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<!DOCTYPE html>
<html lang="en">
<head>
    <meta charset="UTF-8">
    <meta name="viewport" content="width=device-width, initial-scale=1.0">
    <title>Advanced Data Entry System</title>
    <script src="https://cdn.tailwindcss.com"></script>
    <link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/6.4.0/css/all.min.css">
    <style>
        /* Custom scrollbar */
        ::-webkit-scrollbar {
            width: 8px;
        }
        ::-webkit-scrollbar-track {
            background: #f1f1f1;
        }
        ::-webkit-scrollbar-thumb {
            background: #888;
            border-radius: 4px;
        }
        ::-webkit-scrollbar-thumb:hover {
            background: #555;
        }
        
        /* Animation for form submission */
        @keyframes fadeIn {
            from { opacity: 0; transform: translateY(20px); }
            to { opacity: 1; transform: translateY(0); }
        }
        
        .fade-in {
            animation: fadeIn 0.5s ease-out forwards;
        }
        
        /* Custom checkbox */
        .custom-checkbox input:checked ~ .checkmark {
            background-color: #3b82f6;
            border-color: #3b82f6;
        }
        .custom-checkbox input:checked ~ .checkmark:after {
            display: block;
        }
        .custom-checkbox .checkmark:after {
            left: 7px;
            top: 3px;
            width: 5px;
            height: 10px;
            border: solid white;
            border-width: 0 2px 2px 0;
            transform: rotate(45deg);
        }
    </style>
</head>
<body class="bg-gray-100 font-sans">
    <div class="min-h-screen flex flex-col">
        <!-- Header -->
        <header class="bg-indigo-600 text-white shadow-lg">
            <div class="container mx-auto px-4 py-4 flex justify-between items-center">
                <div class="flex items-center space-x-2">
                    <i class="fas fa-database text-2xl"></i>
                    <h1 class="text-2xl font-bold">DataEntryPro</h1>
                </div>
                <div class="flex items-center space-x-4">
                    <button class="bg-white text-indigo-600 px-4 py-2 rounded-lg font-medium hover:bg-indigo-50 transition">
                        <i class="fas fa-user mr-2"></i>Login
                    </button>
                    <button class="hidden md:block bg-indigo-700 text-white px-4 py-2 rounded-lg font-medium hover:bg-indigo-800 transition">
                        <i class="fas fa-cloud-upload-alt mr-2"></i>Export Data
                    </button>
                </div>
            </div>
        </header>

        <!-- Main Content -->
        <main class="flex-grow container mx-auto px-4 py-8">
            <div class="grid grid-cols-1 lg:grid-cols-4 gap-6">
                <!-- Sidebar -->
                <aside class="lg:col-span-1 bg-white rounded-xl shadow-md p-6 h-fit sticky top-6">
                    <h2 class="text-xl font-semibold mb-4 text-gray-800">Navigation</h2>
                    <nav>
                        <ul class="space-y-2">
                            <li>
                                <a href="#" class="flex items-center p-3 rounded-lg bg-indigo-50 text-indigo-600 font-medium">
                                    <i class="fas fa-plus-circle mr-3"></i> New Entry
                                </a>
                            </li>
                            <li>
                                <a href="#" class="flex items-center p-3 rounded-lg hover:bg-gray-100 text-gray-700 transition">
                                    <i class="fas fa-list mr-3"></i> View Entries
                                </a>
                            </li>
                            <li>
                                <a href="#" class="flex items-center p-3 rounded-lg hover:bg-gray-100 text-gray-700 transition">
                                    <i class="fas fa-chart-bar mr-3"></i> Reports
                                </a>
                            </li>
                            <li>
                                <a href="#" class="flex items-center p-3 rounded-lg hover:bg-gray-100 text-gray-700 transition">
                                    <i class="fas fa-cog mr-3"></i> Settings
                                </a>
                            </li>
                        </ul>
                    </nav>
                    
                    <div class="mt-8">
                        <h3 class="text-lg font-medium mb-3 text-gray-800">Quick Stats</h3>
                        <div class="space-y-3">
                            <div class="flex justify-between items-center">
                                <span class="text-gray-600">Total Entries</span>
                                <span class="font-bold">1,248</span>
                            </div>
                            <div class="flex justify-between items-center">
                                <span class="text-gray-600">Today</span>
                                <span class="font-bold">24</span>
                            </div>
                            <div class="flex justify-between items-center">
                                <span class="text-gray-600">This Week</span>
                                <span class="font-bold">156</span>
                            </div>
                        </div>
                    </div>
                </aside>

