@extends('layouts.public') @section('title','Register for Assistance') @section('content')<div class="container py-5"><div class="card kw-card p-4 p-lg-5"><div class="mb-4"><h1>Register for Assistance</h1><p class="text-secondary">د مرستې لپاره نوم لیکنه / ثبت نیازمند</p></div><form method="post" action="{{ route('beneficiary.store') }}" class="row g-3">@csrf<div class="col-md-6"><label class="form-label">Full Name</label><input class="form-control" name="full_name" required></div><div class="col-md-6"><label class="form-label">Father Name</label><input class="form-control" name="father_name"></div><div class="col-md-6"><label class="form-label">Phone</label><input class="form-control" name="phone" required></div><div class="col-md-6"><label class="form-label">Tazkira No.</label><input class="form-control" name="tazkira_no"></div><div class="col-md-6"><label class="form-label">Province</label><input class="form-control" name="province"></div><div class="col-md-6"><label class="form-label">District</label><input class="form-control" name="district"></div><div class="col-md-6"><label class="form-label">Family Members</label><input class="form-control" type="number" min="1" name="family_members" value="1" required></div><div class="col-md-6"><label class="form-label">Monthly Income</label><input class="form-control" type="number" step="0.01" name="monthly_income"></div><div class="col-md-6"><label class="form-label">Need Category</label><select class="form-select" name="need_category"><option>Food</option><option>Basic Needs</option><option>Health</option><option>Education</option><option>Water</option><option>Emergency</option><option>Other</option></select></div><div class="col-12"><label class="form-label">Address</label><textarea class="form-control" name="address" rows="2"></textarea></div><div class="col-12"><label class="form-label">Describe your situation / need</label><textarea class="form-control" name="description" rows="5"></textarea></div><div><button class="btn btn-kw">Submit Registration</button></div></form></div></div>@endsection