<form action="{{url('cancelled')}}" method="POST" onsubmit="return validationCancelled()">
	{!!csrf_field()!!}
	<input type="hidden" name="lead_id" value="{{$lead_id}}">
	<fieldset>
		<div class="formtitle">
			<h1>Please select the reason</h1>
		</div>
		<div class="cancltext">
			<label for="cancel_code">Cancel Code : </label>
			<select name="cancel_code" required id="cancel_code" >
				<option value="">Select Cancel Code</option>
				@foreach($cancellation_codes as $cancellation_code)
				<option value="{{$cancellation_code->cancell_code}}">{{$cancellation_code->cancell_reason}}</option>
				@endforeach
			</select>
		</div>
		
		<div class="cancltext">
			<label for="cancel_date">Cancel Date : </label>
			<input type="date" required name="cancel_date" id="cancel_date">
		</div>
		<div class="cancltext cancltextarea">
			<label for="reason">Reason : </label><br/>
			<textarea rows="5" id="reason" name="reason"></textarea>
		</div>
	</fieldset>
	<input class="subbtn" type="submit" value="Submit"/>
</form>


