{!! Form::open(array('url'=>'userconnects', 'class'=>'form-horizontal','files' => true , 'parsley-validate'=>'','novalidate'=>' ')) !!}

	@if(Session::has('messagetext'))
	  
		   {!! Session::get('messagetext') !!}
	   
	@endif
	<ul class="parsley-error-list">
		@foreach($errors->all() as $error)
			<li>{{ $error }}</li>
		@endforeach
	</ul>		


<div class="col-md-12">
						<fieldset><legend> Холбоо барисан хүсэлтүүд</legend>
				{!! Form::hidden('id', $row['id']) !!}					
									  <div class="form-group row  " >
										<label for="First Name" class=" control-label col-md-4 "> First Name </label>
										<div class="col-md-8">
										  <input  type='text' name='first_name' id='first_name' value='{{ $row['first_name'] }}' 
						     class='form-control form-control-sm ' /> 
										 </div> 
										 
									  </div> 					
									  <div class="form-group row  " >
										<label for="Email" class=" control-label col-md-4 "> Email </label>
										<div class="col-md-8">
										  <input  type='text' name='email' id='email' value='{{ $row['email'] }}' 
						     class='form-control form-control-sm ' /> 
										 </div> 
										 
									  </div> 					
									  <div class="form-group row  " >
										<label for="Phone" class=" control-label col-md-4 "> Phone </label>
										<div class="col-md-8">
										  <input  type='text' name='phone' id='phone' value='{{ $row['phone'] }}' 
						     class='form-control form-control-sm ' /> 
										 </div> 
										 
									  </div> 					
									  <div class="form-group row  " >
										<label for="Note" class=" control-label col-md-4 "> Note </label>
										<div class="col-md-8">
										  <textarea name='note' rows='5' id='note' class='form-control form-control-sm '  
				           >{{ $row['note'] }}</textarea> 
										 </div> 
										 
									  </div> 					
									  <div class="form-group row  " >
										<label for="Header Name" class=" control-label col-md-4 "> Header Name </label>
										<div class="col-md-8">
										  <input  type='text' name='header_name' id='header_name' value='{{ $row['header_name'] }}' 
						     class='form-control form-control-sm ' /> 
										 </div> 
										 
									  </div> 					
									  <div class="form-group row  " >
										<label for="States" class=" control-label col-md-4 "> States </label>
										<div class="col-md-8">
										  <input  type='text' name='states' id='states' value='{{ $row['states'] }}' 
						     class='form-control form-control-sm ' /> 
										 </div> 
										 
									  </div> 					
									  <div class="form-group row  " >
										<label for="Back Note" class=" control-label col-md-4 "> Back Note </label>
										<div class="col-md-8">
										  <textarea name='back_note' rows='5' id='back_note' class='form-control form-control-sm '  
				           >{{ $row['back_note'] }}</textarea> 
										 </div> 
										 
									  </div> 					
									  <div class="form-group row  " >
										<label for="Created At" class=" control-label col-md-4 "> Created At </label>
										<div class="col-md-8">
										  
					{!! Form::text('created_at', $row['created_at'],array('class'=>'form-control form-control-sm datetime')) !!}
				 
										 </div> 
										 
									  </div> 					
									  <div class="form-group row  " >
										<label for="Back By" class=" control-label col-md-4 "> Back By </label>
										<div class="col-md-8">
										  <input  type='text' name='back_by' id='back_by' value='{{ $row['back_by'] }}' 
						     class='form-control form-control-sm ' /> 
										 </div> 
										 
									  </div> 					
									  <div class="form-group row  " >
										<label for="Back At" class=" control-label col-md-4 "> Back At </label>
										<div class="col-md-8">
										  
					{!! Form::text('back_at', $row['back_at'],array('class'=>'form-control form-control-sm datetime')) !!}
				 
										 </div> 
										 
									  </div> 					
									  <div class="form-group row  " >
										<label for="Last Name" class=" control-label col-md-4 "> Last Name </label>
										<div class="col-md-8">
										  <input  type='text' name='last_name' id='last_name' value='{{ $row['last_name'] }}' 
						     class='form-control form-control-sm ' /> 
										 </div> 
										 
									  </div> </fieldset></div>

			<div style="clear:both"></div>	
				
					
				  <div class="form-group">
					<label class="col-sm-4 text-right">&nbsp;</label>
					<div class="col-sm-8">	
					<button type="submit" name="apply" class="btn btn-default btn-sm" ><i class="fa  fa-check-circle"></i> {{ Lang::get('core.sb_apply') }}</button>
					<button type="submit" name="submit" class="btn btn-default btn-sm" ><i class="fa  fa-save "></i> {{ Lang::get('core.sb_save') }}</button>
				  </div>	  
			
		</div> 
		 <input type="hidden" name="action_task" value="public" />
		 {!! Form::close() !!}
		 
   <script type="text/javascript">
	$(document).ready(function() { 
		
		 

		$('.removeCurrentFiles').on('click',function(){
			var removeUrl = $(this).attr('href');
			$.get(removeUrl,function(response){});
			$(this).parent('div').empty();	
			return false;
		});		
		
	});
	</script>