@extends('layouts.app')
@section('title', \App\CPU\translate('Kbd Line View'))
@push('css_or_js')
    <meta name="csrf-token" content="{{ csrf_token() }}">
    <style>
        .form-group {
            margin-bottom: 25px;
            padding-right: 25px;
        }
    </style>
@endpush

@section('content')
    <div class="app-main flex-column flex-row-fluid" id="kt_app_main">
        <div id="kt_app_toolbar" class="app-toolbar py-3 py-lg-6">
            <!--begin::Toolbar container-->
            <div id="kt_app_toolbar_container" class="app-container container-xxxl d-flex flex-stack">
                <!--begin::Page title-->
                <div class="page-title d-flex flex-column justify-content-center flex-wrap me-3">
                    <!--begin::Title-->
                    <h1 class="page-heading d-flex text-dark fw-bold fs-3 flex-column justify-content-center my-0">Kbd Line
                        Full Details</h1>
                    <!--end::Title-->
                </div>
                <!--end::Page title-->
            </div>
            <!--end::Toolbar container-->
        </div>

        <!-- Content Row -->
        <div class="app-container container-xxxl d-flex flex-stack">
            <div class="col-md-12">
                <div class="card">
                    <div class="card-body">
                        <form {{-- action="{{route('admin.item.update',[$line['data']['id']])}}" --}} method="post" enctype="multipart/form-data">
                            @csrf
                            <div class="form-group">
                                <div class="row">
                                    <div class="col-4 form-group">
                                        <label for="source_CUSTOMER_ADDRESS1"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('source_CUSTOMER_ADDRESS1'))) }}</label>
                                        <input type="text" name="source_CUSTOMER_ADDRESS1"
                                            value="{{ $line['data']['source_CUSTOMER_ADDRESS1'] }}" class="form-control"
                                            id="source_CUSTOMER_ADDRESS1"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('source_CUSTOMER_ADDRESS1'))) }}">
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="source_CUSTOMER_AREA"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('source_CUSTOMER_AREA'))) }}</label>
                                        <input type="text" value="{{ $line['data']['source_CUSTOMER_AREA'] }}" required
                                            name="source_CUSTOMER_AREA" class="form-control" id="source_CUSTOMER_AREA"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('source_CUSTOMER_AREA'))) }}">
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="source_CUSTOMER_CITY"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('source_CUSTOMER_CITY'))) }}</label>
                                        <input type="text" value="{{ $line['data']['source_CUSTOMER_CITY'] }}"
                                            name="source_CUSTOMER_CITY" class="form-control" id="source_CUSTOMER_CITY"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('source_CUSTOMER_CITY'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="source_TRX_LINE_ID"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('source_TRX_LINE_ID'))) }}</label>
                                        <input type="text" value="{{ $line['data']['source_TRX_LINE_ID'] }}"
                                            name="source_TRX_LINE_ID" class="form-control" id="source_TRX_LINE_ID"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('source_TRX_LINE_ID'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="source_LINE_NO"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('source_LINE_NO'))) }}</label>
                                        <input type="text" value="{{ $line['data']['source_LINE_NO'] }}"
                                            name="source_LINE_NO" class="form-control" id="source_LINE_NO"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('source_LINE_NO'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="source_ITEM_ID"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('source_ITEM_ID'))) }}</label>
                                        <input type="text" value="{{ $line['data']['source_ITEM_ID'] }}"
                                            name="source_ITEM_ID" class="form-control" id="source_ITEM_ID"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('source_ITEM_ID'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="source_ITEM_DESCRIPTION"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('source_ITEM_DESCRIPTION'))) }}</label>
                                        <input type="text" value="{{ $line['data']['source_ITEM_DESCRIPTION'] }}"
                                            name="source_ITEM_DESCRIPTION" class="form-control" id="source_ITEM_DESCRIPTION"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('source_ITEM_DESCRIPTION'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="source_TRX_AMT"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('source_TRX_AMT'))) }}</label>
                                        <input type="text" value="{{ $line['data']['source_TRX_AMT'] }}"
                                            name="source_TRX_AMT" class="form-control" id="source_TRX_AMT"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('source_TRX_AMT'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="source_TRX_PERCENT"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('source_TRX_PERCENT'))) }}</label>
                                        <input type="text" value="{{ $line['data']['source_TRX_PERCENT'] }}"
                                            name="source_TRX_PERCENT" class="form-control" id="source_TRX_PERCENT"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('source_TRX_PERCENT'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="source_TRX_QTY"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('source_TRX_QTY'))) }}</label>
                                        <input type="text" value="{{ $line['data']['source_TRX_QTY'] }}"
                                            name="source_TRX_QTY" class="form-control" id="source_TRX_QTY"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('source_TRX_QTY'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="source_CONTRACT_NO"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('source_CONTRACT_NO'))) }}</label>
                                        <input type="text" value="{{ $line['data']['source_CONTRACT_NO'] }}"
                                            name="source_CONTRACT_NO" class="form-control" id="source_CONTRACT_NO"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('source_CONTRACT_NO'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="cust_TRX_LINE_GL_DIST_ID"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('cust_TRX_LINE_GL_DIST_ID'))) }}</label>
