Files
aroginhealthcare/Modules/Admin/resources/views/partial/form.blade.php
2025-08-17 16:23:14 +05:45

133 lines
6.8 KiB
PHP

@section('pageCss')
@endsection
<div class="row">
<div class="col-md-12">
<ul class="nav nav-pills flex-column flex-md-row mb-3">
<li class="nav-item">
<a class="nav-link active" href="javascript:void(0);">
<i class="bx bx-user me-1"></i> General
</a>
</li>
<li class="nav-item">
<a class="nav-link" href="pages-account-settings-connections.html">
<i class="bx bx-link-alt me-1"></i> Connections
</a>
</li>
</ul>
<div class="card mb-4">
<h5 class="card-header">Site Details</h5>
<!-- Account -->
<div class="card-body">
<div class="d-flex align-items-start align-items-sm-center gap-4">
<img src="../../assets/img/avatars/1.png" alt="user-avatar" class="d-block rounded" height="100"
width="100" id="uploadedAvatar" />
<div class="button-wrapper">
<label for="upload" class="btn btn-primary me-2 mb-4" tabindex="0">
<span class="d-none d-sm-block">Upload</span>
<i class="bx bx-upload d-block d-sm-none"></i>
<input type="file" id="upload" class="account-file-input" hidden
accept="image/png, image/jpeg" />
</label>
<button type="button" class="btn btn-label-secondary account-image-reset mb-4">
<i class="bx bx-reset d-block d-sm-none"></i>
<span class="d-none d-sm-block">Reset</span>
</button>
<p class="mb-0">Allowed JPG, GIF or PNG. Max size of 800K</p>
</div>
</div>
</div>
<hr class="my-0" />
<div class="card-body">
<form id="formAccountSettings" method="POST" onsubmit="return false">
<div class="row">
<div class="mb-3 col-md-6">
<label class="form-label">Name<span class="text-danger"> *</span></label>
{!! Form::text('company_name', $value = null, [
'placeholder' => 'e.g. Jhigu Technologies',
'class' => 'form-control',
'required',
]) !!}
</div>
<div class="mb-3 col-md-6">
<label class="form-label">Address</label>
{!! Form::text('address', $value = null, [
'placeholder' => 'e.g. Bhaktapur, Bagmati, Nepal',
'class' => 'form-control'
]) !!}
</div>
<div class="mb-3 col-md-6">
<label class="form-label">Contact Number</label>
<div class="input-group input-group-merge">
<span class="input-group-text">NP (+977)</span>
{!! Form::text('contact_number', $value = null, [
'placeholder' => 'e.g. 9876543210',
'class' => 'form-control',
]) !!}
</div>
</div>
<div class="mb-3 col-md-6">
<label class="form-label">E-mail (Info)</label>
{!! Form::text('info_email_address', $value = null, [
'placeholder' => 'e.g. info@jhigutech.com',
'class' => 'form-control',
]) !!}
</div>
<div class="mb-3 col-md-6">
<label class="form-label">Mobile Number</label>
<div class="input-group input-group-merge">
<span class="input-group-text">NP (+977)</span>
{!! Form::text('mobile_number', $value = null, [
'placeholder' => 'e.g. 9876543210',
'class' => 'form-control',
]) !!}
</div>
</div>
<div class="mb-3 col-md-6">
<label class="form-label">Mobile Number (Alternative)</label>
<div class="input-group input-group-merge">
<span class="input-group-text">NP (+977)</span>
{!! Form::text('alt_mobile_number', $value = null, [
'placeholder' => 'e.g. 9876543210',
'class' => 'form-control',
]) !!}
</div>
</div>
<div class="mb-3 col-md-6">
<label class="form-label">E-mail (Support)</label>
{!! Form::text('support_email_address', $value = null, [
'placeholder' => 'e.g. support@jhigutech.com',
'class' => 'form-control',
]) !!}
</div>
<div class="mb-3 col-md-6">
<label class="form-label">Opening Hours</label>
{!! Form::text('opening_hours', $value = null, [
'placeholder' => 'e.g. 9:00 AM - 10:00 PM',
'class' => 'form-control',
]) !!}
</div>
<div class="mb-3 col-md-12">
<label class="form-label">Short Description</label>
{!! Form::textarea('short_detail', $value = null, [
'rows' => 5,
'placeholder' => 'Write short description',
'class' => 'form-control',
]) !!}
</div>
</div>
<div class="mt-2">
<button type="submit" class="btn btn-primary me-2">Save Changes</button>
<button type="reset" class="btn btn-label-secondary">Cancel</button>
</div>
</form>
</div>
<!-- /Account -->
</div>
</div>
</div>
@section('pageJs')
@endsection