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<?php 
session_start();
include("config.php");
?>
<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1" />
<meta name="vs_defaultClientScript" content="JavaScript">
<title><?php echo $info['Title']; ?></title>
<meta name="Description" content="<?php echo $info['Description']; ?>">
<meta name="keywords" content="<?php echo $info['Keywords']; ?>">
<link href="style.css" rel="stylesheet" type="text/css">
<link rel="stylesheet" type="text/css" media="screen" href="webaddict/css/cmxform.css" />
<style type="text/css">
body {
font-family:Verdana, Arial, Helvetica, sans-serif;
font-size:11px;
}
.top {
margin-bottom: 15px;
}
.tabpadding{padding:10px;height:25px;}
.messagebox{
  position:absolute;
  width:100px;
  margin-left:30px;
  border:1px solid #c93;
  background:#ffc;
  padding:3px;
}
.messageboxok{
  position:absolute;
  width:auto;
  margin-left:30px;
  border:1px solid #349534;
  background:#C9FFCA;
  padding:3px;
  font-weight:bold;
  color:#008000;
  
}
.messageboxerror{
  position:absolute;
  width:auto;
  margin-left:30px;
  border:1px solid #CC0000;
  background:#F7CBCA;
  padding:3px;
  font-weight:bold;
  color:#CC0000;
}

</style>

$("#MatriForm").validate({
    rules: {
       
      EMAIL: {
        required: true,
        email: true,
        remote: "emails.php"
      },
      
      agree: "required"
      
    },
    messages: {
      fname: "<br><img src=images/error_bang.gif> Please enter your firstname",
      lname: "<br><img src=images/error_bang.gif> Please enter your lastname",
      username: {
        required: "<br><img src=images/error_bang.gif> Username required",
        minlength: "<br><img src=images/error_bang.gif> Your username must consist of at least 5 characters"
        
      },
      bemail: {
        required: "<br><img src=images/error_bang.gif> Valid email required",
        minlength: "<br><img src=images/error_bang.gif> Valid email required",
        remote: jQuery.format(" <img src=images/error_bang.gif> {0} is already in use")
      },
      password: {
        required: "<br><img src=images/error_bang.gif> Password required",
        minlength: "<br><img src=images/error_bang.gif>  Password must be at least 5 characters long"
      },
      confirm_email: {
        required: "<br><img src=images/error_bang.gif>  Email required",
        equalTo: "<br><img src=images/error_bang.gif>  Enter the same email as above"
      },
      confirm_password: {
        required: " <img src=images/error_bang.gif> Password required",
        minlength: "<br><img src=images/error_bang.gif> Password must be at least 5 characters long",
        equalTo: "<br><img src=images/error_bang.gif> Please enter the same password as above"
      },
      dobMonth: {
        required: "<div style='float:right;'> <img src=images/error_bang.gif> Month required</div>"
        },
        dobDay: {
        required: "<div style='float:right;'> <img src=images/error_bang.gif> Date required</div>"
        },
      dobYear: {
        required: "<div style='float:right;'> <img src=images/error_bang.gif>Year required</div>"
        },
      mobile: {
        maxlength: "<br><img src=images/error_bang.gif> mobilenumber must be at 10 characters"
        },  
      message: {
        required: "<br><img src=images/error_bang.gif> Profile required",
        minlength: "<br><img src=images/error_bang.gif> Profile must be at least 50 characters long",
        maxlength: "<br><img src=images/error_bang.gif> Profile must be at maximum 600 characters long"
      },
      captcha_input: {
      required: "<br><img src=images/error_bang.gif> Code required",
        equalTo: "<br><img src=images/error_bang.gif> Please enter the correct Code"
      },
      //email: " Please enter a valid email address",
      agree: " <img src=images/error_bang.gif> Please accept our terms<br>"
    }
  });
  
  // propose username by combining first- and lastname
  $("#username").focus(function() {
    var firstname = $("#firstname").val();
    var lastname = $("#lastname").val();
    if(firstname && lastname && !this.value) {
      this.value = firstname + "." + lastname;
    }
  });
  
  // check if confirm password is still valid after password changed
  $("#password").blur(function() {
    $("#confirm_password").valid();
  });
  
