@extends('layouts/default')

{{-- Page title --}}
@section('title')
{{ trans('general.editprofile') }}
@stop

{{-- Account page content --}}
@section('content')
@include('notifications')
<div class="row">
  <div class="col-md-9">
    <div class="box box-default">
      <div class="box-body">
        {{ Form::open(['method' => 'POST', 'files' => true, 'class' => 'form-horizontal', 'autocomplete' => 'off']) }}
        <!-- CSRF Token -->
        <input type="hidden" name="_token" value="{{ csrf_token() }}" />

        <!-- First Name -->
        <div class="form-group {{ $errors->has('first_name') ? ' has-error' : '' }}">
            <label for="first_name" class="col-md-3 control-label">{{ trans('general.first_name') }}
            </label>
            <div class="col-md-5 required">
                <input class="form-control" type="text" name="first_name" id="first_name" value="{{ Input::old('first_name', $user->first_name) }}" />
                {!! $errors->first('first_name', '<span class="alert-msg"><i class="fa fa-times"></i> :message</span>') !!}
            </div>
        </div>

        <!-- Last Name -->
        <div class="form-group {{ $errors->has('last_name') ? ' has-error' : '' }}">
            <label for="last_name" class="col-md-3 control-label">{{ trans('general.last_name') }}

            </label>
            <div class="col-md-5 required">
                <input class="form-control" type="text" name="last_name" id="last_name" value="{{ Input::old('last_name', $user->last_name) }}" />
                {!! $errors->first('last_name', '<span class="alert-msg"><i class="fa fa-times"></i> :message</span>') !!}
            </div>
        </div>

       

      

    

        <!-- Gravatar Email -->
        <div class="form-group {{ $errors->has('email') ? ' has-error' : '' }}">
            <label for="gravatar" class="col-md-3 control-label">{{ trans('general.email') }}
             <small></small></label>
            <div class="col-md-5">
                <input class="form-control" type="text" readonly="" name="email" id="email" value="{{ Input::old('email', $user->email) }}" />
                {!! $errors->first('email', '<span class="alert-msg"><i class="fa fa-times"></i> :message</span>') !!}
                
            </div>
        </div> 
        <!-- Gravatar phone -->
        <div class="form-group {{ $errors->has('phone') ? ' has-error' : '' }}">
            <label for="gravatar" class="col-md-3 control-label">{{ trans('general.phone') }}
             <small></small></label>
            <div class="col-md-5">
                <input class="form-control" type="text" name="phone" id="phone" value="{{ Input::old('phone', $user->phone) }}" />
                {!! $errors->first('phone', '<span class="alert-msg"><i class="fa fa-times"></i> :message</span>') !!}
                
            </div>
        </div> <!-- Gravatar phone -->
      
         <!-- Gravatar dob -->
        <div class="form-group {{ $errors->has('phone') ? ' has-error' : '' }}">
            <label for="gravatar" class="col-md-3 control-label">{{ trans('general.dob') }}
             <small></small></label>
            <div class="col-md-5">
                <input class="form-control" type="text" name="dob" id="dob" value="{{ Input::old('dob', $user->dob) }}" />
                {!! $errors->first('dob', '<span class="alert-msg"><i class="fa fa-times"></i> :message</span>') !!}
                
            </div>
        </div> <!-- Gravatar address -->
        <div class="form-group {{ $errors->has('address') ? ' has-error' : '' }}">
            <label for="gravatar" class="col-md-3 control-label">{{ trans('general.address') }}
             <small></small></label>
            <div class="col-md-5">
                <input class="form-control" type="text" name="address" id="address" value="{{ Input::old('address', $user->address) }}" />
                {!! $errors->first('address', '<span class="alert-msg"><i class="fa fa-times"></i> :message</span>') !!}
                
            </div>
        </div> <!-- Gravatar address2 -->
        <div class="form-group {{ $errors->has('address2') ? ' has-error' : '' }}">
            <label for="gravatar" class="col-md-3 control-label">{{ trans('general.address2') }}
             <small></small></label>
            <div class="col-md-5">
                <input class="form-control" type="text" name="address2" id="address2" value="{{ Input::old('address2', $user->address2) }}" />
                {!! $errors->first('address2', '<span class="alert-msg"><i class="fa fa-times"></i> :message</span>') !!}
                
            </div>
        </div> 
        <!-- Gravatar city -->
        <div class="form-group {{ $errors->has('city') ? ' has-error' : '' }}">
            <label for="gravatar" class="col-md-3 control-label">{{ trans('general.city') }}
             <small></small></label>
            <div class="col-md-5">
                <input class="form-control" type="text" name="city" id="city" value="{{ Input::old('city', $user->city) }}" />
                {!! $errors->first('city', '<span class="alert-msg"><i class="fa fa-times"></i> :message</span>') !!}
                
            </div>
        </div>
        <!-- Gravatar pin_code -->
        <div class="form-group {{ $errors->has('pin_code') ? ' has-error' : '' }}">
            <label for="gravatar" class="col-md-3 control-label">{{ trans('general.pin_code') }}
             <small></small></label>
            <div class="col-md-5">
                <input class="form-control" type="text" name="pin_code" id="pin_code" value="{{ Input::old('pin_code', $user->pin_code) }}" />
                {!! $errors->first('pin_code', '<span class="alert-msg"><i class="fa fa-times"></i> :message</span>') !!}
                
            </div>
        </div>

    

      


  



      </div>
      <div class="box-footer text-right">
        <button type="submit" class="btn btn-success"><i class="fa fa-ok icon-white"></i> {{ trans('general.save') }}</button>
      </div>
    </div>
  </div>
</div>




</form>

@stop
@section('moar_scripts')
<script type="text/javascript">
  $('#dob').datepicker({
     format: 'yyyy-mm-dd',
  });
  //$('#start_date').datepicker('show');
</script>
@stop