@include('dataentry.header')

  <!-- Content Wrapper. Contains page content -->
  <div class="content-wrapper">
    <!-- Content Header (Page header) -->
    <div class="content-header">
      <div class="container-fluid">
        <div class="row mb-2">
          <div class="col-sm-6">
            <h1 class="m-0">{{ ucfirst($page_title) }}</h1>
          </div><!-- /.col -->
          <div class="col-sm-6">
            <ol class="breadcrumb float-sm-right">
              <li class="breadcrumb-item"><a href="#">Home</a></li>
              <li class="breadcrumb-item active">{{ ucfirst($page_title) }}</li>
            </ol>
          </div><!-- /.col -->
        </div><!-- /.row -->
      </div><!-- /.container-fluid -->
    </div>
    <!-- /.content-header -->

    <!-- Main content -->
    <section class="content">
      <div class="container-fluid">
        <!-- Small boxes (Stat box) -->
        <div class="row">
            <div class="col-md-12">
            <div class="card">
                  <div class="card-body">
                    <form action="/dataentry/company/search-results" method="post">
                        @csrf
                        <div class="row">
                            <div class="col-md-8">
                                <div class="form-group">
                                    <label for="">Company Name</label>
                                    <input type="text" class="form-control" id="company_name" name="company_name">
                                </div>
                            </div>
                            <div class="col-md-4">
                                <div class="form-group">
                                    <label for="">Phone Number</label>
                                    <input type="text" class="form-control" id="phone" name="phone">
                                </div>
                            </div>
                            <div class="col-md-4">
                                <div class="form-group">
                                    <label for="">Email</label>
                                    <input type="text" class="form-control" id="email" name="email">
                                </div>
                            </div>
                            <div class="col-md-4">
                                <div class="form-group">
                                    <label for="">City</label>
                                    <input type="text" class="form-control" id="city" name="city">
                                </div>
                            </div>
                            <div class="col-md-4">
                                <div class="form-group">
                                    <label for="states">Select your state:</label>
                                    <select id="state" name="state" class="form-control">
                                        <option value="">- Select -</option>
                                        <option value="andhra pradesh">Andhra Pradesh</option>
                                        <option value="arunachal pradesh">Arunachal Pradesh</option>
                                        <option value="assam">Assam</option>
                                        <option value="bihar">Bihar</option>
                                        <option value="chhattisgarh">Chhattisgarh</option>
                                        <option value="goa">Goa</option>
                                        <option value="gujarat">Gujarat</option>
                                        <option value="haryana">Haryana</option>
                                        <option value="himachal pradesh">Himachal Pradesh</option>
                                        <option value="jharkhand">Jharkhand</option>
                                        <option value="karnataka">Karnataka</option>
                                        <option value="kerala">Kerala</option>
                                        <option value="madhya pradesh">Madhya Pradesh</option>
                                        <option value="maharashtra">Maharashtra</option>
                                        <option value="manipur">Manipur</option>
                                        <option value="meghalaya">Meghalaya</option>
                                        <option value="mizoram">Mizoram</option>
                                        <option value="nagaland">Nagaland</option>
                                        <option value="odisha">Odisha</option>
                                        <option value="punjab">Punjab</option>
                                        <option value="rajasthan">Rajasthan</option>
                                        <option value="sikkim">Sikkim</option>
                                        <option value="tamil nadu">Tamil Nadu</option>
                                        <option value="telangana">Telangana</option>
                                        <option value="tripura">Tripura</option>
                                        <option value="uttar pradesh">Uttar Pradesh</option>
                                        <option value="uttarakhand">Uttarakhand</option>
                                        <option value="west bengal">West Bengal</option>
                                        <option value="delhi">Delhi</option>
                                    </select>
                                </div>
                            </div>
                        </div>
                        <div class="row">
                            <div class="col-md-12 text-center">
                                <div class="form-group">
                                    <button class="btn btn-primary">Search</button>
                                </div>
                            </div>
                        </div>
                    </form>
                  </div>
              </div>
            </div>
        <!-- /.row -->

        <!-- /.row (main row) -->
      </div><!-- /.container-fluid -->
    </section>
    <!-- /.content -->
  </div>
  <!-- /.content-wrapper -->

  @include('dataentry.footer')