@extends('layouts.backend')

@section('content')
    <div class="right_col" role="main">
        <div class="">
            <div class="page-title">
                <div class="title_left">
                    <h3>Plain Page</h3>
                </div>

                <div class="title_right">
                    <div class="col-md-5 col-sm-5 col-xs-12 form-group pull-right top_search">
                        <div class="input-group">
                            <input type="text" class="form-control" placeholder="Search for...">
                    <span class="input-group-btn">
                      <button class="btn btn-default" type="button">Go!</button>
                    </span>
                        </div>
                    </div>
                </div>
            </div>

            <div class="clearfix"></div>

            <div class="row">
                <div class="col-md-12 col-sm-12 col-xs-12">
                    @include('parts.message')
                    <div class="x_panel">
                        <div class="x_title">
                            <h2>Plain Page</h2>
                            <ul class="nav navbar-right panel_toolbox">
                                <li><a class="collapse-link"><i class="fa fa-chevron-up"></i></a>
                                </li>
                                <li class="dropdown">
                                    <a href="#" class="dropdown-toggle" data-toggle="dropdown" role="button" aria-expanded="false"><i class="fa fa-wrench"></i></a>
                                    <ul class="dropdown-menu" role="menu">
                                        <li><a href="#">Settings 1</a>
                                        </li>
                                        <li><a href="#">Settings 2</a>
                                        </li>
                                    </ul>
                                </li>
                                <li><a class="close-link"><i class="fa fa-close"></i></a>
                                </li>
                            </ul>
                            <div class="clearfix"></div>
                        </div>
                        <div class="x_content">
                            <br>
                            <form id="demo-form2" data-parsley-validate class="form-horizontal form-label-left">

                                <div class="form-group">
                                    <label class="control-label col-md-3 col-sm-3 col-xs-12" for="first-name">First Name <span class="required">*</span>
                                    </label>
                                    <div class="col-md-6 col-sm-6 col-xs-12">
                                        <input type="text" id="first-name" required="required" class="form-control col-md-7 col-xs-12">
                                    </div>
                                </div>
                                <div class="form-group">
                                    <label class="control-label col-md-3 col-sm-3 col-xs-12" for="last-name">Last Name <span class="required">*</span>
                                    </label>
                                    <div class="col-md-6 col-sm-6 col-xs-12">
                                        <input type="text" id="last-name" name="last-name" required="required" class="form-control col-md-7 col-xs-12">
                                    </div>
                                </div>
                                <div class="form-group">
                                    <label for="middle-name" class="control-label col-md-3 col-sm-3 col-xs-12">Middle Name / Initial</label>
                                    <div class="col-md-6 col-sm-6 col-xs-12">
                                        <input id="middle-name" class="form-control col-md-7 col-xs-12" type="text" name="middle-name">
                                    </div>
                                </div>
                                <div class="form-group">
                                    <label class="control-label col-md-3 col-sm-3 col-xs-12">Gender</label>
                                    <div class="col-md-6 col-sm-6 col-xs-12">
                                        <div id="gender" class="btn-group" data-toggle="buttons">
                                            <label class="btn btn-default" data-toggle-class="btn-primary" data-toggle-passive-class="btn-default">
                                                <input type="radio" name="gender" value="male"> &nbsp; Male &nbsp;
                                            </label>
                                            <label class="btn btn-primary" data-toggle-class="btn-primary" data-toggle-passive-class="btn-default">
                                                <input type="radio" name="gender" value="female"> Female
                                            </label>
                                        </div>
                                    </div>
                                </div>
                                <div class="form-group">
                                    <label class="control-label col-md-3 col-sm-3 col-xs-12">Date Of Birth <span class="required">*</span>
                                    </label>
                                    <div class="col-md-6 col-sm-6 col-xs-12">
                                        <input id="birthday" class="date-picker form-control col-md-7 col-xs-12" required="required" type="text">
                                    </div>
                                </div>
                                <div class="ln_solid"></div>
                                <div class="form-group">
                                    <div class="col-md-6 col-sm-6 col-xs-12 col-md-offset-3">
                                        <button type="submit" class="btn btn-primary">Cancel</button>
                                        <button type="submit" class="btn btn-success">Submit</button>
                                    </div>
                                </div>

                            </form>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
@endsection