<div class="col-8">
 <div class="card">
 <h2 class="card-header">Edit Clinic</h2>
 <div class="card-body">
 <form method="post" action="/Clinics/Edit/1">
 <input type="hidden" data-val="true" data-val-required="The Id field is required." id="Id" name="Id" value="1" />
 <div class="md-form">
 <input class="form-control" type="text" data-val="true" data-val-required="Please enter a valid clinic name." id="Name" name="Name" value="Freddy's" />
 <label for="Name">Name</label>
 <span class="text-danger field-validation-valid" data-valmsg-for="Name" data-valmsg-replace="true"></span>
 </div>
 <div class="md-form">
 <input class="form-control" type="text" id="AddressLine1" name="AddressLine1" value="Suite 202" />
 <label for="AddressLine1">Address Line 1</label>
 <span class="text-danger field-validation-valid" data-valmsg-for="AddressLine1" data-valmsg-replace="true"></span>
 </div>
 <div class="md-form">
 <input class="form-control" type="text" id="AddressLine2" name="AddressLine2" value="400 Hunter Street" />
 <label for="AddressLine2">Address Line 2</label>
 <span class="text-danger field-validation-valid" data-valmsg-for="AddressLine2" data-valmsg-replace="true"></span>
 </div>
 <div class="form-row">
 <div class="md-form col-md-6">
 <input class="form-control" type="text" id="Suburb" name="Suburb" value="NEWCASTLE" />
 <label for="Suburb">Suburb</label>
 </div>
 <div class="md-form col-md-3">
 <input class="form-control" type="text" id="Postcode" name="Postcode" value="2300" />
 <label for="Postcode">Postcode</label>
 </div>
 <div class="md-form col-md-3">
 <select class="mdb-select" id="State" name="State"><option value="0">ACT</option>
<option selected="selected" value="1">NSW</option>
<option value="2">NT</option>
<option value="3">QLD</option>
<option value="4">SA</option>
<option value="5">TAS</option>
<option value="6">VIC</option>
<option value="7">WA</option>
</select>
 <label for="State">State</label>
 </div>
 </div>
 <div class="md-form">
 <input class="form-control" type="text" id="PhoneNumber" name="PhoneNumber" value="" />
 <label for="PhoneNumber">Phone Number</label>
 <span class="text-danger field-validation-valid" data-valmsg-for="PhoneNumber" data-valmsg-replace="true"></span>
 </div>
 <div class="md-form">
 <input class="form-control" type="text" data-val="true" data-val-regex="Fax number must be exactly 10 digits long, without spaces or letters, and begin with a 0. Have you included the area code?" data-val-regex-pattern="0[2378]d{8}$" data-val-required="Fax number is required." id="FaxNumber" name="FaxNumber" value="0200000000" />
 <label for="FaxNumber">Fax Number</label>
 <span class="text-danger field-validation-valid" data-valmsg-for="FaxNumber" data-valmsg-replace="true"></span>
 </div>
 <div class="text-center">
 <button class="btn btn-primary" type="submit">Save</button>
 <a onclick="history.go(-1)" class="btn btn-outline-dark">Cancel</a>
 </div>
 </div>
 </div>
</div>