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Server: Apache
System: Linux e2e-78-16.ssdcloudindia.net 3.10.0-1160.45.1.el7.x86_64 #1 SMP Wed Oct 13 17:20:51 UTC 2021 x86_64
User: imensosw (1005)
PHP: 8.0.30
Disabled: exec,passthru,shell_exec,system
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File: /home/imensosw/www/imenso.co/dev/CaseManagement_design/AddCase_Model.php
<div class="modal fade" id="AddCase_Model" tabindex="-1" role="dialog" aria-labelledby="AddCase_Model" aria-hidden="true">
  <div class="modal-dialog modal-dialog-slideout" role="document">
    <div class="modal-content">
      <div class="modal-header">
        <h5 class="modal-title" id="exampleModalLabel">Add New Case</h5>
        <button type="button" class="close" data-dismiss="modal" aria-label="Close">
          <span aria-hidden="true">×</span>
        </button>
      </div>
      <div class="modal-body">
        <div class="row">
          <div class="col-md-12">
             <div class="form-group">
                <label>Title <span class="mandatory">*</span></label>
                <input type="text" id="name" placeholder="" class="form-control" >
             </div>
          </div>
          <div class="col-md-12 mb-3">
            <div class="form-group">
              <label>Case Type <span class="mandatory">*</span></label>
              <select name="Category" class="chosen-select w-100" >
                <option>Select Type</option>
                <option>Civil</option>
                <option>Criminal</option>
                <option>Training</option>
                <option>Consulting</option>
              </select>
            </div>
          </div>
          <div class="col-md-12">
             <div class="form-group">
                <label>Agency <span class="mandatory">*</span></label>
                <input type="text" id="name" placeholder="" class="form-control" >
             </div>
          </div>
          <div class="col-md-6">
             <div class="form-group">
                <label>contact number <span class="mandatory">*</span></label>
                <input type="text" id="name" placeholder="" class="form-control" >
             </div>
          </div>
          <div class="col-md-6">
             <div class="form-group">
                <label>Mail <span class="mandatory">*</span></label>
                <input type="text" id="name" placeholder="" class="form-control" >
             </div>
          </div>
          <div class="col-md-12">
             <div class="form-group">
                <label>Description</label>
                <textarea class="form-control" rows="4"></textarea>
             </div>
          </div>
        </div>
      </div>
      <div class="modal-footer">
        <button type="button" class="btn btn-default" data-dismiss="modal">Close</button>
        <a href="add_case.php" class="btn btn-primary">Add Case</a>
      </div>
    </div>
  </div>
</div>