{include file="sections/header.tpl"}

		<div class="row">
			<div class="col-sm-12 col-md-12">
				<div class="panel panel-default panel-hovered panel-stacked mb30">
					<div class="panel-heading">{$_L['Edit_Contact']}</div>
						<div class="panel-body">
						
							<form class="form-horizontal" method="post" role="form" action="{$_url}customers/edit-post" >         
							<input type="hidden" name="id" value="{$d['id']}">
								<div class="form-group">
									<label class="col-md-2 control-label">{$_L['Username']}</label>
									<div class="col-md-6">
										<input type="text" class="form-control" id="username" name="username" value="{$d['username']}">
									</div>
								</div>
								<div class="form-group">
									<label class="col-md-2 control-label">{$_L['Full_Name']}</label>
									<div class="col-md-6">
										<input type="text" class="form-control" id="fullname" name="fullname" value="{$d['fullname']}">
									</div>
								</div>
								<div class="form-group">
									<label class="col-md-2 control-label">{$_L['Password']}</label>
									<div class="col-md-6">
										<input type="password" class="form-control" id="password" name="password">
										<span class="help-block">{$_L['password_change_help']}</span>
									</div>
								</div>
								<div class="form-group">
									<label class="col-md-2 control-label">{$_L['Confirm_Password']}</label>
									<div class="col-md-6">
										<input type="password" class="form-control" id="cpassword" name="cpassword">
									</div>
								</div>
								<div class="form-group">
									<label class="col-md-2 control-label">{$_L['Address']}</label>
									<div class="col-md-6">
										<textarea name="address" id="address"  class="form-control">{$d['address']}</textarea>
									</div>
								</div>
								<div class="form-group">
									<label class="col-md-2 control-label">{$_L['Phone_Number']}</label>
									<div class="col-md-6">
										<input type="text" class="form-control" id="phonenumber" name="phonenumber" value="{$d['phonenumber']}">
									</div>
								</div>

								<div class="form-group">
									<div class="col-lg-offset-2 col-lg-10">
										<button class="btn btn-primary waves-effect waves-light" type="submit">{$_L['Save']}</button>
										Or <a href="{$_url}customers/list">{$_L['Cancel']}</a>
									</div>
								</div>
							</form>
						</div>
					</div>
				</div>
			</div>
		</div>

{include file="sections/footer.tpl"}