<!-- Modal ADD Branch -->
<?php ($uniqid = uniqid()); ?>
<div class="modal fade" id="md_update_dealer" tabindex="-1" role="dialog" aria-labelledby="exampleModallabel" aria-hidden="true">
  <?php echo e(Form::open(array('route' => 'dealer.update','id' => 'form_update_dealer', '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 Dealer / Sub Dealer / Vendor</h5>
        <button type="button" class="close" data-dismiss="modal" aria-label="Close">
          <span aria-hidden="true"></span>
        </button>
      </div>
      <input type="hidden" name="user_id">
      <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 = "<?php echo e(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="*"><?php echo e($errors->first('cnic',":message")); ?></small>
              <div class="input-group mb-3">
                <?php echo e(Form::Text('cnic', '', ['class' => 'form-control form-control-sm  cls_cnic', 'data-mask' => '00000-0000000-0', 'data-mask-clearifnotmatch' => 'true' ,'placeholder' => '00000-0000000-0' ,'autocomplete' =>'off' ,'aria-label' => 'Default', 'aria-describedby' => 'inputGroup-sizing-default'])); ?>

              </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="*"><?php echo e($errors->first('full_name',":message")); ?></small>

            <div class="input-group mb-3">

              <?php echo e(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="*"><?php echo e($errors->first('father_name',":message")); ?></small>

            <div class="input-group mb-3">

              <?php echo e(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-12">

              <small class="form-errors pull-right req" value="*"><?php echo e($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">
                  <label class="label-color" >Contact: <i style = "color:red;">*</i></label>
            <small class="form-errors pull-right req" value="*"><?php echo e($errors->first('contact',":message")); ?></small>

            <div class="input-group mb-3">

              <?php echo e(Form::Text('contact', '', ['class' => 'form-control form-control-sm  cls_contact', '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" >Email:</label>
               <small class="form-errors pull-right " value=""><?php echo e($errors->first('email',":message")); ?></small>

            <div class="input-group mb-3">

               <?php echo e(Form::Email('email', '', ['class' => 'form-control form-control-sm  cls_email', 'placeholder' => 'Email' , 'aria-label' => 'Default', 'aria-describedby' => 'inputGroup-sizing-default'])); ?>

            </div>
           </div>

           <div class="col-sm-6">
            <label class="label-color"> Agency Name: <i style = "color:red;">*</i></label>
            <label  class="checkbox-inline float-right"><input onclick="NTNVerify('<?php echo e($uniqid); ?>')" name="filer" class="filer_<?php echo e($uniqid); ?> is_filer" type="checkbox" >&nbsp;<b>Filer / Non Filer</b></label>
            <small class="form-errors pull-right req" value="*"><?php echo e($errors->first('agency_name',":message")); ?></small>

            <div class="input-group mb-3">
                <?php echo e(Form::Text('agency_name', '', ['class' => 'form-control form-control-sm  cls_fullname', 'placeholder' => 'Agency Name' , 'aria-label' => 'Default', 'aria-describedby' => 'inputGroup-sizing-default'])); ?>

            </div>
        </div>


          <div class="col-sm-6">
              <div  class="ntn_section_<?php echo e($uniqid); ?>">
            <label class="label-color">NTN #: </label>
         <small class="form-errors pull-right req" value=""><?php echo e($errors->first('ntn',":message")); ?></small>
         <div class="input-group mb-3">
          <input placeholder="NTN Number" type="text" name="ntn" class="form-control form-control-sm ntn_number_<?php echo e($uniqid); ?>" >
         </div>
              </div>
       </div>

          <div class="col-sm-12">
                <label class="label-color">Agency Address:</label>
            <small class="form-errors pull-right req" value=""><?php echo e($errors->first('agency_address',":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-address-card   "></i>
                </span>
              </div> -->
              <?php echo e(Form::Textarea('agency_address', '', ['class' => 'form-control form-control-sm', 'placeholder' => 'Agency address' , 'aria-label' => 'Default', 'aria-describedby' => 'inputGroup-sizing-default','rows' => 2])); ?>

            </div>
          </div>



      </div>
          </div>
        </div>
        
  </div>
      <div class="modal-footer">
        <button type="button" class="btn btn-secondary" data-dismiss="modal">Close</button>
        <button type="submit" class="btn btn-primary cls_submit" content="update dealer/sub dealer/vendor">Update Dealer</button>
      </div>

  </div>
  <?php echo e(Form::close()); ?>

</div>
</div>
<!-- END MODAL ADD BRANCH -->
<?php /**PATH /home/ubuntu/rebmgisplus/skylite/resources/views/user/modals/update_dealer.blade.php ENDPATH**/ ?>