000

<form action="<?php echo e(URL('/user/edit-dealer')); ?>" role="form" id="editDealerForm">
	<div class="row">
		<input type="hidden" value="<?php echo e($dealer->id); ?>" name="id">

<div class="col-md-4">
			<div class="form-group">
				<label for="name">Name</label>
				<input type="text" class="form-control"  value="<?php echo e($dealer->name); ?>" name="name" id="name" placeholder="Name">
				<span class="label label-danger" id="edit_name_error" style="display: none;"></span>
			</div>
		</div>

<div class="col-md-4">
			<div class="form-group">
				<label for="hindi_name">Hindi Name</label>
				<input type="text" class="form-control convertHindi"  value="<?php echo e($dealer->hindi_name); ?>" name="hindi_name" id="hindi_name" placeholder="Hindi Name">
			</div>
		</div>

<div class="col-md-4">
			<div class="form-group">
				<label for="phone">Phone</label>
				<input type="text" class="form-control" name="phone" id="phone" value="<?php echo e($dealer->phone); ?>"  placeholder="Phone">
				<span class="label label-danger" id="edit_phone_error" style="display: none;"></span>
			</div>
		</div>
		<div class="clearfix"></div>

<div class="col-md-4">
			<div class="form-group">
				<label for="address1">Address</label>
				<input type="text" class="form-control" name="address1" id="address1" value="<?php echo e($dealer->address1); ?>"  placeholder="Address">
				<span class="label label-danger" id="edit_address1_error" style="display: none;"></span>
			</div>
		</div>

<div class="col-md-4">
			<div class="form-group">
				<label for="hindi_address">Hindi Address 1</label>
				<input type="text" class="form-control convertHindi" name="hindi_address1" id="hindi_address1" placeholder="Hindi Address1" value="<?php echo e($dealer->hindi_address1); ?>">
			</div>
		</div>

<div class="col-md-4">
			<div class="form-group">
				<label for="address2">Address2</label>
				<input type="text" class="form-control" name="address2" id="address2" value="<?php echo e($dealer->address2); ?>" placeholder="Address2">
			</div>
		</div>	
		<div class="clearfix"></div>
		<div class="col-md-4">
			<div class="form-group">
				<label for="hindi_address2">Hindi Address2</label>
				<input type="text" class="form-control convertHindi" name="hindi_address2" id="hindi_address2" placeholder="Hindi Address2">
			</div>
		</div>

<div class="col-md-4">
			<div class="form-group">
				<label for="district">District</label>
				<input type="text" class="form-control" name="district" id="district" value="<?php echo e($dealer->district); ?>" placeholder="District">
				<span class="label label-danger" id="add_district_error" style="display: none;"></span>
			</div>
		</div>

<div class="col-md-4">
			<div class="form-group">
				<label for="pin_code">Pin Code</label>
				<input type="text" class="form-control" name="pin_code" id="pin_code" value="<?php echo e($dealer->pin_code); ?>" placeholder="Pin Code">
				<span class="label label-danger" id="add_pin_code_error" style="display: none;"></span>
			</div>
		</div>
		<div class="clearfix"></div>

<div class="col-md-4">
			<div class="form-group">
				<label for="owner_name">Owner</label>
				<input type="text" class="form-control" name="owner_name" id="owner_name" value="<?php echo e($dealer->owner_name); ?>" placeholder="Owner">
			</div>
		</div>

<div class="col-md-4">
			<div class="form-group">
				<label for="mobile_number">Mobile Number</label>
				<input type="text" class="form-control" name="mobile_number" id="mobile_number" value="<?php echo e($dealer->mobile_number); ?>" placeholder="Mobile Number">
				<span class="label label-danger" id="add_mobile_number_error" style="display: none;"></span>
			</div>
		</div>

<div class="col-md-4">
			<div class="form-group">
				<label for="email">Email</label>
				<input type="text" class="form-control" name="email" id="email" value="<?php echo e($dealer->email); ?>" placeholder="Email">
				<span class="label label-danger" id="add_email_error" style="display: none;"></span>
			</div>
		</div>

<div class="col-md-4">
			<div class="form-group">
				<label for="ifms_code">IFMS Code</label>
				<input type="text" class="form-control" name="ifms_code" id="ifms_code" value="<?php echo e($dealer->ifms_code); ?>" placeholder="IFMS Code">
			</div>
		</div>

<div class="col-md-4">
			<div class="form-group">
				<label for="gst_number">GST Number</label>
				<input type="text" class="form-control" name="gst_number" id="gst_number" value="<?php echo e($dealer->gst_number); ?>" placeholder="GST Number">
				<span class="label label-danger" id="add_gst_number_error" style="display: none;"></span>
			</div>
		</div>

<div class="col-md-4">
			<div class="form-group">
				<label for="show_separate_report">Show Separate Report</label>
				<input type="checkbox"  name="show_separate_report" id="show_separate_report" <?php echo e($dealer->show_separate_report ? "checked":""); ?>>
			</div>
		</div>

</div>
</div>
<div class="modal-footer">
	<button type="button" class="btn btn-default" data-dismiss="modal">Close</button>
	<button type="button" id="editDealerBtn" class="btn btn-primary" onclick="updateDealer()">Submit</button>
</div>
</form>

<?php /**PATH /home/pmmsanvp/public_html/srt/resources/views/dashboard/master/edit-dealer.blade.php ENDPATH**/ ?>