@extends('user.layouts.master')
@section('content')
    <section class="section">



        <div class="section-body">
            <div class="row">
                <div class="col-12 col-md-6 col-lg-12">
                    @if ($message = Session::get('success'))
                        <div class="alert alert-success">
                            <strong>{{ $message }}</strong>
                        </div>
                    @endif
                    @if ($message = Session::get('errors'))
                        <div class="alert alert-danger">
                            <strong>{{ $message }}</strong>
                        </div>
                    @endif
                    <div class="card">
                        <div class="card-header">
                            <h4>Report </h4>
                        </div>
                        <div class="card-body">
                            <form action="{{ route('user.pages.report.report') }}" method="POST"
                                enctype="multipart/form-data">
                                @csrf
                                <div class="form-group">
                                    <label>User Name </label>
                                    <div class="input-group">
                                        <input type="text" name="user_name" class="form-control" placeholder="Name:">
                                        <span class="text-danger">{{ $errors->first('user_name') }}</span>

                                        <select class="form-control" name="payment_type">
                                            <option value="payment_type">Payment Type</option>
                                            <option value="Venmo">1.Venmo</option>
                                            <option value="Zelle">2.Zelle</option>
                                            <option value="Paypal">3.Paypal</option>
                                            <option value="Cashapp">4.Cashapp</option>
                                            <option value="Googlepay">5.Googlepay</option>
                                            <option value="Facebook Messenger">6.Facebook Messenger</option>
                                            <option value="Other">7.Other</option>

                                            {{-- <option>6 Months</option>
                                        <option>7 Months</option>
                                        <option>8 Months</option>
                                        <option>9 Months</option>
                                        <option>10 Months</option>
                                        <option>11 Months</option> --}}
                                        </select>
                                        <span class="text-danger">{{ $errors->first('payment_type') }}</span>

                                    </div>
                                </div>

                                <div class="form-group">
                                    <label>Phone Number </label>
                                    <div class="input-group">
                                        <div class="input-group-prepend">
                                            <div class="input-group-text">
                                                <i class="fas fa-phone"></i>
                                            </div>
                                        </div>
                                        <input type="text" name="phone_number" class="form-control phone-number">
                                        <span class="text-danger">{{ $errors->first('phone_number') }}</span>
                                    </div>
                                </div>

                                <div class="form-group">
                                    <label>Email</label>
                                    <input type="text" name="email" class="form-control">
                                    <span class="text-danger">{{ $errors->first('email') }}</span>

                                </div>

                                <div class="form-group">
                                    <label>Upload Image</label>
                                    <input type="file" name="images" class="form-control">
                                    <span class="text-danger">{{ $errors->first('images') }}</span>
                                </div>


                                {{-- <div class="form-group">
                                <label>Password Strength</label>
                                <div class="input-group">
                                    <div class="input-group-prepend">
                                        <div class="input-group-text">
                                            <i class="fas fa-lock"></i>
                                        </div>
                                    </div>
                                    <input type="password" class="form-control pwstrength" data-indicator="pwindicator">
                                </div>
                                <div id="pwindicator" class="pwindicator">
                                    <div class="bar"></div>
                                    <div class="label"></div>
                                </div>
                            </div> --}}

                                {{-- <div class="form-group">
                  <label>Purchase Code</label>
                  <input type="text" class="form-control purchase-code" placeholder="ASDF-GHIJ-KLMN-OPQR">
                </div> --}}
                                <div class="form-group">
                                    <label>Description</label>
                                    <input type="text" name="notes" class="form-control invoice-input">
                                    <span class="text-danger">{{ $errors->first('notes') }}</span>
                                </div>
                                {{-- <div class="form-group">
                  <label>Date</label>
                  <input type="text" class="form-control datemask" placeholder="YYYY/MM/DD">
                </div> --}}
                                {{-- <div class="form-group">
                  <label>Credit Card</label>
                  <input type="text" class="form-control creditcard">
                </div> --}}
                                {{-- <div class="form-group">
                  <label>Tags</label>
                  <input type="text" class="form-control inputtags">
                </div> --}}
                                <div class="form-groups">
                                    <button type="submit" class="btn btn-primary theme-bg full-width">AddReport</button>
                                </div>
                        </div>
                        </form>
                    </div>


                </div>

            </div>




        </div>
    </section>

   
    @endsection