<?php include "layouts/menu.php"; ?> <div class="right_col" role="main">
            <div class="row">
                 <!-- page header -->
                <div class="col-lg-12">
                    <h1 class="page-header">Documentation Charge</h1>
                </div>
                <!--end page header -->
            </div>
            <div class="row">
                <div class="col-lg-12">
                    <!-- Form Elements -->
                    <div class="panel panel-default">
                        <div class="panel-heading">
                            Fill the form
                        </div>
                        <div class="panel-body">
                            <div class="row">
   <div class="alert alert-info">Register Document Charge Here</div>
   <form name="form1" class="form-horizontal" method="post" action="dc.php" enctype="multipart/form-data">
      <div class="form-group">
    <label for="inputPassword3" class="col-sm-2 control-label">HPL</label>
    <div class="col-sm-4">
      <input type="text" class="form-control" id="hpl" name="hpl" value="" placeholder="E.g 1008" required>
    </div>
  </div>
   <div class="form-group">
    <label for="inputPassword3" class="col-sm-2 control-label">Credit</label>
    <div class="col-sm-4">
      <input type="text" class="form-control" id="txt1" name="credit" value="" placeholder="Amount in Rs" required>
    </div>
  </div>
    <div class="form-group">
    <label for="inputPassword3" class="col-sm-2 control-label">Debit</label>
    <div class="col-sm-4">
      <input type="text" class="form-control" id="txt2" name="debit" value="" placeholder="Amount in Rs" required>

    </div>
  </div>
     	  <input style="margin-left:150px;margin-bottom:10px;" type="button" value="BAL" onclick="add()">
      <div class="form-group">
    <label for="inputPassword3" class="col-sm-2 control-label">Balance</label>
    <div class="col-sm-4">
      <input type="text" class="form-control" id="bal" name="bal" value="" placeholder="Amount in Rs" required>
    </div>
  </div>
  <div class="form-group">
    <label for="inputPassword3" class="col-sm-2 control-label">Date</label>
    <div class="col-sm-4">
      <input type="text" class="form-control" id="datepicker" name="date" value="" placeholder="DD/MM/YYYY"  required>
    </div>
  </div>
  <div class="form-group">
    <div class="col-sm-offset-2 col-sm-10">
      <button type="submit" class="btn btn-default" name="s1">Save This</button>
    </div>
  </div>  
      <div class="alert alert-success">
	  <?php include "programs/dc.php"; ?>
	  </div>
</form>
</div>
 
 
</div>
</div></div>
</div></div></div> <?php include "layouts/footer.php"; ?></body></html>