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admin
2025-03-31 03:46:05 +03:00
parent b0a69145d7 c7fdd2968a
commit 2dc2287379
6454 changed files with 1520539 additions and 9 deletions
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docker/statistics/Modules/Insurance/Resources/views/insurance_benefits/create.blade.php
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@extends('layouts.main')
@push('styles')
<link href="{{ asset('elite/bower_components/select2/select2.min.css') }}" rel="stylesheet" />
@endpush
@section('content')
<div class="row bg-title">
<div class="col-lg-3 col-md-4 col-sm-4 col-xs-12">
<h4 class="page-title">{{ __('insurance_benefits.create_insurance_benefit') }}</h4>
</div>
<div class="col-lg-9 col-sm-8 col-md-8 col-xs-12">
<ol class="breadcrumb">
<li><a href="{{ route('home') }}">{{ __('insurance_groups.dashboard') }}</a></li>
<li><a href="/insurance_benefits/">{{ __('insurance_benefits.insurance_benefits') }}</a></li>
<li class="active">{{ __('insurance_benefits.create') }}</li>
</ol>
</div>
</div>
@include('insurance::insurance_benefits.menu')
<div class="white-box">
@include('flash::message')
{{ Form::open(['route' => 'insurance_benefits.store','data-toggle'=>'validator']) }}
<div class="row">
<div class="col-md-6">
<div class="form-group">
{{ Form::label('name', __('insurance_benefits.benefit_name')) }}
{{ Form::text('name', '', ['class' => 'form-control compulsory', 'required']) }}
</div>
<div class="form-group">
{{ Form::label('waiting_period', __('insurance_benefits.waiting_period_days')) }}
{{ Form::number('waiting_period', '', ['class' => 'form-control compulsory', 'required']) }}
</div>
<div class="form-group">
{{ Form::label('annual_member_limit', __('insurance_benefits.annual_member_limit') . ' (' . __('insurance_claims.no_limit_applicable') . ')') }}
{{ Form::number('annual_member_limit', '', ['class' => 'form-control compulsory', 'required']) }}
</div>
<div class="form-group">
{{ Form::label('opd_percentage', __('insurance_benefits.opd_percentage') . ' (' . __('insurance_benefits.applied_to_cash_amount') . ')') }}
{{ Form::number('opd_percentage', '', ['class' => 'form-control', 'step' => '0.01']) }}
</div>
<div class="form-group">
{{ Form::label('ward_id', __('insurance_benefits.wards_benefit_will_be_applied_to')) }}
{{ Form::select('ward_id[]', $wards, 0,['class' => 'form-control ward_id', 'data-error'=>'Select the ward', 'multiple']) }}
</div>
</div>
<div class="col-md-6">
<div class="form-group">
{{ Form::label('plan_id', __('insurance_benefits.plan')) }}
{{ Form::select('plan_id', $insurance_plans, '', ['class' => 'form-control compulsory', 'required', 'id' => 'plan_id']) }}
</div>
<div class="form-group">
{{ Form::label('fee', __('insurance_benefits.fee')) }}
{{ Form::number('fee', 0, ['class' => 'form-control compulsory', 'required']) }}
</div>
<div class="form-group">
{{ Form::label('annual_family_limit', __('insurance_benefits.annual_family_limit') . ' (' . __('insurance_claims.no_limit_applicable') . ')') }}
{{ Form::number('annual_family_limit', '', ['class' => 'form-control compulsory', 'required']) }}
</div>
<div class="form-group">
{{ Form::label('ipd_percentage', __('insurance_benefits.ipd_percentage') . ' (' . __('insurance_benefits.applied_to_cash_amount') . ')') }}
{{ Form::number('ipd_percentage', '', ['class' => 'form-control', 'step' => '0.01']) }}
</div>
</div>
</div>
{{ Form::button(__('insurance_groups.submit'),['type'=>'submit','class'=>'btn btn-success waves-effect waves-light m-r-10']) }}
{{ Form::button(__('insurance_groups.cancel'),['type'=>'reset','class'=>'btn btn-default waves-effect waves-light']) }}
{{ Form::close() }}
</div>
@endsection
@push('scripts')
<script src="{{ asset('elite/bower_components/select2/select2.min.js') }}"></script>
<script>
$('#plan_id, .ward_id').select2({
placeholder: "Select"
});
</script>
@endpush