PK
<head>
<script language="JavaScript" type="text/javascript">
<!--
function checkform ( form ){
// ** START **
if (form.certificateno.value == "") {
alert( "Please enter Certificate no. here." );
form.certificateno.focus();
return false ;
}
// ** END **
// ** START **
if (form.datefumigantion.value == "") {
alert( "Please enter date and place of fumigation." );
form.datefumigantion.focus();
return false ;
}
// ** END **
// ** START **
if (form.temp.value == "") {
alert( "Please enter Temp here." );
form.temp.focus();
return false ;
}
// ** END **
// ** START **
if (form.volume.value == "") {
alert( "Please enter Volume." );
form.volume.focus();
return false ;
}
// ** END **
// ** START **
if (form.value.value == "") {
alert( "Please enter Value:" );
form.value.focus();
return false ;
}
// ** END **
// ** START **
if (form.gsheet.value == "") {
alert( "Please enter gsheet:" );
form.gsheet.focus();
return false ;
}
// ** END **
// ** START **
if (form.seelno.value == "") {
alert( "Please enter seel no:" );
form.seelno.focus();
return false ;
}
// ** END **
// ** START **
if (form.port.value == "") {
alert( "Please enter Destination Port:" );
form.port.focus();
return false ;
}
// ** END **
// ** START **
if (form.vessal.value == "") {
alert( "Please enter vessal:" );
form.vessal.focus();
return false ;
}
// ** END **
// ** START **
if (form.desc.value == "") {
alert( "Please enter Desc:" );
form.desc.focus();
return false ;
}
// ** END **
// ** START **
if (form.quantity.value == "") {
alert( "Please enter quantity:" );
form.quantity.focus();
return false ;
}
// ** END **
// ** START **
if (form.packing.value == "") {
alert( "Please enter packing value:" );
form.packing.focus();
return false ;
}
// ** END **
// ** START **
if (form.brand.value == "") {
alert( "Please enter brand:" );
form.brand.focus();
return false ;
}
// ** END **
// ** START **
if (form.invoice.value == "") {
alert( "Please enter invoice no. and date :" );
form.invoice.focus();
return false ;
}
// ** END **
// ** START **
if (form.amount.value == "") {
alert( "Please enter amount here:" );
form.amount.focus();
return false ;
}
// ** END **
return true ;
}
//-->
</script>
</head>
<table cellspacing="3" align="center" width="100%" border="4" cellpadding="3">
<!-- <form action="certificate-nspm-confirm.php" method="get" onsubmit="return checkform(this);"> -->
<form action="form/confirmform_nspm.php" method="post" onSubmit="return checkform(this);">
<input type="hidden" name="cert_id" value="<?php echo "$_GET[cert_id]" ;?>">
<input type="hidden" name="formno" value="<?php echo "$_REQUEST[formno]" ;?>">
<input type="hidden" name="dtype" value="<?php echo "$_REQUEST[dtype]" ;?>">
<input type="hidden" name="sub_c" value="<?php echo "$_REQUEST[sub_c]";?>">
<input type="hidden" name="parent_cert" value="<?php echo "$_REQUEST[parent_cert]"; ?>">
<tr>
<td valign="top" colspan="8">
<center>
<h3> FUMIGATION CERTIFICATE - NSPM</h3>
</center>
</td>
</tr>
<tr>
<td colspan="8" align="center">
<p>This is to certify that the goods
deseibed below were treated in accordance with the fumigation treatment
requirements of importing country USA and declared that the consignment
has been verified free of impervious surfaces/layers such as plastic
wrapping or laminated plastic films,lacqured or painted surface,aluminium
foil,tarred or waxed paper etc.that may adversely effect the penetration
of the fumigant,prior to fumigation.
