<!-- Modal ADD Branch -->
<div class="modal fade" id="md_update_customer" tabindex="-1" role="dialog" aria-labelledby="exampleModallabel" aria-hidden="true">
  {{ Form::open(array('route' => 'customer.update', 'id' => 'form_update_customer', 'class' => 'cls_form', 'enctype' => 'multipart/form-data')) }}
  <div class="modal-dialog modal-lg" role="document">
    <div class="modal-content">
      <div class="modal-header">
        <h5 class="modal-title" id="exampleModallabel">Update Customer</h5>
        <button type="button" class="close" data-dismiss="modal" aria-label="Close">
          <span aria-hidden="true"></span>
        </button>
      </div>
      <div class="modal-body">

        <div class = "card" >
          <div class = "card-header">
            <div class = "col-md-5">
    <strong class="strong-margin">PERSONAL INFORMATION</strong>
     </div>
              <div class = "col-md-6">
               
   
     </div>
             <div class = "col-md-1">
           <img src = "{{asset('assets/images/icons/userinformation.png')}}"/>
               
   
     </div>
          </div>
          <div class = "card-body  form-fieldset">
             <div class="row">           
            <div class="col-sm-12">
                  <label class="label-color" >CNIC: <i style = "color:red;"></i></label>
            <small class="form-errors pull-right req" value="*">{{ $errors->first('cnic',":message") }}</small>
            <div class="input-group mb-3">
            
              {{Form::Text('cnic', '', ['class' => 'form-control form-control-sm  ', 'data-mask' => '00000-0000000-0', 'data-mask-clearifnotmatch' => 'true' ,'placeholder' => '00000-0000000-0'  , 'aria-label' => 'Default', 'aria-describedby' => 'inputGroup-sizing-default', 'readonly' => 'true'])}}
            </div>
          </div>

          <div class="col-sm-6">
                <label class="label-color" >Name: <i style = "color:red;">*</i></label>
            <small class="form-errors pull-right req" value="*">{{ $errors->first('full_name',":message") }}</small>

            <div class="input-group mb-3">
            
              {{Form::Text('full_name', '', ['class' => 'form-control form-control-sm  cls_fullname', 'placeholder' => 'Full name' , 'aria-label' => 'Default', 'aria-describedby' => 'inputGroup-sizing-default'])}}
            </div>
          </div>

          <div class="col-sm-6">
                <label class="label-color" >Father Name: <i style = "color:red;">*</i></label>
            <small class="form-errors pull-right req" value="*">{{ $errors->first('father_name',":message") }}</small>

            <div class="input-group mb-3">
          
              {{Form::Text('father_name', '', ['class' => 'form-control form-control-sm  cls_fullname', 'placeholder' => 'Father name' , 'aria-label' => 'Default', 'aria-describedby' => 'inputGroup-sizing-default'])}}
            </div>
          </div>

         <div class="col-sm-6">
              <small class="form-errors pull-right req" value="*">{{ $errors->first('gender',":message") }}</small>
               <label class="radio-inline mb-3" >
                            <label class="label-color" >Gender:</label>
                      <input type="radio" name="gender" value="Male" checked> Male
                </label>
                <label class="radio-inline">
                  <input type="radio" name="gender" value="Female"> Female
                </label>
            </div>

            <div class="col-sm-6">
              <small class="form-errors pull-right req" value="*">{{ $errors->first('relation',":message") }}</small>
               <label class="radio-inline mb-3" >
                            <label class="label-color" >Relation:</label>
                      <input type="radio" name="relation" value="S/O" checked> S / O 
                </label>

                <label class="radio-inline">
                  <input type="radio" name="relation" value="D/O"> D / O 
                </label>

                <label class="radio-inline">
                  <input type="radio" name="relation" value="W/O"> W / O 
                </label>
            </div>

  

          <div class="col-sm-6">
                <label class="label-color" > Nationality:</label>
            <small class="form-errors pull-right req" value="">{{ $errors->first('nationality',":message") }}</small>

            <div class="input-group mb-3">
            
              {{Form::Text('nationality', '', ['class' => 'form-control form-control-sm  cls_fullname', 'placeholder' => 'Nationality' , 'aria-label' => 'Default', 'aria-describedby' => 'inputGroup-sizing-default'])}} 

            </div>
          </div>
                 <div class="col-sm-6">
               <label class="label-color">Passport:</label>
            <small class="form-errors pull-right req" value="">{{ $errors->first('nationality',":message") }}</small>

            <div class="input-group mb-3">
              {{Form::Text('passport', '', ['class' => 'form-control form-control-sm cls_alpha_numeric', 'placeholder' => 'Passport' , 'aria-label' => 'Default', 'aria-describedby' => 'inputGroup-sizing-default'])}} 

            </div>
          </div>

          <div class="col-sm-6">
                <label class="label-color" >Occupation:</label>
            <small class="form-errors pull-right req" value="">{{ $errors->first('occupation',":message") }}</small>

            <div class="input-group mb-3">
              
              {{Form::Text('occupation', '', ['class' => 'form-control form-control-sm  cls_fullname', 'placeholder' => 'Occupation' , 'aria-label' => 'Default', 'aria-describedby' => 'inputGroup-sizing-default'])}} 

