@extends('user-layouts.user_template')
@section('content')
<div class="content-wrapper" style="min-height: 916px;">
    <!-- Content Header (Page header) -->
    <section class="content-header">
        <h1>
            Address Book
            <!-- <small>Control panel</small> -->
        </h1>
        <ol class="breadcrumb">
            <li><a href="{{ url ('user') }}"><i class="fa fa-home"></i> Home</a></li>
            <li><a href="{{ url ('user/address-book') }}"><i class="fa fa-address-book-o"></i> Address Book</a></li>
            <li class="active">Add New Address</li>

        </ol>
    </section>

    <!-- Main content -->
    <section class="content">
        <div class="row">
            <div class="col-md-12">
                <div class="box box-primary">
                    <div class="box-header with-border">

                        <h3 class="box-title">
                            Add New Address
                        </h3>
                    </div>
                    <form role="form" id="frm-create-address-book">
                        <div class="box-body">
                            <div class="row">
                                <div class="col-md-6">
                                    <div class="form-group">
                                        <label>Fullname</label>
                                        <input type="text" class="form-control" name="fullname" placeholder="Fullaname">
                                    </div>
                                    <div class="form-group">
                                        <label>Mobile Number</label>
                                        <input type="text" class="form-control" name="mobilenumber" placeholder="Please enter your mobile number">
                                    </div>
                                    <div class="form-group">
                                        <label>Other Notes</label>
                                        <input type="text" class="form-control" name="othernotes" placeholder="Please enter your notes">
                                    </div>
                                    <!-- /.box-body -->
                                </div>
                                <div class="col-md-6">
                                    <div class="form-group">
                                        <label>Country</label>
                                        <select class="form-control" name="countryCode" id="select_country" onchange="selectCountry(this)">
                                            <option value="">Select Country</option>
                                            <option value="US">United States</option>
                                            <option value="CA">Canada</option>
                                        </select>
                                    </div>
                                    <div class="form-group">
                                        <label>State / Province</label>
                                        <select class="form-control" name="state" id="lst-states">
                                            <option value="">Select State</option>
                                        </select>
                                    </div>
                                    <div class="form-group">
                                        <label>City</label>
                                        <select class="form-control" name="city" id="lst-cities">
                                            <option value="">Select City</option>
                                        </select>
                                    </div>
                                    <div class="form-group">
                                        <label>Address 1</label>
                                        <textarea type="text" class="form-control" name="address" placeholder="Address 1"></textarea>
                                    </div>
                                    <div class="form-group">
                                        <label>Address 2</label>
                                        <textarea type="text" class="form-control" name="address2" placeholder="Address 2"></textarea>
                                    </div>
                                    <div class="form-group">
                                        <label>Zip Code</label>
                                        <input type="text" class="form-control" name="zipcode" placeholder="Please enter your zip code">
                                    </div>
                                </div>
                            </div>
                        </div>
                        <div class="box-footer">
                            <button type="submit" class="btn btn-primary btn-custom-save">Save</button>
                        </div>
                    </form>
                    <div>
                    </div>
                </div>
    </section>
    <!-- /.content -->
</div>
@endsection