  //code to hide topic selection, disable for demo
  var newsletter = $("#newsletter");
  // newsletter topics are optional, hide at first
  var inital = newsletter.is(":checked");
  var topics = $("#newsletter_topics")[inital ? "removeClass" : "addClass"]("gray");
  var topicInputs = topics.find("input").attr("disabled", !inital);
  // show when newsletter is checked
  newsletter.click(function() {
    topics[this.checked ? "removeClass" : "addClass"]("gray");
    topicInputs.attr("disabled", !this.checked);
  });
});
</script>
</head>
<script type="text/javascript">
function nospaces(t){
 }
</script>

function updateDay(change,formName,yearName,monthName,dayName)
{ 
  
  var form = document.forms[formName];
  var yearSelect = form[yearName];
  var monthSelect = form[monthName];
  var daySelect = form[dayName];
  var year = yearSelect[yearSelect.selectedIndex].value;
  var month = monthSelect[monthSelect.selectedIndex].value;
  var day = daySelect[daySelect.selectedIndex].value;

if (change == 'month' || (change == 'year' && month == 2))
  {
    var i = 31;
    var flag = true;
    while(flag)
    {
      var date = new Date(year,month-1,i);
      if (date.getMonth() == month - 1)
      {
        flag = false;
      }
      else
      {
        i = i - 1;
      }
    }

daySelect.length = 0;
    daySelect.length = i;
    var j = 0;
    while(j < i)
    {
      daySelect[j] = new Option(j+1,j+1);
      j = j + 1;
    }
    if (day <= i)
    {
      daySelect.selectedIndex = day - 1;
    }
    else
    {
      daySelect.selectedIndex = daySelect.length - 1;
    }
  }
}

</script>

<!--
<script language="javascript1.1">

function nospaces(t){
if(t.value.match(/\s/g)){
alert('Sorry, you are not allowed to enter any spaces');
t.value=t.value.replace(/\s/g,'');
}
}
</script>
-->
<script language="javascript1.1">
function HaveChildnp()
  {
//    var MARST = document.MatriForm.MARITAL_STATUS.options[document.MatriForm.MARITAL_STATUS.selectedIndex].value;

var CHILDLW = document.MatriForm.NOOFCHILDREN.options[document.MatriForm.NOOFCHILDREN.selectedIndex].value;

if(document.MatriForm.MARITAL_STATUS[0].checked )
    {
    
    document.MatriForm.NOOFCHILDREN.value ='';
    document.MatriForm.NOOFCHILDREN.disabled=true;  
    document.MatriForm.CHILDLIVINGWITHME[0].disabled=true;    
    document.MatriForm.CHILDLIVINGWITHME[1].disabled=true;                  
      }
     else if ( document.MatriForm.MARITAL_STATUS[1].checked || document.MatriForm.MARITAL_STATUS[2].checked  || document.MatriForm.MARITAL_STATUS[3].checked)
    {
    document.MatriForm.NOOFCHILDREN.disabled=false;     
    document.MatriForm.CHILDLIVINGWITHME[0].disabled=false;   
    document.MatriForm.CHILDLIVINGWITHME[1].disabled=false;                     
    }
    
    if(document.MatriForm.MARITAL_STATUS[0].checked && document.MatriForm.CHILDLIVINGWITHME[0].checked || document.MatriForm.CHILDLIVINGWITHME[1].checked)
    {
    document.MatriForm.CHILDLIVINGWITHME[0].disabled=true;    
    document.MatriForm.CHILDLIVINGWITHME[1].disabled=true;                      
    }

if(CHILDLW > 0)
    {
      if ( document.MatriForm.MARITAL_STATUS[0].checked)
      {
          if ( (document.MatriForm.CHILDLIVINGWITHME[0].checked || document.MatriForm.CHILDLIVINGWITHME[1].checked) && (!document.MatriForm.CHILDLIVINGWITHME[0].checked || !document.MatriForm.CHILDLIVINGWITHME[1].checked) )
          {
              document.MatriForm.CHILDLIVINGWITHME[0].checked=false;
              document.MatriForm.CHILDLIVINGWITHME[1].checked=false;
              document.MatriForm.CHILDLIVINGWITHME[0].disabled=true;    
              document.MatriForm.CHILDLIVINGWITHME[1].disabled=true;  
          }
          
    
          
      }
    }

if(CHILDLW == 0)
    {
    document.MatriForm.CHILDLIVINGWITHME[0].disabled=true;    
    document.MatriForm.CHILDLIVINGWITHME[1].disabled=true;              
      }
       
    else if ( CHILDLW > 1)
    {
    document.MatriForm.CHILDLIVINGWITHME[0].disabled=false;   
    document.MatriForm.CHILDLIVINGWITHME[1].disabled=false;             
    }
    
