@extends('layouts.vertical', ['title' => 'Customer Registration']) @push('head-script') @endpush @push('head-scriptTwo') @endpush @section('content')

@csrf

{{-- Personal details section --}}

Member Details

First Name *

Middle Name

Last Name *

Gender *

Male

Female

Email

Birth Date *

Phone Number*

Occupation *

Country

Region

District

ID Type *

ID Number *

{{-- /Personal details section --}}

{{-- Insurance Details section --}}

Insurance Details

Insurance Type*

Currency* {{-- --}}

Monthly Fee *

Insurance Term *

{{-- /Insurance Details section --}}

{{-- Beneficiaries Details section --}}

Beneficiaries Detail

First Name*

Last Name *

Relationship *

Phonenumber

ID Type

ID Number *

{{-- /Beneficiaries Details section --}}

{{-- Overseer Details section --}}

Overseer Details

First Name *

Last Name *

Relationship *

Phone Number *

ID Type*

ID Number*

I Attest that the information I have provided above is true and correct to the best of my knowledge.

{{-- /Overseer Details section --}}

@endsection