<head>
<link href="//maxcdn.bootstrapcdn.com/bootstrap/3.3.0/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css">
<script src="//maxcdn.bootstrapcdn.com/bootstrap/3.3.0/js/bootstrap.min.js"></script>
<script src="//code.jquery.com/jquery-1.11.1.min.js"></script>
<!------ Include the above in your HEAD tag ---------->
</head>
<body>
<div class="container register">
<div class="row">
<div class="col-md-12 col-sm-12">
<div class="panel panel-primary">
<div class="panel-heading">
Enter Your Details Here
</div>
<div class="panel-body">
<form name="myform">
<div class="form-group col-md-6 col-sm-6">
<div class="form-group">
<label for="myName">First Name *</label>
<input id="myName" name="myName" class="form-control" type="text" data-validation="required">
<span id="error_name" class="text-danger"></span>
</div>
<div class="form-group">
<label for="lastname">Last Name *</label>
<input id="lastname" name="lastname" class="form-control" type="text" data-validation="email">
<span id="error_lastname" class="text-danger"></span>
</div>
<div class="form-group">
<label for="age">Age *</label>
<input id="age" name="age" class="form-control" type="number" min="1">
<span id="error_age" class="text-danger"></span>
</div>
<div class="form-group">
<label for="dob">Date Of Birth *</label>
<input type="date" name="dob" id="dob" class="form-control">
<span id="error_dob" class="text-danger"></span>
</div>
<div class="form-group">
<label for="gender">Gender</label>
<select name="gender" id="gender" class="form-control">
<option selected>Male</option>
<option>Female</option>
<option>Other</option>
</select>
<span id="error_gender" class="text-danger"></span>
</div>
<div class="form-group">
<label for="phone">Phone Number *</label>
<input type="text" id="phone" name="phone" class="form-control">
<span id="error_phone" class="text-danger"></span>
</div>
<div class="form-group">
<label for="disc">Discription</label>
<textarea class="form-control" rows="3"></textarea>
</div>
</div>
<div class="form-group col-md-6 col-sm-6">
<div class="form-group">
<label for="myName">First Name *</label>
<input id="myName" name="myName" class="form-control" type="text" data-validation="required">
<span id="error_name" class="text-danger"></span>
</div>
<div class="form-group">
<label for="lastname">Last Name *</label>
<input id="lastname" name="lastname" class="form-control" type="text" data-validation="email">
<span id="error_lastname" class="text-danger"></span>
</div>
<div class="form-group">
<label for="age">Age *</label>
<input id="age" name="age" class="form-control" type="number" min="1">
<span id="error_age" class="text-danger"></span>
</div>
<div class="form-group">
<label for="dob">Date Of Birth *</label>
<input type="date" name="dob" id="dob" class="form-control">
<span id="error_dob" class="text-danger"></span>
</div>
<div class="form-group">
<label for="gender">Gender</label>
<select name="gender" id="gender" class="form-control">
<option selected>Male</option>
<option>Female</option>
<option>Other</option>
</select>
<span id="error_gender" class="text-danger"></span>
</div>
<div class="form-group">
<label for="phone">Phone Number *</label>
<input type="text" id="phone" name="phone" class="form-control">
<span id="error_phone" class="text-danger"></span>
</div>
<div class="form-group">
<label for="disc">Discription</label>
<textarea class="form-control" rows="3"></textarea>
</div>
</div>
<button id="submit" type="submit" value="submit" style="background: -webkit-linear-gradient(left, #3931af, #00c6ff)" class="btn btn-primary center">Submit</button>
</form>
</div>
</div>
</div>
</div>
</div>
<script>
$(document).ready(function () {
$flag = 1;
$("#myName").focusout(function () {
if ($(this).val() == '') {
$(this).css("border-color", "#FF0000");
$('#submit').attr('disabled', true);
$("#error_name").text("* You have to enter your first name!");
}
else {
$(this).css("border-color", "#2eb82e");
$('#submit').attr('disabled', false);
$("#error_name").text("");
}
});
$("#lastname").focusout(function () {
if ($(this).val() == '') {
$(this).css("border-color", "#FF0000");
$('#submit').attr('disabled', true);
$("#error_lastname").text("* You have to enter your Last name!");
}
else {
$(this).css("border-color", "#2eb82e");
$('#submit').attr('disabled', false);
$("#error_lastname").text("");
}
});
$("#dob").focusout(function () {
if ($(this).val() == '') {
$(this).css("border-color", "#FF0000");
$('#submit').attr('disabled', true);
$("#error_dob").text("* You have to enter your Date of Birth!");
}
else {
$(this).css("border-color", "#2eb82e");
$('#submit').attr('disabled', false);
$("#error_dob").text("");
}
});
$("#gender").focusout(function () {
$(this).css("border-color", "#2eb82e");
});
$("#age").focusout(function () {
if ($(this).val() == '') {
$(this).css("border-color", "#FF0000");
$('#submit').attr('disabled', true);
$("#error_age").text("* You have to enter your Age!");
}
else {
$(this).css({ "border-color": "#2eb82e" });
$('#submit').attr('disabled', false);
$("#error_age").text("");
}
});
$("#phone").focusout(function () {
$pho = $("#phone").val();
if ($(this).val() == '') {
$(this).css("border-color", "#FF0000");
$('#submit').attr('disabled', true);
$("#error_phone").text("* You have to enter your Phone Number!");
}
else if ($pho.length != 10) {
$(this).css("border-color", "#FF0000");
$('#submit').attr('disabled', true);
$("#error_phone").text("* Lenght of Phone Number Should Be Ten");
}
else if (!$.isNumeric($pho)) {
$(this).css("border-color", "#FF0000");
$('#submit').attr('disabled', true);
$("#error_phone").text("* Phone Number Should Be Numeric");
}
else {
$(this).css({ "border-color": "#2eb82e" });
$('#submit').attr('disabled', false);
$("#error_phone").text("");
}
});
$("#submit").click(function () {
if ($("#myName").val() == '') {
$("#myName").css("border-color", "#FF0000");
$('#submit').attr('disabled', true);
$("#error_name").text("* You have to enter your first name!");
}
if ($("#lastname").val() == '') {
$("#lastname").css("border-color", "#FF0000");
$('#submit').attr('disabled', true);
$("#error_lastname").text("* You have to enter your Last name!");
}
if ($("#dob").val() == '') {
$("#dob").css("border-color", "#FF0000");
$('#submit').attr('disabled', true);
$("#error_dob").text("* You have to enter your Date of Birth!");
}
if ($("#age").val() == '') {
$("#age").css("border-color", "#FF0000");
$('#submit').attr('disabled', true);
$("#error_age").text("* You have to enter your Age!");
}
if ($("#phone").val() == '') {
$("#phone").css("border-color", "#FF0000");
$('#submit').attr('disabled', true);
$("#error_phone").text("* You have to enter your Phone Number!");
}
});
});
</script>
<style type="text/css">
.register {
margin-top: 5%;
padding: 2%;
}
.palel-primary {
border-color: #bce8f1;
}
.panel-primary > .panel-heading {
/*background:#bce8f1;*/
background: -webkit-linear-gradient(left, #3931af, #00c6ff);
}
.panel-primary > .panel-body {
background-color: #EDEDED;
}
</style>
</body>
</html>
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