    
  }
</script>

for( var Idx1 = 0; Idx1 < String.length; Idx1 ++) 
        {
           if( Char == String.charAt( Idx1 ) ) 
           Match = true;
        }
        
        if ( !Match ) 
          return false;
    }

return true;
  }

function ValidateEmail( Email )
  {
    var atCharPresent = false;
    var dotPresent = false;

for ( var Idx = 0; Idx < Email.length; Idx++ )
    {
      if ( Email.charAt ( Idx ) == '@' )
        atCharPresent = true;
      if ( Email.charAt ( Idx ) == '.' )
        dotPresent = true;
    }

if ( !atCharPresent || !dotPresent )
      return false;

return true;
  }

function ResetValues( )
  {
    var MatriForm = this.document.MatriForm;

MatriForm.EMAIL.value = "";
    MatriForm.EMAILconfirm.value = "";
    MatriForm.txtp.value = "";
    MatriForm.txtcp.value = "";
    MatriForm.txtname.value = "";
    MatriForm.txtgender.value = "";
    MatriForm.txtmaritalstatus.value = "";
    
    return true;
  }

// Function to validate all the inputs
  function Validate()
  {
    var MatriForm = this.document.MatriForm;
    
    
    // Check the Name field
    if ( MatriForm.txtName.value == "" )
    {
      alert( "Please Enter your name." );
      MatriForm.txtName.focus( );
      return false;
    }

var iChars = "!@#$%^&*()+=-[]\\\';,./{}|\":<>?0123456789";

for (var i = 0; i < MatriForm.txtName.value.length; i++) {
    if (iChars.indexOf(MatriForm.txtName.value.charAt(i)) != -1) {
    alert ("Special characters and numbers are not allowed in Name.\n Please remove them.");
  MatriForm.txtName.focus( );
    return false;
    }
  }

// Check gender field
    if ( !MatriForm.txtGender[0].checked && !MatriForm.txtGender[1].checked)
    {
      //alert( "Please select the gender." );
      //alert("Welcome "  txtName "\nHow are we today");
      alert("Please Select the gender.");

MatriForm.txtGender[0].focus( );
      return false;
    }

if (document.MatriForm.dobMonth.options[document.MatriForm.dobMonth.selectedIndex].text=="-Month-") 
          {
            alert("Select Month");
          MatriForm.dobMonth.focus();
          return false;
          }
        if (document.MatriForm.dobDay.options[document.MatriForm.dobDay.selectedIndex].text=="-DATE-")  
          {
            alert("Select Day");
          MatriForm.dobDay.focus();
          return false;
          }
        if (document.MatriForm.dobYear.value=="0")    
          {
            alert("Select Year");
          MatriForm.dobYear.focus();
          return false;
          }
    
    
    
    // Check Marital Status
    if ( !MatriForm.MARITAL_STATUS[0].checked && !MatriForm.MARITAL_STATUS[1].checked && !MatriForm.MARITAL_STATUS[2].checked && !MatriForm.MARITAL_STATUS[3].checked)
    {
      alert( "Please Select the Marital Status." );
      MatriForm.MARITAL_STATUS[0].focus( );
      return false;
    }

if ( !(document.MatriForm.MARITAL_STATUS[0].checked) && MatriForm.NOOFCHILDREN.selectedIndex == 0 )
    {
      alert( "Please select the number of children" );
      MatriForm.NOOFCHILDREN.focus( );
      return false;
    }     
    
    if ( !(document.MatriForm.MARITAL_STATUS[0].checked) && document.MatriForm.NOOFCHILDREN.options[document.MatriForm.NOOFCHILDREN.selectedIndex].value >= 1 && !MatriForm.CHILDLIVINGWITHME[0].checked && !MatriForm.CHILDLIVINGWITHME[1].checked)
    {
      alert("Please indicate whether the child /children is/are living with you.");
      MatriForm.CHILDLIVINGWITHME[0].focus( );
      return false;
    }
    
    
    
    // Check Language
    if ( MatriForm.Language.selectedIndex == 0 )
    {
      alert( "Please Select your Language." );  
      MatriForm.Language.focus( );
      return false;
    }
    
    // Check Religion
    //if ( MatriForm.religion.selectedIndex == 0 )
    //{
    /// alert( "Please Select your Religion." );  
    /// MatriForm.religion.focus( );
    //  return false;
    //}
    
