{{ Form::open(['action' => 'SuppliersController@create','id' => 'supplierForm','autocomplete' => 'off']) }}

* Name :

Supplier Type :

GST No :

Phone No :

Email :

Address :

Pincode :

City :

State :

Supply Type :

Drug Licence No. :

Active :

Yes No

Contact Details

Name	Phone

{{ Form::close() }}