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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>Unified Lead Capture</title>
    <script src="https://cdn.tailwindcss.com"></script>
    <link href="https://unpkg.com/aos@2.3.1/dist/aos.css" rel="stylesheet">
    <script src="https://unpkg.com/aos@2.3.1/dist/aos.js"></script>
    <script src="https://cdn.jsdelivr.net/npm/feather-icons/dist/feather.min.js"></script>
    <script src="https://unpkg.com/feather-icons"></script>
    <style>
        .form-section {
            transition: all 0.3s ease;
        }
        .form-section:hover {
            box-shadow: 0 4px 6px -1px rgba(0, 0, 0, 0.1), 0 2px 4px -1px rgba(0, 0, 0, 0.06);
        }
        .dropdown-arrow {
            pointer-events: none;
        }
        .file-upload {
            border: 2px dashed #d1d5db;
            transition: all 0.3s ease;
        }
        .file-upload:hover {
            border-color: #3b82f6;
        }
    </style>
</head>
<body class="bg-gray-50">
    <div class="max-w-6xl mx-auto px-4 py-8">
        <header class="mb-10 text-center">
            <h1 class="text-3xl font-bold text-gray-800 mb-2">Unified Lead Capture</h1>
            <p class="text-gray-600">Capture leads from all channels in one place</p>
        </header>

        <form class="space-y-8">
            <!-- Section 1: Lead Source & Channel -->
            <div class="form-section bg-white rounded-lg p-6 shadow-sm" data-aos="fade-up">
                <div class="flex items-center mb-4">
                    <div class="w-8 h-8 bg-blue-500 rounded-full flex items-center justify-center text-white mr-3">
                        <i data-feather="source"></i>
                    </div>
                    <h2 class="text-xl font-semibold text-gray-800">Lead Source & Channel</h2>
                </div>
                
                <div class="grid grid-cols-1 md:grid-cols-2 gap-6">
                    <div>
                        <label class="block text-sm font-medium text-gray-700 mb-1">Channel</label>
                        <select class="w-full px-4 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
                            <option value="">Select Channel</option>
                            <option>Online</option>
                            <option>WhatsApp</option>
                            <option>Excel</option>
                            <option>Social Media</option>
                            <option>Walk-In</option>
                            <option>Website</option>
                        </select>
                    </div>
                    
                    <div>
                        <label class="block text-sm font-medium text-gray-700 mb-1">Source</label>
                        <select class="w-full px-4 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
                            <option value="">Select Source</option>
                            <option>Campaign</option>
                            <option>Referral</option>
                            <option>Event</option>
                            <option>Dealer Partner</option>
                            <option>Service Department</option>
                        </select>
                    </div>
                </div>
            </div>

            <!-- Section 2: Customer Information -->
            <div class="form-section bg-white rounded-lg p-6 shadow-sm" data-aos="fade-up">
                <div class="flex items-center mb-4">
                    <div class="w-8 h-8 bg-blue-500 rounded-full flex items-center justify-center text-white mr-3">
                        <i data-feather="user"></i>
                    </div>
                    <h2 class="text-xl font-semibold text-gray-800">Customer Information</h2>
                </div>
                
                <div class="grid grid-cols-1 md:grid-cols-2 gap-6">
                    <div>
                        <label class="block text-sm font-medium text-gray-700 mb-1">Full Name</label>
                        <input type="text" class="w-full px-4 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
                    </div>
                    
                    <div>
                        <label class="block text-sm font-medium text-gray-700 mb-1">Primary Contact Number</label>
                        <input type="tel" class="w-full px-4 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
                    </div>
                    
                    <div>
                        <label class="block text-sm font-medium text-gray-700 mb-1">Alternate Contact Number</label>
                        <input type="tel" class="w-full px-4 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
                    </div>
                    
                    <div>
                        <label class="block text-sm font-medium text-gray-700 mb-1">Email ID</label>
                        <input type="email" class="w-full px-4 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
                    </div>
                    
                    <div>
                        <label class="block text-sm font-medium text-gray-700 mb-1">Customer Type</label>
                        <select class="w-full px-4 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
                            <option value="">Select Type</option>
                            <option>Individual</option>
                            <option>Corporate</option>
                            <option>Fleet</option>
                        </select>
                    </div>
                    
