Convert PDF form to online form using PHP/MySQL - 2

I need a PDF form converted to online form using PHP/MySQL. Fields need to be created as per the type (e.g., if the field expects a date, the form should have a pop-up calendar for that field. Each section in the PDF should be 1 online page/form. On clicking "Save" on each page, the form contents should get saved in the database. One user can submit each record (entire pdf) once and if he logs in again, he can see his existing form entries. There should be a left menu navigation which should link to each page/form. Layout needs to be at least as per the attached screenshot or better. Maximum budget for this project is Rs. 4500 and I need it done in 4 days max. I can pay 50% only after I see that more than 50% of the work is done, so please do not ask for upfront payment. First 2 sections of the project need to be completed within 2 days of awarding the project. If you have any questions, please ask before bidding.