</p>
</td>
</tr>
<tr>
<td valign="top" colspan="4">Dte PPQS Regd.No.:584/MB</td>
<td valign="top" colspan="4">Date:15/05/2017</td>
</tr>
<tr>
<td valign="top" colspan="4">Treatment Certificate No.:
<em>Auto assigned</em>
</td>
<td colspan="4">
Date:<input type="text" name="issuedate" class="datepicker" value="<?php echo date('Y-m-d'); ?>">
</td>
</tr>
<tr>
<td align="left" colspan="6"><strong><font color="#339933">PARTY DETAILS:</font> </strong></td>
</tr>
<?php
//echo"<input type=hidden name=clntid value=$_GET[clntid]>";
echo"<input type=hidden name=dtype value=$_GET[dtype]>";
$sql="SELECT * From head WHERE headid='$_GET[clntid]'";
$result=mysql_query($sql) or die('error in getting client details');
while($row=mysql_fetch_array($result)){
if($_GET['dtype']=='import'){
$clnitsid = $_GET['clntid'];
echo "<input type=hidden name=declarednameaddress value=$clnitsid>";
echo "<tr>
<td align=left colspan=3>Name and address of consignor/exporter:</td>
<td align=center colspan=3>";
/*
echo "<select name=nameaddress>";
$sqlb="SELECT * From clients where subname<>'.' AND subname<>'' AND subname<>'..' ORDER BY subname ASC";
$resultb=mysql_query($sqlb) or die('error in getting Sub client details');
echo"<option value='1121'>.</option>";
while($rowb=mysql_fetch_array($resultb))
{
$subid="{$rowb['subid']}";
$subname="{$rowb['subname']}";
echo"<option value=$subid>".substr($subname,0,25)." -> ".substr($rowb['subaddress'],0,25)."</option>";
}
echo"</select>";
*/
?>
<input name='nameaddress' id="exporterslist" size="80" type="text" />
<?
echo "</td>
</tr>
<br>
<tr>
<td colspan=3>Name & address of consignee:</td>
<td align=center colspan=3>
<b>{$row['headname']}</b><br>{$row['headaddress']}<br>{$row['headphone']}
</td>
</tr>
";
}else{
$clnitsid = $_GET['clntid'];
echo "<input type=hidden name=nameaddress value=$clnitsid>";
echo "<tr>
<td colspan=3>Name and address of consignor/exporter:</td>
<td align=center colspan=3>
<b>{$row['headname']}</b><br>{$row['headaddress']}<br>{$row['headphone']}
</td>
</tr>
<br>
<tr>
<td colspan=3>Name & address of consignee:</td>
<td align=center colspan=3>";
/*
echo <select name=declarednameaddreZZ>";
$sqlb="SELECT * From clients where subname<>'.' AND subname<>'' AND subname<>'..' ORDER BY subname ASC";
$resultb=mysql_query($sqlb) or die('error in getting Sub client details');
echo"<option value='1121'>.</option>";
while($rowb=mysql_fetch_array($resultb))
{
$subid="{$rowb['subid']}";
$subname="{$rowb['subname']}";
echo"<option value=$subid>".substr($subname,0,25)." -> ".substr($rowb['subaddress'],0,25)."</option>";
}
echo"</select>";
*/
?>
<input name='declarednameaddress' id="exporterslist" size="80" type="text" />
<?php
echo "</td>
</tr>
";
}
}
?>
<tr>
<td valign="top" colspan="4">Country</td>
<td colspan="4"><input type="text" name="country" value="<?php echo $_POST['country']; ?>" /></td>
</tr>
<tr>
<td colspan="8" align="center">
<hr>
<font color="#339933"><strong>DETAILS OF TREATMENT:</strong></font>
</td>
</tr>
<tr>
<td colspan="2">Name of fumigation:<br></td>
<td colspan="2">
<select name="namefumigant">
<option <?php echo($_POST[namefumigant]=="METHYL BROMIDE"?"selected":"")?>>METHYL BROMIDE</option>
<option <?php echo($_POST[namefumigant]=="ALUMINIUM PHOSPHIDE"?"selected":"")?>>ALUMINIUM PHOSPHIDE</option>
