50 lines
1.7 KiB
PHP
50 lines
1.7 KiB
PHP
@extends('layout.app')
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@section('left-menu')
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@parent
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<ul>
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<a href="/strazacy/add"><li>Dodaj<img src="img/left_menu_icon/add.png"></li></a>
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<li>Edytuj<img src="img/left_menu_icon/edit.png"></li>
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<li>Wyklucz<img src="img/left_menu_icon/delete.png"></li>
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<li>Zawieś<img src="img/left_menu_icon/suspended.png"></li>
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<li>Więcej<img src="img/left_menu_icon/more.png"></li>
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</ul>
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@stop
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@section('center-area')
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@parent
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<form method="POST" action="/strazacy">
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{{ csrf_field() }}
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<div class="form-group">
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<label for="name">Imię:</label>
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<input type="text" class="form-control" id="name" name="name" value="{{ old('name') }} ">
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</div>
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<div class="form-group">
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<label for="name">Nazwisko:</label>
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<input type="text" class="form-control" id="surname" name="surname" value="{{ old('surname') }}">
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</div>
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<div class="form-group">
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<label for="name">Pesel:</label>
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<input type="text" class="form-control" id="PESEL" name="PESEL" value="{{ old('PESEL') }}">
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</div>
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<div class="form-group">
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<label for="name">Numer telefonu:</label>
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<input type="text" class="form-control" id="phoneNumber" name="phoneNumber" value="{{ old('phoneNumber') }}">
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</div>
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<div class="form-group">
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<label for="email">Adres e-mail:</label>
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<input type="email" class="form-control" id="email" name="email" value="{{ old('email') }}">
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</div>
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<div class="form-group">
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<button style="cursor:pointer" type="submit" class="btn btn-primary">Submit</button>
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</div>
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@include('inc.formerrors')
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</form>
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@stop
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