@extends('admin.layout.app')

@section('main-content')
 <section class="content-header">
  <h1>
   Insurer
  </h1>

 </section>

 <section class="content">

  <!-- Default box -->
  <div class="box">
   <div class="box-header with-border">
    <h3 class="box-title">Insurer</h3>

    <div class="box-tools pull-right">
     <button type="button" class="btn btn-box-tool" data-widget="collapse" data-toggle="tooltip" title="Collapse">
      <i class="fa fa-minus"></i></button>

    </div>
   </div>
   @include('includes.messages')
   <form role="form" method="post" action="{{ route('insurer.store') }}" enctype="multipart/form-data"
    id="myFormId">
    {{ csrf_field() }}
    <div class="box-body">
     <div class="col-md-offset-0 col-md-6">
      <div class="col-md-8">
       <div class="form-group">
        <label for="name">Insurer Name</label>
        <input type="text" class="form-control" id="name" name="name" placeholder="Insurer" required>
       </div>

       <div class="form-group">
        <label for="address">Address</label>
        <textarea type="textarea" class="form-control" id="address" name="address" placeholder="Address" rows="4"
         cols="50" required></textarea>
       </div>

       <div class="form-group">
        <label for="bank_name">Bank Name</label>
        <input type="text" class="form-control" id="bank_name" name="bank_name" placeholder="Bank Name" required>
       </div>

       <div class="form-group">
        <label for="bank_address">Bank Address</label>
        <textarea type="textarea" class="form-control" id="bank_address" name="bank_address" placeholder="Bank Address"
         rows="4" cols="50" required></textarea>
       </div>

       <div class="form-group">
        <label for="acct_no">Account No.</label>
        <input type="text" class="form-control" id="acct_no" name="acct_no" placeholder="Account no.">
       </div>

       <div class="form-group">
        <label for="location">Bank Location</label>
        <input type="text" class="form-control" id="location" name="location" placeholder="Bank Location">
       </div>

       <div class="form-group">
        <label for="iban">Iban Number</label>
        <input type="text" class="form-control" id="iban" name="iban" placeholder="Iban Number" required>
       </div>

       <div class="form-group">
        <label for="swift">Swift Code</label>
        <input type="text" class="form-control" id="swift" name="swift" placeholder="Swift Code">
       </div>

       <div class="form-group">
        <label for="sort">Sort Code</label>
        <input type="text" class="form-control" id="sort" name="sort" placeholder="Sort Code">
       </div>

       <div class="form-group">
        <label for="start">Start Date</label>
        <input type="date" class="form-control" id="start" name="start" placeholder="Start Date" required>
       </div>

       <div class="form-group">
        <label for="end">End Date</label>
        <input type="date" class="form-control" id="end" name="end" placeholder="End Date">
       </div>

      </div>

     </div>
    </div>

    <!-- /.box-body -->
    <div class="box-footer">
     <button type="submit" class="btn btn-primary" id="submit_form">Submit</button>
    </div>
   </form>
   <!-- /.box-footer-->
  </div>
  <!-- /.box -->

 </section>
@endsection

@section('more-scripts')
 <script src="{{ asset('admin/bower_components/ckeditor/ckeditor.js') }}"></script>
 <script>
  $(function() {
   // Replace the <textarea id="editor1"> with a CKEditor
   // instance, using default configuration.
   $('.select2').select2();

   $('#myFormId').submit(function() {
    $("#submit_form", this)
     .html("Please Wait...")
     .attr('disabled', 'disabled');
    return true;
   });
  })
 </script>
@endsection