                                        <input type="text" value="{{ $line['data']['cust_TRX_LINE_GL_DIST_ID'] }}"
                                            name="cust_TRX_LINE_GL_DIST_ID" class="form-control"
                                            id="cust_TRX_LINE_GL_DIST_ID"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('cust_TRX_LINE_GL_DIST_ID'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="ref_SOURCE_TRX_ID"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('ref_SOURCE_TRX_ID'))) }}</label>
                                        <input type="text" value="{{ $line['data']['ref_SOURCE_TRX_ID'] }}"
                                            name="ref_SOURCE_TRX_ID" class="form-control" id="ref_SOURCE_TRX_ID"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('ref_SOURCE_TRX_ID'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="ref_SOURCE_TRX_NO"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('ref_SOURCE_TRX_NO'))) }}</label>
                                        <input type="text" value="{{ $line['data']['ref_SOURCE_TRX_NO'] }}"
                                            name="ref_SOURCE_TRX_NO" class="form-control" id="ref_SOURCE_TRX_NO"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('ref_SOURCE_TRX_NO'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="ref_SOURCE_TRX_DATE"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('ref_SOURCE_TRX_DATE'))) }}</label>
                                        <input type="text" value="{{ $line['data']['ref_SOURCE_TRX_DATE'] }}"
                                            name="ref_SOURCE_TRX_DATE" class="form-control" id="ref_SOURCE_TRX_DATE"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('ref_SOURCE_TRX_DATE'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="ref_SOURCE_TRX_AMT"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('ref_SOURCE_TRX_AMT'))) }}</label>
                                        <input type="text" value="{{ $line['data']['ref_SOURCE_TRX_AMT'] }}"
                                            name="ref_SOURCE_TRX_AMT" class="form-control" id="ref_SOURCE_TRX_AMT"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('ref_SOURCE_TRX_AMT'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="ref_SOURCE_TRX_PRICE"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('ref_SOURCE_TRX_PRICE'))) }}</label>
                                        <input type="text" value="{{ $line['data']['ref_SOURCE_TRX_PRICE'] }}"
                                            name="ref_SOURCE_TRX_PRICE" class="form-control" id="ref_SOURCE_TRX_PRICE"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('ref_SOURCE_TRX_PRICE'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="ref_SOURCE_TRX_QTY"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('ref_SOURCE_TRX_QTY'))) }}</label>
                                        <input type="text" value="{{ $line['data']['ref_SOURCE_TRX_QTY'] }}"
                                            name="ref_SOURCE_TRX_QTY" class="form-control" id="ref_SOURCE_TRX_QTY"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('ref_SOURCE_TRX_QTY'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="item_COST"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('item_COST'))) }}</label>
                                        <input type="text" value="{{ $line['data']['item_COST'] }}" name="item_COST"
                                            class="form-control" id="item_COST"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('item_COST'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="item_MARKUP"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('item_MARKUP'))) }}</label>
                                        <input type="text" value="{{ $line['data']['item_MARKUP'] }}"
                                            name="item_MARKUP" class="form-control" id="item_MARKUP"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('item_MARKUP'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="cif_DISCOUNT_AMT"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('cif_DISCOUNT_AMT'))) }}</label>
                                        <input type="text" value="{{ $line['data']['cif_DISCOUNT_AMT'] }}"
                                            name="cif_DISCOUNT_AMT" class="form-control" id="cif_DISCOUNT_AMT"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('cif_DISCOUNT_AMT'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="commission"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('commission'))) }}</label>
                                        <input type="text" value="{{ $line['data']['commission'] }}"
                                            name="commission" class="form-control" id="commission"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('commission'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="claim_LINE_AMT"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('claim_LINE_AMT'))) }}</label>
                                        <input type="text" value="{{ $line['data']['claim_LINE_AMT'] }}"
                                            name="claim_LINE_AMT" class="form-control" id="claim_LINE_AMT"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('claim_LINE_AMT'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="claim_LINE_VAT_AMT"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('claim_LINE_VAT_AMT'))) }}</label>
                                        <input type="text" value="{{ $line['data']['claim_LINE_VAT_AMT'] }}"
                                            name="claim_LINE_VAT_AMT" class="form-control" id="claim_LINE_VAT_AMT"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('claim_LINE_VAT_AMT'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="interface_LINE_ATTRIBUTE2"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('interface_LINE_ATTRIBUTE2'))) }}</label>
                                        <input type="text" value="{{ $line['data']['interface_LINE_ATTRIBUTE2'] }}"
                                            name="interface_LINE_ATTRIBUTE2" class="form-control"
                                            id="interface_LINE_ATTRIBUTE2"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('interface_LINE_ATTRIBUTE2'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="claim_BATCH_ID"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('claim_BATCH_ID'))) }}</label>
                                        <input type="text" value="{{ $line['data']['claim_BATCH_ID'] }}"
                                            name="claim_BATCH_ID" class="form-control" id="claim_BATCH_ID"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('claim_BATCH_ID'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="intended_USE"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('intended_USE'))) }}</label>
