@extends('layouts.master') @section('title', 'Create Customers') @section('css') @endsection @section('breadcrumb')

Create Customers

@endsection @section('main_content')

Create new customer

Please fill in this secure form to create a comprehensive client profile. Fields marked with * are required for policy compliance and underwriting purposes.

{{-- PERSONAL INFORMATION --}}

Basic Customer Information

Please select gender.
Please provide a valid date.
{{-- CONTACT INFORMATION --}}

Contact Information

Please provide a valid email.
Please provide a valid phone number.
{{-- EMPLOYMENT INFORMATION --}}

Employment Information

{{-- SYSTEM/ACCOUNT INFORMATION --}}

System / Account Information

Preview

Drag & drop or click to upload

{{-- MARKETING PREFERENCES --}}

Marketing Preferences

Please select a language.

Insurance Policy Details

Please select a policy type.
Please select a coverage type.
Please enter the policy name.
Please enter a description.
Please select the start date.
Please select the end date.
Please select the issue date.
Please select the maturity date.
Please select the renewal date.
Please enter the sum assured amount.
Please enter the premium amount.
Please select premium frequency.
Please select payment method.
Please select policy status.
Please enter number of beneficiaries (0 or more).
Example: ["https://example.com/doc1.jpg", "https://example.com/doc2.pdf"]
Please select source.

Beneficiary Information

* Total allocation must equal 100%

Risk Assessment

Select all that apply
@endsection @section('scripts') @endsection