
    
    
<?php $__env->startSection('title', 'Customer Management'); ?>
<style type="text/css">
    .bootstrap-select.btn-group .btn .caret {
    
    visibility: hidden;
}
</style>
<?php $__env->startSection('breadcrumb'); ?>
    <ol class="breadcrumb border-0 m-0 px-0 px-md-3">
        <li class="breadcrumb-item">Home</li>
        <li class="breadcrumb-item"><a href="<?php echo e(route('admin.dashboard')); ?>">Admin</a></li>
        <li class="breadcrumb-item"><a href="<?php echo e(route('admin.customer')); ?>">Customer Management</a></li>
        <li class="breadcrumb-item active">Add Customer</li>
    </ol>
<?php $__env->stopSection(); ?>
<?php $__env->startSection('content'); ?>
    <div class="row">
        <div class="col-lg-12">
            <div class="card">
                <div class="card-header"> <strong> Personal information / Mailing address</strong></div>
                <form class="form-horizontal" action="" method="post">
                    <?php echo csrf_field(); ?>
                    <div class="card-body">
                        <div class="fluid-container" style="margin:auto;width: 96%;">
                            <div class="form-group row">
                                <div class="row">
                                    <div class="col-6">
                                        <label for="input1" style="margin-left: 12px; margin-left: 15px; margin-top: -12px; position: absolute; background-color: white; border: 2px solid white;">left part 1st</label>
                                        <div id="input1" style="border: 1px solid #EDEADE;padding: 20px;">
                                            <div class="row">
                                                <div class="col-md-4">
                                                    <p style="padding-left: 10px;">Account Number:</p>
                                                </div>
                                                <div class="col-md-8">
                                                    <input type="text" name="" class="form-control">
                                                </div>
                                            </div>
                                            <div class="row" style="margin-top:5px;">
                                                <div class="col-md-4">
                                                    <p style="padding-left: 10px;">Customer Name:</p>
                                                </div>
                                                <div class="col-md-8">
                                                    <input type="text" name="" class="form-control">
                                                </div>
                                            </div>
                                            <br>
                                            <div class="row" >
                                                <div class="col-md-4">
                                                    <p></p>
                                                </div>
                                                <div class="col-md-8">
                                                    <div class="form-check">
                                                        <input class="form-check-input" type="radio" name="flexRadioDefault" id="flexRadioDefault1">
                                                        <label class="form-check-label" for="flexRadioDefault1">
                                                            Residential
                                                        </label>
                                                    </div>
                                                    <div class="form-check">
                                                        <input class="form-check-input" type="radio" name="flexRadioDefault" id="flexRadioDefault2" checked>
                                                        <label class="form-check-label" for="flexRadioDefault2">
                                                            Business Customer
                                                        </label>
                                                    </div>
                                                </div>
                                            </div>
                                            <br>
                                            <div class="row">
                                                <div class="col-md-4">
                                                    <p style="padding-left: 10px;">Mailing Address:</p>
                                                </div>
                                                <div class="col-md-8">
                                                    <div class="row">
                                                        <div class="col-md-8">
                                                            <input type="text" name="" class="form-control" placeholder="City">
                                                        </div>
                                                        <div class="col-md-4">
                                                            <input type="text" name="" class="form-control" placeholder="Postcode">
                                                        </div>
                                                    </div>
                                                    <div class="row" style="margin-top:5px;">
                                                        <div class="col-md-8">
                                                            <input type="text" name="" class="form-control" placeholder="Street">
                                                        </div>
                                                        <div class="col-md-4">
                                                            <input type="text" name="" class="form-control" placeholder="House Number">
                                                        </div>
                                                    </div>
                                                    <div class="row" style="margin-top:5px;">
                                                        <div class="col-md-3">
                                                            <input type="text" name="" class="form-control" placeholder="Flat">
                                                        </div>
                                                        <div class="col-md-3">
                                                            <input type="text" name="" class="form-control" placeholder="Floor">
                                                        </div>
                                                        <div class="col-md-6">
                                                            <input type="text" name="" class="form-control" placeholder=" GPS ">
                                                        </div>
                                                    </div>
                                                    <div class="row" style="margin-top:5px;">
                                                        <div class="col-md-6">
                                                            <input type="text" name="" class="form-control" placeholder="District">
                                                        </div>
                                                        <div class="col-md-6">
                                                            <input type="text" name="" class="form-control" placeholder="Country">
                                                        </div>
                                                    </div>
                                                    
