
@section('judul')
Tambah Client
@endsection
@section('konten')
<form action="{{ url('client')}}" method="post">
{{ csrf_field() }}
<br>
<table>
	<thead>
		<tr>
			<td><th><label class="col-md-4 control-label" for="image">IMAGE</label> </th></td>
			<td>

				<div class="input-group">
				<span class="input-group-btn">
					<label class="btn btn-default btn-file">Browse&hellip;<input type="file" style="display: none;" name="image" id="browse" required/>
					</label>
				</span>

				<input type="text" class="form-control input-md" id="i" name="i" placeholder="not file selected" disabled="true">
				</div>

				</td>
		</tr>
		<tr>
			<td><th><label class="col-md-4 control-label" for="nama">NAMA</th></td>
			<td><input type="text" name="nama" class="form-control" placeholder="Masukkan nama" required/></td>
		</tr>
		<tr>
			<td><th><label class="col-md-4 control-label" for="jeniskelamin">JENIS KELAMIN</th></td>
			<td><input type= "radio" name= "jeniskelamin" value="Pria" id="jeniskelamin_0">Pria
			<input type= "radio" name= "jeniskelamin" value="Wanita" id="jeniskelamin_1">Wanita
			</td>
		</tr>
		<tr>
			<td><th><label class="col-md-4 control-label" for="tanggallahir">TANGGAL LAHIR</th></td>
			<td><input type="text" name="tanggallahir" class="form-control" placeholder="Masukkan Tanggal Lahir" required/></td>
		</tr>
		<tr>
			<td><th><label class="col-md-4 control-label" for="provinsi">PROVINSI</th></td>
			<td><input type="text" name="provinsi" class="form-control" placeholder="Masukkan Provinsi" required/></td>
		</tr>
		<tr>
			<td><th><label class="col-md-4 control-label" for="distrik">DISTRIK</th></td>
			<td><input type="text" name="distrik" class="form-control" placeholder="Masukkan Distrik" required/></td>
		</tr>
		<tr>
			<td><th><label class="col-md-4 control-label" for="sektor">SEKTOR</th></td>
			<td><input type="text" name="sektor" class="form-control" placeholder="Masukkan Sektor" required/></td>
		</tr>
	</thead>
</table>
<br>
<input type="submit" class="btn btn-success" value="Simpan">
</form>

@endsection