    // Check Caste

// Check E-mail field
    if ( MatriForm.EMAIL.value == "" )
    {
      alert( "Please enter a valid E-mail ID." );
      MatriForm.EMAIL.focus( );
      return false;
    }
    else
    {
      if ( !ValidateEmail( MatriForm.EMAIL.value ) )
      {
        alert( "Invalid E-mail " + MatriForm.EMAIL.value );
        MatriForm.EMAIL.focus( );
        return false;
      }
      for ( var Idx = 0; Idx < MatriForm.EMAIL.value.length; Idx++ )
      {
        if ( MatriForm.EMAIL.value.charAt(Idx) == ' ' 
          || MatriForm.EMAIL.value.charAt(Idx) == ' ' 
          || MatriForm.EMAIL.value.charAt(Idx) == ',' 
          || MatriForm.EMAIL.value.charAt(Idx) == '/' 
          || MatriForm.EMAIL.value.charAt(Idx) == '\\' 
          || MatriForm.EMAIL.value.charAt(Idx) == ';' )
        {
          alert( "Blanks or other invalid characters are not allowed in the e-mail ID.\n Please enter only one E-mail ID." );
          MatriForm.EMAIL.focus( );
          return false;
        }
      }
    }

if ( MatriForm.EMAILconfirm.value != "" && MatriForm.EMAILconfirm.value == "" )
    {
      alert( "Please confirm E-mail address" );
      MatriForm.EMAILconfirm.focus( );
      return false;
    }

if ( MatriForm.EMAIL.value != MatriForm.EMAILconfirm.value )
    {
      alert( "E-mail address did not match, please enter a  confirm E-mail" );
      MatriForm.EMAILconfirm.focus( );
      return false;
    }

// Check Password 
    if ( MatriForm.txtp.value == "" )
    {
      alert( "Please enter a password." );
      MatriForm.txtp.focus( );
      return false;
    }

if ( MatriForm.txtp.value.length < 4 )
    {
      alert( "Password must be atleast 4 characters." );  
      MatriForm.txtp.focus( );
      return false;
    }

if ( MatriForm.txtcp.value == "" )
    {
      alert( "Please enter a confirm password." );
      MatriForm.txtcp.focus( );
      return false;
    }

if ( MatriForm. txtp.value != MatriForm. txtcp.value )
    {
      alert( "Password did not match." );
      MatriForm.txtp.value = "";
      MatriForm.txtcp.value = "";

MatriForm.txtp.focus( );

return false;
    }

tmpPass = MatriForm.txtp.value;

goodPasswd = 1;

for( var idx=0; idx< tmpPass.length; idx++ )
    {
      ch = tmpPass.charAt(idx);

if( !((ch>='a') && (ch<='z')) && !((ch>='A') && (ch<='Z')) && !((ch>=0) && (ch <=9)) )
      {
        goodPasswd = 0;
        break;
      }
    }

if( goodPasswd ==0 )
    {
      alert( "Password must contains only letters and digits." );
      MatriForm. txtp.value="";
      MatriForm. txtcp.value="";
      MatriForm. txtp.focus();
      return false;
    }

//if ( MatriForm.txtGothra.value == "" )
//    {
//      alert( "Please select Gothra" );
//      MatriForm.txtGothra.focus( );
//      return false;
//    }

//var jChars = "!@#$%^&*()+=-[]\\\';,./{}|\":<>?0123456789";

//for (var j = 0; j < MatriForm.txtGothra.value.length; j++) {
  //  if (jChars.indexOf(MatriForm.txtGothra.value.charAt(j)) != -1) {
    //alert ("Special characters and numbers are not allowed in Gothram.\n Please remove them.");
  //MatriForm.txtGothra.focus();
    //return false;
  //  }
 // }
  
  
  var kChars = "!@#$%^&*()+=-[]\\\';,./{}|\":<>?0123456789";

for (var k = 0; k < MatriForm.txtPb.value.length; k++) {
    if (kChars.indexOf(MatriForm.txtPb.value.charAt(k)) != -1) {
    alert ("Special characters and numbers are not allowed in Place of Birth.\n Please remove them.");
  MatriForm.txtPb.focus();
    return false;
    }
  }
  
  
  
  if( !(MatriForm.txtAccept.checked) )
    {
      alert("Please read and accept the terms and conditions.");
      return false;
    }
  
    return true;
  }

</script> 
    
    
    
<script language="JavaScript">

function get_caste(obj,show_default){

var sel_caste = '';

var sel_religion  = obj.options[obj.selectedIndex].text;
    var caste_obj   = obj.form.elements["caste"];
    //CLEAN CASTE SELECT BOX
    while ( caste_obj.options.length ) caste_obj.options[0] = null;

//ADD FIRST SELECT OPTION
    caste_obj.options[0]=new Option("Does not matter","Does not matter",true);

//ADD CASTE OPTIONS FOR SELECTED RELIGION
    //if(obj.selectedIndex>0){
      for(j=0;j<caste[sel_religion].length;j++){
        //NOT TO INCLUDE OPTIONS HAVING NULL VALUES
        if(caste[sel_religion][j]!=""){
          var caste_val = caste[sel_religion][j]=="Does not matter"?"Does not matter":caste[sel_religion][j];
          var def_sel   = (sel_caste == caste_val) ? true : false;
                    caste_obj.options[j+1] = new Option(caste[sel_religion][j], caste_val, true, def_sel);

