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编辑当前文件:/home/qrafawbu/tblonline.org/storage/framework/views/be12c164d149d05f0b5bd481430fa3092bbb8704.php

<?php $__env->startSection('content'); ?>
<div class="row">
	<div class="col-lg-8 offset-lg-2">
		<div class="card">
			<div class="card-header">
				<h4 class="header-title text-center"><?php echo e(_lang('New Payment Request')); ?></h4>
			</div>
			<div class="card-body">
			    <form method="post" class="validate" autocomplete="off" action="<?php echo e(route('payment_requests.store')); ?>" enctype="multipart/form-data">
					<?php echo e(csrf_field()); ?>

<div class="row">
                        <div class="col-md-12">
                            <div class="form-group">
                                <label class="control-label"><?php echo e(_lang('Receiver Account')); ?></label>
                                <input type="text" class="form-control" name="receiver_account" value="<?php echo e(old('receiver_account')); ?>" required>
                            </div>
                        </div>

<div class="col-md-6">
                            <div class="form-group">
                                <label class="control-label"><?php echo e(_lang('Currency')); ?></label>
                                <select class="form-control auto-select select2" data-selected="<?php echo e(old('currency_id')); ?>" name="currency_id" required>
                                    <option value=""><?php echo e(_lang('Select One')); ?></option>
                                    <?php echo e(create_option('currency','id','name','',array('status=' => 1))); ?>

</select>
                            </div>
                        </div>

<div class="col-md-6">
                            <div class="form-group">
                                <label class="control-label"><?php echo e(_lang('Amount')); ?></label>
                                <input type="text" class="form-control float-field" name="amount" value="<?php echo e(old('amount')); ?>" required>
                            </div>
                        </div>

<div class="col-md-12">
							<div class="form-group">
								<button type="submit" class="btn btn-primary btn-lg btn-block"><i class="icofont-check-circled"></i> <?php echo e(_lang('Send Request')); ?></button>
							</div>
						</div>
					</div>
			    </form>
			</div>
		</div>
    </div>
</div>
<?php $__env->stopSection(); ?>
<?php echo $__env->make('layouts.app', \Illuminate\Support\Arr::except(get_defined_vars(), ['__data', '__path']))->render(); ?><?php /**PATH /home/qrafawbu/tblonline.org/resources/views/backend/customer_portal/payment_request/create.blade.php ENDPATH**/ ?>