[text* product_name class:form-control class:h-100
class:text-truncate class:rounded-0 class:border-end-0
class:border-start-0 class:border-top-0 class:px-0
placeholder "Product Name ..."]
[text* full_name class:form-control class:h-100
class:text-truncate class:rounded-0 class:border-end-0
class:border-start-0 class:border-top-0 class:px-0
placeholder "Your Name * ..."]
[email* email class:form-control class:h-100
class:text-truncate class:rounded-0 class:border-end-0
class:border-start-0 class:border-top-0 class:px-0
placeholder "Email * ..."]
[text* area class:form-control class:h-100
class:text-truncate class:rounded-0 class:border-end-0
class:border-start-0 class:border-top-0 class:px-0
placeholder "Area* ..."]
[text* phone class:form-control class:h-100
class:text-truncate class:rounded-0 class:border-end-0
class:border-start-0 class:border-top-0 class:px-0
placeholder "Phone* ..."]
[text* store_name class:form-control class:h-100
class:text-truncate class:rounded-0 class:border-end-0
class:border-start-0 class:border-top-0 class:px-0
placeholder "Store Name* ..."]
[date* purchase_date class:form-control class:h-100
class:text-truncate class:rounded-0 class:border-end-0
class:border-start-0 class:border-top-0 class:px-0
placeholder "Purchase Date* ..."]
[file* original_tax id:originalTaxField
class:form-control class:w-100
class:border-0 class:text-truncate
class:p-0 class:bg-transparent class:lh-1 filetypes:application/*
limit:5mb]
PDF, DOC, DOCX, Max. File size 5MB