<option <?php echo($_POST[namefumigant]=="."?"selected":"")?>>.</option>
</select>
</td>
<td colspan="2">Dosage rate of fumigation:<br></td>
<td colspan="2">
<select name="dosagefumigant">
<option <?php echo($_POST[dosagefumigant]=="6 Gms Per Cubic Meter"?"selected":"")?>>6 Gms Per Cubic Meter</option>
<option <?php echo($_POST[dosagefumigant]=="9 Gms Per Cubic Meter"?"selected":"")?>>9 Gms Per Cubic Meter</option>
<option <?php echo($_POST[dosagefumigant]=="12 Gms Per Cubic Meter"?"selected":"")?>>12 Gms Per Cubic Meter</option>
<option <?php echo($_POST[dosagefumigant]=="16 Gms Per Cubic Meter"?"selected":"")?>>16 Gms Per Cubic Meter</option>
<option <?php echo($_POST[dosagefumigant]=="24 Gms Per Cubic Meter"?"selected":"")?>>24 Gms Per Cubic Meter</option>
<option <?php echo($_POST[dosagefumigant]=="32 Gms Per Cubic Meter"?"selected":"")?>>32 Gms Per Cubic Meter</option>
<option <?php echo($_POST[dosagefumigant]=="40 Gms Per Cubic Meter"?"selected":"")?>>40 Gms Per Cubic Meter</option>
<option <?php echo($_POST[dosagefumigant]=="48 Gms Per Cubic Meter"?"selected":"")?>>48 Gms Per Cubic Meter</option>
<option <?php echo($_POST[dosagefumigant]=="56 Gms Per Cubic Meter"?"selected":"")?>>56 Gms Per Cubic Meter</option>
<option <?php echo($_POST[dosagefumigant]=="64 Gms Per Cubic Meter"?"selected":"")?>>64 Gms Per Cubic Meter</option>
<option <?php echo($_POST[dosagefumigant]=="80 Gms Per Cubic Meter"?"selected":"")?>>80 Gms Per Cubic Meter</option>
<option <?php echo($_POST[dosagefumigant]=="88 Gms Per Cubic Meter"?"selected":"")?>>88 Gms Per Cubic Meter</option>
<option <?php echo($_POST[dosagefumigant]=="96 Gms Per Cubic Meter"?"selected":"")?>>96 Gms Per Cubic Meter</option>
<option <?php echo($_POST[dosagefumigant]=="100 Gms Per Cubic Meter"?"selected":"")?>>100 Gms Per Cubic Meter</option>
<option <?php echo($_POST[dosagefumigant]=="9 Gms Per Ton"?"selected":"")?>>9 Gms Per Ton</option>
<option <?php echo($_POST[dosagefumigant]=="12 Gms Per Ton"?"selected":"")?>>12 Gms Per Ton</option>
<option <?php echo($_POST[dosagefumigant]=="."?"selected":"")?>>.</option>
</select>
</td>
</tr>
<tr>
<td colspan="4" nowrap>
Date of Fumigation:
<select name="fumi_completed">
<option value="" <?php echo ($_POST['fumi_completed']==0?"selected":""); ?>>Blank</option>
<option value="1" <?php echo ($_POST['fumi_completed']?"selected":""); ?>>Completed</option>
</select>
<!-- <input type="text" name="fumi_completed" value="<?php echo $_POST['fumi_completed']; ?>" /> -->
<input type="text" name="datefumigantion" class="datepicker" value="<?php echo $_POST['datefumigantion']; ?>" />
</td>
<td colspan="2">Place of Fumigation:</td>
<td colspan="2">
<input type="text" name="placefumigantion" value="<?php echo $_POST['placefumigantion']; ?>" />
</td>
</tr>
<tr>
<td colspan="2">Duration of Exposure:<br></td>
<td colspan="2">
<select name="durationfumigantion">
<option <?php echo($_POST[durationfumigantion]=="2 Hour"?"selected":"")?>>2 Hour</option>
<option <?php echo($_POST[durationfumigantion]=="2.5 Hour"?"selected":"")?>>2.5 Hour</option>
<option <?php echo($_POST[durationfumigantion]=="12 Hour"?"selected":"")?>>12 Hour</option>
