| <div class="grid8"> | <div class="grid8"> | ||||
| <span class="grid4"> | <span class="grid4"> | ||||
| <label><b>City : </b></label> | <label><b>City : </b></label> | ||||
| <input type="text" name="city" id="city" value="{{ $form->Subscriber->city }}" readonly required /> | |||||
| <input type="text" name="city" id="city" value="{{ $form->Subscriber->city }}" required /> | |||||
| </span> | </span> | ||||
| <span class="grid4"> | <span class="grid4"> | ||||
| <label><b>Postcode : </b></label> | <label><b>Postcode : </b></label> | ||||
| <input type="text" name="postcode" id="postcode" value="{{ $form->Subscriber->postcode }}" readonly required /> | |||||
| <input type="text" name="postcode" id="postcode" value="{{ $form->Subscriber->postcode }}" required /> | |||||
| </span> | </span> | ||||
| <span class="grid4"> | <span class="grid4"> | ||||
| <label><b>State : </b></label> | <label><b>State : </b></label> | ||||
| <input type="text" name="state" id="state" value="{{ $form->Subscriber->state }}" readonly required /> | |||||
| <input type="text" name="state" id="state" value="{{ $form->Subscriber->state }}" required /> | |||||
| </span> | </span> | ||||
| </div> | </div> | ||||
| <div class="grid2"> </div> | <div class="grid2"> </div> |
| <div class="grid8"> | <div class="grid8"> | ||||
| <span class="grid4"> | <span class="grid4"> | ||||
| <label><b>City : </b></label> | <label><b>City : </b></label> | ||||
| <input type="text" name="city" id="city" value="{{ $form->Subscriber->city }}" readonly required /> | |||||
| <input type="text" name="city" id="city" value="{{ $form->Subscriber->city }}" required /> | |||||
| </span> | </span> | ||||
| <span class="grid4"> | <span class="grid4"> | ||||
| <label><b>Postcode : </b></label> | <label><b>Postcode : </b></label> | ||||
| <input type="text" name="postcode" id="postcode" value="{{ $form->Subscriber->postcode }}" readonly required /> | |||||
| <input type="text" name="postcode" id="postcode" value="{{ $form->Subscriber->postcode }}" required /> | |||||
| </span> | </span> | ||||
| <span class="grid4"> | <span class="grid4"> | ||||
| <label><b>State : </b></label> | <label><b>State : </b></label> | ||||
| <input type="text" name="state" id="state" value="{{ $form->Subscriber->state }}" readonly required /> | |||||
| <input type="text" name="state" id="state" value="{{ $form->Subscriber->state }}" required /> | |||||
| </span> | </span> | ||||
| </div> | </div> | ||||
| <div class="grid2"> </div> | <div class="grid2"> </div> |
| <div class="grid8"> | <div class="grid8"> | ||||
| <span class="grid4"> | <span class="grid4"> | ||||
| <label><b>City : </b></label> | <label><b>City : </b></label> | ||||
| <input type="text" name="city" id="city" value="{{ $form->city }}" readonly required /> | |||||
| <input type="text" name="city" id="city" value="{{ $form->city }}" required /> | |||||
| </span> | </span> | ||||
| <span class="grid4"> | <span class="grid4"> | ||||
| <label><b>Postcode : </b></label> | <label><b>Postcode : </b></label> | ||||
| <input type="text" name="postcode" id="postcode" value="{{ $form->postcode }}" readonly required /> | |||||
| <input type="text" name="postcode" id="postcode" value="{{ $form->postcode }}" required /> | |||||
| </span> | </span> | ||||
| <span class="grid4"> | <span class="grid4"> | ||||
| <label><b>State : </b></label> | <label><b>State : </b></label> | ||||
| <input type="text" name="state" id="state" value="{{ $form->state }}" readonly required /> | |||||
| <input type="text" name="state" id="state" value="{{ $form->state }}" required /> | |||||
| </span> | </span> | ||||
| </div> | </div> | ||||
| <div class="grid2"> </div> | <div class="grid2"> </div> |
| <div class="grid8"> | <div class="grid8"> | ||||
| <span class="grid4"> | <span class="grid4"> | ||||
| <label><b>City : </b></label> | <label><b>City : </b></label> | ||||
| <input type="text" name="city" id="city" value="{{ $form->Subscriber->city }}" readonly required /> | |||||
| <input type="text" name="city" id="city" value="{{ $form->Subscriber->city }}" required /> | |||||
| </span> | </span> | ||||
| <span class="grid4"> | <span class="grid4"> | ||||
| <label><b>Postcode : </b></label> | <label><b>Postcode : </b></label> | ||||
| <input type="text" name="postcode" id="postcode" value="{{ $form->Subscriber->postcode }}" readonly required /> | |||||
| <input type="text" name="postcode" id="postcode" value="{{ $form->Subscriber->postcode }}" required /> | |||||
| </span> | </span> | ||||
| <span class="grid4"> | <span class="grid4"> | ||||
| <label><b>State : </b></label> | <label><b>State : </b></label> | ||||
| <input type="text" name="state" id="state" value="{{ $form->Subscriber->state }}" readonly required /> | |||||
| <input type="text" name="state" id="state" value="{{ $form->Subscriber->state }}" required /> | |||||
| </span> | </span> | ||||
| </div> | </div> | ||||
| <div class="grid2"> </div> | <div class="grid2"> </div> |
| <div class="grid8"> | <div class="grid8"> | ||||
| <span class="grid4"> | <span class="grid4"> | ||||
| <label><b>City : </b></label> | <label><b>City : </b></label> | ||||
| <input type="text" name="city" id="city" value="{{$customer->city}}" readonly required /> | |||||
| <input type="text" name="city" id="city" value="{{$customer->city}}" required /> | |||||
| </span> | </span> | ||||
| <span class="grid4"> | <span class="grid4"> | ||||
| <label><b>Postcode : </b></label> | <label><b>Postcode : </b></label> | ||||
| <input type="text" name="postcode" id="postcode" value="{{$customer->postcode}}" readonly required /> | |||||
| <input type="text" name="postcode" id="postcode" value="{{$customer->postcode}}" required /> | |||||
| </span> | </span> | ||||
| <span class="grid4"> | <span class="grid4"> | ||||
| <label><b>State : </b></label> | <label><b>State : </b></label> | ||||
| <input type="text" name="state" id="state" value="{{$customer->state}}" readonly required /> | |||||
| <input type="text" name="state" id="state" value="{{$customer->state}}" required /> | |||||
| </span> | </span> | ||||
| </div> | </div> | ||||
| <div class="grid2"> </div> | <div class="grid2"> </div> |