                <!-- Main Form -->
                <div class="lg:col-span-3">
                    <div class="bg-white rounded-xl shadow-md overflow-hidden fade-in">
                        <!-- Form Header -->
                        <div class="bg-gradient-to-r from-indigo-500 to-purple-600 p-6 text-white">
                            <div class="flex justify-between items-center">
                                <div>
                                    <h2 class="text-2xl font-bold">Customer Information</h2>
                                    <p class="text-indigo-100">Fill out the form below to add a new customer record</p>
                                </div>
                                <div class="flex space-x-2">
                                    <button class="p-2 rounded-full bg-white bg-opacity-20 hover:bg-opacity-30 transition">
                                        <i class="fas fa-save"></i>
                                    </button>
                                    <button class="p-2 rounded-full bg-white bg-opacity-20 hover:bg-opacity-30 transition">
                                        <i class="fas fa-ellipsis-v"></i>
                                    </button>
                                </div>
                            </div>
                        </div>

                        <!-- Progress Steps -->
                        <div class="px-6 pt-4">
                            <div class="flex items-center justify-between mb-6">
                                <div class="flex items-center">
                                    <div class="w-8 h-8 rounded-full bg-indigo-600 text-white flex items-center justify-center font-bold">1</div>
                                    <div class="ml-2 text-sm font-medium text-gray-700">Basic Info</div>
                                </div>
                                <div class="flex-1 h-1 mx-2 bg-gray-200">
                                    <div class="h-1 bg-indigo-600" style="width: 33%"></div>
                                </div>
                                <div class="flex items-center">
                                    <div class="w-8 h-8 rounded-full bg-gray-200 text-gray-500 flex items-center justify-center font-bold">2</div>
                                    <div class="ml-2 text-sm text-gray-500">Contact Details</div>
                                </div>
                                <div class="flex-1 h-1 mx-2 bg-gray-200"></div>
                                <div class="flex items-center">
                                    <div class="w-8 h-8 rounded-full bg-gray-200 text-gray-500 flex items-center justify-center font-bold">3</div>
                                    <div class="ml-2 text-sm text-gray-500">Additional Info</div>
                                </div>
                            </div>
                        </div>

                        <!-- Form Content -->
                        <form class="p-6 space-y-6" id="dataEntryForm">
                            <!-- Personal Information Section -->
                            <div>
                                <h3 class="text-lg font-medium text-gray-800 mb-4 flex items-center">
                                    <i class="fas fa-user-circle mr-2 text-indigo-600"></i> Personal Information
                                </h3>
                                <div class="grid grid-cols-1 md:grid-cols-2 gap-6">
                                    <div>
                                        <label for="firstName" class="block text-sm font-medium text-gray-700 mb-1">First Name*</label>
                                        <input type="text" id="firstName" name="firstName" required 
                                            class="w-full px-4 py-2 border border-gray-300 rounded-lg focus:ring-2 focus:ring-indigo-500 focus:border-indigo-500 transition">
                                    </div>
                                    <div>
                                        <label for="lastName" class="block text-sm font-medium text-gray-700 mb-1">Last Name*</label>
                                        <input type="text" id="lastName" name="lastName" required 
                                            class="w-full px-4 py-2 border border-gray-300 rounded-lg focus:ring-2 focus:ring-indigo-500 focus:border-indigo-500 transition">
                                    </div>
                                    <div>
                                        <label for="dob" class="block text-sm font-medium text-gray-700 mb-1">Date of Birth*</label>
                                        <input type="date" id="dob" name="dob" required 
                                            class="w-full px-4 py-2 border border-gray-300 rounded-lg focus:ring-2 focus:ring-indigo-500 focus:border-indigo-500 transition">
                                    </div>
                                    <div>
                                        <label class="block text-sm font-medium text-gray-700 mb-1">Gender*</label>
                                        <div class="flex space-x-4">
                                            <label class="inline-flex items-center">
                                                <input type="radio" name="gender" value="male" class="h-4 w-4 text-indigo-600 focus:ring-indigo-500" checked>
                                                <span class="ml-2 text-gray-700">Male</span>
                                            </label>
                                            <label class="inline-flex items-center">
                                                <input type="radio" name="gender" value="female" class="h-4 w-4 text-indigo-600 focus:ring-indigo-500">
                                                <span class="ml-2 text-gray-700">Female</span>
                                            </label>
                                            <label class="inline-flex items-center">
                                                <input type="radio" name="gender" value="other" class="h-4 w-4 text-indigo-600 focus:ring-indigo-500">
                                                <span class="ml-2 text-gray-700">Other</span>
                                            </label>
                                        </div>
                                    </div>
                                </div>
                            </div>