<option <?php echo($_POST[durationfumigantion]=="24 Hour"?"selected":"")?>>24 Hour</option>
<option <?php echo($_POST[durationfumigantion]=="48 Hour"?"selected":"")?>>48 Hour</option>
<option <?php echo($_POST[durationfumigantion]=="72 Hour"?"selected":"")?>>72 Hour</option>
<option <?php echo($_POST[durationfumigantion]=="120 Hour"?"selected":"")?>>120 Hour</option>
<option <?php echo($_POST[durationfumigantion]=="7 days"?"selected":"")?>>7 days</option>
</select>
</td>
</tr>
<tr>
<td valign="top" colspan="2">Temparure During Fumigation:</td>
<td colspan="2"><input type="text" name="airtemp" value="<?php echo $_POST['airtemp']; ?>" /></td>
<td valign="top" colspan="2">Fumigation Performed under Gastight Sheets:</td>
<td colspan="2"><input type="text" name="gsheet" value="<?php echo $_POST['presstest']; ?>" /></td>
</tr>
<tr>
<td valign="top" colspan="6">If Containers are not fumigated Under Gas-Tight sheers,Pressure decay Value (From 200-100 Pascal's Insecond:</td>
<td colspan="2"><input type="text" name="gas_tight_value" value="<?php echo $_POST['gas_tight_value']; ?>" ></td>
</tr>
<tr>
<td colspan="8" align="center"><strong>Descripition of Goods</strong></td>
</tr>
<tr>
<td valign="top" colspan="4">Container Number(or Numerical Link)./ Seal Number:</td>
<td colspan="4"><input type="text" name="conslinkno" value="<?php echo $_POST['conslinkno']; ?>"></td>
</tr>
<tr>
<td valign="top" colspan="4">Port of Discharge:</td>
<td colspan="4"><input type="text" name="port" value="<?php echo $_POST['portcountry']; ?>"></td>
</tr>
<tr>
<td valign="top" colspan="4">Vessal Name:</td>
<td colspan="4"><input type="text" name="vessal" value="<?php echo $_POST['nameship']; ?>"></td>
</tr>
<!-- <tr>
<td valign="top" colspan="4">Name & Address Of Exporter:</td>
<td colspan="4"><?php echo"$_GET[clntid]";?></td>
</tr> -->
<tr>
<td valign="top" colspan="4">Type and Description of Cargo:</td>
<td colspan="4"><input type="text" name="desc" value="<?php echo $_POST['contype']; ?>"></td>
</tr>
<tr>
<td valign="top" colspan="4">Quantity(MTS)/No Of Packages/No Of Pieces:</td>
<td colspan="4"><input type="text" name="quantitydeclared" value="<?php echo $_POST['quantitydeclared']; ?>"></td>
</tr>
<tr>
<td valign="top" colspan="4">Description Of Packing Material:</td>
<td colspan="4"><input type="text" name="packing" value="<?php echo $_POST['desgood']; ?>"></td>
</tr>
<tr>
<td valign="top" colspan="4">Shipping marks or Brand:</td>
<td colspan="4"><input type="text" name="brand" value="<?php echo $_POST['brand']; ?>" /></td>
</tr>
<!-- <tr>
<td valign="top" colspan="4">Invoice No.& Date:</td>
<td colspan="4"><input type="text" name="invoice"></td>
</tr> -->
<tr>
<td valign="top" colspan="4">Additional Declaration:</td>
<td colspan="4"><textarea name="decla" rows="2" cols="60"><?php echo $_POST['decla']; ?></textarea></td>
</tr>
<tr>
<td valign="top" colspan="4">Distinguishing Mark:</td>
<td colspan="4"><input type="text" name="distmarks" value="<?php echo ($_POST[distmarks]?$_POST[distmarks]:"N/A")?>" /></td>
</tr>
<tr>
<td valign="top" colspan="4">
<input type="checkbox" <?php echo ($_POST[shiper_containerno_shw]?"checked":"")?> value="1" name="shiper_containerno_shw" />
As per shipper Cargo is Loaded in Container No:
</td>
