000

<?php $__env->startSection('title','Generate Claims'); ?>
<?php $__env->startSection('style'); ?>
<?php echo e(Html::style("assets/css/bootstrap-datepicker3.min.css")); ?>

<?php $__env->stopSection(); ?>

<?php $__env->startSection('content'); ?>

<div class="main-content">
	<div class="main-content-inner">
		<div class="breadcrumbs ace-save-state" id="breadcrumbs">
			<ul class="breadcrumb">
				<li>
					<i class="ace-icon fa fa-home home-icon"></i>
					<a href="#"><?php echo e(__('messages.Home')); ?></a>
				</li>
				<li class="active">Generate Claims</li>
			</ul>
		</div>

<div class="page-header">
				<h1>
					Generate Claims
				</h1>
			</div>

<form action="<?php echo e(URL('\user\print-claims')); ?>" role="form" id="generateClaimForm" method="post">
				<?php echo e(csrf_field()); ?>

<div class="container">
					<div class="row">
						<div class="panel panel-primary">
							<div class="panel-heading">
								<h3 class="panel-title">Generate Claim</h3>
							</div>

<div class="panel-body">
								<div class="col-md-3">
									<div class="form-group">
										<label for="master_rake_id"> <?php echo e(__('messages.masterrake')); ?></label>
										<select class="form-control select2" name="master_rake_id" id="master_rake_id">
											<option value=""> <?php echo e(__('messages.SelectMasterRake')); ?></option>
											<?php $__currentLoopData = $master_rakes; $__env->addLoop($__currentLoopData); foreach($__currentLoopData as $master_rake): $__env->incrementLoopIndices(); $loop = $__env->getLastLoop(); ?>
											<option value="<?php echo e($master_rake->id); ?>" <?php echo e(isset($master_rake_id) && $master_rake_id==$master_rake->id ? "selected":""); ?>><?php echo e($master_rake->name); ?></option>
											<?php endforeach; $__env->popLoop(); $loop = $__env->getLastLoop(); ?>
										</select>
										<?php if($errors->has('master_rake_id')): ?>
										<span class="label label-danger"><?php echo e($errors->first('master_rake_id')); ?></span>
										<?php endif; ?>
									</div>
								</div>

<div class="col-md-3">
									<div class="form-group">
										<label for="company_id">Company</label>
										<select class="form-control select2" name="company_id" id="company_id">
											<option value="">Select Company</option>
											<?php $__currentLoopData = $companies; $__env->addLoop($__currentLoopData); foreach($__currentLoopData as $company): $__env->incrementLoopIndices(); $loop = $__env->getLastLoop(); ?>
											<option value="<?php echo e($company->id); ?>" <?php echo e(isset($company_id) && $company_id==$company->id ? "selected":""); ?>><?php echo e($company->name); ?></option>
											<?php endforeach; $__env->popLoop(); $loop = $__env->getLastLoop(); ?>
										</select>
										<?php if($errors->has('company_id')): ?>
										<span class="label label-danger"><?php echo e($errors->first('company_id')); ?></span>
										<?php endif; ?>
									</div>
								</div>

<div class="clearfix"></div>
								<div class="col-md-3">
									<div class="form-group">
										<button type="submit" class="btn btn-primary">Submit</button>
									</div>
								</div>
							</div>

</div>

</div>
				</div>
			</form>
		</div>
	</div>
</div>

<?php $__env->startSection('script'); ?>

<?php echo e(Html::script("assets/js/jquery.dataTables.min.js")); ?>

<?php echo e(Html::script("assets/js/jquery.dataTables.bootstrap.min.js")); ?>

<?php echo e(Html::script("assets/js/dataTables.buttons.min.js")); ?>

<?php echo e(Html::script("assets/js/buttons.flash.min.js")); ?>

<?php echo e(Html::script("assets/js/buttons.html5.min.js")); ?>

<?php echo e(Html::script("assets/js/buttons.print.min.js")); ?>

<?php echo e(Html::script("assets/js/buttons.colVis.min.js")); ?>

<?php echo e(Html::script("assets/js/dataTables.select.min.js")); ?>

<?php echo e(Html::script("assets/js/ace-elements.min.js")); ?>

<?php echo e(Html::script("assets/js/ace.min.js")); ?>

<?php echo e(Html::script("assets/js/bootstrap-datepicker.min.js")); ?>