فهرست منبع

Add cell number and email to /join form

Vijayakrishnan Krishnan 5 سال پیش
والد
کامیت
89f31940c7
1فایلهای تغییر یافته به همراه4 افزوده شده و 2 حذف شده
  1. 4 2
      resources/views/join.blade.php

+ 4 - 2
resources/views/join.blade.php

@@ -25,9 +25,11 @@
             <input type="text" name="medicareNumber" class="form-control" placeholder="Medicare Number" required>
         </div>
         <div class="form-group mb-3">
-            <input type="text" name="ssn" class="form-control" placeholder="SSN" required>
+            <input type="tel" name="cellNumber" class="form-control" placeholder="Cell Number">
+        </div>
+        <div class="form-group mb-3">
+            <input type="email" name="emailAddress" class="form-control" placeholder="Email Address">
         </div>
-
         <button type="submit" class="btn btn-primary btn-block mx-auto w-50 mt-4 mb-2">Check In</button>
     </form>
     <script>