy_id').hide();
$('#source_policy_start_date').hide();
$('#source_policy_end_date').hide();
$('#source_policy_id').closest('.form-group').hide();
$('#source_policy_start_date').closest('.form-group').hide();
$('#source_policy_end_date').closest('.form-group').hide();
$('.source_policy_id').find('select, input').attr('required', 'required');
$('.source_policy_start_date').find('select, input').attr('required', 'required');
$('.source_policy_end_date').find('select, input').attr('required', 'required');
$('.rolloverhide').hide();
if (resetValues) {
$('#gst').val('');

View File

@ -935,6 +935,30 @@ if (isset($selected_lead_type)) {
}
}
if(lead_type == 3){
let incurred_claim_date_id = 'incurred_claim_date';
if ($('#' + incurred_claim_date_id).length) {
flatpickr("#" + incurred_claim_date_id, {
dateFormat: "d/m/Y",
allowInput: false,
onChange: function (selectedDates) {
try {
let increment = this.input.id.split('_').pop();
let policyStartDate = $("#source_policy_start_date");
if (policyStartDate.val()) {
calculatePolicyRunDays(increment);
}
} catch (error) {
console.error('Error in incurred_claim_datepicker:', error);
}
}
});
} else {
console.warn(`Incurred claim date field #${incurred_claim_date_id} not found.`);
}
}
// if (lead_type == 3) {
// $('#client_id').prepend($('<option>', {