                    <div class="grid grid-cols-3 gap-4">
                        <div>
                            <label class="block text-sm font-medium text-gray-700 mb-1">Country</label>
                            <select class="w-full px-4 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
                                <option>Select Country</option>
                                <option>India</option>
                                <option>USA</option>
                                <option>UK</option>
                            </select>
                        </div>
                        <div>
                            <label class="block text-sm font-medium text-gray-700 mb-1">State</label>
                            <select class="w-full px-4 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
                                <option>Select State</option>
                                <option>Maharashtra</option>
                                <option>California</option>
                                <option>London</option>
                            </select>
                        </div>
                        <div>
                            <label class="block text-sm font-medium text-gray-700 mb-1">City</label>
                            <select class="w-full px-4 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
                                <option>Select City</option>
                                <option>Mumbai</option>
                                <option>Los Angeles</option>
                                <option>Manchester</option>
                            </select>
                        </div>
                    </div>
                    
                    <div>
                        <label class="block text-sm font-medium text-gray-700 mb-1">Preferred Communication</label>
                        <div class="flex flex-wrap gap-3 mt-2">
                            <label class="inline-flex items-center">
                                <input type="checkbox" class="rounded border-gray-300 text-blue-600 shadow-sm focus:border-blue-300 focus:ring focus:ring-blue-200 focus:ring-opacity-50">
                                <span class="ml-2">Call</span>
                            </label>
                            <label class="inline-flex items-center">
                                <input type="checkbox" class="rounded border-gray-300 text-blue-600 shadow-sm focus:border-blue-300 focus:ring focus:ring-blue-200 focus:ring-opacity-50">
                                <span class="ml-2">SMS</span>
                            </label>
                            <label class="inline-flex items-center">
                                <input type="checkbox" class="rounded border-gray-300 text-blue-600 shadow-sm focus:border-blue-300 focus:ring focus:ring-blue-200 focus:ring-opacity-50">
                                <span class="ml-2">WhatsApp</span>
                            </label>
                            <label class="inline-flex items-center">
                                <input type="checkbox" class="rounded border-gray-300 text-blue-600 shadow-sm focus:border-blue-300 focus:ring focus:ring-blue-200 focus:ring-opacity-50">
                                <span class="ml-2">Email</span>
                            </label>
                        </div>
                    </div>
                </div>
            </div>

            <!-- Section 3: Lead Type & Assignment -->
            <div class="form-section bg-white rounded-lg p-6 shadow-sm" data-aos="fade-up">
                <div class="flex items-center mb-4">
                    <div class="w-8 h-8 bg-blue-500 rounded-full flex items-center justify-center text-white mr-3">
                        <i data-feather="clipboard"></i>
                    </div>
                    <h2 class="text-xl font-semibold text-gray-800">Lead Type & Assignment</h2>
                </div>
                
                <div class="grid grid-cols-1 md:grid-cols-2 gap-6">
                    <div>
                        <label class="block text-sm font-medium text-gray-700 mb-1">Lead Status</label>
                        <select class="w-full px-4 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
                            <option value="">Select Status</option>
                            <option>New</option>
                            <option>In Progress</option>
                            <option>Negotiation</option>
                            <option>Won</option>
                            <option>Lost</option>
                            <option>Not in Stock</option>
                        </select>
                    </div>
                    
                    <div>
                        <label class="block text-sm font-medium text-gray-700 mb-1">Assigned Sales Executive</label>
                        <select class="w-full px-4 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
                            <option value="">Select Executive</option>
                            <option>John Doe</option>
                            <option>Jane Smith</option>
                            <option>Robert Johnson</option>
                        </select>
                    </div>
                    
                    <div>
                        <label class="block text-sm font-medium text-gray-700 mb-1">Dealership Location</label>
                        <select class="w-full px-4 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
                            <option value="">Select Location</option>
                            <option>Main Branch</option>
                            <option>Westside Branch</option>
                            <option>Downtown Branch</option>
                        </select>
                    </div>
                    
                    <div>
                        <label class="block text-sm font-medium text-gray-700 mb-1">Expected Closure Date</label>
                        <input type="date" class="w-full px-4 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
                    </div>
                </div>
            </div>

            <!-- Section 4: Vehicle / Service Details -->
            <div class="form-section bg-white rounded-lg p-6 shadow-sm" data-aos="fade-up">
                <div class="flex items-center mb-4">
                    <div class="w-8 h-8 bg-blue-500 rounded-full flex items-center justify-center text-white mr-3">
                        <i data-feather="car"></i>
                    </div>
                    <h2 class="text-xl font-semibold text-gray-800">Vehicle / Service Details</h2>
                </div>
                