                                                </div>
                                            </div>
                                            <br>
                                        </div>

                                        <!-- left part 2nd -->
                                        <div style="margin-top:15px;">
                                            <label for="input1" style="margin-left: 12px; margin-left: 15px; margin-top: -12px; position: absolute; background-color: white; border: 2px solid white;">left part 2nd</label>
                                            
                                            <div id="input1" style="border: 1px solid #EDEADE;padding: 20px;">
                                                <div class="row">
                                                <div class="col-md-4">
                                                    <p style="padding-left: 10px;">CATV Access Line:</p>
                                                </div>
                                                <div class="col-md-8">
                                                    <input type="text" name="" class="form-control" placeholder="0" disabled>
                                                </div>
                                                <div class="col-md-4">
                                                    <p style="padding-left: 10px;">City:</p>
                                                </div>
                                                <div class="col-md-8" style="margin-top:10px;">
                                                    <select class="form-control selectpicker" id="select-country" data-live-search="true">
                                                        <option data-tokens="name">name</option>
                                                        <option data-tokens="family">family</option>
                                                    </select>
                                                </div>
                                                </div>
                                            </div>
                                        </div>
                                        <!-- left part 2nd -->

                                        <!-- left part 3rd -->
                                        <div style="margin-top:15px;">
                                            <label for="input1" style="margin-left: 12px; margin-left: 15px; margin-top: -12px; position: absolute; background-color: white; border: 2px solid white;">left part 3rd</label>
                                                
                                            <div id="input1" style="border: 1px solid #EDEADE;padding: 20px;">
                                                <div class="row" style="margin-top:15px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">ID # (Drivers Licence ,Sin etc. ) :</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <input type="text" name="" class="form-control">
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">BirthDate:</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <input type="text" name="" class="form-control">
                                                    </div>
                                                </div>
                                            </div>
                                        </div>
                                        <!-- left part 3rd -->

                                        <!-- left part 4th -->
                                        <div style="margin-top:15px;">
                                            <label for="input1" style="margin-left: 12px; margin-left: 15px; margin-top: -12px; position: absolute; background-color: white; border: 2px solid white;">left part 4th</label>
                                                    
                                            <div id="input1" style="border: 1px solid #EDEADE;padding: 20px;">
                                                <div class="row" style="margin-top:15px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Email :</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <input type="text" name="" class="form-control">
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Invoicing email :</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <input type="text" name="" class="form-control">
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Technical email :</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <input type="text" name="" class="form-control">
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Business email :</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <input type="text" name="" class="form-control">
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Phone :</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <input type="text" name="" class="form-control">
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Mobile Number :</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <input type="text" name="" class="form-control">
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Fix :</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <input type="text" name="" class="form-control">
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Web Site:</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <input type="text" name="" class="form-control">
                                                    </div>
                                                </div>
                                            </div>
                                        </div>
                                        <!-- left part 4th -->

                                    </div>
                                    <div class="col-6" >
                                        <!-- right part 1st -->
                                        <div>
                                            <div class="row">
                                                <div class="col-md-5">
                                                    <button class="btn btn-primary">Search</button>
                                                </div>
                                                <div class="col-md-7">
                                                    <div class="form-check">
                                                        <input class="form-check-input" type="checkbox" value="" id="flexCheckChecked" checked>
                                                        <label class="form-check-label" for="flexCheckChecked">
                                                            Show on map
                                                        </label>
                                                    </div>
                                                </div>
                                            </div><br>
                                            <div class="row">
                                                <iframe src="https://www.google.com/maps/embed?pb=!1m26!1m12!1m3!1d56967.586413384495!2d75.75965416368793!3d26.82486744022622!2m3!1f0!2f0!3f0!3m2!1i1024!2i768!4f13.1!4m11!3e6!4m3!3m2!1d26.853375999999997!2d75.7825536!4m5!1s0x396dc995785bfe0f%3A0x9d00670959c2e91d!2slaxmaya%20technologies%20pvt.%20ltd%20address!3m2!1d26.7967153!2d75.8134591!5e0!3m2!1sen!2sin!4v1663395565630!5m2!1sen!2sin" width="780" height="420" style="border:0;" allowfullscreen="" loading="lazy" referrerpolicy="no-referrer-when-downgrade"></iframe>
                                            </div>
                                        </div>
                                        <!-- right part 1st -->
                                        
