streamline-emr/docker/streamline-src/Modules/Insurance/Resources/views/risks/edit.blade.php

@extends('layouts.main')

@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">{{ __('risks.risk') }}</h4>
    </div>
    <div class="col-lg-9 col-sm-8 col-md-8 col-xs-12">
        <ol class="breadcrumb">
            <li><a href="{{ route('home') }}">{{ __('risks.dashboard') }}</a></li>
            <li><a href="{{ route('risks.index') }}">{{ __('risks.risk') }}</a></li>
            <li class="active">{{ __('risks.edit') }}</li>
        </ol>
    </div>
</div>

@include('insurance::risks.menu')

<div class="row">
    <div class="col-md-12">
        <!--Flash messages at the top -->
        @include('flash::message')        
        <div class="white-box">
            @if ($errors->any())
                <div class="alert alert-danger">
                    <strong>Whoops!</strong> There were some problems with your input.<br><br>
                    <ul>
                        @foreach ($errors->all() as $error)
                            <li>{{ $error }}</li>
                        @endforeach
                    </ul>
                </div>
            @endif
            {{ Form::model($risk, ['method' => 'PUT', 'route' => ['risks.update', $risk], 'data-toggle' =>'validator']) }}
            <div class="row">
                <div class="col-md-12">

                    <div class="form-group">
                        {{ Form::label('name', __('risks.risk_name')) }}
                        {{ Form::text('name', $risk->name, ['class' => 'form-control compulsory', 'required']) }}
                        <div class="help-block with-errors"></div>
                    </div>

                    <div class="form-group">
                        {{ Form::label('code', __('risks.risk_code')) }}
                        {{ Form::text('code', $risk->code, ['class' => 'form-control compulsory', 'required']) }}
                        <div class="help-block with-errors"></div>
                    </div>

                    <div class="form-group">
                        {{ Form::label('factor', __('risks.risk_factor')) }}
                        {{ Form::number('factor',  $risk->factor, ['class' => 'form-control compulsory', 'step' => '0.001', 'required', 'data-error' => '', 'min' => 0]) }}
                        <div class="help-block with-errors"></div>
                    </div>

                    <div class="form-group">
                        {{ Form::label('amount', __('risks.risk_amount')) }}
                        {{ Form::number('amount',  $risk->amount, ['class' => 'form-control compulsory', 'required', 'data-error' => '', 'step' => '0.01', 'min' => 0]) }}
                        <div class="help-block with-errors"></div>
                    </div>
                </div>
                {{ Form::button(__('risks.submit'),['type'=>'submit','class'=>'btn btn-success waves-effect waves-light m-r-10']) }}
                {{ Form::button(__('risks.cancel'),['type'=>'reset','class'=>'btn btn-default waves-effect waves-light']) }}
                {{ Form::close() }}
            </div>
        </div>
    </div>
</div>
@endsection

@push('scripts')
<script src="{{ asset('elite/js/validator.js') }}"></script>
@endpush