@extends('master')

@section('title')
     Bank Code Report
@stop

@section('styles')
<style>

</style>
@stop

@section('content')

<img style="max-width: 30%;display: block; margin-top: -3rem; margin-left: auto; margin-right: auto;" src="/img/Prestige_Logo.jpg" />
<a  href="/bank-code-options"><button style="    margin-left: 32rem;
                                         padding-bottom: 0.01rem;
                                         margin-top: 2rem;
                                         padding-left: 0rem;
                                         padding-right: 3rem;
                                         background-color: #093c68;
                                         padding-top: 1rem;"><i style="font-size: 1rem;" class="fa fa-arrow-circle-left" aria-hidden="true"></i>Back</button></a>

<h1>Request Commercial/Business Bank Code Report</h1>

{{ Form::open() }}
<div class="row">
    <div class="large-6 columns">
        <label>Account Holder</label>
        {{ Form::text('accountHolder') }}
    </div>
    <div class="large-6 columns">
        <label>Registration or ID Number</label>
        {{ Form::text('idNumber') }}
    </div>
</div>

<div class="row">
    <div class="large-6 columns">
        <label>Bank Name</label>
        {{ Form::text('bank') }}
    </div>
    <div class="large-6 columns">
        <label>Bank Country</label>
        {{ Form::text('country') }}
    </div>
</div>

<div class="row">
    <div class="large-6 columns">
        <label>Branch Code</label>
        {{ Form::text('branch') }}
    </div>
    <div class="large-6 columns">
         <label>Branch Name</label>
         {{ Form::text('branchName') }}
    </div>
</div>

<div class="row">
    <div class="large-6 columns">
        <label>Account Type</label>
        {{ Form::text('accountType') }}
    </div>
    <div class="large-6 columns">
        <label>Amount</label>
        {{ Form::text('amount') }}
    </div>
</div>

<div class="row">
    <div class="large-6 columns">
        <label>Terms</label>
        {{ Form::text('terms') }}
    </div>
    <div class="large-6 columns">
         <label>Account Number</label>
         {{ Form::text('accountNumber') }}
    </div>
</div>

<button class="myButton" type="submit">Submit</button>

{{ Form::close() }}

@stop