{!! Form::label('pharmacy_id','Pharmacy ID') !!}

{!! Form::number('pharmacy_id', null, ['class' => 'form-control', 'data-parsley-required'=>'true', 'data-parsley-trigger'=>'change', 'placeholder'=>'Enter Pharmacy ID','required', 'maxlength'=>"25"]) !!}

{!! Form::label('name','Pharmacy Name') !!}

{!! Form::text('name', null, ['class' => 'form-control', 'data-parsley-required'=>'true', 'data-parsley-trigger'=>'change', 'placeholder'=>'name','required', 'maxlength'=>"100"]) !!}

{!! Form::label('address','Pharmacy Address') !!}

{!! Form::text('address', null, ['class' => 'form-control', 'data-parsley-required'=>'true', 'data-parsley-trigger'=>'change', 'placeholder'=>'Address','required', 'maxlength'=>"100"]) !!}

{!! Form::label('license_no','Pharmacy Valid License No') !!}

{!! Form::text('license_no', null, ['class' => 'form-control', 'data-parsley-required'=>'true', 'data-parsley-trigger'=>'change', 'placeholder'=>'Enter License No..','required', 'maxlength'=>"100"]) !!}

{!! Form::label('distribution_id', 'Distributor Name') !!}

{!! Form::select('distribution_id',$distribution,null , ['class' => 'form-control', 'data-parsley-required' => 'true', 'data-parsley-trigger' => 'change', 'placeholder' => 'Select Distributor Name', 'required', 'maxlength' => '100']) !!}

{!! Form::label('employee_code','Employee Code') !!}

{!! Form::number('employee_code', null, ['class' => 'form-control', 'data-parsley-required'=>'true', 'data-parsley-trigger'=>'change', 'placeholder'=>'Enter Employee Code','required', 'maxlength'=>"25"]) !!}

{!! Form::label('username','Pharmacy Owner Name') !!}

{!! Form::text('user_name',$pharmacy->user->name ?? '' , ['class' => 'form-control', 'data-parsley-required'=>'true', 'data-parsley-trigger'=>'change', 'placeholder'=>'Enter User Name','required', 'maxlength'=>"100"]) !!}

{!! Form::label('email','Email (If Available)') !!}

{!! Form::email('email', $pharmacy->user->email ?? '', ['class' => 'form-control', 'data-parsley-required'=>'true', 'data-parsley-trigger'=>'change', 'placeholder'=>'Enter Email', 'maxlength'=>"100"]) !!}

{!! Form::label('ptcl_no','Valid PTCL') !!}

{!! Form::number('ptcl_no', null, ['class' => 'form-control', 'data-parsley-required'=>'true', 'data-parsley-trigger'=>'change', 'placeholder'=>'Enter Phone No..', 'maxlength'=>"100"]) !!}

{!! Form::label('mobileno','Valid Mobile No') !!}

{!! Form::number('mobileno',$pharmacy->user->mobileno ?? '', ['class' => 'form-control', 'data-parsley-required'=>'true', 'data-parsley-trigger'=>'change', 'placeholder'=>'Enter Mobile No..','required','min'=>'10', 'maxlength'=>"25"]) !!}

{!! Form::label('cnic_no',' Valid CNIC No') !!}

{!! Form::text('cnic_no', $pharmacy->user->cnic_no ?? '', ['class' => 'form-control', 'data-parsley-required'=>'true', 'data-parsley-trigger'=>'change', 'placeholder'=>'Enter CNIC No..', 'maxlength'=>"100"]) !!}

{!! Form::label('userpassword','Pharmacy Password') !!}

{!! Form::password('password',['class' => 'form-control', 'data-parsley-required'=>'true', 'data-parsley-trigger'=>'change', 'placeholder'=>'Enter Pharmacy Password','id'=>'myInput', 'maxlength'=>"100"]) !!}

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