@section('optional_css')
    <!-- Select2 -->
    <link rel="stylesheet" href="{{ asset('plugins/select2/css/select2.min.css') }}">
    <link rel="stylesheet" href="{{ asset('plugins/select2-bootstrap4-theme/select2-bootstrap4.min.css') }}">
    <!-- summernote -->
    <link rel="stylesheet" href="{{ asset('plugins/summernote/summernote-bs4.min.css') }}">
    <!-- CodeMirror -->
    <link rel="stylesheet" href="{{ asset('plugins/codemirror/codemirror.css') }}">
    <link rel="stylesheet" href="{{ asset('plugins/codemirror/theme/monokai.css') }}">
@endsection
@section('optional_js')
    <!-- Select2 -->
    <script src="{{ asset('plugins/select2/js/select2.full.min.js') }}"></script>
    <!-- Summernote -->
    <script src="{{ asset('plugins/summernote/summernote-bs4.min.js') }}"></script>
    <!-- CodeMirror -->
    <script src="{{ asset('plugins/codemirror/codemirror.js') }}"></script>
    <script src="{{ asset('plugins/codemirror/mode/css/css.js') }}"></script>
    <script src="{{ asset('plugins/codemirror/mode/xml/xml.js') }}"></script>
    <script src="{{ asset('plugins/codemirror/mode/htmlmixed/htmlmixed.js') }}"></script>

    <script src="{{ asset('plugins/fileinput/fileinput.min.js') }}"></script>

    <!-- Bootstrap Switch -->
    <script src="{{ asset('plugins/bootstrap-switch/js/bootstrap-switch.min.js') }}"></script>

    <script>
        $(document).ready(function () {
            $('.select2').select2({
                theme: 'bootstrap4'
            })
        })
    </script>
@endsection
<x-app-layout>
    <x-slot name="header">
        <div class="row mb-2">
            <div class="col-sm-6">
                <h1 class="m-0">{{ __('Buat Tagihan') }}</h1>
            </div><!-- /.col -->
            <div class="col-sm-6">
            </div><!-- /.col -->
        </div><!-- /.row -->
    </x-slot>
    @if(session('success'))
        <x-alert-success>
            {{ session('success') }}
        </x-alert-success>
    @endif
    <form class="form-horizontal" action="{{ route('admin.tagihanbpjs.inquiry') }}" method="POST" enctype="multipart/form-data">
        <x-card class="col-sm-12">
            <x-slot name="title">{{ __('Create') }} {{ __('Tagihan') }}</x-slot>
            @csrf
            <div class="form-group row">
                <x-label class="col-sm-2">{{ __('Nomor Telepon') }}</x-label>
                <div class="col-sm-10">
                    <x-input id="msisdn" class="{{ $errors->has('msisdn') ? 'is-invalid' : '' }}" type="text" name="msisdn" :value="old('msisdn')"/>
                    @if ($errors->has('msisdn'))
                        <small class="error invalid-feedback">{{ $errors->first('msisdn') }}</small>
                    @endif
                </div>
            </div>
            <div class="form-group row">
                <x-label class="col-sm-2">{{ __('Customer ID') }}</x-label>
                <div class="col-sm-10">
                    <x-input id="customer_id" class="{{ $errors->has('customer_id') ? 'is-invalid' : '' }}" type="text" name="customer_id" :value="old('customer_id')"/>
                    @if ($errors->has('customer_id'))
                        <small class="error invalid-feedback">{{ $errors->first('customer_id') }}</small>
                    @endif
                </div>
            </div>
            <x-slot name="footer">
                <x-button class="float-right">{{ __('Save') }}</x-button>
            </x-slot>
        </x-card>
    </form>
</x-app-layout>