<?php $__env->startSection("content"); ?>
<div>
	<ol class="breadcrumb">
		<li><a href="<?php echo e(URL::route('mechanicalmaintenance.index')); ?>">Bio-Medical Maintenance Log</a></li>
		<li><a href="<?php echo e(URL::route('mechanicalbreakdown.index')); ?>">BIo-Medical Equipment Breakdown Log</a></li>
		<li><a  href="<?php echo URL::route('mechanicalsupplier.index'); ?>">Bio-Medical Equipment Suppliers</a></li>
		<li class="active">Bio-Medical Equipment Supplier</li>
	</ol>
</div>
<?php if(Session::has('message')): ?>
<div class="alert alert-info"><?php echo trans(Session::get('message')); ?></div>
<?php endif; ?>
<?php if($errors->all()): ?>
<div class="alert alert-danger">
	<?php echo HTML::ul($errors->all()); ?>

</div>
<?php endif; ?>


<div class="panel panel-default">
	<div class="panel-heading ">
		<span class="glyphicon glyphicon-user"></span>
		Bio-Medical Equipment supplier
	</div>
	<div class="panel-body">

		<?php echo Form::open(array('url' => 'mechanicalsupplier/store', 'autocomplete' => 'off', 'class' => 'form-horizontal', 'data-toggle' => 'validator')); ?>

		<fieldset>
			<div class="form-group">
				<?php echo Form::label('supplier_name', 'Name', ['class' => 'col-lg-2 control-label']); ?>

				<div class="col-lg-7">
					<?php echo Form::text('supplier_name',null,['class' => 'form-control','placeholder' => 'Name', 'required' => 'true']); ?>


					<?php if($errors->has('supplier_name')): ?>
					<span class="text-danger">
						<strong><?php echo $errors->first('supplier_name'); ?></strong>
					</span>
					<?php endif; ?>

				</div>
			</div>

			<div class="form-group">
				<?php echo Form::label('phone', 'Phone', ['class' => 'col-lg-2 control-label']); ?>

				<div class="col-lg-7">
					<?php echo Form::text('phone',null,['class' => 'form-control','placeholder' => 'Phone', 'type'=>'number','required' => 'true']); ?>


					<?php if($errors->has('phone')): ?>
					<span class="text-danger">
						<strong><?php echo $errors->first('phone'); ?></strong>
					</span>
					<?php endif; ?>

				</div>
			</div>

			<div class="form-group">
				<?php echo Form::label('email', 'Email', ['class' => 'col-lg-2 control-label']); ?>

				<div class="col-lg-7">
					<?php echo Form::text('email',null,['class' => 'form-control','placeholder' => 'Email', 'type'=>'email','required' => 'true']); ?>


					<?php if($errors->has('email')): ?>
					<span class="text-danger">
						<strong><?php echo $errors->first('email'); ?></strong>
					</span>
					<?php endif; ?>

				</div>
			</div>

			<div class="form-group">
				<?php echo Form::label('address', 'Address', ['class' => 'col-lg-2 control-label']); ?>

				<div class="col-lg-7">
					<?php echo Form::textarea('address',null,['rows' => '3','class' => 'form-control','placeholder' => 'Address', 'required' => 'true']); ?>


					<?php if($errors->has('address')): ?>
					<span class="text-danger">
						<strong><?php echo $errors->first('address'); ?></strong>
					</span>
					<?php endif; ?>

				</div>
			</div>
			<div class="form-group">
				<div class="col-lg-10 col-lg-offset-2">
					<a href="<?php echo url('/equipmentsupplier'); ?>" class="btn btn-default">Cancel</a>
					<button type="submit" class="btn btn-primary">Submit</button>
				</div>
			</div>
		</div>

	</fieldset>

	<?php echo Form::close(); ?>


	<?php
	Session::put('SOURCE_URL', URL::full());?>
</div>

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

<?php echo $__env->make("layout", array_except(get_defined_vars(), array('__data', '__path')))->render(); ?>