osb/resources/views/theme/backend/adminlte/service/widget/broadband/update.blade.php

<div class="form-group row">
	<label for="reference" class="col-sm-3 col-form-label text-right">Service Number</label>
	<div class="col-sm-6">
		<div class="input-group">
			<div class="input-group-prepend">
				<span class="input-group-text"><i class="fa fa-fw fa-phone"></i></span>
			</div>
			<input type="text" class="form-control" name="broadband[service_number]" value="{{ $o->service_number ?? '' }}">
		</div>
	</div>
</div>

<div class="form-group row">
	<label for="reference" class="col-sm-3 col-form-label text-right">Service Username</label>
	<div class="col-sm-6">
		<div class="input-group">
			<div class="input-group-prepend">
				<span class="input-group-text"><i class="fa fa-fw fa-user"></i></span>
			</div>
			<input type="text" class="form-control" name="broadband[service_username]" value="{{ $o->service_username ?? '' }}">
		</div>
	</div>
</div>

<div class="form-group row">
	<label for="reference" class="col-sm-3 col-form-label text-right">Service Password</label>
	<div class="col-sm-6">
		<div class="input-group">
			<div class="input-group-prepend">
				<span class="input-group-text"><i class="fa fa-fw fa-lock"></i></span>
			</div>
			<input type="text" class="form-control" name="broadband[service_password]" value="{{ $o->service_password ?? '' }}">
		</div>
	</div>
</div>

<div class="form-group row">
	<label for="reference" class="col-sm-3 col-form-label text-right">Service Connect Date</label>
	<div class="col-sm-6">
		<div class="input-group">
			<div class="input-group-prepend">
				<span class="input-group-text"><i class="fa fa-fw fa-calendar"></i></span>
			</div>
			<input type="date" class="form-control" name="broadband[connect_at]" value="{{ $o->connect_at ? $o->connect_at->format('Y-m-d') : '' }}">
		</div>
	</div>
</div>

<div class="form-group row">
	<label for="reference" class="col-sm-3 col-form-label text-right">Service Contract Date</label>
	<div class="col-sm-6">
		<div class="input-group">
			<div class="input-group-prepend">
				<span class="input-group-text"><i class="fa fa-fw fa-calendar"></i></span>
			</div>
			<!-- @todo We changed contract_date in the DB, what happened to it and how do we work it out now -->
			<!--
			<input type="date" class="form-control" name="broadband[service_contract_date]" value="{{ $o->service_contract_date ? $o->service_contract_date->format('Y-m-d') : '' }}">
			-->
		</div>
	</div>
</div>

<div class="form-group row">
	<label for="reference" class="col-sm-3 col-form-label text-right">Service Billing Start Date</label>
	<div class="col-sm-6">
		<div class="input-group">
			<div class="input-group-prepend">
				<span class="input-group-text"><i class="fa fa-fw fa-calendar"></i></span>
			</div>
			<input type="date" class="form-control" name="start_at" value="{{ $o->service->start_at ? $o->service->start_at->format('Y-m-d') : '' }}">
		</div>
	</div>
</div>