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@@ -281,17 +281,31 @@ |
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<div class="formRow"> |
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<div class="grid2"> </div> |
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<div class="grid2"><label><b>Unit No : </b></label></div> |
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<div class="grid2"><label><b>Building : </b></label></div> |
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<div class="grid6"> |
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<input type="text" name="unit_no" id="unit_no" value="{{ $form->unit_no }}" required /> |
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<select class="styled" name="building" id="building" required> |
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@foreach($coverage as $c) |
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@if($c->building_name == $form->building_name) |
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<option value='{{ $c->building_name }}' selected>{{ $c->building_name }}</option> |
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@else |
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<option value='{{ $c->building_name }}'>{{ $c->building_name }}</option> |
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@endif |
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@endforeach |
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</select> |
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</div> |
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<div class="grid2"> </div> |
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</div> |
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<div class="formRow"> |
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<div class="grid2"> </div> |
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<div class="grid2"><label><b>Address : </b></label></div> |
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<div class="grid6"><textarea rows="3" cols="" name="address" id="address" class="auto" style="overflow: hidden; word-wrap: break-word; resize: horizontal; height: 70px;" required>{{ $form->street }}</textarea></div> |
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<div class="grid4"> |
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<label><b>Unit No : </b></label> |
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<input type="text" name="unit_no" id="unit_no" value="{{ $form->unit_no }}" required /> |
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</div> |
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<div class="grid4"> |
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<label><b>Street : </b></label> |
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<input type="text" name="street" id="street" value="{{ $form->street }}" /> |
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</div> |
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<div class="grid2"> </div> |
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</div> |
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@@ -300,15 +314,15 @@ |
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<div class="grid8"> |
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<span class="grid4"> |
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<label><b>City : </b></label> |
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<input type="text" name="city" id="city" value="{{ $form->city }}" required /> |
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<input type="text" name="city" id="city" value="{{ $form->city }}" readonly required /> |
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</span> |
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<span class="grid4"> |
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<label><b>Postcode : </b></label> |
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<input type="text" name="postcode" id="postcode" value="{{ $form->postcode }}" required /> |
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<input type="text" name="postcode" id="postcode" value="{{ $form->postcode }}" readonly required /> |
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</span> |
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<span class="grid4"> |
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<label><b>State : </b></label> |
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<input type="text" name="state" id="state" value="{{ $form->state }}" required /> |
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<input type="text" name="state" id="state" value="{{ $form->state }}" readonly required /> |
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</span> |
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</div> |
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<div class="grid2"> </div> |