                                        <!-- right part 2nd -->
                                        <div style="margin-top:15px;">
                                            <label for="input1" style="margin-left: 12px; margin-left: 15px; margin-top: -12px; position: absolute; background-color: white; border: 2px solid white;">Right part 2nd</label>
                                            <div id="input1" style="border: 1px solid #EDEADE;padding: 20px;">
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Mark Client :</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <div class="form-check form-switch">
                                                            <input class="form-check-input" type="checkbox" role="switch" id="flexSwitchCheckDefault">
                                                            <label class="form-check-label" for="flexSwitchCheckDefault"></label>
                                                        </div>
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Don't Send Bulk e-mail/SMS  :</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <div class="form-check form-switch">
                                                            <input class="form-check-input" type="checkbox" role="switch" id="flexSwitchCheckDefault">
                                                            <label class="form-check-label" for="flexSwitchCheckDefault"></label>
                                                        </div>
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Show info messages  :</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <div class="form-check form-switch">
                                                            <input class="form-check-input" type="checkbox" role="switch" id="flexSwitchCheckDefault">
                                                            <label class="form-check-label" for="flexSwitchCheckDefault"></label>
                                                        </div>
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Customer Name :</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <input type="text" name="" class="form-control" disabled>
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Password :</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <input type="text" name="" class="form-control">
                                                    </div>
                                                </div>
                                            </div>
                                        </div>
                                        <!-- right part 2nd -->

                                        <!-- right part 3rd -->
                                        <div style="margin-top:15px;">
                                            <label for="input1" style="margin-left: 12px; margin-left: 15px; margin-top: -12px; position: absolute; background-color: white; border: 2px solid white;">Right part 3rd</label>
                                            <div  id="input1" style="border: 1px solid #EDEADE;padding: 20px;">
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Group :</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <select class="form-control selectpicker" id="select-country" data-live-search="true">
                                                            <option data-tokens="name">name</option>
                                                            <option data-tokens="family">family</option>
                                                        </select>
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Status :</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <select class="form-control selectpicker" id="select-country" data-live-search="true">
                                                            <option data-tokens="name">name</option>
                                                            <option data-tokens="family">family</option>
                                                        </select>
                                                    </div>
                                                </div>  
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Location :</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <select class="form-control selectpicker" id="select-country" data-live-search="true">
                                                            <option data-tokens="name">name</option>
                                                            <option data-tokens="family">family</option>
                                                        </select>
                                                    </div>
                                                </div>
                                            </div>
                                        </div>
                                   
                                        <!-- right part 3rd -->

                                        <!-- right part 4th -->
                                        <div style="margin-top:15px;">
                                            <label for="input1" style="margin-left: 12px; margin-left: 15px; margin-top: -12px; position: absolute; background-color: white; border: 2px solid white;">Right part 4th</label>
                                            <div  id="input1" style="border: 1px solid #EDEADE;padding: 20px;">
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Internal Note 1:</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <input type="text" name="" class="form-control">
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Internal Note 1:</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <input type="text" name="" class="form-control">
                                                    </div>
                                                </div>
                                            </div>
                                        </div>
                                   
                                        <!-- right part 5th -->
                                    </div>
                                    <div class="" style="width:97%;margin: auto;">
                                        <h4 > Invoice Group/Client</h4>
                                        <hr style="border:0.5px solid black;width: 100%;">
                                    </div>
                                    <div class="col-6">
                                       <!-- left part 4th -->
                                        <div style="margin-top:15px;">
                                            <label for="input1" style="margin-left: 12px; margin-left: 15px; margin-top: -12px; position: absolute; background-color: white; border: 2px solid white;">left part 5th</label>
                                                    
