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Server:

LiteSpeed

System:

Linux 5.14.0-611.24.1.el9_7.x86_64

PHP Version:

8.2.30

User:

u784288082

Directory:

/home/u784288082/domains/digitechhealthcare.com/public_html/ila/storage/framework/views

Free Space:

9.05 TB

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✏️ Editing: 747cc99e0be222134194b3d3f5a7e02e.php

<form wire:submit="save">
    <div class="row">
        <div class="col-lg-12 mb-20">
            <div class="form-inner">
                <label>Name*</label>
                <input type="text" wire:model="name" placeholder="Your Name...">
                <?php if(\Livewire\Mechanisms\ExtendBlade\ExtendBlade::isRenderingLivewireComponent()): ?><?php endif; ?><?php $__errorArgs = ['name'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?> <span class="form-text"><?php echo e($message); ?></span> <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?><?php if(\Livewire\Mechanisms\ExtendBlade\ExtendBlade::isRenderingLivewireComponent()): ?><?php endif; ?>
            </div>
        </div>
        <div class="col-lg-6 mb-20">
            <div class="form-inner">
                <label>Phone</label>
                <input type="text" wire:model="phone" placeholder="Phone Number...">
                <?php if(\Livewire\Mechanisms\ExtendBlade\ExtendBlade::isRenderingLivewireComponent()): ?><?php endif; ?><?php $__errorArgs = ['phone'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?> <span class="form-text"><?php echo e($message); ?></span> <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?><?php if(\Livewire\Mechanisms\ExtendBlade\ExtendBlade::isRenderingLivewireComponent()): ?><?php endif; ?>
            </div>
        </div>
        <div class="col-lg-6 mb-20">
            <div class="form-inner">
                <label>Email</label>
                <input type="email" wire:model="email" placeholder="Email Us....">
                <?php if(\Livewire\Mechanisms\ExtendBlade\ExtendBlade::isRenderingLivewireComponent()): ?><?php endif; ?><?php $__errorArgs = ['email'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?> <span class="form-text"><?php echo e($message); ?></span> <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?><?php if(\Livewire\Mechanisms\ExtendBlade\ExtendBlade::isRenderingLivewireComponent()): ?><?php endif; ?>
            </div>
        </div>
        <div class="col-lg-12 mb-20 ">
            <div class="form-inner">
                <label>Services</label>
                <select wire:model="services" class="bg-white">
                    <option value="" selected disabled>Select an option...</option>
                    
                    <?php if(\Livewire\Mechanisms\ExtendBlade\ExtendBlade::isRenderingLivewireComponent()): ?><?php endif; ?><?php $__currentLoopData = \App\Models\Service::all(); $__env->addLoop($__currentLoopData); foreach($__currentLoopData as $service): $__env->incrementLoopIndices(); $loop = $__env->getLastLoop(); ?>
                        <option value="<?php echo e($service->title); ?>"><?php echo e($service->title); ?></option>
                        <?php endforeach; $__env->popLoop(); $loop = $__env->getLastLoop(); ?><?php if(\Livewire\Mechanisms\ExtendBlade\ExtendBlade::isRenderingLivewireComponent()): ?><?php endif; ?>
                </select>
                <?php if(\Livewire\Mechanisms\ExtendBlade\ExtendBlade::isRenderingLivewireComponent()): ?><?php endif; ?><?php $__errorArgs = ['services'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?> <span class="form-text"><?php echo e($message); ?></span> <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?><?php if(\Livewire\Mechanisms\ExtendBlade\ExtendBlade::isRenderingLivewireComponent()): ?><?php endif; ?>
            </div>
        </div>
        <div class="col-lg-12 mb-30">
            <div class="form-inner">
                <label>Write Your Massage*</label>
                <textarea wire:model="message" placeholder="What’s on your mind"></textarea>
                <?php if(\Livewire\Mechanisms\ExtendBlade\ExtendBlade::isRenderingLivewireComponent()): ?><?php endif; ?><?php $__errorArgs = ['message'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?> <span class="form-text"><?php echo e($message); ?></span> <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?><?php if(\Livewire\Mechanisms\ExtendBlade\ExtendBlade::isRenderingLivewireComponent()): ?><?php endif; ?>
            </div>
        </div>
        <div class="col-lg-12">
            <div class="form-inner">
                <button class="primary-btn1 btn-hover" type="submit">
                    Submit Now
                </button>
            </div>
        </div>
    </div>
</form><?php /**PATH /home/u784288082/domains/digitechhealthcare.com/public_html/ila/resources/views/livewire/contact-form.blade.php ENDPATH**/ ?>

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