<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Address')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-address" data-toggle="addresspicker" data-input-id="c-address" data-lat-id="c-lat" data-lng-id="c-lng" class="form-control" name="row[address]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Address_detail')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-address_detail" class="form-control" name="row[address_detail]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Lat')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-lat" class="form-control" data-rule="required" readonly="readonly" name="row[lat]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Lng')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-lng" class="form-control" data-rule="required" readonly="readonly" name="row[lng]" type="text">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>