                                            <div id="input1" style="border: 1px solid #EDEADE;padding: 20px;">
                                                
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Send Invoice by Postal Service :</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <div class="form-check form-switch">
                                                            <input class="form-check-input" type="checkbox" role="switch" id="flexSwitchCheckDefault">
                                                            <label class="form-check-label" for="flexSwitchCheckDefault"></label>
                                                        </div>
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Send Invoice by e-mail :</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <div class="form-check form-switch">
                                                            <input class="form-check-input" type="checkbox" role="switch" id="flexSwitchCheckDefault">
                                                            <label class="form-check-label" for="flexSwitchCheckDefault"></label>
                                                        </div>
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Do not Send Invoice created from proforma invoices  :</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <div class="form-check form-switch">
                                                            <input class="form-check-input" type="checkbox" role="switch" id="flexSwitchCheckDefault">
                                                            <label class="form-check-label" for="flexSwitchCheckDefault"></label>
                                                        </div>
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Do not Auto Send Payment Request :</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <div class="form-check form-switch">
                                                            <input class="form-check-input" type="checkbox" role="switch" id="flexSwitchCheckDefault">
                                                            <label class="form-check-label" for="flexSwitchCheckDefault"></label>
                                                        </div>
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Issue a Pro-forma Inovice  :</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <div class="form-check form-switch">
                                                            <input class="form-check-input" type="checkbox" role="switch" id="flexSwitchCheckDefault">
                                                            <label class="form-check-label" for="flexSwitchCheckDefault"></label>
                                                        </div>
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Tax # :</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <div class="row">
                                                            <div class="col-md-8">
                                                                <input type="text" name="" class="form-control">
                                                            </div>
                                                            <div class="col-md-4">
                                                                
                                                            </div>
                                                        </div>
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Sale Tax# :</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <div class="row">
                                                            <div class="col-md-8">
                                                                <input type="text" name="" class="form-control">
                                                            </div>
                                                            <div class="col-md-4">
                                                                <button class="btn btn-info">View</button>
                                                            </div>
                                                        </div>
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Bank Information :</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <div class="row">
                                                            <div class="col-md-8">
                                                                <input type="text" name="" class="form-control">
                                                            </div>/
                                                            <div class="col-md-3">
                                                                <input type="text" name="" class="form-control">
                                                            </div>
                                                        </div>
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">IBAN :</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <div class="row">
                                                            <div class="col-md-8">
                                                                <input type="text" name="" class="form-control">
                                                            </div>
                                                            <div class="col-md-4">
                                                                
                                                            </div>
                                                        </div>
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">BIC :</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <div class="row">
                                                            <div class="col-md-8">
                                                                <input type="text" name="" class="form-control">
                                                            </div>
                                                            <div class="col-md-4">
                                                                
                                                            </div>
                                                        </div>
                                                    </div>
                                                </div>
                                                
                                            </div>
                                        </div>
                                        <!-- left part 5th -->

                                        <!-- Left part 6th -->
                                        <div style="margin-top:15px;">
                                            <label for="input1" style="margin-left: 12px; margin-left: 15px; margin-top: -12px; position: absolute; background-color: white; border: 2px solid white;">Left part 6th</label>
                                            <div  id="input1" style="border: 1px solid #EDEADE;padding: 20px;">
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Use Alternate Address:</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <div class="form-check form-switch">
                                                            <input class="form-check-input" type="checkbox" role="switch" id="useAlternateAddress">
                                                            <label class="form-check-label" for="useAlternateAddress"></label>
                                                        </div>
                                                    </div>
                                                </div>
                                                <div id="showHideAlternativeAddress">
                                                    <div class="row" style="margin-top:5px;">
                                                        <div class="col-md-4">
                                                            <p style="padding-left: 10px;">Customer Name :</p>
                                                        </div>
                                                        <div class="col-md-8">
                                                            <input type="text" name="" class="form-control">
                                                        </div>
                                                    </div>
                                                    <div class="row" style="margin-top:5px;">
                                                        <div class="col-md-4">
                                                            
                                                        </div>
                                                        <div class="col-md-8">
                                                            <input type="text" name="" class="form-control">
                                                        </div>
                                                    </div>
                                                    <div class="row" style="margin-top:5px;">
                                                        <div class="col-md-4">
                                                            <p style="padding-left: 10px;">Address :</p>
                                                        </div>
                                                        <div class="col-md-8">
                                                            <input type="text" name="" class="form-control">
                                                        </div>
                                                    </div>
                                                    <div class="row" style="margin-top:5px;">
                                                        <div class="col-md-4">
                                                            <p style="padding-left: 10px;">Postal Code. City :</p>
                                                        </div>
                                                        <div class="col-md-8">
                                                            <div class="row">
                                                                <div class="col-md-4">
                                                                    <input type="text" name="" class="form-control" placeholder="City">
                                                                </div>
                                                                <div class="col-md-8">
                                                                    <input type="text" name="" class="form-control" placeholder="Postcode">
                                                                </div>
                                                            </div>
                                                        </div>
                                                    </div>
                                                    <div class="row" style="margin-top:5px;">
                                                        <div class="col-md-4">
                                                            <p style="padding-left: 10px;">State/Province :</p>
                                                        </div>
                                                        <div class="col-md-8">
                                                            <input type="text" name="" class="form-control">
                                                        </div>
                                                    </div>