                                        <input type="text" value="{{ $line['data']['intended_USE'] }}"
                                            name="intended_USE" class="form-control" id="intended_USE"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('intended_USE'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="line_DESC_DTL"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('line_DESC_DTL'))) }}</label>
                                        <input type="text" value="{{ $line['data']['line_DESC_DTL'] }}"
                                            name="line_DESC_DTL" class="form-control" id="line_DESC_DTL"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('line_DESC_DTL'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="attribute1"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('attribute1'))) }}</label>
                                        <input type="text" value="{{ $line['data']['attribute1'] }}"
                                            name="attribute1" class="form-control" id="attribute1"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('attribute1'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="attribute2"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('attribute2'))) }}</label>
                                        <input type="text" value="{{ $line['data']['attribute2'] }}"
                                            name="attribute2" class="form-control" id="attribute2"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('attribute2'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="attribute3"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('attribute3'))) }}</label>
                                        <input type="text" value="{{ $line['data']['attribute3'] }}"
                                            name="attribute3" class="form-control" id="attribute3"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('attribute3'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="attribute4"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('attribute4'))) }}</label>
                                        <input type="text" value="{{ $line['data']['attribute4'] }}"
                                            name="attribute4" class="form-control" id="attribute4"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('attribute4'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="attribute5"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('attribute5'))) }}</label>
                                        <input type="text" value="{{ $line['data']['attribute5'] }}"
                                            name="attribute5" class="form-control" id="attribute5"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('attribute5'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="attribute6"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('attribute6'))) }}</label>
                                        <input type="text" value="{{ $line['data']['attribute6'] }}"
                                            name="attribute6" class="form-control" id="attribute6"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('attribute6'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="attribute7"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('attribute7'))) }}</label>
                                        <input type="text" value="{{ $line['data']['attribute7'] }}"
                                            name="attribute7" class="form-control" id="attribute7"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('attribute7'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="attribute8"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('attribute8'))) }}</label>
                                        <input type="text" value="{{ $line['data']['attribute8'] }}"
                                            name="attribute8" class="form-control" id="attribute8"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('attribute8'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="attribute9"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('attribute9'))) }}</label>
                                        <input type="text" value="{{ $line['data']['attribute9'] }}"
                                            name="attribute9" class="form-control" id="attribute9"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('attribute9'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="attribute10"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('attribute10'))) }}</label>
                                        <input type="text" value="{{ $line['data']['attribute10'] }}"
                                            name="attribute10" class="form-control" id="attribute10"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('attribute10'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="creation_DATE"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('creation_DATE'))) }}</label>
                                        <input type="text" value="{{ $line['data']['creation_DATE'] }}"
                                            name="creation_DATE" class="form-control" id="creation_DATE"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('creation_DATE'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="last_UPDATE_DATE"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('last_UPDATE_DATE'))) }}</label>
                                        <input type="text" value="{{ $line['data']['last_UPDATE_DATE'] }}"
                                            name="last_UPDATE_DATE" class="form-control" id="last_UPDATE_DATE"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('last_UPDATE_DATE'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="source_CURRENCY_CODE"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('source_CURRENCY_CODE'))) }}</label>
                                        <input type="text" value="{{ $line['data']['source_CURRENCY_CODE'] }}"
                                            name="source_CURRENCY_CODE" class="form-control" id="source_CURRENCY_CODE"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('source_CURRENCY_CODE'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="source_EXCHANGE_RATE"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('source_EXCHANGE_RATE'))) }}</label>
                                        <input type="text" value="{{ $line['data']['source_EXCHANGE_RATE'] }}"
                                            name="source_EXCHANGE_RATE" class="form-control" id="source_EXCHANGE_RATE"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('source_EXCHANGE_RATE'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="source_CCID"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('source_CCID'))) }}</label>
                                        <input type="text" value="{{ $line['data']['source_CCID'] }}"