            </div>
          </div>
             <div class="col-sm-6">
                <label class="label-color" >DOB:</label>
            <small class="form-errors pull-right req" value="">{{ $errors->first('dob',":message") }}</small>

            <div class="input-group mb-3">
           
              {{Form::Date('dob', '', ['class' => 'form-control form-control-sm', 'placeholder' => 'Date of birth' , 'aria-label' => 'Default', 'aria-describedby' => 'inputGroup-sizing-default'])}}
            </div>
          </div>

          <div class="col-sm-6">
                <label class="label-color" >Contact: <i style = "color:red;">*</i></label>
            <small class="form-errors pull-right req" value="*">{{ $errors->first('contact',":message") }}</small>

            <div class="input-group mb-3">
           
              {{Form::Text('contact', '', ['class' => 'form-control form-control-sm  cls_contacr', 'placeholder' => 'Contact no' , 'aria-label' => 'Default', 'aria-describedby' => 'inputGroup-sizing-default','data-mask' => '0000-0000000', 'data-mask-clearifnotmatch' => 'true' ,'placeholder' => '0000-0000000'])}}
            </div>
          </div>
           <div class="col-sm-6">
               <label class="label-color">Other Contact: </label>
            <small class="form-errors pull-right req" value="">{{ $errors->first('other_contact',":message") }}</small>

            <div class="input-group mb-3">
             <!--  <div class="input-group-prepend">
                <span class="input-group-text" id="inputGroup-sizing-default">
                  <i class="fa fa-phone   "></i>
                </span>
              </div> -->
              {{Form::Text('other_contact', '', ['class' => 'form-control form-control-sm cls_contact', 'placeholder' => 'Other Contact' , 'aria-label' => 'Default', 'aria-describedby' => 'inputGroup-sizing-default'])}}
            </div>
          </div>

       

          <div class="col-sm-6">
                <label class="label-color" >Temporary Address:</label>
            <small class="form-errors pull-right req" value="">{{ $errors->first('temporary_address',":message") }}</small>

            <div class="input-group mb-3">
             
              {{Form::Textarea('temporary_address', '', ['class' => 'form-control form-control-sm ', 'placeholder' => 'Temporary address' , 'aria-label' => 'Default', 'aria-describedby' => 'inputGroup-sizing-default','rows' => 2])}}
            </div>
          </div>

           <div class="col-sm-6">
                <label class="label-color" >Permanent Address:</label>
            <small class="form-errors pull-right req" value="">{{ $errors->first('permanent_address',":message") }}</small>

            <div class="input-group mb-3">
             
              {{Form::textarea('permanent_address', '', ['class' => 'form-control form-control-sm ', 'placeholder' => 'Permanent address' , 'aria-label' => 'Default', 'aria-describedby' => 'inputGroup-sizing-default','rows' => 2])}}
            </div>
          </div>

           <div class="col-sm-12">
            <small class="form-errors pull-right req" value="">{{ $errors->first('user_image',":message") }}</small>

            <div class="input-group mb-3">
                <div class="input-group-prepend">
                <span class="input-group-text" id="inputGroup-sizing-default">
                  <i class="fa fa-camera "></i>
                </span>
              </div>
          
              <input type="file" name="user_image" class="form-control form-control-sm  btn-sm">
             <div class="input-group-prepend">
                <span class="input-group-text" id="inputGroup-sizing-default">
                  <i class ="userimage">PNG,JPG,JPEG</i>
                </span>
              </div>

            </div>
          </div>
         
                      
       </div>
       
          </div>
        </div>
        <div class="card">
          <div class= "card-header">
            <div class = "col-md-5">
    <strong class="strong-margin">ACCOUNT INFORMATION</strong>
     </div>
              <div class = "col-md-6">
               
   
     </div>
             <div class = "col-md-1">
           <img src = "{{asset('assets/images/icons/accountinformation.png')}}"/>
               
   
     </div>
          
          </div>
          <div class="card-body  form-fieldset">
            <div class = "row" >
                <div class="col-sm-12">
                      <label class="label-color" >Email:</label>
                <small class="form-errors pull-right req" value="">{{ $errors->first('email',":message") }}</small>

                <div class="input-group mb-3">
               
                  {{Form::Email('email', '', ['class' => 'form-control form-control-sm  cls_email', 'placeholder' => 'Email' , 'aria-label' => 'Default', 'aria-describedby' => 'inputGroup-sizing-default','autocomplete' => 'false'])}} 

                </div>
              </div>
     
                 {{-- 
              BRANCH CODE REMOVE REQUEST ON FIZZA WAQAR 9TH JULY 2019
                  <div class="col-sm-6">
                    <label class="label-color">Branch: <i style = "color:red;">*</i></label>
                    <small class="form-errors pull-right req" value="*">{{ $errors->first('branch',":message") }}</small>

                   <div class="input-group mb-3">
                    
                       @include('layouts.common.branch')
                          
                    </div>
                </div>
            --}}
            </div>
          </div>
        </div>

       
      </div>
      <div class="modal-footer">
        <button type="button" class="btn btn-secondary" data-dismiss="modal">Close</button>
        <input type="hidden" name="user_id">
        <button type="submit" class="btn btn-primary cls_submit" content="update customer">Update Customer</button>
      </div>
    </div>
  </div>
  {{ Form::close() }}
</div>


<!-- END MODAL ADD BRANCH -->