68 lines
2.4 KiB
PHP
68 lines
2.4 KiB
PHP
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<div class="row">
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<div class="col-lg-12">
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<div class="card">
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{{-- <div class="card-header card-primary">
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<h4 class="card-title mb-0">Personal Details</h4>
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</div> --}}
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<div class="card-body">
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<div class="row gy-2">
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<p class="text-primary">Personal Details</p>
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<hr>
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<div class="col-md-4">
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{{ html()->label('Customer name')->class('form-label') }}
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{{ html()->text('customer_name')->class('form-control')->placeholder('Enter Customer Name')->required() }}
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</div>
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<div class="col-md-4">
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{{ html()->label('Nationality')->class('form-label') }}
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{{ html()->select('nationalities_id', $nationalityList)->class('form-select select2')->placeholder('Select Nationality') }}
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</div>
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<div class="col-md-4">
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{{ html()->label('Email')->class('form-label') }}
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{{ html()->email('email')->class('form-control')->placeholder('Enter Email')->required() }}
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{{ html()->div('Please enter email')->class('invalid-feedback') }}
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</div>
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<div class="col-md-4">
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{{ html()->label('Phone Number')->class('form-label') }}
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{{ html()->text('contact')->class('form-control')->placeholder('Enter Phone Number') }}
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</div>
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<div class="col-md-4">
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{{ html()->label('Upload Profile Picture')->class('form-label') }}
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{{ html()->file('profile_picture')->class('form-control') }}
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</div>
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</div>
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<div class="row gy-1 mt-1">
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<p class="text-primary">Address Details</p>
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<hr>
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<div class="col-md-12">
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{{ html()->label('Permanent Address')->class('form-label') }}
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{{ html()->text('permanent_address')->class('form-control')->placeholder('Enter Permanent Address') }}
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</div>
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</div>
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<div class="row gy-1 mt-1">
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<p class="text-primary">Organization Details</p>
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<hr>
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<div class="col-md-12">
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{{ html()->label('Remarks')->class('form-label') }}
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{{ html()->textarea('remarks')->class('form-control')->placeholder('Enter Remarks') }}
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</div>
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</div>
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</div>
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<!-- end card body -->
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</div>
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<!-- end card -->
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<div class="mb-4 text-end">
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<button type="submit" class="btn btn-success w-sm">Save</button>
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</div>
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</div>
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</div>
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