Filter By
{!! Form::open(array('url' => '#','id' => 'formValidation')) !!}
{!! Form::label('First Name:') !!}
{{ Form::text('first_name', '',
array('id'=>'first_name',
'class'=>'form-control'))
}}
{!! Form::label('Last Name:') !!}
{{ Form::text('last_name', '',
array('id'=>'last_name',
'class'=>'form-control'))
}}
Date of Birth:
{{ Form::text('dob', '',
array('id'=>'dob','data-date-format'=>'dd/mm/yyyy','class'=>'form-control'))
}}
Policy number:
{{ Form::text('policy_number_full', '',
array('id'=>'policy_number_full','class'=>'form-control'))
}}
Email:
{{ Form::text('email', '',
array('id'=>'email','class'=>'form-control'))
}}
Telephone:
{{ Form::text('phone', '',
array('id'=>'phone','class'=>'form-control'))
}}
Date Added:
Application date from:
{{ Form::text('date_added_from', '',
array('id'=>'date_added_from','data-date-format'=>'dd/mm/yyyy','class'=>'form-control'))
}}
Application date to:
{{ Form::text('date_added_to', '',
array('id'=>'date_added_to','data-date-format'=>'dd/mm/yyyy','class'=>'form-control'))
}}
Insurance date from:
{{ Form::text('insurance_date_from', '',
array('id'=>'insurance_date_from','data-date-format'=>'dd/mm/yyyy','class'=>'form-control'))
}}
Insurance date to:
{{ Form::text('insurance_date_to', '',
array('id'=>'insurance_date_to','data-date-format'=>'dd/mm/yyyy','class'=>'form-control'))
}}
Select Affiliate:
{{Form::select('broker_id',$brokerArray,null,array('id' => 'broker_id','class' =>'form-control'))}}
Select Product:
{{Form::select('product_id',$prodArray,null,array('id' => 'product_id','class' =>'form-control'))}}
Lead From:
| Application Date | Insurance Start Date | Policy Number | Policy | Full Name | Cover Type | Source | Submitted By | Status | Customer Status | Payment | Bexhill LoanID | Actions |
|---|