/home2/mshostin/public_html/resources/views/reference/create.blade.php
@extends('layouts.app',['page' => 'Register Reference', 'pageSlug' => 'reference', 'section' => 'reference'])
@section('content')
<div class="container-fluid mt--7">
<div class="row">
<div class="col-xl-12 order-xl-1">
<div class="card">
<div class="card-header">
<div class="row align-items-center">
<div class="col-8">
<h3 class="mb-0">Register Client</h3>
</div>
<div class="col-4 text-right">
<a href="{{ route('reference.index') }}" class="btn btn-sm btn-primary">Back to List</a>
</div>
</div>
</div>
<div class="card-body">
<form method="post" action="{{ route('reference.store') }}" autocomplete="off">
@csrf
<h6 class="heading-small text-muted mb-4">Reference Information</h6>
<div class="pl-lg-4">
<div class="form-group{{ $errors->has('name') ? ' has-danger' : '' }}">
<label class="form-control-label" for="input-name">Name</label>
<input type="text" name="name" id="input-name" class="form-control form-control-alternative{{ $errors->has('name') ? ' is-invalid' : '' }}" placeholder="Name" value="{{ old('name') }}" required autofocus>
@include('alerts.feedback', ['field' => 'name'])
</div>
<div class="row">
{{-- <div class="col-1">
<label class="form-control-label" for="input-document_type">Type</label>
<select name="document_type" id="input-document_type" class="form-control form-control-alternative{{ $errors->has('name') ? ' is-invalid' : '' }}" required>
@foreach (['V', 'E', 'P', 'RIF'] as $document_type)
@if($document_type == old('document_type'))
<option value="{{$document_type}}" selected>{{$document_type}}</option>
@else
<option value="{{$document_type}}">{{$document_type}}</option>
@endif
@endforeach
</select>
</div> --}}
{{-- <div class="col">
<label class="form-control-label" for="input-document_id">Phone</label>
<input type="number" name="name" id="input-document_id" class="form-control form-control-alternative{{ $errors->has('document_id') ? ' is-invalid' : '' }}" placeholder="Document Number" value="{{ old('document_id') }}" required>
@include('alerts.feedback', ['field' => 'document_id'])
</div> --}}
</div>
{{-- <div class="form-group{{ $errors->has('email') ? ' has-danger' : '' }}">
<label class="form-control-label" for="input-email">Email</label>
<input type="email" name="email" id="input-email" class="form-control form-control-alternative{{ $errors->has('email') ? ' is-invalid' : '' }}" placeholder="Email" value="{{ old('email') }}" required>
@include('alerts.feedback', ['field' => 'email'])
</div> --}}
<div class="form-group{{ $errors->has('phone') ? ' has-danger' : '' }}">
<label class="form-control-label" for="input-phone">Telephone</label>
<input type="text" name="phone" id="input-phone" class="form-control form-control-alternative{{ $errors->has('phone') ? ' is-invalid' : '' }}" placeholder="Telephone" value="{{ old('phone') }}" required>
@include('alerts.feedback', ['field' => 'phone'])
</div>
<div class="form-group{{ $errors->has('area') ? ' has-danger' : '' }}">
<label class="form-control-label" for="input-phone">Area</label>
<input type="text" name="area" id="input-area" class="form-control form-control-alternative{{ $errors->has('area') ? ' is-invalid' : '' }}" placeholder="Area" value="{{ old('area') }}" required>
@include('alerts.feedback', ['field' => 'area'])
</div>
<div class="text-center">
<button type="submit" class="btn btn-success mt-4">Save</button>
</div>
</div>
</form>
</div>
</div>
</div>
</div>
</div>
@endsection