<form role="form" class="form-horizontal" id="create_guarantor_form" action="#" method="post">
    <input type="hidden" value="<?php echo $type; ?>" name="type" id="type" />
    <input type="hidden" value="<?php echo $guarantor_id; ?>" name="id" id="id" />
    <div class="modal-header">
        <button type="button" class="close" data-dismiss="modal" aria-hidden="true">&times;</button>
        <h4 class="modal-title"><?php echo $pageName; ?></h4>
        <font style="color:#333;">Please fill in the information below. The field labels marked with * are required input fields.</font>
    </div>
    <div class="col-md-12">

    </div>
    <div class="modal-body">
        <div id="error"></div>
        <div class="row">
            <div class="col-md-12">
                <div class="col-md-12">

                    <div class="form-group">
                        <h5>
                            <label class="control-label">
                                Code*
                            </label>
                        </h5>
                        <input type="text" <?php echo (isset($guarantor_details['code'])) ? 'value="' . $guarantor_details['code'] . '"' : null; ?> class="form-control" name="code" id="code" <?php if (isset($type)) if ($type == 'E') echo 'readonly'; ?>>
                    </div>
                    <div class="form-group">
                        <h5>
                            <label class="control-label">
                                Name*
                            </label>
                        </h5>
                        <input type="text" <?php echo (isset($guarantor_details['name'])) ? 'value="' . $guarantor_details['name'] . '"' : null; ?> class="form-control" name="name" id="name">
                    </div>
                    <div class="form-group">
                        <h5>
                            <label class="control-label">
                               Phone
                            </label>
                        </h5>
                        <input type="text" <?php echo (isset($guarantor_details['phone'])) ? 'value="' . $guarantor_details['phone'] . '"' : null; ?> class="form-control" name="phone" id="phone">
                    </div>
                    <div class="form-group">
                        <h5>
                            <label class="control-label">
                               Address
                            </label>
                        </h5>
                        <input type="text" <?php echo (isset($guarantor_details['address'])) ? 'value="' . $guarantor_details['address'] . '"' : null; ?> class="form-control" name="address" id="address">
                    </div>

                    -
                </div>
            </div>
        </div>
        <div class="modal-footer">
            <input type="submit" name="add_category" value="<?php echo $btnText; ?>" class="btn btn-primary">
        </div>
    </div> <!--/.col-md-12-->
</form>

<!-- start: JAVASCRIPTS REQUIRED FOR THIS PAGE ONLY VALIDATION-->
<script src="<?php echo asset_url(); ?>js/form-validation-create_guarantor.js"></script>
<!-- end: JAVASCRIPTS REQUIRED FOR THIS PAGE ONLY  VALIDATION-->

<script>
    jQuery(document).ready(function() {
        FormValidator.init();
    });
</script>

<script type="text/javascript">
    function insertLocationData() {

        var id = $('#id').val();
        var type = $('#type').val();
        var name = $('#name').val();
        var code = $('#code').val();
        var address = $('#address').val();
        var phone = $('#phone').val();

        $.post("<?php echo base_url('customers/save_guarantor'); ?>", {
                type: type,
                id: id,
                name: name,
                code: code,
                phone: phone,
                address: address
            })
            .done(function(data) {

                var obj = jQuery.parseJSON(data);
                // alert(obj.type); //last id

                if (obj.status == 0) {
                    $('div#error').html('<div class="alert alert-block alert-danger fade in"><button type="button" class="close" data-dismiss="alert">×</button><h4 class="alert-heading"><i class="fa fa-times-circle"></i> Error!</h4>' + obj.validation + '</div>');
                    $('body').modalmanager('removeLoading');
                    $('body').attr('class', '');
                } else {

                    $('div#ajax-modal').modal('hide');
                    loadGrid(); // load location data

                    if (obj.type == 'E') {

                        displayNotice('page', 'guarantor has been updated successfully!')
                    }
                    if (obj.type == 'A') {
                        displayNotice('page', 'guarantor has been added successfully!')
                    }
                }
            });
        return false;
    }
</script>