@php($s = $supplier ?? null)
<div class="grid grid-2">
    <div class="field"><label>Razão social / nome *</label><input name="name" value="{{ old('name', $s?->name) }}" required></div>
    <div class="field"><label>Nome fantasia</label><input name="trade_name" value="{{ old('trade_name', $s?->trade_name) }}"></div>
    <div class="field"><label>CPF/CNPJ</label><input name="tax_id" value="{{ old('tax_id', $s?->tax_id) }}"></div>
    <div class="field"><label>Contato</label><input name="contact_name" value="{{ old('contact_name', $s?->contact_name) }}"></div>
    <div class="field"><label>Telefone</label><input name="phone" value="{{ old('phone', $s?->phone) }}"></div>
    <div class="field"><label>WhatsApp</label><input name="whatsapp" value="{{ old('whatsapp', $s?->whatsapp) }}"></div>
    <div class="field"><label>E-mail</label><input type="email" name="email" value="{{ old('email', $s?->email) }}"></div>
    <div class="field"><label>CEP</label><input name="zip_code" value="{{ old('zip_code', $s?->zip_code) }}"></div>
    <div class="field"><label>Endereço</label><input name="street" value="{{ old('street', $s?->street) }}"></div>
    <div class="field"><label>Número</label><input name="number" value="{{ old('number', $s?->number) }}"></div>
    <div class="field"><label>Complemento</label><input name="complement" value="{{ old('complement', $s?->complement) }}"></div>
    <div class="field"><label>Bairro</label><input name="district" value="{{ old('district', $s?->district) }}"></div>
    <div class="field"><label>Cidade</label><input name="city" value="{{ old('city', $s?->city) }}"></div>
    <div class="field"><label>UF</label><input name="state" maxlength="2" value="{{ old('state', $s?->state) }}"></div>
</div>
<div class="field"><label>Observações</label><textarea name="notes">{{ old('notes', $s?->notes) }}</textarea></div>
<div class="row">
    <input type="hidden" name="active" value="0">
    <label style="font-weight:500"><input style="width:auto" type="checkbox" name="active" value="1" @checked(old('active', $s?->active ?? true))> Fornecedor ativo</label>
    <input type="hidden" name="is_laboratory" value="0">
    <label style="font-weight:500"><input style="width:auto" type="checkbox" name="is_laboratory" value="1" @checked(old('is_laboratory', $s?->is_laboratory ?? false))> Este fornecedor também é laboratório óptico</label>
</div>