@if (auth()->user()->eRole == 'Field')

Back

@else

Back

@endif {{ Form::open(['url' => '#', 'name' => 'validateForm', 'id' => 'validateForm', 'enctype' => 'multipart/form-data', 'class' => 'form-validate']) }}

Add New Request

SKU *

Factory (Manufacturing site) *

Factory Person *

Manufacturing Factory Address *

Factory Courier Address *

Purchased Units *

Invoice Number *

@php $today = date('Y-m-d'); @endphp

Invoice Date *

Invoice Value (Rs.) *

Batch No. *

Mfg Month *

Exp Month *

Name of Retail Pharmacy *

Retail pharmacy address*

City of Purchase *

Locality / Place*

MRP on Product Pack *

Product Image (Max. size 10 MB per file ) *

Invoice Copy (Max. size 10 MB per file ) *

LR copy (Max. size 10 MB per file )*

Courier Name *

Courier Docket Number *

{{--

Date of Receipt at Plant

--}} {{--

Date of Physical verification completed by plant

--}}

@if (isset($editData->eCounterfeitStatus)) @if ($editData->eCounterfeitStatus == 'drafted') @endif @else @endif