
<?php $__env->startSection('content'); ?>

<!-- page-title -->
<div class="prt-titlebar-wrapper prt-bg about-img">
    <div class="prt-titlebar-wrapper-bg-layer prt-bg-layer"></div>
    <div class="prt-titlebar-wrapper-inner">
        <div class="container">
            <div class="row align-items-center">
                <div class="col-lg-12">
                    <div class="prt-page-title-row-heading">
                        <div class="page-title-heading">
                            <h2 class="title"><?php echo e(ucwords(str_replace('-',' ',$page_name))); ?></h2>
                        </div>
                        <div class="breadcrumb-wrapper">
                            <i class="flaticon-home"></i>
                            <span>
                                <a title="Homepage" href="/">Home</a>
                            </span>
                            <div class="prt-sep"> - </div>
                            <span><?php echo e(ucwords(str_replace('-',' ',$page_name))); ?></span>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
</div>
<!-- page-title end -->

<!-- ==================== Start Book Appointment ==================== -->
<section class="prt-row">
    <div class="container">
        <div class="row">
            <div class="col-lg-6"></div>
            <div class="col-lg-6 offset-lg-3">
                <div class="registration_forn">
                    <form action="<?php echo e(route('registration.store')); ?>" method="POST" enctype="multipart/form-data">
                        <?php echo csrf_field(); ?>
                            <?php if($message = Session::get('success')): ?>
                                <div class="alert alert-success">
                                <p><?php echo e($message); ?></p>
                                </div>
                            <?php endif; ?>

                            

                        <div class="controls">
                            <div class="row">
                                <div class="col-md-12">
                                    <div class="form-group">
                                        <input id="form_name" type="text" name="name" placeholder="Name" required>
                                    </div>
                                </div>

                                <div class="col-md-12">
                                    <div class="form-group">
                                        <input id="form_email" type="number" name="phone" placeholder="Phone Number" required>
                                    </div>
                                </div>

                                <div class="col-md-12">
                                    <div class="form-group">
                                        <input id="form_email" type="email" name="email" placeholder="Email" required>
                                    </div>
                                </div>

                                <div class="col-md-12">
                                    <div class="form-group">
                                        <input type="text" name="organisation" placeholder="Your Organisation" required>
                                    </div>
                                </div>

                                <div class="col-md-12">
                                    <div class="form-group">
                                        <input type="text" name="designation" placeholder="Designation" required>
                                    </div>
                                </div>

                               
                            </div>
                            <input type="hidden" name="page_name" value="<?php echo e($page_name); ?>">
                            <button type="submit" class="submit prt-btn prt-btn-size-md prt-btn-shape-round prt-btn-style-fill prt-btn-color-skincolor"><span>Submit</span></button>
                        </div>
                    </form>
                </div>
            </div>

        </div>
    <div class="clearfix"></div>
        <div class="row">
            <div class="col-md-12">
            </div>
        </div>
    </div>


</section>

<?php $__env->stopSection(); ?>

<?php echo $__env->make('frontend.layouts.app', \Illuminate\Support\Arr::except(get_defined_vars(), ['__data', '__path']))->render(); ?><?php /**PATH C:\xampp\htdocs\tpl-groups\resources\views/frontend/book-appointment.blade.php ENDPATH**/ ?>