{!! Form::model(new App\ComplaintModel, ['route' => ['vtiger_users.store'], 'class'=>'', 'role' => 'form', 'enctype' => 'multipart/form-data']) !!}

    <div class="mdl-card__supporting-text">
        <div class="mdl-grid full-grid padding-0">
            <div class="mdl-cell mdl-cell--12-col-phone mdl-cell--12-col-tablet mdl-cell--12-col-desktop">

                <div class="mdl-grid ">

                    <div class="mdl-cell mdl-cell--4-col-tablet mdl-cell--6-col-desktop">
                        <div class="mdl-textfield mdl-js-textfield mdl-textfield--floating-label {{ $errors->has('user') ? 'is-invalid' :'' }}">
                            {!! Form::text('user', NULL, array('id' => 'complaint-user', 'class' => 'mdl-textfield__input mdl-color-text--white')) !!}
                            {!! Form::label('user', 'User', array('class' => 'mdl-textfield__label mdl-color-text--white')); !!}
                            <span class="mdl-textfield__error">User is required</span>
                        </div>
                    </div>

                    <div class="mdl-cell mdl-cell--4-col-tablet mdl-cell--6-col-desktop">
                        <div class="mdl-textfield mdl-js-textfield mdl-textfield--floating-label {{ $errors->has('user_email') ? 'is-invalid' :'' }}">
                            {!! Form::text('user_email', NULL, array('id' => 'complaint-user_email', 'class' => 'mdl-textfield__input mdl-color-text--white')) !!}
                            {!! Form::label('user_email', 'User Email', array('class' => 'mdl-textfield__label mdl-color-text--white')); !!}
                            <span class="mdl-textfield__error">User Email is required</span>
                        </div>
                    </div>

                    <div class="mdl-cell mdl-cell--4-col-tablet mdl-cell--6-col-desktop">
                        <div class="mdl-textfield mdl-js-textfield mdl-textfield--floating-label {{ $errors->has('vtiger_url') ? 'is-invalid' :'' }}">
                            {!! Form::text('vtiger_url', NULL, array('id' => 'complaint-vtiger_url', 'class' => 'mdl-textfield__input mdl-color-text--white')) !!}
                            {!! Form::label('vtiger_url', 'Vtiger Url', array('class' => 'mdl-textfield__label mdl-color-text--white')); !!}
                            <span class="mdl-textfield__error">Vtiger Url is required</span>
                        </div>
                    </div>

                    <div class="mdl-cell mdl-cell--4-col-tablet mdl-cell--6-col-desktop">
                        <div class="mdl-textfield mdl-js-textfield mdl-textfield--floating-label {{ $errors->has('admin_username') ? 'is-invalid' :'' }}">
                            {!! Form::text('admin_username', NULL, array('id' => 'complaint-admin_username', 'class' => 'mdl-textfield__input mdl-color-text--white')) !!}
                            {!! Form::label('admin_username', 'Admin Username', array('class' => 'mdl-textfield__label mdl-color-text--white')); !!}
                            <span class="mdl-textfield__error">Admin Username is required</span>
                        </div>
                    </div>

                    <div class="mdl-cell mdl-cell--4-col-tablet mdl-cell--6-col-desktop">
                        <div class="mdl-textfield mdl-js-textfield mdl-textfield--floating-label {{ $errors->has('admin_accesskey') ? 'is-invalid' :'' }}">
                            {!! Form::text('admin_accesskey', NULL, array('id' => 'complaint-admin_accesskey', 'class' => 'mdl-textfield__input mdl-color-text--white')) !!}
                            {!! Form::label('admin_accesskey', 'Admin AccessKey', array('class' => 'mdl-textfield__label mdl-color-text--white')); !!}
                            <span class="mdl-textfield__error">Admin AccessKey is required</span>
                        </div>
                    </div>

                    <div class="mdl-cell mdl-cell--4-col-tablet mdl-cell--6-col-desktop">
                        <div class="mdl-textfield mdl-js-textfield mdl-textfield--floating-label {{ $errors->has('db_user') ? 'is-invalid' :'' }}">
                            {!! Form::text('db_user', NULL, array('id' => 'complaint-db_user', 'class' => 'mdl-textfield__input mdl-color-text--white')) !!}
                            {!! Form::label('db_user', 'Database Username', array('class' => 'mdl-textfield__label mdl-color-text--white')); !!}
                            <span class="mdl-textfield__error">Database Username is required</span>
                        </div>
                    </div>

                    <div class="mdl-cell mdl-cell--4-col-tablet mdl-cell--6-col-desktop">
                        <div class="mdl-textfield mdl-js-textfield mdl-textfield--floating-label {{ $errors->has('db_pass') ? 'is-invalid' :'' }}">
                            {!! Form::text('db_pass', NULL, array('id' => 'complaint-db_pass', 'class' => 'mdl-textfield__input mdl-color-text--white')) !!}
                            {!! Form::label('db_pass', 'Database Password', array('class' => 'mdl-textfield__label mdl-color-text--white')); !!}
                            <span class="mdl-textfield__error">Database Password is required</span>
                        </div>
                    </div>

                    <div class="mdl-cell mdl-cell--4-col-tablet mdl-cell--6-col-desktop">
                        <div class="mdl-textfield mdl-js-textfield mdl-textfield--floating-label {{ $errors->has('db_host') ? 'is-invalid' :'' }}">
                            {!! Form::text('db_host', NULL, array('id' => 'complaint-db_host', 'class' => 'mdl-textfield__input mdl-color-text--white')) !!}
                            {!! Form::label('db_host', 'Database Host', array('class' => 'mdl-textfield__label mdl-color-text--white')); !!}
                            <span class="mdl-textfield__error">Database Host is required</span>
                        </div>
                    </div>

                    <div class="mdl-cell mdl-cell--4-col-tablet mdl-cell--6-col-desktop">
                        <div class="mdl-textfield mdl-js-textfield mdl-textfield--floating-label {{ $errors->has('db_name') ? 'is-invalid' :'' }}">
                            {!! Form::text('db_name', NULL, array('id' => 'complaint-db_name', 'class' => 'mdl-textfield__input mdl-color-text--white')) !!}
                            {!! Form::label('db_name', 'Database Name', array('class' => 'mdl-textfield__label mdl-color-text--white')); !!}
                            <span class="mdl-textfield__error">Database Name is required</span>
                        </div>
                    </div>
                    
                        

                    

                </div>
            </div>

        </div>
    </div>

    <div class="mdl-card__actions padding-top-0">
        <div class="mdl-grid padding-top-0">
            <div class="mdl-cell mdl-cell--12-col padding-top-0 margin-top-0 margin-left-1-1">

                <span class="save-actions">
                    {!! Form::button('Create Vtiger User', array('class' => 'dialog-button-save mdl-button mdl-js-button mdl-js-ripple-effect mdl-color--primary mdl-color-text--white mdl-button--raised margin-bottom-1 margin-top-1 margin-top-0-desktop margin-right-1 padding-left-1 padding-right-1 ')) !!}
                </span>

            </div>
        </div>
    </div>

    <div class="mdl-card__menu mdl-color-text--white">

        <span class="save-actions">
            {!! Form::button('<i class="material-icons">save</i>', array('class' => 'dialog-button-icon-save mdl-button mdl-button--icon mdl-js-button mdl-js-ripple-effect mdl-button-colored', 'title' => 'Update Vtiger User')) !!}
        </span>

    </div>

    @include('dialogs.dialog-save')

{!! Form::close() !!}