                                            name="source_CCID" class="form-control" id="source_CCID"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('source_CCID'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="ap_DESCRIPTION"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('ap_DESCRIPTION'))) }}</label>
                                        <input type="text" value="{{ $line['data']['ap_DESCRIPTION'] }}"
                                            name="ap_DESCRIPTION" class="form-control" id="ap_DESCRIPTION"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('ap_DESCRIPTION'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="claim_LINE_AMT_ORIGINAL"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('claim_LINE_AMT_ORIGINAL'))) }}</label>
                                        <input type="text" value="{{ $line['data']['claim_LINE_AMT_ORIGINAL'] }}"
                                            name="claim_LINE_AMT_ORIGINAL" class="form-control"
                                            id="claim_LINE_AMT_ORIGINAL"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('claim_LINE_AMT_ORIGINAL'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="record_ID"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('record_ID'))) }}</label>
                                        <input type="text" value="{{ $line['data']['record_ID'] }}" name="record_ID"
                                            class="form-control" id="record_ID"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('record_ID'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="claimed_AMT"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('claimed_AMT'))) }}</label>
                                        <input type="text" value="{{ $line['data']['claimed_AMT'] }}"
                                            name="claimed_AMT" class="form-control" id="claimed_AMT"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('claimed_AMT'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="org_ID"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('org_ID'))) }}</label>
                                        <input type="text" value="{{ $line['data']['org_ID'] }}" name="org_ID"
                                            class="form-control" id="org_ID"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('org_ID'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="vendor_ID"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('vendor_ID'))) }}</label>
                                        <input type="text" value="{{ $line['data']['vendor_ID'] }}" name="vendor_ID"
                                            class="form-control" id="vendor_ID"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('vendor_ID'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="vendor_SITE_ID"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('vendor_SITE_ID'))) }}</label>
                                        <input type="text" value="{{ $line['data']['vendor_SITE_ID'] }}"
                                            name="vendor_SITE_ID" class="form-control" id="vendor_SITE_ID"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('vendor_SITE_ID'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="business"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('business'))) }}</label>
                                        <input type="text" value="{{ $line['data']['business'] }}" name="business"
                                            class="form-control" id="business"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('business'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="process_STATUS"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('process_STATUS'))) }}</label>
                                        <input type="text" value="{{ $line['data']['process_STATUS'] }}"
                                            name="process_STATUS" class="form-control" id="process_STATUS"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('process_STATUS'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="payment_INTEGRATION"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('payment_INTEGRATION'))) }}</label>
                                        <input type="text" value="{{ $line['data']['payment_INTEGRATION'] }}"
                                            name="payment_INTEGRATION" class="form-control" id="payment_INTEGRATION"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('payment_INTEGRATION'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="integration_STATUS"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('integration_STATUS'))) }}</label>
                                        <input type="text" value="{{ $line['data']['integration_STATUS'] }}"
                                            name="integration_STATUS" class="form-control" id="integration_STATUS"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('integration_STATUS'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="erp_AP_TRX_ID"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('erp_AP_TRX_ID'))) }}</label>
                                        <input type="text" value="{{ $line['data']['erp_AP_TRX_ID'] }}"
                                            name="erp_AP_TRX_ID" class="form-control" id="erp_AP_TRX_ID"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('erp_AP_TRX_ID'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="erp_AP_TRX_NO"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('erp_AP_TRX_NO'))) }}</label>
                                        <input type="text" value="{{ $line['data']['erp_AP_TRX_NO'] }}"
                                            name="erp_AP_TRX_NO" class="form-control" id="erp_AP_TRX_NO"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('erp_AP_TRX_NO'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="erp_AP_TRX_DATE"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('erp_AP_TRX_DATE'))) }}</label>
                                        <input type="text" value="{{ $line['data']['erp_AP_TRX_DATE'] }}"
                                            name="erp_AP_TRX_DATE" class="form-control" id="erp_AP_TRX_DATE"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('erp_AP_TRX_DATE'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="claim_SOURCE"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('claim_SOURCE'))) }}</label>
                                        <input type="text" value="{{ $line['data']['claim_SOURCE'] }}"
                                            name="claim_SOURCE" class="form-control" id="claim_SOURCE"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('claim_SOURCE'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="claim_TYPE"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('claim_TYPE'))) }}</label>
                                        <input type="text" value="{{ $line['data']['claim_TYPE'] }}"