}
      }
    //}

}

</script>

</script>

MatriForm.EMAIL.value=""
  MatriForm.EMAILconfirm.value=""
  MatriForm.txtp.value=""
  MatriForm.txtcp.value=""
  //MatriForm.Accept.unChecked
  }
//-->
</script>

<div align="center" style="margin-top:10px;">
  <table width="780" border="0" cellpadding="0" cellspacing="0" bgcolor="#FFFFFF"  class="bordertopless" >
    
    <tr>
      <td width="780" height="164">
    
  
        <table width="935" border="0" align="center" cellpadding="0" cellspacing="0" >
          
         
          <tr>            </tr>
         
          
          <tr valign="top">
            <td height="206" colspan="2">
               
                  <table width="100%" border="0" align="center" cellpadding="0" cellspacing="0">
                    <tr>
                      <td width="570" class="LgHeading" bgcolor="#E8E3CD" style="padding:10px;">Fill Your Complete Registration Form,</td>
                   
                    </tr>
                  </table>
                 
         
                  
                  <div align="center">
                      <TABLE cellSpacing=0 cellPadding=0 width="846" border=0>
                        
                        <TR>
                          <TD class=grebg width=5  bgcolor="#E8E3CD"></TD>
                          <TD vAlign=top width=722><TABLE cellSpacing=3 cellPadding=3 width=739  border=0 style="background:url(images/privacy.jpg) no-repeat right top;">
                              <tr>
                      
                                <td colspan="2" align="right"> <span class="Alert">* </span> Mandatory fields</td>
                              </tr>
                    <tr>
                   
                      <td height="54" colspan="2" class="text_2"><div align="left"><img src="pics/chklist-tick.gif" width="9" height="9"> Please mention accurate information in this form or your profile may be declined.<br>
                          <img src="pics/chklist-tick.gif" width="9" height="9"> Spend a Few minutes to create your Profile to find a suitable life partner. <br>
                      </div></td>
                    </tr>
                
                
                        
          <TR>
          <TD class=grebg colSpan=2><IMG height=1  src="pics/trans.gif"></TD>
          </TR>
          <TR class=tabpadding>
            <TD colspan="2" class=grtxtbold1><div align="left"><span class="bodysg">Basic Information </span></div></TD>
            </TR>
            
                
 
  <tr>
    <td>Name<span style="color:#FF0000">*</span></td><td><input type="text" name="name" class="textfield" size="31"></td>
    
  </tr>
  <tr>
    <td>Gender<span style="color:#FF0000">*</span></td>
  <td><input type="radio" name="gender" value="male" >Male
&nbsp;&nbsp;&nbsp;<input type="radio" name="gender" value="female" >Female

</td>
    
  </tr>
  <tr>
    <td>Date Of Birth <span style="color:#FF0000">*</span></td><td> <select name="year" id="UsersDobYear" class="selectfield"> 
  