                <div class="grid grid-cols-1 md:grid-cols-2 gap-6">
                    <div>
                        <label class="block text-sm font-medium text-gray-700 mb-1">Requirement Type</label>
                        <select class="w-full px-4 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
                            <option value="">Select Type</option>
                            <option>Buy Car</option>
                            <option>Sell Car</option>
                            <option>Insurance</option>
                            <option>Service</option>
                            <option>Finance</option>
                        </select>
                    </div>
                    
                    <div class="grid grid-cols-3 gap-4">
                        <div>
                            <label class="block text-sm font-medium text-gray-700 mb-1">Make</label>
                            <select class="w-full px-4 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
                                <option>Select Make</option>
                                <option>Toyota</option>
                                <option>Honda</option>
                                <option>BMW</option>
                            </select>
                        </div>
                        <div>
                            <label class="block text-sm font-medium text-gray-700 mb-1">Model</label>
                            <select class="w-full px-4 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
                                <option>Select Model</option>
                                <option>Camry</option>
                                <option>Civic</option>
                                <option>X5</option>
                            </select>
                        </div>
                        <div>
                            <label class="block text-sm font-medium text-gray-700 mb-1">Variant/Year</label>
                            <select class="w-full px-4 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
                                <option>Select Variant/Year</option>
                                <option>LX</option>
                                <option>EX</option>
                                <option>2023</option>
                            </select>
                        </div>
                    </div>
                    
                    <div>
                        <label class="block text-sm font-medium text-gray-700 mb-1">Condition (for used cars)</label>
                        <select class="w-full px-4 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
                            <option value="">Select Condition</option>
                            <option>Excellent</option>
                            <option>Good</option>
                            <option>Fair</option>
                            <option>Poor</option>
                        </select>
                    </div>
                    
                    <div class="grid grid-cols-2 gap-4">
                        <div>
                            <label class="block text-sm font-medium text-gray-700 mb-1">Min Budget</label>
                            <input type="text" class="w-full px-4 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
                        </div>
                        <div>
                            <label class="block text-sm font-medium text-gray-700 mb-1">Max Budget</label>
                            <input type="text" class="w-full px-4 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
                        </div>
                    </div>
                    
                    <div>
                        <label class="block text-sm font-medium text-gray-700 mb-1">Lead Value</label>
                        <div class="relative rounded-md shadow-sm">
                            <div class="absolute inset-y-0 left-0 pl-3 flex items-center pointer-events-none">
                                <span class="text-gray-500 sm:text-sm">₹</span>
                            </div>
                            <input type="text" class="block w-full pl-8 pr-12 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
                        </div>
                    </div>
                </div>
            </div>

            <!-- Section 5: Additional Information -->
            <div class="form-section bg-white rounded-lg p-6 shadow-sm" data-aos="fade-up">
                <div class="flex items-center mb-4">
                    <div class="w-8 h-8 bg-blue-500 rounded-full flex items-center justify-center text-white mr-3">
                        <i data-feather="info"></i>
                    </div>
                    <h2 class="text-xl font-semibold text-gray-800">Additional Information</h2>
                </div>
                
                <div class="grid grid-cols-1 md:grid-cols-2 gap-6">
                    <div>
                        <label class="block text-sm font-medium text-gray-700 mb-1">Reference/Referral Name</label>
                        <input type="text" class="w-full px-4 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500">
                    </div>
                    
                    <div>
                        <label class="block text-sm font-medium text-gray-700 mb-1">Tags</label>
                        <div class="flex flex-wrap gap-3 mt-2">
                            <label class="inline-flex items-center">
                                <input type="checkbox" class="rounded border-gray-300 text-blue-600 shadow-sm focus:border-blue-300 focus:ring focus:ring-blue-200 focus:ring-opacity-50">
                                <span class="ml-2">Hot Lead</span>
                            </label>
                            <label class="inline-flex items-center">
                                <input type="checkbox" class="rounded border-gray-300 text-blue-600 shadow-sm focus:border-blue-300 focus:ring focus:ring-blue-200 focus:ring-opacity-50">
                                <span class="ml-2">Priority</span>
                            </label>
                            <label class="inline-flex items-center">
                                <input type="checkbox" class="rounded border-gray-300 text-blue-600 shadow-sm focus:border-blue-300 focus:ring focus:ring-blue-200 focus:ring-opacity-50">
                                <span class="ml-2">Repeat Customer</span>
                            </label>
                            <label class="inline-flex items-center">
                                <input type="checkbox" class="rounded border-gray-300 text-blue-600 shadow-sm focus:border-blue-300 focus:ring focus:ring-blue-200 focus:ring-opacity-50">
                                <span class="ml-2">Corporate</span>
                            </label>
                        </div>
                    </div>
                    
