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updated streamline-setup v2

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admin
2025-01-15 08:53:49 -08:00
committed by alec.turner
parent a2ce9248f0
commit 4b569f81b0
20228 changed files with 2932048 additions and 63204 deletions
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docker/_streamline-src/Modules/Patients/Resources/views/consultations/document/add.blade.php
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<div class="modal" id="document_modal" tabindex="-1" role="dialog" aria-labelledby="document_modal_label" aria-hidden="true">
<div class="modal-dialog modal-lg" role="document">
<div class="modal-content">
<div class="modal-header">
<h5 class="modal-title" id="debt_plan_modal_label"><b>Add Patient Document</b></h5>
</div>
<div class="modal-body">
<div class="row">
{{ Form::open(['route' => 'patient_documents.modal_store','data-toggle'=>'validator','files'=>'true']) }}
{{--<form id="add_document_form" method="post" enctype="multipart/form-data">--}}
<div class="col-sm-12">
<div class="row">
<div class="col-sm-6">
<div class="form-group">
{{ Form::label('patientnumber','Patient Number') }}
{{ Form::text('patientnumber',$patient->number,['class' => 'form-control compulsory', 'required',
'data-error'=>'','readonly'=>'true', 'id'=>'patientnumber']) }}
<div class="help-block with-errors"></div>
</div>
<div class="form-group">
{{ Form::label('documenttitle','Document Title') }}
{{ Form::text('documenttitle','',['class' => 'form-control compulsory', 'required', 'data-error'=>'', 'id'=>'documenttitle' ]) }}
<div class="help-block with-errors"></div>
</div>
<div class="form-group">
{{ Form::label('description','Description') }}
{{ Form::textArea('description','',['class' => 'form-control', 'id'=>'description']) }}
</div>
</div>
<div class="col-sm-6">
<div class="form-group">
{{ Form::label('documentdate','Date of document') }}
<div class="input-group">
{{ Form::text('documentdate','',['class' => 'form-control compulsory', 'required','readonly',
'id'=>'documentdate']) }}
<span class="input-group-addon"><i class="icon-calender"></i></span>
</div>
<div class="help-block with-errors"></div>
</div>
<div class="form-group">
{{ Form::label('document','Document') }}
{{ Form::file('document',['class' => 'form-control compulsory', 'required', 'id'=>'document']) }}
<div class="help-block with-errors"></div>
</div>
</div>
</div>
<button type="button" class="btn btn-danger" data-dismiss="modal">Cancel Document</button>
<button type="submit" class="btn btn-success" >Save Document</button>
</div>
{{--</form>--}}
{{ Form::close() }}
</div>
</div>
<div class="modal-footer">
</div>
</div>
</div>
</div>