diff --git a/pages/admin/surveys/public/_survey.vue b/pages/admin/surveys/public/_survey.vue
index b4dd3d3..50f995b 100644
--- a/pages/admin/surveys/public/_survey.vue
+++ b/pages/admin/surveys/public/_survey.vue
@@ -5,10 +5,37 @@
       <CButton size="sm" color="primary" class="mr-auto" :to="{ name: 'admin-surveys-public' }">برگشت به صفحه قبل</CButton>
     </CustomSubHeader>
     <CRow>
+      
       <CCol xl="12">
         <CCard>
           <CCardBody>
             <CForm>
+              <div class="row m-2">
+                <div class="col-lg-3 col-sm-12 mt-4">
+            <div class="mb-3">
+            <label> نام و نام خانوادگی</label>
+            </div>
+          <CInput v-model="survey.fullName"  placeholder="نام و نام خانوادگی" disabled></CInput>
+        </div>
+        <div class="col-lg-3 col-sm-12 mt-4">
+          <div class="mb-3">
+              <label>کد ملی </label>
+            </div>
+          <CInput v-model="survey.national"  placeholder="کد ملی" disabled></CInput>
+        </div>
+        <div class="col-lg-3 col-sm-12 mt-4">
+          <div class="mb-3">
+              <label>شماره تلفن </label>
+            </div>
+          <CInput v-model="survey.phoneNumber"   placeholder="شماره تلفن" disabled></CInput>
+        </div>
+        <div class="col-lg-3 col-sm-12 mt-4">
+          <div class="mb-3">
+              <label>ایمیل </label>
+            </div>
+          <CInput v-model="survey.email"  placeholder="ایمیل" disabled></CInput>
+        </div>
+              </div>
               <CInput v-if="survey.code" :value="survey.code" label="شماره پذیرش دایم" disabled />
               <CInput
                 v-for="item in surveyOptions"