View File

@ -5,75 +5,75 @@
<div class="form-row renewalCalculation">
<div class="form-group col-md-3 renewalFields" style="display: none;">
<div class="form-group col-md-3 renewalFields rolloOverFields" style="display: none;">
<label for="incurred_claim_date">Incurred Claim Date<span class="text-danger">*</span></label>
<input value="<?= isset($lead_edit_data['incurred_claims_date']) ? $lead_edit_data['incurred_claims_date'] : '' ?>" type="text" class="form-control incurred_claim" id="incurred_claim_date<?= $increment ?>"
name="incurred_claim_date[]" placeholder="Enter DOE" oninput="calculatePolicyMetrics(this)">
</div>
<div class="form-group col-md-3 renewalFields" style="display: none;">
<div class="form-group col-md-3 renewalFields rolloOverFields" style="display: none;">
<label for="paid_claims">Paid Claims<span class="text-danger">*</span></label>
<input value="<?= isset($lead_edit_data['paid_claims']) ? $lead_edit_data['paid_claims'] : '' ?>" type="text" class="form-control" id="paid_claims<?= $increment ?>" name="paid_claims[]"
placeholder="Enter Paid Claims" oninput="calculatePolicyMetrics(this)">
</div>
<div class="form-group col-md-3 renewalFields" style="display: none;">
<div class="form-group col-md-3 renewalFields rolloOverFields" style="display: none;">
<label for="outstanding_claims">Outstanding Claims<span class="text-danger">*</span></label>
<input value="<?= isset($lead_edit_data['outstanding_claims']) ? $lead_edit_data['outstanding_claims'] : '' ?>" type="text" class="form-control" id="outstanding_claims<?= $increment ?>" name="outstanding_claims[]"
placeholder="Enter Outstanding Claims" oninput="calculatePolicyMetrics(this)">
</div>
<div class="form-group col-md-3 renewalFields" style="display: none;">
<div class="form-group col-md-3 renewalFields rolloOverFields" style="display: none;">
<label for="incurred_claims">Incurred Claim<span class="text-danger">*</span></label>
<input value="<?= isset($lead_edit_data['incurred_claims']) ? $lead_edit_data['incurred_claims'] : '' ?>" type="text" class="form-control" id="incurred_claims<?= $increment ?>" name="incurred_claims[]"
placeholder="Enter Incurred Claim" oninput="calculatePolicyMetrics(this)" readonly>
</div>
<div class="form-group col-md-3 renewalFields" style="display: none;">
<div class="form-group col-md-3 renewalFields rolloOverFields" style="display: none;">
<label for="policy_run_days">Policy Run Days<span class="text-danger">*</span></label>
<input value="<?= isset($lead_edit_data['policy_run_days']) ? $lead_edit_data['policy_run_days'] : '' ?>" type="text" class="form-control" id="policy_run_days<?= $increment ?>" name="policy_run_days[]"
placeholder="Enter Policy Run Days" oninput="calculatePolicyMetrics(this)" readonly>
</div>
<div class="form-group col-md-3 renewalFields" style="display: none;">
<div class="form-group col-md-3 renewalFields rolloOverFields" style="display: none;">
<label for="premium_at_inception">Premium Paid at Inception<span
class="text-danger">*</span></label>
<input value="<?= isset($lead_edit_data['premium_at_inception']) ? $lead_edit_data['premium_at_inception'] : '' ?>" type="text" class="form-control" id="premium_at_inception<?= $increment ?>" name="premium_at_inception[]"
placeholder="Enter Premium Paid" oninput="calculatePolicyMetrics(this)">
</div>
<div class="form-group col-md-3 renewalFields" style="display: none;">
<div class="form-group col-md-3 renewalFields rolloOverFields" style="display: none;">
<label for="premium_date">Premium as on Date<span class="text-danger">*</span></label>
<input value="<?= isset($lead_edit_data['premium_date']) ? $lead_edit_data['premium_date'] : '' ?>" type="text" class="form-control" id="premium_date<?= $increment ?>" name="premium_date[]"
placeholder="Enter Premium Date" oninput="calculatePolicyMetrics(this)">
</div>
<div class="form-group col-md-3 renewalFields" style="display: none;">
<div class="form-group col-md-3 renewalFields rolloOverFields" style="display: none;">
<label for="earned_premium">Earned Premium<span class="text-danger">*</span></label>
<input value="<?= isset($lead_edit_data['earned_premium']) ? $lead_edit_data['earned_premium'] : '' ?>" type="text" class="form-control" id="earned_premium<?= $increment ?>" name="earned_premium[]"
placeholder="Enter Earned Premium" oninput="calculatePolicyMetrics(this)" readonly>
</div>
<div class="form-group col-md-3 renewalFields" style="display: none;">
<div class="form-group col-md-3 renewalFields rolloOverFields" style="display: none;">
<label for="annualised_claims">Annualised Claims<span class="text-danger">*</span></label>
<input value="<?= isset($lead_edit_data['annualised_claims']) ? $lead_edit_data['annualised_claims'] : '' ?>" type="text" class="form-control" id="annualised_claims<?= $increment ?>" name="annualised_claims[]"
placeholder="Enter Annualised Claims" oninput="calculatePolicyMetrics(this)" readonly>
</div>
<div class="form-group col-md-3 renewalFields" style="display: none;">
<div class="form-group col-md-3 renewalFields rolloOverFields" style="display: none;">
<label for="incurred_claims_ratio">Incurred Claims Ratio(%) <span
class="text-danger">*</span></label>
<input value="<?= isset($lead_edit_data['incurred_claims_ratio']) ? $lead_edit_data['incurred_claims_ratio'] : '' ?>" type="text" class="form-control" id="incurred_claims_ratio<?= $increment ?>"
name="incurred_claims_ratio[]" placeholder="Enter Incurred Claims Ratio" readonly>
</div>
<div class="form-group col-md-3 renewalFields" style="display: none;">
<div class="form-group col-md-3 renewalFields rolloOverFields" style="display: none;">
<label for="earned_claims_ratio">Earned Claims Ratio(%) <span class="text-danger">*</span></label>
<input value="<?= isset($lead_edit_data['earned_claims_ratio']) ? $lead_edit_data['earned_claims_ratio'] : '' ?>" type="text" class="form-control" id="earned_claims_ratio<?= $increment ?>" name="earned_claims_ratio[]"
placeholder="Enter Earned Claims Ratio" readonly>
</div>
<div class="form-group col-md-3 renewalFields" style="display: none;">
<div class="form-group col-md-3 renewalFields rolloOverFields" style="display: none;">
<span class="info-icon-wrapper">
<i class="mdi mdi-information-outline text-primary"></i>
<div class="info-tooltip">
@ -89,7 +89,7 @@
</div>
<!-- <div class="form-group col-md-3 renewalFields" style="display: none;">
<!-- <div class="form-group col-md-3 renewalFields rolloOverFields" style="display: none;">
<label for="location">Location <span class="text-danger">*</span></label>
<input value="<?php //echo isset($lead_edit_data['location']) ? $lead_edit_data['location'] : '' ?>" type="text" class="form-control" id="location" name="location[]" placeholder="Enter Location">
</div> -->
@ -161,20 +161,20 @@
<div class="form-row">
<div class="form-group col-md-4 renewalFields" style="display: none;">
<div class="form-group col-md-4 renewalFields rolloOverFields" style="display: none;">
<label for="exp_emp_count"> No of Employees at Expiry <span class="text-danger"></span></label>
<input value="<?= isset($lead_edit_data['exp_emp_count']) ? $lead_edit_data['exp_emp_count'] : '' ?>" type="text" class="form-control" id="exp_emp_count" name="exp_emp_count[]"
placeholder="Enter Lives">
</div>
<div class="form-group col-md-4 renewalFields" style="display: none;">
<div class="form-group col-md-4 renewalFields rolloOverFields" style="display: none;">
<label for="exp_dept_count"> No of Dependents at Expiry <span
class="text-danger"></span></label>
<input value="<?= isset($lead_edit_data['exp_dept_count']) ? $lead_edit_data['exp_dept_count'] : '' ?>" type="text" class="form-control" id="exp_dept_count" name="exp_dept_count[]"
placeholder="Enter Lives">
</div>
<div class="form-group col-md-4 renewalFields" style="display: none;">
<div class="form-group col-md-4 renewalFields rolloOverFields" style="display: none;">
<label for="exp_no_of_lives"> Total Lives at Expiry <span class="text-danger"></span></label>
<input value="<?= isset($lead_edit_data['exp_no_of_lives']) ? $lead_edit_data['exp_no_of_lives'] : '' ?>" type="text" class="form-control" id="exp_no_of_lives" name="exp_no_of_lives[]"
placeholder="Enter Lives">
@ -184,21 +184,21 @@
<div class="form-row">
<div class="form-group col-md-4 renewalFields" style="display: none;">
<div class="form-group col-md-4 renewalFields rolloOverFields" style="display: none;">
<label for="renewal_emp_count"> No of Employees at Renewal <span
class="text-danger"></span></label>
<input value="<?= isset($lead_edit_data['renewal_emp_count']) ? $lead_edit_data['renewal_emp_count'] : '' ?>" type="text" class="form-control" id="renewal_emp_count" name="renewal_emp_count[]"
placeholder="Enter Lives">
</div>
<div class="form-group col-md-4 renewalFields" style="display: none;">
<div class="form-group col-md-4 renewalFields rolloOverFields" style="display: none;">
<label for="renewal_dept_count"> No of Dependents at Renewal <span
class="text-danger"></span></label>
<input value="<?= isset($lead_edit_data['renewal_dept_count']) ? $lead_edit_data['renewal_dept_count'] : '' ?>" type="text" class="form-control" id="renewal_dept_count" name="renewal_dept_count[]"
placeholder="Enter Lives">
</div>
<div class="form-group col-md-4 renewalFields" style="display: none;">
<div class="form-group col-md-4 renewalFields rolloOverFields" style="display: none;">
<label for="renewal_no_of_lives"> Total Lives at Renewal <span
class="text-danger"></span></label>
<input value="<?= isset($lead_edit_data['renewal_no_of_lives']) ? $lead_edit_data['renewal_no_of_lives'] : '' ?>" type="text" class="form-control" id="renewal_no_of_lives" name="renewal_no_of_lives[]"

