admin_hura_8/template/customer/customer_add.html

<div class="w-full mb-[50px]">

    <div class="text-sm breadcrumbs">
        <ul>
            <li><a href="/admin/customer">Danh sách khách hàng</a></li>
            <li class="text-active">Form thêm khách hàng</li>
        </ul>
    </div>
    <div class="w-7xl mx-auto">
        <div class="bg-white p-3 rounded-sm shadow mt-5">
            <div class="flex items-center justify-between">
                <div>
                    <h1 class="text-[20px] font-[700]">Cập nhật lại khách hàng</h1>
                    <span class="text-[#6B7280]">Khách hàng: Nguyễn Duy Thành</span>
                </div>
                <a href="/admin/customer/customer-add" class="btn btn-outline btn-view btn-sm">
                    <span data-lucide="circle-plus" class="size-4">+</span>
                    <span class="">Thêm khách hàng mới</span>
                </a>
            </div>
        </div>

        <div class="grid grid-cols-4 gap-5 mt-5">
            <div class="left">
                <div class="list-tab">
                    <a href="javascript:void(0)"
                        class="item block w-full text-white bg-[#0041E8] rounded-sm text-[13px] p-2 font-bold">Nội
                        dung</a>
                </div>
            </div>
            <div class="right col-span-3">
                <div class="bg-white p-3 rounded-sm shadow ">
                    <b class="text-xl block">Thông tin khách hàng</b>
                    <div class="flex items-center my-2">
                        <b class="text-gray-500 mr-2">Thuộc tính khách hàng</b>
                        <a href="/admin/customer/customer-group" class="text-active">Quản lý nhóm khách hàng</a>
                    </div>

                    <div class="flex items-center gap-5 mt-5">
                        <label class="flex items-center cursor-pointer">
                            <input type="checkbox" name="change_url_on_update" value="1" checked
                                class="checkbox checkbox-active checkbox-sm rounded-sm">
                            <span class="label-text ml-2 text-gray-500">Mua lẻ</span>
                        </label>
                        <label class="flex items-center cursor-pointer">
                            <input type="checkbox" name="change_url_on_update" value="1"
                                class="checkbox checkbox-active checkbox-sm rounded-sm">
                            <span class="label-text ml-2 text-gray-500">Khách HCM</span>
                        </label>
                        <label class="flex items-center cursor-pointer">
                            <input type="checkbox" name="change_url_on_update" value="1"
                                class="checkbox checkbox-active checkbox-sm rounded-sm">
                            <span class="label-text ml-2 text-gray-500">Khách VIP</span>
                        </label>
                    </div>

                    <div class="grid grid-cols-2 gap-5 mt-5">
                        <div class="form-control">
                            <label class="font-bold text-base">Tên khách hàng</label>
                            <input type="text" size="60" name="" placeholder="Tên khách hàng"
                                class="w-full input input-bordered input-md rounded-sm shadow mt-3">
                        </div>
                        <div class="">
                            <label class="block font-bold text-base">Sinh nhật</label>
                            <div class="grid grid-cols-3 gap-5 mt-3">
                                <div class="input-date">
                                    <input type="day" name="" placeholder="Ngày"
                                        class="w-full input input-md rounded-sm shadow">
                                </div>
                                <div class="input-date">
                                    <input type="day" name="" placeholder="Tháng"
                                        class="w-full input input-md rounded-sm shadow">
                                </div>
                                <div class="input-date">
                                    <input type="day" name="" placeholder="Năm"
                                        class="w-full input input-md rounded-sm shadow">
                                </div>
                            </div>
                        </div>
                    </div>

                    <div class="flex items-center mt-5">
                        <label class="w-[120px] font-bold text-base">Giới tính</label>
                        <div class="flex items-center">
                            <label class="cursor-pointer flex items-center mr-[25px] gap-2">
                                <input type="radio" name="info[sex]" value="0" class="radio radio-active radio-sm"
                                    checked="checked" />
                                <span class="label-text">Nam</span>
                            </label>

                            <label class="cursor-pointer flex items-center gap-2">
                                <input type="radio" name="info[sex]" value="1" class="radio radio-active radio-sm" />
                                <span class="label-text">Nữ</span>
                            </label>

                        </div>
                    </div>

                    <div class="mt-5 grid grid-cols-3 gap-5">
                        <div class="form-control">
                            <label class="font-bold text-base">Địa chỉ Email</label>
                            <input type="text" size="60" name="" placeholder="Địa chỉ Email"
                                class="w-full input input-bordered input-md rounded-sm shadow mt-3" />
                        </div>
                        <div class="form-control">
                            <label class="font-bold text-base">Điện thoại nhà</label>
                            <input type="text" size="60" name="" placeholder="Điện thoại nhà"
                                class="w-full input input-bordered input-md rounded-sm shadow mt-3" />
                        </div>
                        <div class="form-control">
                            <label class="font-bold text-base">Điện thoại di động</label>
                            <input type="text" size="60" name="" placeholder="Điện thoại di động"
                                class="w-full input input-bordered input-md rounded-sm shadow mt-3" />
                        </div>
                    </div>

                    <div class="mt-5 grid grid-cols-2 gap-5">
                        <div class="form-control">
                            <label class="font-bold text-base">Tỉnh/TP</label>
                            <select name="" class="w-full select select-bordered rounded-sm shadow mt-3">
                                <option value="">Hà nội</option>
                            </select>
                        </div>
                        <div class="form-control">
                            <label class="font-bold text-base">Quận huyện</label>
                            <select name="" class="w-full select select-bordered rounded-sm shadow mt-3">
                                <option value="">Quận Ba Đình</option>
                            </select>
                        </div>
                    </div>

                    <div class="form-control mt-5">
                        <label class="font-bold text-base">Địa chỉ</label>
                        <textarea type="text" size="60" name="" placeholder="Địa chỉ"
                            class="w-full h-[120px] textarea textarea-bordered rounded-sm shadow mt-3"></textarea>
                    </div>

                    <div class="form-control mt-5">
                        <label class="font-bold text-base">Tên công ty</label>
                        <input type="text" size="60" name="" placeholder="Tên công ty"
                            class="w-full h-[35px] input input-bordered input-md rounded-sm shadow mt-3" />
                    </div>

                    <div class="form-control mt-5">
                        <label class="font-bold text-base">Mã số thuế</label>
                        <input type="text" size="60" name="" placeholder="Mã số thuế"
                            class="w-full h-[35px] input input-bordered input-md rounded-sm shadow mt-3" />
                    </div>

                    <div class="form-control mt-5">
                        <label class="font-bold text-base">Địa chỉ công ty</label>
                        <input type="text" size="60" name="" placeholder="Địa chỉ công ty"
                            class="w-full h-[35px] input input-bordered input-md rounded-sm shadow mt-3" />
                    </div>

                    <div class="form-control mt-5">
                        <label class="font-bold text-base">Ghi chú về khách hàng này</label>
                        <textarea type="text" size="60" name="" placeholder="Ghi chú về khách hàng này"
                            class="w-full h-[120px] textarea textarea-bordered rounded-sm shadow mt-3"></textarea>
                    </div>

                </div>
                <div class="bg-white p-3 rounded-sm shadow mt-5">
                    <input class="btn btn-active" id="submit-collection-btn" name="commit" type="submit"
                        value="Cập nhật" />
                </div>
            </div>

        </div>
    </div>