{!! Form::open(array('url'=>'claimcomment/savepublic', 'class'=>'form-vertical','files' => true , 'parsley-validate'=>'','novalidate'=>' ')) !!}

	@if(Session::has('messagetext'))
	  
		   {!! Session::get('messagetext') !!}
	   
	@endif
	<ul class="parsley-error-list">
		@foreach($errors->all() as $error)
			<li>{{ $error }}</li>
		@endforeach
	</ul>		


<div class="sbox1"><div class="col-md-6">
						<fieldset class="sbox" style="border-top:0; border-radius: 5px;"><legend> Claim Comment</legend>
				<?php if( !isset($row['id']))  $row['id'] = null;   ?>
		<input  type='hidden' name='id' id='id' value='{{$row['id']}}' />
									
									  <div class="form-group  depen-  wrap-claim_id  " >
										<label for="ipt" class=" control-label "> Claim Id    </label>
										
										
										  <?php if( !isset($row['claim_id']))  $row['claim_id'] = null;   ?>
		<input  type='number' name='claim_id' id='claim_id' value='{{ $row['claim_id'] }}' 
						       class='form-control is_number'  /> 						
									  </div> 					
									  <div class="form-group  depen-  wrap-comment  " >
										<label for="ipt" class=" control-label "> Comment    </label>
										
										
										  <?php if( !isset($row['comment']))  $row['comment'] = null;   ?>
		<textarea name='comment' rows='5' id='comment' class='form-control input-sm '  
				             >{{ $row['comment'] }}</textarea> 						
									  </div></fieldset>
			</div>
			
			<div class="col-md-6">
						<fieldset class="sbox" style="border-top:0; border-radius: 5px;"><legend> Additional Details</legend>
									
									  <div class="form-group  depen-  wrap-commented_by  " >
										<label for="ipt" class=" control-label "> Commented By    </label>
										
										
										  <?php if( strlen($row['commented_by']) < 1 )  $row['commented_by']  = 'admin'; 	  ?>
		
					<?php $commented_by = explode(',',$row['commented_by']);
					$commented_by_opt = array( 'admin' => 'Admin' ,  'user' => 'User' , ); ?>
					<select name='commented_by' rows='5'   placeholder='Select Commented By' data-placeholder='Select Commented By'    class='select2'  > 
						<?php 
						foreach($commented_by_opt as $key=>$val)
						{
							echo "<option  value ='$key' ".($row['commented_by'] == $key ? " selected='selected' " : '' ).">$val</option>"; 						
						}						
						?></select> 						
									  </div> 					
									  <div class="form-group  depen-  wrap-created_at  " >
										<label for="ipt" class=" control-label "> Created At    </label>
										
										
										  <?php if( strlen($row['created_at']) < 1 ) $row['created_at']  = date('Y-m-d H:i:s'); ?>
		
				<div class="input-group m-b" style="width:150px !important;">
				
				<input  type='text' name='created_at' id='created_at' value='{{ $row['created_at'] }}' 
				       class='form-control input-sm @if(trim('  ')!='readonly') datetime @endif ' />

					<span class="input-group-addon calwrap"><i class="fa fa-calendar"></i></span>
				</div>
				 						
									  </div> </fieldset>
			</div>
			
			
		</div>
		
		

			<div style="clear:both"></div>	
				
					
				  <div class="form-group">
					<label class="col-sm-4 text-right">&nbsp;</label>
					<div class="col-sm-8">	
					<button type="submit" name="apply" class="btn btn-info btn-sm" ><i class="fa  fa-check-circle"></i> {{ Lang::get('core.sb_apply') }}</button>
					<button type="submit" name="submit" class="btn btn-primary btn-sm" ><i class="fa  fa-save "></i> {{ Lang::get('core.sb_save') }}</button>
				  </div>	  
			
		</div> 
		 <input type="hidden" name="action_task" value="public" />
		 {!! Form::close() !!}
		 
   <script type="text/javascript">
	$(document).ready(function() { 
		
		 

		$('.removeCurrentFiles').on('click',function(){
			var removeUrl = $(this).attr('href');
			$.get(removeUrl,function(response){});
			$(this).parent('div').empty();	
			return false;
		});		
		
	});
	</script>