@extends('layouts.default') @section('content')
Two Wheeler Insurance Form
@csrf
Insurance Co. Details
Insurance Company Name
Select an Option
Plan Name
Select an Option
Sub Plan Name
Select an Option
Personal Details
Name
DOB
Gender
Select an Option
personal_gender=='male' ? 'selected': ''}}>Male
personal_gender=='female' ? 'selected': ''}}>Female
personal_gender=='others' ? 'selected': ''}}>Others
Aadhaar No
Is Pan Card available ?
Select an Option
pancard_available=='Yes' ? 'selected': ''}}>Yes
pancard_available=='No' ? 'selected': ''}}>No
PAN NO
Email
Mobile No
Alternate Mobile No
Permanent Address
Same as Permanent Address
Communication Address
Vehicle Details
Make / Model
Engine No
Chassis No
CC / HP
Vehicle No / Registration No
RTO Location
Year of Manufacture
Team Details
TEAM DETAILS
team_detail_type=='employee' ? 'selected' : ''}}>Employee
team_detail_type=='partner' ? 'selected' : ''}}>Partner
Caller
Select an Option
@foreach ($caller_list as $data)
employee_code == $twowheeler->caller_code) selected @endif>{{ $data->firstname }} {{ $data->lastname }}-{{$data->employee_code }}
@endforeach
Team Leader
Assistant Manager
Manager
Center Head
Regional Head / AVP
Zonal Head
Vice President
SM / RM
Select an Option
@foreach ($leads->ResponseObject as $data)
employee_code == $twowheeler->sm_code) selected @endif> {{ $data->firstname }} {{ $data->lastname}}-{{$data->employee_code }}
@endforeach
Branch - Center Location Name
Select an Option
@foreach ($branchlist->ResponseObject as $branch)
branch_id == $twowheeler->team_location_code) selected @endif> {{ $branch->branch_name }}
@endforeach
Partner Details
Choose an option
Manager Details
Relationship Manager
Choose an option
Payout Cycle
Location
Attachments
Add Attchment
@if($checkattachfile == 0 || $checkattachfile == "0")
Document Type
Select an Option
Pan
Aadhaar Front Side
Aadhaar Back Side
Recent Photo
File
Remarks
@endif @foreach($policy_attachmentss as $key => $attchment)
Document Type
Select an Option
Pan
Aadhaar Front Side
Aadhaar Back Side
Recent Photo
File
@if($attchment['file_attach_type'] == "image")
x
@else
x
@endif
Remarks
{{$attchment['attachments_remarks']}}
@endforeach
Remarks
Add Remarks
@if($remarks =='')
Remarks
Remarks Filled by
@endif @foreach($remarks as $remark)
Remarks
{{$remark['remarks']}}
Remarks Filled by
@endforeach
Submit
@stop