<form action="<?php echo e(route('parents.store')); ?>" class="ajax-submit" enctype="multipart/form-data" method="post" accept-charset="utf-8">
	<?php echo csrf_field(); ?>
	<div class="col-sm-12">
		<div class="form-group">
			<label class="control-label"><?php echo e(_lang('Parent Name')); ?></label>
			<input type="text" class="form-control" name="parent_name" value="<?php echo e(old('parent_name')); ?>" required>
		</div>
	</div>
	<div class="col-md-12">
		<div class="form-group">
			<label control-label"><?php echo e(_lang("Father's Name")); ?></label>
			<input type="text" class="form-control" name="f_name" value="<?php echo e(old('f_name')); ?>" required>
		</div>
	</div>
	<div class="col-md-12">
		<div class="form-group">
			<label class="control-label"><?php echo e(_lang("Mother's Name")); ?></label>
			<input type="text" class="form-control" name="m_name" value="<?php echo e(old('m_name')); ?>" required>
		</div>
	</div>
	<div class="col-md-12">
		<div class="form-group">
			<label class="control-label"><?php echo e(_lang("Father's Profession")); ?></label>
			<input type="text" class="form-control" name="f_profession" value="<?php echo e(old('f_profession')); ?>">
		</div>
	</div>
	<div class="col-md-12">
		<div class="form-group">
			<label class="control-label"><?php echo e(_lang("CNIC")); ?></label>			
			<input type="text" class="form-control" name="m_profession" value="<?php echo e(old('m_profession')); ?>">
		</div>
	</div>
	<div class="col-md-12">
		<div class="form-group">
			<label class="control-label"><?php echo e(_lang('Phone')); ?></label>			
			<input type="text" class="form-control" name="phone" value="<?php echo e(old('phone')); ?>">
		</div>
	</div>
	<div class="col-md-12">
		<div class="form-group">
			<label class="control-label"><?php echo e(_lang('Address')); ?></label>		
			<textarea class="form-control" name="address"><?php echo e(old('address')); ?></textarea>
		</div>
	</div>
	
	
	<div class="col-md-12">
		<div class="form-group">
			<label class="control-label"><?php echo e(_lang('Email')); ?></label>
			<input type="email" class="form-control" name="email" value="<?php echo e(old('email')); ?>" required>
		</div>
	</div>
	<div class="col-md-12">
		<div class="form-group">
			<label class="control-label"><?php echo e(_lang('Password')); ?></label>
			<input type="password" class="form-control" name="password" required>
		</div>
	</div>
	<div class="col-md-12">
		<div class="form-group">
			<label class="control-label"><?php echo e(_lang('Confirm Password')); ?></label>
			<input type="password" class="form-control" name="password_confirmation" required>
		</div>
	</div>
	
	<div class="col-md-12">
		<div class="form-group">
			<label class="control-label"><?php echo e(_lang('Profile Picture')); ?></label>
			<input type="file" class="form-control dropify" name="image" data-allowed-file-extensions="png jpg jpeg PNG JPG JPEG">
		</div>
	</div>

	<div class="form-group">
		<div class="col-sm-12">
			<button type="submit" class="btn btn-info btn-block">Save Parent</button>
		</div>
	</div>
</form>
	   <?php /**PATH D:\Projects\hms_fatima\hms_fatima\resources\views/backend/parents/modal/create.blade.php ENDPATH**/ ?>