<td colspan="4"><input type="text" name="shiper_containerno" value="<?php echo $_POST[shiper_containerno]?>" /></td>
</tr>
<tr>
<td valign="top" colspan="4">
<input type="checkbox" <?php echo ($_POST[consignment_details_shw]?"checked":"")?> value="1" name="consignment_details_shw" />
Consignment details as declared by the Exporter:
</td>
<td colspan="4"><input type="text" name="consignment_details" value="<?php echo $_POST[consignment_details]?>" /></td>
</tr>
<tr>
<td valign="top" colspan="8" align="center">P.S.No Liability to the Certifying or Its proprietors or repersentative with Respect to this Certificate.</td>
</tr>
<tr>
<td colspan="7" align="center">
<center>
<strong>MAKE INVOICE:</strong>
</center>
</td>
</tr>
<tr>
<td colspan="3">For agent:-</td>
<td colspan="4">
<input name='ajtname' id="agentslist" size="80" type="text" />
<!--select name="ajtname">
<option value="0">Select an agent</option>
<?php
$sql="SELECT ajcomp,ajid FROM ajent order by ajcomp";
$result=mysql_query($sql) or die('error in fetch');
if
(mysql_num_rows($result) == 0)
{ echo "<option value=0>no agents found</option>";
}
while($row=mysql_fetch_array($result))
{
echo"<option value='".$row['ajid']."'>{$row['ajcomp']}</option>";
}
?></select-->
</td>
</tr>
<tr>
<td colspan="3" align="right"><strong>Fumigation Amount</strong> :</td>
<td align="center" colspan="4"> Rs.
<input type="text" name="famount">/-</td>
</tr>
<tr>
<tr>
<td colspan="3" align="right"><strong>Travel Expenses</strong> :</td>
<td align="center" colspan="4"> Rs.
<input type="text" name="tamount">/-</td>
</tr>
<tr>
<td colspan="3" align="right"><strong>Miscellaneous</strong> :</td>
<td align="center" colspan="4"> Rs.
<input type="text" name="mamount">/-</td>
</tr>
<tr>
<td colspan="3" align="right"> Discount:<em>(in %age)</em></td>
<td colspan="4" align="center">
<input type="text" name="discount" size="4" value="0" onfocus="this.value=''"> %
</td>
</tr>
<tr>
<td colspan="3" align="right">
<input type="checkbox" name="stax" value="yes" checked>
GST :
</td>
<td colspan="4" align="center">
<input type="text" name="srtax" value="18" size="4"> %
</td>
</tr>
<tr class="highlight">
<td colspan="3" align="right">No. of Container:</td>
<td colspan="4">
<input name="qty" size="4" value="1" type="text">
</td>
</tr>
<tr>
<td colspan="3" align="right">IGST :</td>
<td colspan="4">
<input name="gst_combine" value="1" type="checkbox">
</td>
</tr>
<tr class="highlight">
<td colspan="3" align="right">Name of Product/Service:</td>
<td colspan="4">
<input name="product" size="100" value="Disinfecting and exterminating services" type="text">
</td>
</tr>
<tr>
<td colspan="3" align="right">SAC:</td>
<td colspan="4">
<input name="hsn" size="40" value="998531" type="text">
</td>
</tr>
<tr class="highlight">
<td colspan="3" align="right">UOM :</td>
<td colspan="4">
<input name="uom" size="40" type="text">
</td>
</tr>
<tr>
<td colspan="3" align="center" valign="middle">Particulars</td>
<td colspan="4">
<textarea name="particular" rows="2" cols="40"></textarea>
</td>
</tr>
<tr>
<td colspan="8" align="center">
<center><input type="submit" value="» Confirm details »" class="amo-submit"></center>
</td>
</tr>
</form>
</table>
<script>
$(".datepicker").datepicker({
dateFormat: 'yy-mm-dd'
});
</script>
PK 99