{{ Form::model($record, array('url' => ['online_student/profile/edit/personal', $userRecord->slug], 'method'=>'patch')) }}

{{getPhrase('personal_details')}}

{{ Form::label('first_name', getphrase('first_name')) }} * {{ Form::text('first_name', $value = null , $attributes = array('class'=>'form-control', 'placeholder' => 'Jack')) }}
{{ Form::label('middle_name', getphrase('middle_name')) }} {{ Form::text('middle_name', $value = null , $attributes = array('class'=>'form-control', 'placeholder' => 'Jarvis')) }}
{{ Form::label('last_name', getphrase('last_name')) }} {{ Form::text('last_name', $value = null , $attributes = array('class'=>'form-control', 'placeholder' => 'Magi')) }}
@if($birth_date=='')
{{ Form::label('date_of_birth', getphrase('date_of_birth')) }} *
{{ Form::text('date_of_birth', $value = date('Y/m/d') , $attributes = array('class'=>'form-control', 'placeholder' => '2015/7/17', 'id'=>'dp')) }}
@else
{{ Form::label('date_of_birth', getphrase('date_of_birth')) }} *
{{ Form::text('date_of_birth', $value = $birth_date , $attributes = array('class'=>'form-control', 'placeholder' => '2015/7/17', 'id'=>'dp')) }}
@endif
{{ Form::label('gender', getphrase('gender')) }}
{{ Form::radio('gender', 'male', true, array('id'=>'free')) }}
{{ Form::radio('gender', 'female', true, array('id'=>'paid')) }}
{{ Form::label('blood_group', getphrase('blood_group')) }} {{Form::select('blood_group', getBloodGroups(), null, ['placeholder' => getPhrase('select'),'class'=>'form-control'])}}
{{ Form::label('fathers_name', getphrase('fathers_name')) }} * {{ Form::text('fathers_name', $value = null , $attributes = array('class'=>'form-control', 'placeholder' => 'Jim')) }}
{{ Form::label('mothers_name', getphrase('mothers_name')) }} * {{ Form::text('mothers_name', $value = null , $attributes = array('class'=>'form-control', 'placeholder' => 'Arlo')) }}
{{ Form::label('nationality', getphrase('nationality')) }} {{Form::select('nationality', $countries, null, ['placeholder' => getPhrase('select'),'class'=>'form-control select1'])}}
{{ Form::label('mother_tongue', getphrase('mother_tongue')) }} {{ Form::text('mother_tongue', $value = null , $attributes = array('class'=>'form-control', 'placeholder' => 'English')) }}
{{ Form::label('religion_id', getphrase('religion')) }} * {{Form::select('religion_id', $religions, null, ['placeholder' => getPhrase('select'),'class'=>'form-control select1'])}}
{{ Form::label('category_id', getphrase('category')) }} * {{Form::select('category_id', $categories, null, ['placeholder' => getPhrase('select'),'class'=>'form-control select1'])}}