65 lines
3.7 KiB
PHP
65 lines
3.7 KiB
PHP
<div class="modal fade" id="newSenderIdFormModal" tabindex="-1" role="dialog" aria-labelledby="senderidModalLabel" aria-hidden="true">
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<div class="modal-dialog modal-sm" role="document">
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<div class="modal-content">
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<div class="modal-header">
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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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<h4 class="modal-title" id="senderidModalLabelLabel">New Sender ID Form</h4>
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</div>
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<div class="modal-body">
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<div id="senderIdnotifyArea" class="alert alert-danger hidden"></div>
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<form class="form-vertical" method="POST" id="newSenderIdForm" action="">
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{{ csrf_field() }}
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<input type="hidden" name="client_id" id="clientID" value="{{ $showclient->id }}">
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<input type="hidden" name="created_by" id="createdByIDD" value="{{ session('current_user.id') }}">
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<input type="hidden" name="last_modified_by" id="modifiedByIDD" value="{{ session('current_user.id') }}">
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<input type="hidden" name="" id="">
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<div class="row">
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<div class="col-md-12">
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<div class="form-group">
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<label class="control-label" for="senderIDD">Sender ID *</label>
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<div class="{{ $errors->has('senderid') ? 'has-error' : ''}}">
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{!! Form::text('senderid', old('senderid'), ['class' => 'form-control ', 'placeholder'=>'Enter sender ID' , 'id' => 'senderIDD', 'required' => 'true']) !!}
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{!! $errors->first('name', '<p class="help-block">:message</p>') !!}
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</div>
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</div>
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<div class="form-group">
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<label class="control-label" for="status">Status *</label>
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<div class=" {{ $errors->has('status') ? 'has-error' : ''}}">
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{!! Form::select('status', $sender_id_statuses ,old('status'), ['class' => 'form-control ', 'placeholder'=>'Select Status ' , 'id' => 'status', 'required' => 'true', 'style' => 'width: 100%']) !!}
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{!! $errors->first('status', '<p class="help-block">:message</p>') !!}
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</div>
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</div>
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<div class="form-group">
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<label class="control-label" for="network">Network *</label>
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<div class=" {{ $errors->has('network') ? 'has-error' : ''}}">
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{!! Form::select('network_id', $networks, old('network_id'), ['class' => 'form-control ', 'placeholder'=>'Select Network ' , 'id' => 'network', 'required' => 'true', 'style' => 'width: 100%']) !!}
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{!! $errors->first('network', '<p class="help-block">:message</p>') !!}
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</div>
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</div>
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<div class="form-group">
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<label class="control-label" for="remarks">Remarks</label>
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<div class=" {{ $errors->has('remarks') ? 'has-error' : ''}}">
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{!! Form::text('remarks', old('remarks'), ['class' => 'form-control ', 'placeholder'=>'Enter remarks here' , 'id' => 'remarks']) !!}
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{!! $errors->first('remarks', '<p class="help-block">:message</p>') !!}
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</div>
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</div>
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<div class="ln_solid"></div>
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<div class="form-group">
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<div class="">
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<button type="submit" class="btn btn-success btn-block"><i class="fa fa-save"></i> Submit</button>
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</div>
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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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