@extends('layouts.main') @push('styles') @endpush @section('content')
| {{ __('diagnoses.id') }} | {{ __('diagnoses.diagnosis_name') }} | {{ __('diagnoses.icd_10_code') }} | {{ __('diagnoses.hmis_out_patient_number') }} | {{ __('diagnoses.hmis_inpatient_category') }} | {{ __('diagnoses.diagnosis_prompt') }} | {{ __('diagnoses.chronic_status') }} | {{ __('diagnoses.reference_areas_seperate_with_commas') }} | {{ __('diagnoses.reference_names_seperate_with_commas') }} | {{ __('diagnoses.hmis_category') }} |
|---|---|---|---|---|---|---|---|---|---|
| {{ __('diagnoses.id') }} | {{ __('diagnoses.diagnosis_name') }} | {{ __('diagnoses.icd_10_code') }} | {{ __('diagnoses.hmis_out_patient_number') }} | {{ __('diagnoses.hmis_inpatient_category') }} | {{ __('diagnoses.diagnosis_prompt') }} | {{ __('diagnoses.chronic_status') }} | {{ __('diagnoses.reference_areas_seperate_with_commas') }} | {{ __('diagnoses.reference_names_seperate_with_commas') }} | {{ __('diagnoses.hmis_category') }} |
| {{ Form::text('id[]', $diagnosis->id, ['class' => 'form-control']) }} | {{ Form::text('name[]', $diagnosis->name, ['class' => 'form-control compulsory', 'required']) }} | {{ Form::text('icd10_code[]', $diagnosis->icd10_code, ['class' => 'form-control']) }} | {{ Form::text('hmis_no_outpatient[]', $diagnosis->hmis_no_outpatient, ['class' => 'form-control']) }} | {{ Form::text('hmis_no_inpatient[]', $diagnosis->hmis_no_inpatient, ['class' => 'form-control']) }} | {{ Form::textArea('prompts[]', $diagnosis->prompts, ['class' => 'form-control', 'rows' => 5]) }} | {{ Form::select('chronic_status[]', [1 => 'Yes', 0 => 'No'], $diagnosis->chronic_status, ['class' => 'form-control']) }} | {{ Form::text('reference_areas[]', $diagnosis->reference_areas, ['class' => 'form-control']) }} | {{ Form::text('reference_names[]', $diagnosis->reference_names, ['class' => 'form-control']) }} | {{ Form::select('hmis_category[]', $hmis_categories, $diagnosis->hmis_category, ['class' => 'form-control']) }} |