                                            name="claim_TYPE" class="form-control" id="claim_TYPE"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('claim_TYPE'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="doc_CAT"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('doc_CAT'))) }}</label>
                                        <input type="text" value="{{ $line['data']['doc_CAT'] }}" name="doc_CAT"
                                            class="form-control" id="doc_CAT"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('doc_CAT'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="note"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('note'))) }}</label>
                                        <input type="text" value="{{ $line['data']['note'] }}" name="note"
                                            class="form-control" id="note"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('note'))) }}" required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="process_PERIOD"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('process_PERIOD'))) }}</label>
                                        <input type="text" value="{{ $line['data']['process_PERIOD'] }}"
                                            name="process_PERIOD" class="form-control" id="process_PERIOD"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('process_PERIOD'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="source_TRX_ID"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('source_TRX_ID'))) }}</label>
                                        <input type="text" value="{{ $line['data']['source_TRX_ID'] }}"
                                            name="source_TRX_ID" class="form-control" id="source_TRX_ID"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('source_TRX_ID'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="source_TRX_NO"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('source_TRX_NO'))) }}</label>
                                        <input type="text" value="{{ $line['data']['source_TRX_NO'] }}"
                                            name="source_TRX_NO" class="form-control" id="source_TRX_NO"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('source_TRX_NO'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="source_TRX_DATE"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('source_TRX_DATE'))) }}</label>
                                        <input type="text" value="{{ $line['data']['source_TRX_DATE'] }}"
                                            name="source_TRX_DATE" class="form-control" id="source_TRX_DATE"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('source_TRX_DATE'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="source_CUSTOMER_ID"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('source_CUSTOMER_ID'))) }}</label>
                                        <input type="text" value="{{ $line['data']['source_CUSTOMER_ID'] }}"
                                            name="source_CUSTOMER_ID" class="form-control" id="source_CUSTOMER_ID"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('source_CUSTOMER_ID'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="source_CUSTOMER_NO"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('source_CUSTOMER_NO'))) }}</label>
                                        <input type="text" value="{{ $line['data']['source_CUSTOMER_NO'] }}"
                                            name="source_CUSTOMER_NO" class="form-control" id="source_CUSTOMER_NO"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('source_CUSTOMER_NO'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="source_CUSTOMER_NAME"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('source_CUSTOMER_NAME'))) }}</label>
                                        <input type="text" value="{{ $line['data']['source_CUSTOMER_NAME'] }}"
                                            name="source_CUSTOMER_NAME" class="form-control" id="source_CUSTOMER_NAME"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('source_CUSTOMER_NAME'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="source_SITE_NO"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('source_SITE_NO'))) }}</label>
                                        <input type="text" value="{{ $line['data']['source_SITE_NO'] }}"
                                            name="source_SITE_NO" class="form-control" id="source_SITE_NO"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('source_SITE_NO'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="source_SITE_USE_ID"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('source_SITE_USE_ID'))) }}</label>
                                        <input type="text" value="{{ $line['data']['source_SITE_USE_ID'] }}"
                                            name="source_SITE_USE_ID" class="form-control" id="source_SITE_USE_ID"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('source_SITE_USE_ID'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="source_LOCATION_NO"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('source_LOCATION_NO'))) }}</label>
                                        <input type="text" value="{{ $line['data']['source_LOCATION_NO'] }}"
                                            name="source_LOCATION_NO" class="form-control" id="source_LOCATION_NO"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('source_LOCATION_NO'))) }}"
                                            required>
                                    </div>
                                    <div class="col-4 form-group">
                                        <label for="source_CUST_ACCT_SITE_ID"
                                            class="title-color">{{ ucwords(strtolower(\App\CPU\translate('source_CUST_ACCT_SITE_ID'))) }}</label>
                                        <input type="text" value="{{ $line['data']['source_CUST_ACCT_SITE_ID'] }}"
                                            name="source_CUST_ACCT_SITE_ID" class="form-control"
                                            id="source_CUST_ACCT_SITE_ID"
                                            placeholder="{{ ucwords(strtolower(\App\CPU\translate('source_CUST_ACCT_SITE_ID'))) }}"
                                            required>
                                    </div>
                                </div>
                            </div>
                            {{-- <div class="d-flex justify-content-end">
													<button type="submit" class="btn btn-primary px-4">{{ ucwords(strtolower(\App\CPU\translate('Update')))}}</button>
												</div> --}}
                        </form>
                    </div>
                </div>
            </div>
        </div>

    </div>
@endsection

@push('script')
    <script src="{{ asset('public/assets/back-end') }}/js/select2.min.js"></script>
@endpush