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<form method="post" class="ajax-screen-submit" autocomplete="off" action="<?php echo e(route('customers.store')); ?>" enctype="multipart/form-data">
	<?php echo csrf_field(); ?>
	<div class="row px-2">
		<div class="col-md-6">
			<div class="form-group">
				<label class="control-label"><?php echo e(_lang('Name')); ?></label>						
				<input type="text" class="form-control" name="name" value="<?php echo e(old('name')); ?>" required>
			</div>
		</div>

<div class="col-md-6">
			<div class="form-group">
				<label class="control-label"><?php echo e(_lang('Company Name')); ?></label>						
				<input type="text" class="form-control" name="company_name" value="<?php echo e(old('company_name')); ?>">
			</div>
		</div>

<div class="col-md-6">
			<div class="form-group">
				<label class="control-label"><?php echo e(_lang('Email')); ?></label>						
				<input type="text" class="form-control" name="email" value="<?php echo e(old('email')); ?>">
			</div>
		</div>

<div class="col-md-6">
			<div class="form-group">
				<label class="control-label"><?php echo e(_lang('Mobile')); ?></label>						
				<input type="text" class="form-control" name="mobile" value="<?php echo e(old('mobile')); ?>">
			</div>
		</div>

<div class="col-md-6">
			<div class="form-group">
				<label class="control-label"><?php echo e(_lang('Country')); ?></label>						
				<select class="form-control auto-select select2" data-selected="<?php echo e(old('country')); ?>" name="country">
					<option value=""><?php echo e(_lang('Select One')); ?></option>
					<?php echo e(get_country_list()); ?>

</select>
			</div>
		</div>

<div class="col-md-6">
			<div class="form-group">
				<label class="control-label"><?php echo e(_lang('Currency')); ?></label>						
				<select class="form-control auto-select select2" data-selected="<?php echo e(old('currency')); ?>" name="currency" required>
					<option value=""><?php echo e(_lang('Select One')); ?></option>
					<?php echo e(get_currency_list()); ?>

</select>
				<small class="text-danger"><i class="fas fa-exclamation-circle mr-1"></i><?php echo e(_lang('You will be not able to change this currency !')); ?></small>
			</div>
		</div>

<div class="col-md-6">
			<div class="form-group">
				<label class="control-label"><?php echo e(_lang('Vat ID')); ?></label>						
				<input type="text" class="form-control" name="vat_id" value="<?php echo e(old('vat_id')); ?>">
			</div>
		</div>

<div class="col-md-6">
			<div class="form-group">
				<label class="control-label"><?php echo e(_lang('Reg No')); ?></label>						
				<input type="text" class="form-control" name="reg_no" value="<?php echo e(old('reg_no')); ?>">
			</div>
		</div>

<div class="col-md-12">
			<div class="form-group">
				<label class="control-label"><?php echo e(_lang('City')); ?></label>						
				<input type="text" class="form-control" name="city" value="<?php echo e(old('city')); ?>">
			</div>
		</div>

<div class="col-md-6">
			<div class="form-group">
				<label class="control-label"><?php echo e(_lang('State')); ?></label>						
				<input type="text" class="form-control" name="state" value="<?php echo e(old('state')); ?>">
			</div>
		</div>

<div class="col-md-6">
			<div class="form-group">
				<label class="control-label"><?php echo e(_lang('ZIP')); ?></label>						
				<input type="text" class="form-control" name="zip" value="<?php echo e(old('zip')); ?>">
			</div>
		</div>

<div class="col-md-6">
			<div class="form-group">
				<label class="control-label"><?php echo e(_lang('Address')); ?></label>						
				<textarea class="form-control" name="address"><?php echo e(old('address')); ?></textarea>
			</div>
		</div>

<div class="col-md-6">
			<div class="form-group">
				<label class="control-label"><?php echo e(_lang('Remarks')); ?></label>						
				<textarea class="form-control" name="remarks"><?php echo e(old('remarks')); ?></textarea>
			</div>
		</div>

<div class="col-md-12">
			<div class="form-group">
				<label class="control-label"><?php echo e(_lang('Profile Picture')); ?></label>						
				<input type="file" class="form-control dropify" name="profile_picture" >
			</div>
		</div>
			
		<div class="col-md-12 mt-2">
			<div class="form-group">
				<button type="submit" class="btn btn-primary"><i class="ti-check-box mr-2"></i><?php echo e(_lang('Save Changes')); ?></button>
			</div>
		</div>
	</div>
</form>
<?php /**PATH /home/eliosofonline/acc.eliosof.com/resources/views/backend/user/customer/modal/create.blade.php ENDPATH**/ ?>

Server Info

Hostname: server1.winmanyltd.com
Server IP: 203.161.60.52
PHP Version: 8.3.27
Server Software: Apache
System: Linux server1.winmanyltd.com 4.18.0-553.22.1.el8_10.x86_64 #1 SMP Tue Sep 24 05:16:59 EDT 2024 x86_64
HDD Total: 117.98 GB
HDD Free: 59.79 GB
Domains on IP: N/A (Requires external lookup)

System Features

Safe Mode: Off
disable_functions: None
allow_url_fopen: On
allow_url_include: Off
magic_quotes_gpc: Off
register_globals: Off
open_basedir: None
cURL: Enabled
ZipArchive: Enabled
MySQLi: Enabled
PDO: Enabled
wget: Yes
curl (cmd): Yes
perl: Yes
python: Yes (py3)
gcc: Yes
pkexec: Yes
git: Yes

User Info

Username: eliosofonline
User ID (UID): 1002
Group ID (GID): 1003
Script Owner UID: 1002
Current Dir Owner: 1002

Casa Cuisine