<?php include('link/header.php')?>
    
    <?php
   // $fee=$_REQUEST['fee'];
     $apply=$_REQUEST['flag'];
     
     if($apply=='Health Worker')
     {
         $fee='0';
     }
     else {
         $fee='0';
     }
    
    ?>
    <script src="https://ajax.googleapis.com/ajax/libs/jquery/3.7.1/jquery.min.js"></script>
    <script>
$(document).ready(function(){
	$("#chek").change(function(){
	   
		
		if($(this).prop("checked")==true)
		{
		    $("#show1").css("display","inline-block");
			$("#btn").prop("disabled",true);
			
			
		
		}
		else
		{
			$("#show1").css("display","none");
		    $("#btn").prop("disabled",false);
		
		}
	
	});

		
	});
        
        
	 $(document).ready(function(){
		// alert();
		var pri=$("#pri").val();
				$("#n").hide();
				$("#myform21").submit(function(e){
					
					
					$("#btnContinue").prop("disabled",true);
					e.preventDefault();
					$.ajax({
						url:"code/registrationcode.php?flag=22",
						type:"POST",
						data: new FormData(this),
						contentType:false,
						processData:false,
						success:function(res){
					//	alert(res);
						//	$("#n").show();
							$("#show").html(res);
							
						
							 //	window.location.href='payment.php?flag='+res;
							
						
							
						},
						error:function(){
							alert("error");
							$("#btnContinue").prop("disabled",false);
						}
					});
				});
				
			});
			
    </script>
      <!-- Top header section -->
      <h2 class="text-center mt-5"><u>Free Area</u></h2>
        <section class="d-flex justify-content-center align-items-center pt-3 pb-5 p-3">
            
            <div class="col-md-6" id="box">
                
                <form id="myform21">
                    <div class="form-row">
                         <div class="col-md-12 mb-12">
                        <label for="validationServer023">Date Of Birth<span class="star">*</span></label>
                        <input type="date" name="dob" class="form-control " id="validationServer023" placeholder=""
                            required>
                        
                      </div>
                     
                      <div class="col-md-12 mb-12">
                        <label for="validationServer023">Mobile No<span class="star">*</span></label>
                        <input type="number" name="mobile" class="form-control " id="validationServer023" placeholder=""
                            required>
                        
                      </div>
                     
                   
			
                  <!-- 
                   <button class="btn btn-primary" type="submit">Submit form</button>
                   
               -->
               <br/>
                <div class="col-md-12 mb-12"><br/>
                         <center><div id='show1'><button class="btn btn-primary btn-sm" >Search</button></div></center>
                        
                      </div>
              
                      
                </form>
                
                <div id='show'></div>
                
            </div>
        </section>
        
        
      
  

  <!-- header end -->

        <!-- Footer Section End --> 
         
    <!-- Option 1: jQuery and Bootstrap Bundle (includes Popper) -->

    <script>
        AOS.init({
            offset: 300,
            duration: 1000,
        });
        </script>
  
    </body>

</html>