<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">Claim Details</x-slot>

            <form method="post" wire:submit="createClaim">
                <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.select name="redress_type" label="Redress Type" :options="$redress_types" wire:model="redress_type" />
                </div>

                <x-ui.button>Submit</x-ui.button>
            </form>
        </x-card>
    </div>
    <div class="col-md-4"></div>
</div>