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  1. <html>
  2. <head>
  3. <title>ROMA</title>
  4. <meta charset="UTF-8">
  5. <meta name="viewport" content="width=device-width, initial-scale=1.0">
  6. <!-- Latest compiled and minified CSS -->
  7. <link rel="stylesheet" href="https://maxcdn.bootstrapcdn.com/bootstrap/3.3.2/css/bootstrap.min.css">
  8. <!-- Latest compiled and minified JavaScript -->
  9. <script src="//code.jquery.com/jquery-migrate-1.2.1.min.js"></script>
  10. <script src="//code.jquery.com/jquery-1.11.2.min.js"></script>
  11. <script src="https://maxcdn.bootstrapcdn.com/bootstrap/3.3.2/js/bootstrap.min.js"></script>
  12. <script src="/js/customers.js"></script>
  13. </head>
  14. <body>
  15. <div class="container">
  16. <h2>Add new Customer</h2>
  17. <form class="form-horizontal" id="createCustomer">
  18. <div class="form-group">
  19. <label class="control-label col-sm-2">First Name:</label>
  20. <div class="col-sm-10">
  21. <input type="text" name="first_name" class="form-control" id="first_name" placeholder="first name">
  22. </div>
  23. </div>
  24. <div class="form-group">
  25. <label class="control-label col-sm-2">Last Name:</label>
  26. <div class="col-sm-10">
  27. <input type="text" name="last_name" class="form-control" id="last_name" placeholder="last name">
  28. </div>
  29. </div>
  30. <div class="form-group">
  31. <label class="control-label col-sm-2">Mail: </label>
  32. <div class="col-sm-10">
  33. <input type="text" name="mail" class="form-control" id="mail" placeholder="ex. fredde990@gmail.com">
  34. </div>
  35. </div>
  36. <div class="form-group">
  37. <label class="control-label col-sm-2">Phone:</label>
  38. <div class="col-sm-10">
  39. <input type="text" name="phone" class="form-control" id="phone" placeholder="10 numbers">
  40. </div>
  41. </div>
  42. <div class="form-group">
  43. <label class="control-label col-sm-2">Street:</label>
  44. <div class="col-sm-10">
  45. <input type="text" name="street" class="form-control" id="street" placeholder="Ex. Övre husargatan">
  46. </div>
  47. </div>
  48. <div class="form-group">
  49. <label class="control-label col-sm-2">City:</label>
  50. <div class="col-sm-10">
  51. <input type="text" name="city" class="form-control" id="city" placeholder="Ex. Estocolmo">
  52. </div>
  53. </div>
  54. <div class="form-group">
  55. <label class="control-label col-sm-2">Zip:</label>
  56. <div class="col-sm-10">
  57. <input type="text" name="zip" class="form-control" id="zip" placeholder="Ex. 41422">
  58. </div>
  59. </div>
  60. <div class="form-group">
  61. <label class="control-label col-sm-2">Gender:</label>
  62. <div class="col-sm-10">
  63. <input type="text" name="gender" class="form-control" id="gender" placeholder="M or F">
  64. </div>
  65. </div>
  66. <div class="form-group">
  67. <label class="control-label col-sm-2">ssn:</label>
  68. <div class="col-sm-10">
  69. <input type="text" name="ssn" class="form-control" id="ssn" placeholder="date of birth">
  70. </div>
  71. </div>
  72. <div class="form-group">
  73. <div class="col-sm-offset-2 col-sm-10">
  74. <button type="submit" class="btn btn-default createCustomerButton" id="submit">Submit</button>
  75. </div>
  76. </div>
  77. </form>
  78. </div>
  79. </body>
  80. </html>
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