                                                </div>
                                            </div>
                                        </div>
                                        <!-- Left part 6th -->

                                        <!-- Left part 7th -->
                                        <div style="margin-top:15px;">
                                            <label for="input1" style="margin-left: 12px; margin-left: 15px; margin-top: -12px; position: absolute; background-color: white; border: 2px solid white;">Left part 7th</label>
                                            <div  id="input1" style="border: 1px solid #EDEADE;padding: 20px;">
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Opening Balance:</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                            <input type="text" class="form-control">  
                                                    </div>
                                                </div>
                                           
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Returned Contract :</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <div class="form-check form-switch">
                                                            <input class="form-check-input" type="checkbox" role="switch" id="flexSwitchCheckDefault">
                                                            <label class="form-check-label" for="flexSwitchCheckDefault"></label>
                                                        </div>
                                                    </div>
                                                </div>
                                            </div>
                                        </div>
                                        <!-- Left part 7th -->

                                    </div>
                                    <div class="col-6" >
                                        <!-- right part 2nd -->
                                        <div style="margin-top:15px;">
                                            <label for="input1" style="margin-left: 12px; margin-left: 15px; margin-top: -12px; position: absolute; background-color: white; border: 2px solid white;">Right part 5th</label>
                                            <div id="input1" style="border: 1px solid #EDEADE;padding: 20px;">
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Invoice By :</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <select class="form-control selectpicker" id="select-country" data-live-search="true">
                                                            <option data-tokens="name">name</option>
                                                            <option data-tokens="family">family</option>
                                                        </select>
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Payment Method :</p>
                                                    </div>
                                                    <div class="col-md-8" >
                                                        <select class="form-control selectpicker" id="select-country" data-live-search="true">
                                                            <option data-tokens="name">name</option>
                                                            <option data-tokens="family">family</option>
                                                        </select>
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Invoice Date:</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                            <input type="text" class="form-control">  
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Set Invoice Iusse Date According to Invoice Iusse Date:</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <div class="form-check form-switch">
                                                            <input class="form-check-input" type="checkbox" role="switch" id="flexSwitchCheckDefault">
                                                            <label class="form-check-label" for="flexSwitchCheckDefault"></label>
                                                        </div>
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Invoice Due Date:</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                            <input type="text" class="form-control">  
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Suspend Service:</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                            <input type="text" class="form-control">  
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;"></p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <div class="form-check form-switch">
                                                            <input class="form-check-input" type="checkbox" role="switch" id="flexSwitchCheckDefault">
                                                            <label class="form-check-label" for="flexSwitchCheckDefault">Don't Suspend</label>
                                                        </div>
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Assigned Client #:</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                            <input type="text" class="form-control">  
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Assigned Client #:</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                            <input type="text" class="form-control">  
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Assigned Client #:</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                            <input type="text" class="form-control">  
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Don't Show Payment Delays:</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <div class="form-check form-switch">
                                                            <input class="form-check-input" type="checkbox" role="switch" id="flexSwitchCheckDefault">
                                                            <label class="form-check-label" for="flexSwitchCheckDefault"></label>
                                                        </div>
                                                    </div>
                                                </div>
                                                <div class="row" style="margin-top:5px;">
                                                    <div class="col-md-4">
                                                        <p style="padding-left: 10px;">Do Not Send Notifications:</p>
                                                    </div>
                                                    <div class="col-md-8">
                                                        <div class="form-check form-switch">
                                                            <input class="form-check-input" type="checkbox" role="switch" id="flexSwitchCheckDefault">
                                                            <label class="form-check-label" for="flexSwitchCheckDefault"></label>
                                                        </div>
                                                    </div>
                                                </div>
                                            </div>
                                        </div>
                                        <!-- right part 2nd -->
                                    </div>
