{{{ ucfirst(Lang::get('messages.company_name')) }}} {{ Form::select('company_id', $companies) }} {{ $errors->first('company_id', ':message') }}

{{{ ucfirst(Lang::choice('messages.note', 1)) }}} {{ Form::textarea('note') }} {{ $errors->first('note', ':message') }}

{{{ ucfirst(Lang::get('messages.note_date_occured')) }}} {{ Form::text('date_occured', null, ['class' => 'datepicker']) }} {{ $errors->first('date_occured', ':message') }}

{{ Form::submit(Lang::get('messages.save'), ['class' => 'button']) }}