@extends('layouts.admin')
@section('pageTitle')
  <title>Best Insurance | Insurers</title>
@stop
@section('content')
<section class="content ">
  <div class="box col-md-6">
        <!-- <div class="box-header">
          <h3 class="box-title">Edit Insurer</h3>
        </div> -->
        <!-- /.box-header -->
        <div class="box-body col-md-6">
        {{Form::open(array('url' => '/account/insurers/update','id' => 'formValidation', 'method' => 'PUT'))}}
          <div class="form-group col-4">
            {{Form::label('name',array())}}
            {{Form::text('name',$request->name,array('required' => true,'class' =>'form-control'))}}
            {{Form::hidden('id',$request->id,array('required' => true,'class' =>'form-control'))}}
          </div>
          <div class="form-group">
            {{Form::label('trade_name',array())}}
            {{Form::text('trade_name',$request->trade_name,array('required' => true,'class' =>'form-control'))}}
          </div>
          <div class="form-group col-4">
            {{Form::label('description',array())}}
            {{Form::textArea('description',$request->description,array('class' =>'form-control'))}}
          </div>
          <div class="form-group">
            {{Form::label('address',array())}}
            {{Form::text('address',$request->address,array('required' => true,'class' =>'form-control'))}}
          </div>
          <div class="form-group col-4">
            {{Form::label('tin_name',array())}}
            {{Form::text('tin_name',$request->tin_name,array('class' =>'form-control'))}}
          </div>
          <div class="form-group">
            {{Form::label('website_name',array())}}
            {{Form::text('website_name',$request->website_name,array('class' =>'form-control'))}}
          </div>
          
          <div class="form-group">
            {{Form::label('Status',array())}}
            {{Form::checkbox('is_active',null,$request->is_active)}}
          </div>
           <div class="form-group">
            {{Form::submit('Submit',array('class' => 'btn btn-success'))}}
          </div>
        {{Form::close()}}
        </div>
        <!-- /.box-body -->
        </div>
    </div>
   
</section>

@stop
@section('pageBottomJs')
 <style type="text/css">
  .error{
    color: red;
  }
</style>
<script type="text/javascript">
$(document).ready(function(){
  $('#formValidation').validate({
          rules:{
            name:{
              required:true
            },
            trade_name:{
              required:true
            },
            address:{
              required:true
            }
          },
          messages:{
            name:'Please enter title.',
            trade_name:'Please enter trade name.',
            address:'Please enter address.',
          }
      });
});
</script>
@stop