{{ Form::label('first_name', __('messages.user.first_name') . ':', ['class' => 'form-label']) }} {{ Form::text('first_name', null, ['class' => 'form-control', 'required', 'tabindex' => '1','placeholder'=>__('messages.user.first_name')]) }}

{{ Form::label('last_name', __('messages.user.last_name') . ':', ['class' => 'form-label']) }} {{ Form::text('last_name', null, ['class' => 'form-control','required', 'tabindex' => '2','placeholder'=>__('messages.user.last_name')]) }}

{{ Form::label('email', __('messages.user.email') . ':', ['class' => 'form-label']) }} {{ Form::email('email', null, ['class' => 'form-control','required', 'tabindex' => '3', 'id'=>'caseHandlerEmail','placeholder'=>__('messages.user.email')]) }}

{{ Form::label('designation', __('messages.user.designation') . ':', ['class' => 'form-label']) }} {{ Form::text('designation', null, ['class' => 'form-control','required', 'tabindex' => '4','placeholder'=>__('messages.user.designation')]) }}

{{ Form::label('phone', __('messages.user.phone') . ':', ['class' => 'form-label']) }}
{{ Form::tel('phone', getCountryCode(), ['class' => 'form-control phoneNumber', 'id' => 'caseHandlerPhoneNumber', 'onkeyup' => 'if (/\D/g.test(this.value)) this.value = this.value.replace(/\D/g,"")', 'tabindex' => '5']) }} {{ Form::hidden('prefix_code', null, ['class' => 'prefix_code']) }}

{{ Form::label('gender', __('messages.user.gender') . ':', ['class' => 'form-label']) }}
{{ __('messages.user.male') }} {{ Form::radio('gender', '0', true, ['class' => 'form-check-input', 'tabindex' => '6', 'id' => 'caseHandlerMale']) }} {{ __('messages.user.female') }} {{ Form::radio('gender', '1', false, ['class' => 'form-check-input', 'tabindex' => '7', 'id' => 'caseHandlerFemale']) }}

{{ Form::label('status', __('messages.common.status') . ':', ['class' => 'form-label']) }}

{{ Form::label('qualification', __('messages.user.qualification') . ':', ['class' => 'form-label']) }} {{ Form::text('qualification', null, ['class' => 'form-control','required', 'tabindex' => '8','placeholder'=>__('messages.user.qualification')]) }}

{{ Form::label('dob', __('messages.user.dob').':', ['class' => 'form-label']) }} {{ Form::text('dob', null, ['id'=>'caseHandlerBirthDate', 'class' => (getLoggedInUser()->thememode ? 'bg-light birthDate form-control' : 'bg-white birthDate form-control'),'autocomplete' => 'off', 'tabindex' => '9','placeholder'=>__('messages.user.dob')]) }}

{{ Form::label('blood_group', __('messages.user.blood_group') . ':', ['class' => 'form-label']) }} {{ Form::select('blood_group', $bloodGroup, null, ['class' => 'form-select', 'id' => 'caseHandlerBloodGroup', 'placeholder' => __('messages.user.select_blood_group'), 'data-control' => 'select2', 'tabindex' => '10']) }}

{{ Form::label('password', __('messages.user.password') . ':', ['class' => 'form-label']) }} {{ Form::password('password', ['class' => 'form-control','required','min' => '6','max' => '10','placeholder'=>__('messages.user.password')]) }}

{{ Form::label('password_confirmation', __('messages.user.password_confirmation') . ':', ['class' => 'form-label']) }} {{ Form::password('password_confirmation', ['class' => 'form-control','required','min' => '6','max' => '10','placeholder'=>__('messages.user.password_confirmation')]) }}

{{ Form::label('image', __('messages.common.profile') . ':', ['class' => 'form-label']) }}

{{ Form::label('address1', __('messages.user.address1').':', ['class' => 'form-label']) }} {{ Form::text('address1', null, ['class' => 'form-control','placeholder'=>__('messages.user.address1')]) }}

{{ Form::label('address2', __('messages.user.address2').':', ['class' => 'form-label']) }} {{ Form::text('address2', null, ['class' => 'form-control','placeholder'=>__('messages.user.address2')]) }}

{{ Form::label('city', __('messages.user.city').':', ['class' => 'form-label fs-6 fw-bolder text-gray-700 mb-3']) }} {{ Form::text('city', null, ['class' => 'form-control','placeholder'=>__('messages.user.city')]) }}

{{ Form::label('zip', __('messages.user.zip').':', ['class' => 'form-label']) }} {{ Form::text('zip', null, ['class' => 'form-control', 'maxlength' => '6','minlength' => '6','placeholder'=>__('messages.user.zip')]) }}

{{ __('messages.user.address_details') }}