<option value="2010" selected="selected">2010</option> 
<option value="2009">2009</option> 
<option value="2008">2008</option> 
<option value="2007">2007</option> 
<option value="2006">2006</option> 
<option value="2005">2005</option> 
<option value="2004">2004</option> 
<option value="2003">2003</option> 
<option value="2002">2002</option> 
<option value="2001">2001</option> 
<option value="2000">2000</option> 
<option value="1999">1999</option> 
<option value="1998">1998</option> 
<option value="1997">1997</option> 
<option value="1996">1996</option> 
<option value="1995">1995</option> 
<option value="1994">1994</option> 
<option value="1993">1993</option> 
<option value="1992">1992</option> 
<option value="1991">1991</option> 
<option value="1990">1990</option> 
<option value="1989">1989</option> 
<option value="1988">1988</option> 
<option value="1987">1987</option> 
<option value="1986">1986</option> 
<option value="1985">1985</option> 
<option value="1984">1984</option> 
<option value="1983">1983</option> 
<option value="1982">1982</option> 
<option value="1981">1981</option> 
<option value="1980">1980</option> 
<option value="1979">1979</option> 
<option value="1978">1978</option> 
<option value="1977">1977</option> 
<option value="1976">1976</option> 
<option value="1975">1975</option> 
<option value="1974">1974</option> 
<option value="1973">1973</option> 
<option value="1972">1972</option> 
<option value="1971">1971</option> 
<option value="1970">1970</option> 
<option value="1969">1969</option> 
<option value="1968">1968</option> 
<option value="1967">1967</option> 
<option value="1966">1966</option> 
<option value="1965">1965</option> 
<option value="1964">1964</option> 
<option value="1963">1963</option> 
<option value="1962">1962</option> 
<option value="1961">1961</option> 
<option value="1960">1960</option> 
<option value="1959">1959</option> 
<option value="1958">1958</option> 
<option value="1957">1957</option> 
<option value="1956">1956</option> 
<option value="1955">1955</option> 
<option value="1954">1954</option> 
<option value="1953">1953</option> 
<option value="1952">1952</option> 
<option value="1951">1951</option> 
<option value="1950">1950</option> 
<option value="1949">1949</option> 
<option value="1948">1948</option> 
<option value="1947">1947</option> 
<option value="1946">1946</option> 
<option value="1945">1945</option> 
<option value="1944">1944</option> 
<option value="1943">1943</option> 
<option value="1942">1942</option> 
<option value="1941">1941</option> 
<option value="1940">1940</option> 
<option value="1939">1939</option> 
<option value="1938">1938</option> 
<option value="1937">1937</option> 
<option value="1936">1936</option> 
<option value="1935">1935</option> 
<option value="1934">1934</option> 
<option value="1933">1933</option> 
<option value="1932">1932</option> 
<option value="1931">1931</option> 
<option value="1930">1930</option> 
</select>-<select name="month" id="UsersDobMonth" class="selectfield"> 
<option value="01" selected="selected">January</option> 
<option value="02">February</option> 
<option value="03">March</option> 
<option value="04">April</option> 
<option value="05">May</option> 
<option value="06">June</option> 
<option value="07">July</option> 
<option value="08">August</option> 
<option value="09" >September</option> 
<option value="10">October</option> 
<option value="11">November</option> 
<option value="12">December</option> 
</select>-<select name="day" id="UsersDobDay" class="selectfield"> 
<option value="01" selected="selected">1</option> 
<option value="02">2</option> 
<option value="03">3</option> 
<option value="04" selected="selected">4</option> 
<option value="05">5</option> 
<option value="06">6</option> 
<option value="07">7</option> 
<option value="08">8</option> 
<option value="09">9</option> 
<option value="10">10</option> 
<option value="11">11</option> 
<option value="12">12</option> 
<option value="13">13</option> 
<option value="14">14</option> 
<option value="15">15</option> 
<option value="16">16</option> 
<option value="17">17</option> 
<option value="18">18</option> 
<option value="19">19</option> 
<option value="20">20</option> 
<option value="21">21</option> 
<option value="22">22</option> 
<option value="23">23</option> 
<option value="24">24</option> 
<option value="25">25</option> 
<option value="26">26</option> 
<option value="27">27</option> 
<option value="28">28</option> 
<option value="29">29</option> 
<option value="30">30</option> 
<option value="31">31</option> 
</select> 
  </td>
  </tr>

<tr>
  
    <td width="215">Email<span style="color:#FF0000">*</span></td>
    <td width="392"><input type="text" name="email" class="textfield" size="31"></td>
    
  </tr>

<TR>
                                <TD class=grebg colSpan=2><IMG height=1  src="pics/trans.gif"></TD>
                              </TR>
                              <TR class=tabpadding>
                                <TD class=grtxtbold1 vAlign=center><div align="left">Marital Status<span class="Alert"> *</span></div></TD>
                                <TD class=smalltxt><div align="left">
<input name=MARITAL_STATUS type=radio class="forminput" onClick="return HaveChildnp(this)" value=1>
Unmarried &nbsp;
<input name=MARITAL_STATUS type=radio class="forminput" onClick="return HaveChildnp(this)" value=2>
Widow/Widower &nbsp;
<input name=MARITAL_STATUS type=radio class="forminput" onClick="return HaveChildnp(this)" value=3>
Divorcee 
</div></TD>
                              </TR>

<TR>
                                <TD class=grebg colSpan=2><IMG height=1  src="pics/trans.gif"></TD>
                              </TR>
                              <TR class=tabpadding>
                                <TD class=grtxtbold1 width=201><div align="left">Handicapped</div></TD>
                                <TD vAlign=top><div align="left">
                                  <select name="hand"  class="selectfield" style="width:215px;">
                                    <option value="no" selected>No</option>
                                    <option value="yes">Yes</option>
                                    
                                  </select>
                                </div></TD>
                              </TR>