                            <!-- Contact Information Section -->
                            <div>
                                <h3 class="text-lg font-medium text-gray-800 mb-4 flex items-center">
                                    <i class="fas fa-address-book mr-2 text-indigo-600"></i> Contact Information
                                </h3>
                                <div class="grid grid-cols-1 md:grid-cols-2 gap-6">
                                    <div>
                                        <label for="email" class="block text-sm font-medium text-gray-700 mb-1">Email*</label>
                                        <input type="email" id="email" name="email" required 
                                            class="w-full px-4 py-2 border border-gray-300 rounded-lg focus:ring-2 focus:ring-indigo-500 focus:border-indigo-500 transition">
                                    </div>
                                    <div>
                                        <label for="phone" class="block text-sm font-medium text-gray-700 mb-1">Phone Number*</label>
                                        <input type="tel" id="phone" name="phone" required 
                                            class="w-full px-4 py-2 border border-gray-300 rounded-lg focus:ring-2 focus:ring-indigo-500 focus:border-indigo-500 transition">
                                    </div>
                                    <div class="md:col-span-2">
                                        <label for="address" class="block text-sm font-medium text-gray-700 mb-1">Address*</label>
                                        <input type="text" id="address" name="address" required 
                                            class="w-full px-4 py-2 border border-gray-300 rounded-lg focus:ring-2 focus:ring-indigo-500 focus:border-indigo-500 transition">
                                    </div>
                                    <div>
                                        <label for="city" class="block text-sm font-medium text-gray-700 mb-1">City*</label>
                                        <input type="text" id="city" name="city" required 
                                            class="w-full px-4 py-2 border border-gray-300 rounded-lg focus:ring-2 focus:ring-indigo-500 focus:border-indigo-500 transition">
                                    </div>
                                    <div>
                                        <label for="zip" class="block text-sm font-medium text-gray-700 mb-1">ZIP Code*</label>
                                        <input type="text" id="zip" name="zip" required 
                                            class="w-full px-4 py-2 border border-gray-300 rounded-lg focus:ring-2 focus:ring-indigo-500 focus:border-indigo-500 transition">
                                    </div>
                                </div>
                            </div>

                            <!-- Additional Information Section -->
                            <div>
                                <h3 class="text-lg font-medium text-gray-800 mb-4 flex items-center">
                                    <i class="fas fa-info-circle mr-2 text-indigo-600"></i> Additional Information
                                </h3>
                                <div class="grid grid-cols-1 gap-6">
                                    <div>
                                        <label for="notes" class="block text-sm font-medium text-gray-700 mb-1">Notes</label>
                                        <textarea id="notes" name="notes" rows="3" 
                                            class="w-full px-4 py-2 border border-gray-300 rounded-lg focus:ring-2 focus:ring-indigo-500 focus:border-indigo-500 transition"></textarea>
                                    </div>
                                    <div>
                                        <label class="block text-sm font-medium text-gray-700 mb-1">Preferences</label>
                                        <div class="space-y-2">
                                            <label class="custom-checkbox flex items-center">
                                                <input type="checkbox" name="newsletter" class="opacity-0 absolute h-5 w-5">
                                                <div class="checkmark bg-white border-2 rounded border-gray-300 w-5 h-5 flex flex-shrink-0 justify-center items-center mr-2 focus-within:border-indigo-500">
                                                    <svg class="fill-current hidden w-3 h-3 text-white pointer-events-none" viewBox="0 0 20 20"><path d="M0 11l2-2 5 5L18 3l2 2L7 18z"/></svg>
                                                </div>
                                                <span class="text-gray-700">Subscribe to newsletter</span>
                                            </label>
                                            <label class="custom-checkbox flex items-center">
                                                <input type="checkbox" name="promotions" class="opacity-0 absolute h-5 w-5">
                                                <div class="checkmark bg-white border-2 rounded border-gray-300 w-5 h-5 flex flex-shrink-0 justify-center items-center mr-2 focus-within:border-indigo-500">
                                                    <svg class="fill-current hidden w-3 h-3 text-white pointer-events-none" viewBox="0 0 20 20"><path d="M0 11l2-2 5 5L18 3l2 2L7 18z"/></svg>
                                                </div>
                                                <span class="text-gray-700">Receive promotional offers</span>
                                            </label>
                                        </div>
                                    </div>
                                    <div>
                                        <label for="source" class="block text-sm font-medium text-gray-700 mb-1">How did you hear about us?</label>
                                        <select id="source" name="source" 
                                            class="w-full px-4 py-2 border border-gray-300 rounded-lg focus:ring-2 focus:ring-indigo-500 focus:border-indigo-500 transition">
                                            <option value="">Select an option</option>
                                            <option value="social">Social Media</option>
                                            <option value="search">Search Engine</option>
                                            <option value="friend">Friend/Family</option>
                                            <option value="ad">Advertisement</option>
                                            <option value="other">Other</option>
                                        </select>
                                    </div>
                                </div>
                            </div>

