<div class="modal-header">
    <h3>
        <span translate>cases.comp.main.addAppealOtherReason.title</span>
    </h3>
</div>
<div class="modal-body">
    <form name="addAppealOtherReasonForm">
        <div class="row">
            <div class="form-group col-sm-6">
                <label class="control-label" translate> cases.comp.main.addAppealOtherReason.otherReason</label>
                <select ng-model="objectInfo.otherReason"
                        ng-options="otherReason.key as otherReason.value | translate for otherReason in otherReasonsLookup"
                        class="form-control input-md" ng-change="changeOtherReason()" ng-required="isOtherRequired">
                </select>
            </div>
            <div class="form-group col-sm-6">
                <label class="control-label" translate> cases.comp.main.addAppealOtherReason.custom.label</label>
                <input type="text" ng-model="customOtherReason" class="input-md form-control" ng-readonly="isCustomDisabled"
                        placeholder="{{ 'cases.comp.main.addAppealOtherReason.custom.placeholder'  | translate }}"
                        ng-required="!isCustomDisabled">
            </div>
        </div>
    </form>
</div>
<div class="modal-footer">
    <button class="btn btn-secondary" ng-click="onClickCancel()">
        <span translate>cases.comp.main.addAppealOtherReason.btnCancel</span>
    </button>
    <button class="btn btn-primary" ng-click="onClickOk()" ng-disabled="addAppealOtherReasonForm.$invalid">
        <span translate>cases.comp.main.addAppealOtherReason.btnOk</span>
    </button>
</div>