<TR>
                                <TD class=grebg colSpan=2><IMG height=1  src="pics/trans.gif"></TD>
                              </TR>
                              <TR class=tabpadding>
                                <TD class=grtxtbold1 width=201><div align="left">No. of Children</div></TD>
                                <TD vAlign=top><div align="left">
                                  <select name=NOOFCHILDREN  class="selectfield" onChange="return HaveChildnp(this)" style="width:215px;">
                                    <option value="" selected>- Select -</option>
                                    <option value=0>None</option>
                                    <option value="One">1</option>
                                    <option value="Two">2</option>
                                    <option value="Three">3</option>
                                    <option value="Four and above">4 and above</option>
                                  </select>
                                </div></TD>
                              </TR>
                              <TR>
                                <TD class=grebg colSpan=2><IMG height=1  src="pics/trans.gif"></TD>
                              </TR>
                              <TR class=tabpadding>
                                <TD class=grtxtbold1><div align="left">Children Living Status</div></TD>
                                <TD class=grtxt><div align="left">
                                  <input  name=CHILDLIVINGWITHME type=radio class="forminput" value=Yes>
Living with me &nbsp;
<input name=CHILDLIVINGWITHME type=radio class="forminput" onFocus=if(disabled)blur(); value=No>
Not living with me </div></TD>
                              </TR>
                              <TR>
                                <TD class=grebg colSpan=2><IMG height=1  src="pics/trans.gif"></TD>
                              </TR>
                              <TR>
                                <TD class=grebg colSpan=2><IMG height=1  src="pics/trans.gif"></TD>
                              </TR>
                              <TR class=tabpadding>
                                <TD class=grtxtbold1><div align="left">Religion<span class="Alert"> *</span></div></TD>
                                <TD class=grtxt><div align="left">
                                  <select name="religion" class="selectfield" id="religion" onChange="return caste_disable(document.MatriForm.religion);" style="width:220px;">
                                   <option value="- Select -" selected>- Select -</option>
                                    <option value="Hindu">Hindu</option>
                                    
                                  </select></div></TD>
                              </TR>
                              <TR>
                                <TD class=grebg colSpan=2><IMG height=1  src="pics/trans.gif"></TD>
                              </TR>
                              <TR class=tabpadding>
                                <TD class=grtxtbold1><div align="left">Caste<span class="Alert"> *</span></div></TD>
                                <TD class=grtxt><div align="left">
                                  <select name="caste" class="selectfield" id="caste" style="width:220px;">
                                  </select></div></TD>
                              </TR>
                
                
                              <TR>
                                <TD class=grebg colSpan=2><IMG height=1  src="pics/trans.gif"></TD>
                              </TR>
                              
                
        
        
         <TR>
                                <TD class=grebg colSpan=2><IMG height=1  src="pics/trans.gif"></TD>
                            </TR>
                              
        
          
                
                              <TR>
                                <TD class=grebg colSpan=2><IMG height=1  src="pics/trans.gif"></TD>
                              </TR>
                              <TR class=tabpadding>
                                <TD class=grtxtbold1><div align="left">Profile Created by </div></TD>
                                <TD><div align="left">
                                  <select name="txtPC" class="selectfield" id="txtPC" style="width:220px;">
                                    <option value="Self">Self</option>
                                    <option value="Parents">Parents</option>
                                    <option value="Guardian">Guardian</option>
                                    <option value="Friends">Friends</option>
                                    <option value="Sibling">Sibling</option>
                                    <option value="Relatives">Relatives</option>
                                  </select>
                                </div></TD>
                              </TR>
                              <TR>
                                <TD class=grebg colSpan=2><IMG height=1  src="pics/trans.gif"></TD>
                              </TR>
                              <TR class=tabpadding>
                                <TD class=grtxtbold1><div align="left">Reference by </div></TD>
                                <TD class=grtxt><div align="left">
                                  <select name="txtRef" class="selectfield" id="txtRef" style="width:220px;">
                                    <option value="Advertisements">Advertisements</option>
                                    <option value="Friends">Friends</option>
                                    <option value="Searh Engines">Searh Engines</option>
                                    <option value="Others">Others</option>
                                  </select>
                                </div></TD>
                              </TR>
                
          <TR>
          <TD class=greendot colSpan=2></TD>
          </TR>
          <TR class=tabpadding>
          <TD colspan="2" class=grtxtbold1><div align="left"><span class="bodysg">Socio Religious Attributes </span></div>            <div align="left"></div></TD>
          </TR>
                         
                
                
                
          <TR>
          <TD class=grebg colSpan=2><IMG height=1  src="pics/trans.gif"></TD>
          </TR>
          <TR class=tabpadding>
          <TD class=grtxtbold1><div align="left">Gothra(m)</div></TD>
          <TD><div align="left">
                    
                       <input name="txtGothra" type="text" class="textfield" id="txtGothra" size="40" maxlength="40" style="width:215px;" />
            
          </div></TD>
          </TR>
          
          
                
