<?php $__env->startSection('panel'); ?>
    <div class="row justify-content-center">
        <div class="col-lg-6 mb-30">
            <div class="card">
                <div class="card-body">
                    <h5 class="card-title mb-4 border-bottom pb-2"><?php echo app('translator')->get('Complete Profile'); ?></h5>
                    <form action="<?php echo e(route('user.data.submit')); ?>" method="POST" class="disableSubmission">
                        <?php echo csrf_field(); ?>
                        <div class="row">
                            <div class="col-12">
                                <div class="form-group ">
                                    <label><?php echo app('translator')->get('Address'); ?></label>
                                    <input class="form-control" type="text" name="address" value="<?php echo e(old('address')); ?>"
                                        required>
                                </div>
                                <div class="form-group">
                                    <label><?php echo app('translator')->get('State'); ?></label>
                                    <input class="form-control" type="text" name="state" value="<?php echo e(old('state')); ?>"
                                        required>
                                </div>
                                <div class="form-group">
                                    <label><?php echo app('translator')->get('Zip Code'); ?></label>
                                    <input class="form-control" type="text" name="zip" value="<?php echo e(old('zip')); ?>"
                                        required>
                                </div>
                                <div class="form-group">
                                    <label><?php echo app('translator')->get('City'); ?></label>
                                    <input class="form-control" type="text" name="city" value="<?php echo e(old('city')); ?>"
                                        required>
                                </div>
                            </div>
                        </div>
                        <button type="submit" class="btn btn--primary h-45 w-100"><?php echo app('translator')->get('Submit'); ?></button>
                    </form>
                </div>
            </div>
        </div>
    </div>
<?php $__env->stopSection(); ?>

<?php echo $__env->make('staff.layouts.app', \Illuminate\Support\Arr::except(get_defined_vars(), ['__data', '__path']))->render(); ?><?php /**PATH /home/bdedition/public_html/core/resources/views/staff/user_data.blade.php ENDPATH**/ ?>