

<?php $__env->startSection('content'); ?>

<div class="col-12 grid-margin stretch-card">
    <div class="card">
        <div class="card-body">
            <h4 class="card-title">Permision Create</h4>
            <p class="card-description">
            </p>
            <form id="add_permission" class="ajax-form forms-sample" method="post" action="<?php echo e(route('admin.labs.create')); ?>" data-redirect="<?php echo e(route('admin.near_labs')); ?>"> 
                <?php echo csrf_field(); ?>
                <div class="row"> 
                    <div class="col-md-6">
                        <div class="form-group">
                            <label for="first_name" class="form-label required">Name</label>
                            <input type="text" class="form-control <?php $__errorArgs = ['name'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?> is-invalid <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?>" name="name" value="<?php echo e(old('name')); ?>">
                            <?php $__errorArgs = ['first_name'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?>
                            <span class="text-danger"><?php echo e($message); ?></span>
                            <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?>
                        </div> 
                        
                         <div class="form-group">
                            <label for="email" class="form-label required">Email</label>
                            <input type="email" class="form-control <?php $__errorArgs = ['name'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?> is-invalid <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?>" name="email" value="<?php echo e(old('email')); ?>">
                            <?php $__errorArgs = ['email'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?>
                            <span class="text-danger"><?php echo e($message); ?></span>
                            <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?>
                        </div>
                         <div class="form-group">
                            <label for="phone" class="form-label required">Phone</label>
                            <input type="text" class="form-control <?php $__errorArgs = ['name'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?> is-invalid <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?>" name="phone" value="<?php echo e(old('phone')); ?>">
                            <?php $__errorArgs = ['phone'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?>
                            <span class="text-danger"><?php echo e($message); ?></span>
                            <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?>
                        </div>
                         <div class="form-group">
                            <label for="address" class="form-label required">Address</label>
                            <input type="text" class="form-control <?php $__errorArgs = ['address'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?> is-invalid <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?>" name="address" value="<?php echo e(old('address')); ?>">
                            <?php $__errorArgs = ['address'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?>
                            <span class="text-danger"><?php echo e($message); ?></span>
                            <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?>
                        </div> 
                         <div class="form-group">
                            <label for="latitude" class="form-label required">Latitude</label>
                            <input type="text" class="form-control <?php $__errorArgs = ['latitude'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?> is-invalid <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?>" name="latitude" value="<?php echo e(old('latitude')); ?>">
                            <?php $__errorArgs = ['latitude'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?>
                            <span class="text-danger"><?php echo e($message); ?></span>
                            <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?>
                        </div> 
                         <div class="form-group">
                            <label for="longitude" class="form-label required">Longitude</label>
                            <input type="text" class="form-control <?php $__errorArgs = ['address'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?> is-invalid <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?>" name="longitude" value="<?php echo e(old('longitude')); ?>">
                            <?php $__errorArgs = ['longitude'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?>
                            <span class="text-danger"><?php echo e($message); ?></span>
                            <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?> 
                        </div> 
                        
                        <div class="form-group">
                            <label for="icon_url" class="form-label required">Map Icon</label>
                            <input type="file" class="form-control " name="icon_url" accept="image/*" value="">
                        </div>
                        
                       
                  </div>
                 </div>
                <button type="submit" class="btn btn-primary me-2">Submit</button>
                <a href="<?php echo e(route('admin.patient')); ?>" class="btn btn-light">Cancel</a>
            </form>
        </div> 
    </div>
</div>
   
<?php $__env->stopSection(); ?>;
<?php echo $__env->make('admin.layouts.app', array_diff_key(get_defined_vars(), ['__data' => 1, '__path' => 1]))->render(); ?><?php /**PATH /var/www/html/resources/views/admin/nearlabs/create.blade.php ENDPATH**/ ?>