@extends("layout") @section("content")
  1. {{trans('messages.home')}}
  2. Orders
  3. New Order

{{ Form::open(array('url' => 'facilityrequest', 'id' => 'form-facilityrequest', 'method' => 'POST')) }}

{{ HTML::image(Config::get('kblis.organization-logo'), Config::get('kblis.country') . trans('messages.court-of-arms'), array('width' => '150px')) }}
{{ strtoupper(Config::get('constants.FACILITY_REQUEST_FORM_HEADER')) }}
{{Config::get('kblis.address-info')}}




{{ Form::label('facility_id', 'Facility Name:', array('class'=>'col-sm-2')) }} {{ Form::select('facility_id', $facility, Input::old('facility_id'), array('class' => 'form-control col-sm-4')) }} @if ($errors->has('facility_id')) {{ $errors->first('facility_id') }} @endif {{ Form::label('district_id', 'District:', array('class'=>'col-sm-2')) }} {{ Form::select('district_id', $district, Input::old('district_id'), array('class' => 'form-control col-sm-4')) }} {{ Form::label('ip', 'IP:', array('class'=>'col-sm-2')) }} {{ Form::select('ip_id', $ip, Input::old('ip_id'), array('class' => 'form-control col-sm-4')) }}
{{ Form::label('start_date', 'Report Start Date:', array('class'=>'col-sm-2')) }} {{ Form::text('start_date', Input::old('start_date'),array('class' => 'form-control standard-datepicker','required'=>'required','id'=>'start_date')) }} {{ Form::label('end_date', 'End Date:', array('class'=>'col-sm-2')) }} {{ Form::text('end_date', Input::old('end_date'),array('class' => 'form-control standard-datepicker','required'=>'required','id'=>'_date')) }} {{ Form::label('requested_by', 'Order Prepared By:', array('class' =>'col-sm-2 ')) }} {{ Form::text('requested_by', Auth::user()->name,array('class' => 'form-control col-sm-4', 'readonly')) }} {{ Form::label('date_submitted', 'Date Submitted:', array('class' =>'col-sm-2 ')) }} {{ Form::text('date_submitted', Input::old('date_submitted'),array('class' => 'form-control standard-datepicker','required'=>'required','id'=>'expiry_date')) }}
Item/Commodity UoM Unit Price Opening Balance
at start
of opening cycle		 Qty Received
during the
reporting period		 Total Consumption
during the
reporting period		 Losses / Adjustments
(-/+)		 Total Closing Balance Maximum Stock Quantity Required Quantity To Order Total Cost Comments
{{ Form::button(" ".trans('messages.save'), array('class' => 'btn btn-primary', 'onclick' => 'submit()')) }}