<div id="slider-range" style="width: 13em; margin-top: 15px;"></div> </td> </tr> <tr> <td valign="top">Born Before:</td> <td valign="top"><input name="gwpm_dob" id="gwpm_dob" class="gwpm-datepicker" /></td> </tr> <tr> <td valign="top">Address:</td> <td valign="top"><input name="gwpm_address" id="gwpm_address" /></td> </tr> <tr> <td valign="top">Gender:</td> <td valign="top"><?php $this->getSelectItem(getGenderOptions(), 'gwpm_gender'); ?> </td> </tr> <tr> <td valign="top">Marital Status:</td> <td valign="top"> <?php $this->getSelectItem(getMaritalOptions(), 'gwpm_martial_status'); ?> </td> </tr> <tr> <td valign="top">Star Sign (Nakshatram):</td> <td valign="top"> <?php
?> " /><span class="gwpm-mandatory">*</span></td> </tr> <tr> <td valign="top">Contact No:</td> <td valign="top"><input name="gwpm_contact_no" id="gwpm_contact_no" value="<?php gwpm_echo($modelObj->gwpm_contact_no); ?> " maxLength="15" /><span class="gwpm-mandatory">*</span></td> </tr> <tr> <td valign="top">Gender:</td> <td valign="top"> <?php $this->getSelectItem(getGenderOptions(), 'gwpm_gender', $modelObj->gwpm_gender); ?> <span class="gwpm-mandatory">*</span> </td> </tr> <tr> <td valign="top">Address Line 1:</td> <td valign="top"><input name="gwpm_address[address1]" id="gwpm_address[address1]" value="<?php echo $modelObj->gwpm_address['address1']; ?> " maxLength="50" /></td> </tr> <tr> <td valign="top">Address Line 2:</td> <td valign="top"><input name="gwpm_address[address2]" id="gwpm_address[address2]"
<td valign="top"><?php gwpm_echo($modelObj->gwpm_dob); ?> </td> </tr> <tr> <td valign="top">Contact:</td> <td valign="top"> <?php gwpm_echo($modelObj->gwpm_contact_no); ?> </td> </tr> <tr> <td valign="top">Gender:</td> <td valign="top"><?php gwpm_echo(getGenderOptions($modelObj->gwpm_gender)); ?> </td> </tr> </table> </td> </tr> </tbody> </table> <table class='gwpm-table'> <tbody> <tr> <td colspan="2"> <h3> Basic Information </h3> </td> </tr>