First Name {!! Form::text('customer_first_name', null, ['class' => 'form-control']) !!} {{ $errors->first('customer_first_name') }}

Last Name {!! Form::text('customer_last_name', null, ['class' => 'form-control']) !!} {{ $errors->first('customer_last_name') }}

Order Phone {!! Form::text('order_phone', null, ['class' => 'form-control']) !!} {{ $errors->first('order_phone') }}

{{ trans('global.order.fields.order_email') }} * {!! Form::email('order_email', null, ['class' => 'form-control', 'placeholder' => 'eg: foo@bar.com', 'required']) !!} {{ $errors->first('order_email') }}

Choose Township * {{ $errors->first('delivery_id') }}

{{ trans('global.order.fields.order_address') }} * {!! Form::text('order_address', null, ['class' => 'form-control', 'required']) !!} {{ $errors->first('order_address') }}

Delivery Notes {{ $errors->first('order_note') }}

{{ trans('global.order.fields.order_date') }} * {!! Form::date('order_date', null, ['class' => 'form-control', 'required']) !!} {{ $errors->first('order_date') }}

{{ trans('global.order.fields.order_status') }} * {{ $errors->first('order_status') }}

Product	Qty	Price	Discount	Amount
{!! Form::select('product_id[1]', ['' => 'Please Select']+$product, null, ['id' => 'product_id', 'class' => 'form-control product_id','required']) !!}	{!! Form::text('quantity[1]', 1, ['id' => 'quantity', 'class' => 'form-control quantity no_only text-center','min'=>1,'max'=>1] ) !!}	{!! Form::text('price[1]', null, ['id' => 'price', 'class' => 'form-control price no_only text-right', 'readonly']) !!}	{!! Form::text('discount_price[1]', 0, ['id' => 'discount_price', 'class' => 'form-control discount_price no_only text-right']) !!}	{!! Form::text('amount[1]', 0, ['id' => 'order_price', 'class' => 'form-control amount no_only text-right', 'readonly']) !!}
			Sub Total	{!! Form::text('sub_total', 0, ['id' => 'sub_total', 'class' => 'form-control sub_total text-right','readonly']) !!}
			Delivery Fee	{!! Form::text('delivery_fee', 0, ['id' => 'delivery_fee', 'class' => 'form-control delivery_fee text-right','readonly']) !!}
			Tax	{!! Form::text('tax', 0, ['id' => 'tax', 'class' => 'form-control tax text-right','readonly']) !!}
			Grand Total	{!! Form::text('grand_total', 0.00, ['id' => 'grand_total', 'class' => 'form-control grand_total text-right','readonly']) !!}