89 lines
4.7 KiB
PHP
Executable File
89 lines
4.7 KiB
PHP
Executable File
@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 State</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>House Number, Building and Street Name</label>
|
|
<textarea type="text" class="form-control" name="address" placeholder="Please enter your House Number, Building and Street Name"></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 |