{{Form::open(['route' => ['guardar_farmacia'], 'method' => 'POST'])}}
    <div class="modal-dialog">
        <div class="modal-content">
            <div class="modal-header">
                <h5 class="modal-title" id="exampleModalLabel">Agregar Farmacia</h5>
                <button type="button" class="btn-close" data-bs-dismiss="modal" aria-label="Close"></button>
            </div>
           
            <div class="modal-body">
                <div class="row">
                    <div class="col-12">
                        <div class="form-group mb-3">
                            <label for="CardCode">Codigo</label>
                            <input type="text" value="" class="form-control" id="CardCode" required name="CardCode" placeholder="Codigo">
                        </div>
                    </div>
                    <div class="col-12">
                        <div class="form-group mb-3">
                            <label for="CardName">Nombre</label>
                            <input type="text" value="" class="form-control" id="CardName" required name="CardName" placeholder="Nombre">
                        </div>
                    </div>
                    <div class="col-12">
                        <div class="form-group mb-3">
                            <label for="FederalTaxID">RNC</label>
                            <input type="text" value="" class="form-control" id="FederalTaxID" required name="FederalTaxID" placeholder="RNC">
                        </div>
                    </div>
                    <div class="col-12">
                        <div class="form-group mb-3">
                            <label for="Phone1">Telefono</label>
                            <input type="text" value="" class="form-control" id="Phone1" required name="Phone1" placeholder="Telefono">
                        </div>
                    </div>
                    <div class="col-12">
                        <div class="form-group mb-3">
                            <label for="Phone2">Telefono 2</label>
                            <input type="text" value="" class="form-control" id="Phone2" required name="Phone2" placeholder="Telefono 2">
                        </div>
                    </div>

                    <div class="col-12">
                        <div class="form-group mb-3">
                            <label for="Address">Dirección</label>
                            <textarea name="Address" id="Address" style="resize: none" rows="3" class="form-control"></textarea>
                        </div>
                    </div>


                   
                </div>
            </div>
            <div class="modal-footer">
          
                <button type="submit" class="btn btn-primary"  style="background-color:#07CDAE; border:none;">Actualizar</button>

            </div>

        </div>
    </div>
{{Form::close()}}