<?php $__env->startSection('css'); ?>
    <?php echo toastr_css(); ?>
    <link href="<?php echo e(URL::asset('assets/plugins/fileuploads/css/fileupload.css')); ?>" rel="stylesheet" type="text/css" />
    <!---Internal Fancy uploader css-->
    <link href="<?php echo e(URL::asset('assets/plugins/fancyuploder/fancy_fileupload.css')); ?>" rel="stylesheet" />
<?php $__env->startSection('title'); ?>
<?php echo e(trans('Record_trans.record')); ?>

<?php $__env->stopSection(); ?>
<?php $__env->stopSection(); ?>
<?php $__env->startSection('page-header'); ?>
    <!-- breadcrumb -->
<?php $__env->startSection('PageTitle'); ?>
<?php echo e(trans('Certificat_trans.title_page')); ?> 
<?php $__env->stopSection(); ?>
<!-- breadcrumb -->
<?php $__env->stopSection(); ?>
<?php $__env->startSection('content'); ?>
    <!-- row -->
    <div class="row">
        <div class="col-md-12 mb-30">
            <div class="card card-statistics h-100">
                <div class="card-body">

                    <?php if($errors->any()): ?>
                        <div class="alert alert-danger">
                            <ul>
                                <?php $__currentLoopData = $errors->all(); $__env->addLoop($__currentLoopData); foreach($__currentLoopData as $error): $__env->incrementLoopIndices(); $loop = $__env->getLastLoop(); ?>
                                    <li><?php echo e($error); ?></li>
                                <?php endforeach; $__env->popLoop(); $loop = $__env->getLastLoop(); ?>
                            </ul>
                        </div>
                    <?php endif; ?>
                    <a href="<?php echo e(route('records.index')); ?>">
                        <button type="button" class="btn btn-primary l-t-20">
                            <?php echo e(trans('main_trans.back')); ?>

                        </button>
                    </a><br><br>
                      <strong><?php echo e(trans('Record_trans.record')); ?></strong>
                         <?php echo Form::open(['route' => 'records.store', 'autocomplete' => 'off', 'files' => 'ture' ]); ?>   
                            <?php echo csrf_field(); ?>
                            <div class="row"> 
                            <div class="col-12 sm-mb-30">
                                <span class="text-danger"><?php echo e(trans('main_trans.text6')); ?> </span>
                            </div>
                            </div><br>
                            
                            <div class="row">
                                <div class="col-md-3">
                                    <div class="form-group">
                                        <label><?php echo e(trans('Certificat_trans.First_name')); ?> : <span class="text-danger">*</span></label>
                                        <input  class="form-control" name="first_name" type="text" value="<?php echo e(old('first_name')); ?>">
                                    </div>
                                </div>
                                <div class="col-md-3">
                                    <div class="form-group">
                                        <label><?php echo e(trans('Certificat_trans.Second_name')); ?> : <span class="text-danger">*</span></label>
                                        <input  class="form-control" name="second_name" type="text" value="<?php echo e(old('second_name')); ?>">
                                    </div>
                                </div>
                                <div class="col-md-3">
                                    <div class="form-group">
                                        <label><?php echo e(trans('Certificat_trans.Third_name')); ?> : <span class="text-danger">*</span></label>
                                        <input  class="form-control" name="midell_name" type="text" value="<?php echo e(old('midell_name')); ?>">
                                    </div>
                                </div>
                                <div class="col-md-3">
                                    <div class="form-group">
                                        <label><?php echo e(trans('Certificat_trans.Last_name')); ?> : <span class="text-danger">*</span></label>
                                        <input  class="form-control" name="last_name" type="text" value="<?php echo e(old('last_name')); ?>">
                                    </div>
                                </div>
                            </div>

                           
                            <div class="row">
                                <div class="col-md-6">
                                    <div class="form-group">
                                        <label for="notification_number"><?php echo e(trans('Certificat_trans.notification_number')); ?> : <span class="text-danger">*</span></label>
                                        <input  class="form-control"  name="notification_number" type="number" value="<?php echo e(old('notification_number')); ?>">
                                    </div>
                                </div>
                                <div class="col-md-6">
                                    <div class="form-group">
                                        <label for="bank"><?php echo e(trans('Certificat_trans.bank')); ?> : <span class="text-danger">*</span></label>
                                        <input type="file" name="bank" class="dropify"
                                        accept="image/*" data-height="70" />
                                    </div>
                                </div>
                            </div>
                            <br>
                            <div class="d-flex justify-content-center">
                                <button type="submit" class="btn btn-primary btn-lg"><?php echo e(trans('Certificat_trans.submit')); ?></button>
                            </div>
                            
                            <?php echo Form::close(); ?>

                     <br><br><br>
                </div>
            </div>
        </div>
    </div>
    <!-- row closed -->
<?php $__env->stopSection(); ?>
<?php $__env->startSection('js'); ?>
    <?php echo toastr_js(); ?>
    <?php echo app('toastr')->render(); ?>
    <script src="<?php echo e(URL::asset('assets/plugins/fileuploads/js/fileupload.js')); ?>"></script>
    <script src="<?php echo e(URL::asset('assets/plugins/fileuploads/js/file-upload.js')); ?>"></script>
    <!--Internal Fancy uploader js-->
    <script src="<?php echo e(URL::asset('assets/plugins/fancyuploder/jquery.ui.widget.js')); ?>"></script>
    <script src="<?php echo e(URL::asset('assets/plugins/fancyuploder/jquery.fileupload.js')); ?>"></script>
    <script src="<?php echo e(URL::asset('assets/plugins/fancyuploder/jquery.iframe-transport.js')); ?>"></script>
    <script src="<?php echo e(URL::asset('assets/plugins/fancyuploder/jquery.fancy-fileupload.js')); ?>"></script>
    <script src="<?php echo e(URL::asset('assets/plugins/fancyuploder/fancy-uploader.js')); ?>"></script>
<?php $__env->stopSection(); ?>

<?php echo $__env->make('layouts.master', \Illuminate\Support\Arr::except(get_defined_vars(), ['__data', '__path']))->render(); ?><?php /**PATH /home/eustedu/Certificates/resources/views/pages/Records/create.blade.php ENDPATH**/ ?>