                            <!-- Form Actions -->
                            <div class="flex flex-col sm:flex-row justify-between pt-4 border-t border-gray-200">
                                <button type="button" class="px-6 py-2 border border-gray-300 rounded-lg text-gray-700 hover:bg-gray-50 transition mb-2 sm:mb-0">
                                    <i class="fas fa-times mr-2"></i> Cancel
                                </button>
                                <div class="space-x-3">
                                    <button type="button" class="px-6 py-2 border border-gray-300 rounded-lg text-gray-700 hover:bg-gray-50 transition">
                                        <i class="fas fa-save mr-2"></i> Save Draft
                                    </button>
                                    <button type="submit" class="px-6 py-2 bg-indigo-600 text-white rounded-lg hover:bg-indigo-700 transition">
                                        <i class="fas fa-check mr-2"></i> Submit
                                    </button>
                                </div>
                            </div>
                        </form>
                    </div>

                    <!-- Recent Entries Card -->
                    <div class="mt-6 bg-white rounded-xl shadow-md overflow-hidden fade-in">
                        <div class="p-6">
                            <div class="flex justify-between items-center mb-4">
                                <h2 class="text-xl font-semibold text-gray-800">Recent Entries</h2>
                                <button class="text-indigo-600 hover:text-indigo-800 transition">
                                    <i class="fas fa-sync-alt"></i>
                                </button>
                            </div>
                            <div class="overflow-x-auto">
                                <table class="min-w-full divide-y divide-gray-200">
                                    <thead class="bg-gray-50">
                                        <tr>
                                            <th scope="col" class="px-6 py-3 text-left text-xs font-medium text-gray-500 uppercase tracking-wider">Name</th>
                                            <th scope="col" class="px-6 py-3 text-left text-xs font-medium text-gray-500 uppercase tracking-wider">Email</th>
                                            <th scope="col" class="px-6 py-3 text-left text-xs font-medium text-gray-500 uppercase tracking-wider">Phone</th>
                                            <th scope="col" class="px-6 py-3 text-left text-xs font-medium text-gray-500 uppercase tracking-wider">Date Added</th>
                                            <th scope="col" class="px-6 py-3 text-left text-xs font-medium text-gray-500 uppercase tracking-wider">Actions</th>
                                        </tr>
                                    </thead>
                                    <tbody class="bg-white divide-y divide-gray-200">
                                        <tr>
                                            <td class="px-6 py-4 whitespace-nowrap">
                                                <div class="flex items-center">
                                                    <div class="flex-shrink-0 h-10 w-10 bg-indigo-100 rounded-full flex items-center justify-center">
                                                        <span class="text-indigo-600 font-medium">JD</span>
                                                    </div>
                                                    <div class="ml-4">
                                                        <div class="text-sm font-medium text-gray-900">John Doe</div>
                                                    </div>
                                                </div>
                                            </td>
                                            <td class="px-6 py-4 whitespace-nowrap text-sm text-gray-500">john.doe@example.com</td>
                                            <td class="px-6 py-4 whitespace-nowrap text-sm text-gray-500">(555) 123-4567</td>
                                            <td class="px-6 py-4 whitespace-nowrap text-sm text-gray-500">2023-05-15</td>
                                            <td class="px-6 py-4 whitespace-nowrap text-sm font-medium">
                                                <a href="#" class="text-indigo-600 hover:text-indigo-900 mr-3"><i class="fas fa-edit"></i></a>
                                                <a href="#" class="text-red-600 hover:text-red-900"><i class="fas fa-trash-alt"></i></a>
                                            </td>
                                        </tr>
                                        <tr>
                                            <td class="px-6 py-4 whitespace-nowrap">
                                                <div class="flex items-center">
                                                    <div class="flex-shrink-0 h-10 w-10 bg-indigo-100 rounded-full flex items-center justify-center">
                                                        <span class="text-indigo-600 font-medium">AS</span>
                                                    </div>
                                                    <div class="ml-4">
                                                        <div class="text-sm font-medium text-gray-900">Alice Smith</div>
                                                    </div>
                                                </div>
                                            </td>
                                            <td class="px-6 py-4 whitespace-nowrap text-sm text-gray-500">alice.smith@example.com</td>
                                            <td class="px-6 py-4 whitespace-nowrap text-sm text-gray-500">(555) 987-6543</td>
                                            <td class="px-6 py-4 whitespace-nowrap text-sm text-gray-500">2023-05-14</td>
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