@extends('crudbooster::admin_template')

@push('bottom')
<link rel="stylesheet" href="{{ asset('/vendor/libs/datatables/datatables.css') }}">

<script src="{{ asset('/vendor/libs/datatables/datatables.js') }}"></script>

<script src="{{ asset('/js/tables_datatables.js') }}"></script>

@endpush

@section('content')
<!-- Your html goes here -->
<div class='panel panel-default'>
    <div class="message"></div>
    <div class='panel-heading eap-box'>{{$data['page_title']}}</div>
    <div id="message">

    <form class="form-horizontal" method="post" id="form" enctype="multipart/form-data" action="{{CRUDBooster::mainpath('add-save')}}">
    <input type="hidden" name="_token" value="{{ csrf_token() }}">
    <input type="hidden" name="return_url" value="{{ url('admin/treatment_custom_iamges38') }}">
    <input type="hidden" name="ref_mainpath" value="{{ url('admin/treatment_custom_iamges38') }}">
    <div class="box-body" id="parent-form-area">

        <div class="form-group header-group-0 " id="form-group-title" style="">
            <label class="control-label col-sm-2">Title
                <span class="text-danger" title="This field is required">*</span>
            </label>

            <div class="col-sm-10">
                <input type="text" title="Title" required="" placeholder="You can only enter the letter only" maxlength="70" class="form-control" name="title" id="title" value="">

                <div class="text-danger"></div>
                <p class="help-block"></p>
            </div>
        </div>
        <div class="form-group header-group-0 " id="form-group-image" style="">
            <label class="col-sm-2 control-label">Image
                <span class="text-danger" title="This field is required">*</span>
            </label>
            <div class="col-sm-10">
                <input type="file" id="image" title="Image" required="" class="form-control" name="image">
                <p class="help-block">File types support : JPG, JPEG, PNG, GIF, BMP</p>
                <div class="text-danger"></div>
            </div>
        </div>
        <div class="form-group header-group-0 " id="form-group-status" style="">
            <label class="control-label col-sm-2">Status
            </label>
            <div class="col-sm-10">
                <input type="checkbox" name="status">
                <div class="text-danger"></div>
                <p class="help-block"></p>
            </div>
        </div>
    </div><!-- /.box-body -->

    <div class="box-footer" style="background: #F5F5F5">

    <div class="form-group">
        <label class="control-label col-sm-2"></label>
        <div class="col-sm-10">
            <a href="{{ url('admin/treatment_custom_iamges38') }}" class="btn btn-default">
                <i class="fa fa-chevron-circle-left"></i> Back
            </a>

            <input type="submit" name="submit" value="Save &amp; Add More" class="btn btn-success">

            <input type="submit" name="submit" value="Save" class="btn btn-success">

        </div>
    </div>


    </div><!-- /.box-footer-->

    </form>

    </div>
</div>
@endsection