@extends('layouts.main') @push('styles') @endpush @section('content')

{{ __('patients.create') }}

@include('flash::message') @include('errors.list')

{{ __('patients.patient_search') }}

{{ __('patients.patient_information') }}

{{ Form::open(['route' => 'patients.save_appointment']) }} {{ Form::hidden('patient_id', '', ['class' => 'patient_id', 'id' => 'patient_id']) }}
{{ Form::label('clinic_allocation', __('patients.assign_clinic')) }} {{ Form::select('clinic_allocation', $clinics, '', ['class' => 'form-control col-sm-12 compulsory search_criteria', 'id' => 'clinic_allocation']) }}
{{ Form::label('in_charge', __('patients.assign_incharge')) }}
{{ Form::label('appointment_date',__('patients.appointment_date')) }}
{{ Form::text('appointment_date','',['class' => 'compulsory form-control','readonly','id'=>'appointment_date', 'required']) }}
{{ Form::label('appointment_time',__('patients.appointment_time')) }} {{ Form::time('appointment_time','',['class' => 'compulsory form-control','required']) }}
{{ Form::label('comments',__('patients.comments')) }} {{ Form::textarea('comments','',['class' => 'form-control', 'data-error'=>'','id'=>'comments']) }}
{{ Form::button(__('patients.submit'),['type'=>'submit','class'=>'btn btn-success waves-effect waves-light m-r-10', 'id' => 'submit_button']) }} {{ Form::button(__('patients.cancel'),['type'=>'reset','class'=>'btn btn-default waves-effect waves-light']) }} {{ Form::close() }}
@endsection @push('scripts') @endpush