          <TR>
          <TD class=grebg colSpan=2><IMG height=1  src="pics/trans.gif"></TD>
          </TR>
          
          
          
                
          <TR>
          <TD class=grebg colSpan=2><IMG height=1  src="pics/trans.gif"></TD>
          </TR>
          
          
          
                
          <TR>
          <TD class=grebg colSpan=2><IMG height=1  src="pics/trans.gif"></TD>
          </TR>
          <TR class=tabpadding>
          <TD class=grtxtbold1><div align="left">Horoscope Match </div></TD>
          <TD><div align="left">
            <input name=txtHorosMatch type=radio class="forminput" onClick="return HaveChildnp(this)" value=No>
No
                                  &nbsp;
                                  <input name=txtHorosMatch type=radio class="forminput" onClick="return HaveChildnp(this)" value=Yes>
Yes
                                  &nbsp;
                                  <input name="txtHorosMatch" type="radio" class="forminput"  value="Does not matter">
Does not matter&nbsp;</div></TD>
          </TR>
          
          
                
          <TR>
          <TD class=grebg colSpan=2><IMG height=1  src="pics/trans.gif"></TD>
          </TR>
          <TR class=tabpadding>
          <TD class=grtxtbold1><div align="left">Manglik</div></TD>
          <TD><div align="left">
            <input name=txtManglik type=radio class="forminput" onClick="return HaveChildnp(this)" value=No>
No
                                  &nbsp;
                                  <input name=txtManglik type=radio class="forminput" onClick="return HaveChildnp(this)" value=Yes>
Yes
                                  &nbsp;
                                  <input name=txtManglik type=radio class="forminput" onClick="return HaveChildnp(this)" value=Do not know>
Do not know &nbsp;
<input name=txtManglik type=radio class="forminput" onClick="return HaveChildnp(this)" value=Not applicable>
Not applicable </div></TD>
          </TR>
          
          
                
          <TR>
          <TD class=grebg colSpan=2><IMG height=1  src="pics/trans.gif"></TD>
          </TR>
          <TR class=tabpadding>
          <TD class=grtxtbold1><div align="left"><span class="bodywk">Place of Birth </span></div></TD>
          <TD><div align="left">
            <input name="txtPb" type="text" class="textfield" id="txtPb" size="40" maxlength="40" style="width:215px;height:70px">
          </div></TD>
          </TR>
          
                
                
                      
          <TR>
          <TD class=grebg colSpan=2><IMG height=1  src="pics/trans.gif"></TD>
          </TR>
          <TR class=tabpadding>
          <TD class=grtxtbold1><div align="left"><span class="bodywk">Time of Birth </span></div></TD>
          <TD><div align="left">
            <table cellpadding="0" cellspacing="0">
                        <tr valign=center>
                          <td><div align="left">
                            <input name="txtTb" type='text' class="textfield" id='timepicker1' onBlur="validateDatePicker(this)" value='9:00 am' size=8 maxlength=8>
                          </div></td>
                          <td><div align="left"><img src="timePickerImages/timepicker.gif" alt="Pick a Time!" width="30" height="20" border="0" style="cursor:hand" onClick="selectTime(this,timepicker1)"></div></td>
                        </tr>
                      </table>
          </div></TD>
          </TR>
          
                
                
                      
          <TR>
          <TD class=grebg colSpan=2><IMG height=1  src="pics/trans.gif"></TD>
          </TR>
          
          
                
                
                
                
                              <TR class=tabpadding>
                                <TD class=grtxtbold1 vAlign=center>&nbsp;</TD>
                                <TD class=formtxt vAlign=top width=517>&nbsp;</TD>
                              </TR><tr></tr><tr></tr><tr></tr><tr></tr><tr></tr><tr></tr>
                              <TR class=tabpadding>
                                <TD colSpan=3 height=7><div align="center">
                                  <div align="center"><a href="javascript:clearform();"></a>
                                    
                                      <input type="submit" name="Submit" value="Continue My Profile" alt="Continue" class="button" style="*padding:5px 5px !important;margin-top:-30px;">
                                    
                                  </div>
                                </div></TD>
                              </TR>
                          </TABLE></TD>
                          <TD class=grebg width=5  bgcolor="#E8E3CD"></TD>
                        </TR>
                        <TR>
                          <TD class=grebg vAlign=top colSpan=3  height="5" bgcolor="#E8E3CD"></TD>
                        </TR>
                      </TABLE>
                      <br>
                      <br>
                  </div>
                  <br>
              </td>
              
          </tr>
          
        
        </table>

</td>
    </tr>
  </table>
</div>
</form>

</body>
</html>