62 lines
3.2 KiB
PHP
62 lines
3.2 KiB
PHP
<div class="modal fade" id="newIpModal" tabindex="-1" role="dialog" aria-labelledby="paymentModalLabel" aria-hidden="true">
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<div class="modal-dialog">
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<div class="modal-content">
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<div class="modal-header">
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<!-- <h4 class="modal-title">Default Modal</h4> -->
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<h5 class="modal-title text-center" id="paymentModalLabelHeading">IP Addresses</h5>
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<button type="button" class="close" data-dismiss="modal" aria-label="Close">
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<span aria-hidden="true">×</span>
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</button>
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</div>
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<div class="modal-body">
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<div class="hidden" id="ipNotifyArea"></div>
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<form class="form-vertical" method="POST" id="newIpForm" action="{{ url('clients/finance_store') }}">
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{{ csrf_field() }}
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<input type="hidden" name="mno_id" id="mnoID" value="{{ $network_arr->id }}">
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<div class="row">
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<div class="form-group">
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<div class="col-md-12">
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<label for="service">Service *</label>
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{!! Form::select('service', $services , old('service'), ['class' => 'form-control' , 'id' => 'service', 'placeholder' => 'Select Service', 'required' => 'required', 'style' => 'width: 100%']) !!}
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</div>
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</div>
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<div class="form-group" >
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<div class="col-md-12" style="padding-bottom: 5px;">
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<label for="ip">IP Address *</label>
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<input type="text" class="form-control" name="ip_address" id="invoiceNumber" required >
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</div>
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</div>
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<div class="form-group" >
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<div class="col-md-12" style="padding-bottom: 5px;">
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<label for="port">Port</label>
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<input type="number" class="form-control" name="port" id="port" >
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</div>
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</div>
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<div class="form-group">
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<div class="col-md-12" style="padding-bottom: 5px">
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<label for="status">Status *</label>
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{!! Form::select('status', [ 'ACTIVE' => 'ACTIVE', 'INACTIVE' => 'INACTIVE'] , old('status'), ['class' => 'form-control' , 'id' => 'invoiceStatus', 'required' => 'required', 'placeholder' => '', 'style' => 'width: 100%']) !!}
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</div>
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</div>
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<div class="form-group" style="margin-bottom: 0.2rem; padding-bottom: 5px; padding-top: 5px;">
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<div class="col-md-12" style="padding-bottom: 10px;">
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<button type="submit" class="btn btn-success btn-block updateBtn"> <i class="fa fa-send"></i> Submit</button>
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</div>
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</div>
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<div class="form-group" style="margin-bottom: 0.5rem; padding-bottom: 5px; padding-top: 5px;">
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<div class="col-md-12">
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<button type="button" class="btn btn-dark btn-block" data-dismiss="modal"><i class="fa fa-close"></i> Close</button>
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</div>
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</div>
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</div>
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</form>
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</div>
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</div>
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<!-- /.modal-content -->
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</div>
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<!-- /.modal-dialog -->
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</div>
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<!-- /.modal -->
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