                                    <div class="" style="width:98%;margin: auto;">
                                        <div style="margin-top:15px;">
                                            <label for="input1" style="margin-left: 12px; margin-left: 15px; margin-top: -12px; position: absolute; background-color: white; border: 2px solid white;">Part</label>
                                            <div id="input1" style="border: 1px solid #EDEADE;padding: 20px;">
                                                <table class="table">
                                                    <thead class="table-dark">
                                                        <tr>
                                                            <th class="text-center">Customer Name:</th>
                                                            <th class="text-center">Title:</th>
                                                            <th class="text-center">Email:</th>
                                                            <th class="text-center">Phone:</th>
                                                            <th class="text-center">Action:</th>
                                                        </tr>
                                                    </thead>
                                                    <tbody id="showNewInputBox">
                                                        <tr>
                                                            <td><input type="text" class="form-control"></td>
                                                            <td><input type="text" class="form-control"></td>
                                                            <td><input type="text" class="form-control"></td>
                                                            <td><input type="text" class="form-control"></td>
                                                            <td>
                                                                <div class="row">
                                                                    <div class="col-md-6">
                                                                        <a onclick="plusInputBox()">
                                                                            <svg class="c-icon">
                                                                                <use xlink:href="<?php echo e(url('public/assets/vendors/@coreui/icons/svg/free.svg#cil-plus')); ?>"></use>
                                                                            </svg>
                                                                        </a>
                                                                    </div>
                                                                    <div class="col-md-6">
                                                                        <a onclick="minusInputBox()">
                                                                            <svg class="c-icon">
                                                                                <use xlink:href="<?php echo e(url('public/assets/vendors/@coreui/icons/svg/free.svg#cil-minus')); ?>"></use>
                                                                            </svg>
                                                                        </a>
                                                                    </div>
                                                                </div>
                                                            </td >
                                                        </tr>
                                                    </tbody>
                                                </table>
                                            </div>
                                        </div>
                                    </div> 
                                    <div class="" style="width:98%;margin: auto;">
                                        <div class="row">
                                            <div class="col-6">
                                                <div style="margin-top:15px;">
                                                    <label for="input1" style="margin-left: 12px; margin-left: 15px; margin-top: -12px; position: absolute; background-color: white; border: 2px solid white;">Notes</label>
                                                    <div  id="input1" style="border: 1px solid #EDEADE;padding: 20px;">
                                                        <div class="row" style="margin-top:5px;">
                                                            <div class="col-md-12">
                                                                <textarea class="form-control"> </textarea>
                                                            </div>
                                                        </div>
                                                    </div>
                                                </div>
                                            </div>
                                            <div class="col-6"></div>
                                        </div>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="card-footer">
                        <div  style="justify-content: center;align-items: center;display: flex;">
                            <button class="btn btn-sm btn-success" type="submit" style="margin:5px;"> Save </button>
                            <a href="<?php echo e(route('admin.customer')); ?>"class="btn btn-sm btn-light"style="margin:5px;"> Back </a>
                        </div>
                    </div>
                </form>
            </div>
        </div>
    </div>
    <script src="https://ajax.googleapis.com/ajax/libs/jquery/1.11.2/jquery.min.js"></script>
    <script src="https://maxcdn.bootstrapcdn.com/bootstrap/3.3.2/js/bootstrap.min.js"></script>
    <script src="//cdnjs.cloudflare.com/ajax/libs/bootstrap-select/1.6.3/js/bootstrap-select.min.js"></script>
    <link rel="stylesheet" href="//cdnjs.cloudflare.com/ajax/libs/bootstrap-select/1.6.3/css/bootstrap-select.min.css" />
    <link href="//netdna.bootstrapcdn.com/bootstrap/3.2.0/css/bootstrap.min.css" rel="stylesheet">
    <script type="text/javascript">
        $(function(){
            $('.selectpicker').selectpicker();
        });

        $("#showHideAlternativeAddress").hide();
        
        $("#useAlternateAddress").change(function(){
            if($(this).prop('checked'))
            {
                $("#showHideAlternativeAddress").show();
            }
            else
            {
                $("#showHideAlternativeAddress").hide();
            }
        });
        let inputBoxId = 0;
        function plusInputBox()
        {
            inputBoxId++;
            $("#showNewInputBox").append('<tr id="inputBoxRmId'+inputBoxId+'"><td><input type="text" class="form-control"></td><td><input type="text" class="form-control"></td><td><input type="text" class="form-control"></td><td><input type="text" class="form-control"></td><td></td></tr>');
        }
        function minusInputBox()
        {
            $("#inputBoxRmId"+inputBoxId).remove();
            inputBoxId--;
        }
    </script>
<?php $__env->stopSection(); ?>

<?php echo $__env->make('layouts.app', \Illuminate\Support\Arr::except(get_defined_vars(), ['__data', '__path']))->render(); ?><?php /**PATH /home/ng6esvhiqizm/public_html/resources/views/admin/customer/add.blade.php ENDPATH**/ ?>