@extends('layouts.listings')

@section('content')

<div class="row">
    <div class="col-md-8 col-md-offset-2">
        <div class="panel panel-default">
            <div class="panel-heading">
                <h3 class="panel-title">Register your pharmacy</h3>
            </div>
            <div class="panel-body">
                <!--<form action="{{ route('doPharmacyRegistration') }}" method="post">-->
                <!--    {{ csrf_field() }}-->
                <!--    <div class="form-group">-->
                <!--        <label>Personal Name</label>-->
                <!--        <input type="text" name="personal_name" value="{{ old('personal_name') }}" class="form-control" required>-->
                <!--    </div>-->
                <!--    <div class="form-group">-->
                <!--        <label>Contact Email</label>-->
                <!--        <input type="email" name="email" value="{{ old('email') }}" class="form-control" required>-->
                <!--    </div>-->
                <!--    <div class="form-group">-->
                <!--        <label>Pharmacy Name</label>-->
                <!--        <input type="text" name="pharmacy_name" value="{{ old('pharmacy_name') }}" class="form-control" required>-->
                <!--    </div>-->
                <!--    <div class="form-group">-->
                <!--        <label>Phone Number</label>-->
                <!--        <input type="tel" name="phone" value="{{ old('phone') }}" class="form-control" required>-->
                <!--    </div>-->
                <!--    <div class="form-group">-->
                <!--        <button type="submit" class="btn btn-primary">Submit</button>-->
                <!--    </div>-->
                <!--</form>-->
                
                <iframe src="https://docs.google.com/forms/d/e/1FAIpQLSfsJ6-q0JddT3JtZ-xxFxeATycs4f1wbV21Vag5ZpbxJlvMjg/viewform?embedded=true" width="750" height="1188" frameborder="0" marginheight="0" marginwidth="0">Loading…</iframe>
            </div>
        </div>
    </div>
</div>

@endsection