<div class="row">
    <div class="col-12 col-md-4">
        <x-client.client-card :client="$client"/>
    </div>
    <div class="col-12 col-md-8">
        <x-card>
            <x-slot name="title">Edit Claim Details</x-slot>

            <form method="post" wire:submit="updateClaim">
                <div class="mb-3">
                    <x-ui.input name="case_number" label="Application Case Number" wire:model="case_number" />
                </div>

                <div class="mb-3">
                    <x-ui.input name="case_worker" label="Case Worker Name" wire:model="case_worker" />
                </div>

                <div class="mb-3">
                    <x-ui.input type="email" name="case_worker_email" label="Case Worker Email" wire:model="case_worker_email" />
                </div>

                <div class="mb-3">
                    <x-ui.select name="redress_type" label="Redress Type" :options="$redress_types" wire:model="redress_type" />
                </div>

                <div class="d-flex justify-content-between">
                    <x-ui.button>Update Claim</x-ui.button>
                    <a wire:navigate href="{{ route('clients.show', $client) }}" class="btn btn-secondary">Cancel</a>
                </div>
            </form>
        </x-card>
    </div>
</div>