                    <div class="md:col-span-2">
                        <label class="block text-sm font-medium text-gray-700 mb-1">Notes</label>
                        <textarea rows="4" class="w-full px-4 py-2 border border-gray-300 rounded-md focus:ring-blue-500 focus:border-blue-500"></textarea>
                    </div>
                    
                    <div class="md:col-span-2">
                        <label class="block text-sm font-medium text-gray-700 mb-1">Documents Upload</label>
                        <div class="file-upload mt-1 flex justify-center px-6 pt-5 pb-6 border-2 border-gray-300 border-dashed rounded-md">
                            <div class="space-y-1 text-center">
                                <div class="flex text-sm text-gray-600">
                                    <label class="relative cursor-pointer bg-white rounded-md font-medium text-blue-600 hover:text-blue-500 focus-within:outline-none">
                                        <span>Upload files</span>
                                        <input type="file" class="sr-only" multiple>
                                    </label>
                                    <p class="pl-1">or drag and drop</p>
                                </div>
                                <p class="text-xs text-gray-500">PNG, JPG, PDF up to 10MB</p>
                            </div>
                        </div>
                    </div>
                </div>
            </div>

            <!-- Section 6: Engagement / Activity Tracking -->
            <div class="form-section bg-white rounded-lg p-6 shadow-sm" data-aos="fade-up">
                <div class="flex items-center mb-4">
                    <div class="w-8 h-8 bg-blue-500 rounded-full flex items-center justify-center text-white mr-3">
                        <i data-feather="activity"></i>
                    </div>
                    <h2 class="text-xl font-semibold text-gray-800">Engagement / Activity Tracking</h2>
                </div>
                
                <div class="space-y-6">
                    <div>
                        <label class="block text-sm font-medium text-gray-700 mb-2">Activity Log</label>
                        <div class="bg-gray-50 p-4 rounded-md">
                            <p class="text-sm text-gray-500">No activities logged yet. Activities will appear here after submission.</p>
                        </div>
                    </div>
                    
                    <div class="grid grid-cols-1 md:grid-cols-2 gap-6">
                        <button type="button" class="flex items-center justify-center px-4 py-2 border border-transparent text-sm font-medium rounded-md text-white bg-green-600 hover:bg-green-700 focus:outline-none focus:ring-2 focus:ring-offset-2 focus:ring-green-500">
                            <i data-feather="mail" class="mr-2"></i> Send Email
                        </button>
                        
                        <button type="button" class="flex items-center justify-center px-4 py-2 border border-transparent text-sm font-medium rounded-md text-white bg-green-600 hover:bg-green-700 focus:outline-none focus:ring-2 focus:ring-offset-2 focus:ring-green-500">
                            <i data-feather="message-square" class="mr-2"></i> Send WhatsApp Message
                        </button>
                        
                        <button type="button" class="flex items-center justify-center px-4 py-2 border border-transparent text-sm font-medium rounded-md text-white bg-blue-600 hover:bg-blue-700 focus:outline-none focus:ring-2 focus:ring-offset-2 focus:ring-blue-500">
                            <i data-feather="phone" class="mr-2"></i> Schedule Call
                        </button>
                        
                        <button type="button" class="flex items-center justify-center px-4 py-2 border border-transparent text-sm font-medium rounded-md text-white bg-blue-600 hover:bg-blue-700 focus:outline-none focus:ring-2 focus:ring-offset-2 focus:ring-blue-500">
                            <i data-feather="calendar" class="mr-2"></i> Schedule Test Drive
                        </button>
                    </div>
                </div>
            </div>

            <!-- Form Actions -->
            <div class="flex justify-end space-x-4">
                <button type="button" class="px-6 py-2 border border-gray-300 rounded-md text-sm font-medium text-gray-700 bg-white hover:bg-gray-50 focus:outline-none focus:ring-2 focus:ring-offset-2 focus:ring-blue-500">
                    Cancel
                </button>
                <button type="submit" class="px-6 py-2 border border-transparent rounded-md shadow-sm text-sm font-medium text-white bg-blue-600 hover:bg-blue-700 focus:outline-none focus:ring-2 focus:ring-offset-2 focus:ring-blue-500">
                    Save Lead
                </button>
            </div>
        </form>
    </div>

    <script>
        AOS.init();
        feather.replace();
    </script>
</body>
</html>