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@ -13,25 +13,25 @@
<div class="form-group col-md-4">
<label for="total_lives_at_incept" class="total_title">
<span class="total_title_text"> Total Lives at Inception </span> <span class="text-danger"></span></label>
<input value="<?= isset($lead_edit_data['total_lives_at_incept']) ? $lead_edit_data['total_lives_at_incept'] : '' ?>" type="text" class="form-control" id="total_lives_at_incept" name="total_lives_at_incept[]" placeholder="Enter Lives" disabled>
<input value="<?= isset($lead_edit_data['total_lives_at_incept']) ? $lead_edit_data['total_lives_at_incept'] : '' ?>" type="text" class="form-control" id="total_lives_at_incept" name="total_lives_at_incept[]" placeholder="Enter Lives">
</div>
<div class="form-group col-md-4 renewalFields">
<div class="form-group col-md-4 renewalFields rolloOverFields">
<label for="total_si_at_incept"> Total Sum Insured at Inception <span class="text-danger">*</span></label>
<input value="<?= isset($lead_edit_data['total_si_at_incept']) ? $lead_edit_data['total_si_at_incept'] : '' ?>" type="text" class="form-control" id="total_si_at_incept" name="total_si_at_incept[]" placeholder="Enter Sum Insured" required>
</div>
<div class="form-group col-md-4 renewalFields">
<div class="form-group col-md-4 renewalFields rolloOverFields">
<label for="premium_at_incept"> Premium at inception <span class="text-danger">*</span></label>
<input value="<?= isset($lead_edit_data['premium_at_incept']) ? $lead_edit_data['premium_at_incept'] : '' ?>" type="text" class="form-control" id="premium_at_incept" name="premium_at_incept[]" placeholder="Enter Premium" required>
</div>
<div class="form-group col-md-4 renewalFields">
<div class="form-group col-md-4 renewalFields rolloOverFields">
<label for="renewal_emp_count"> No of Employees at Renewal <span class="text-danger">*</span></label>
<input value="<?= isset($lead_edit_data['renewal_emp_count']) ? $lead_edit_data['renewal_emp_count'] : '' ?>" type="text" class="form-control" id="renewal_emp_count" name="renewal_emp_count[]" placeholder="Enter Lives" >
</div>
<div class="form-group col-md-4 renewalFields">
<div class="form-group col-md-4 renewalFields rolloOverFields">
<label for="total_si_at_renewal"> Total Sum Insured at Renewal <span class="text-danger">*</span></label>
<input value="<?= isset($lead_edit_data['total_si_at_renewal']) ? $lead_edit_data['total_si_at_renewal'] : '' ?>" type="text" class="form-control" id="total_si_at_renewal" name="total_si_at_renewal[]" placeholder="Enter Sum Insured" >
</div>