streamline-emr/docker/statistics/Modules/ClinicalData/Resources/views/age_groups/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">{{ __('age_groups.edit_age_group') }}</h4>
    </div>
    <div class="col-lg-9 col-sm-8 col-md-8 col-xs-12">
        <ol class="breadcrumb">
            <li><a href="{{ route('home') }}">{{ __('age_groups.dashboard') }}</a></li>
            <li><a href="/age_groups/index">{{ __('age_groups.age_groups') }}</a></li>
            <li class="active">{{ __('age_groups.create') }}</li>
        </ol>
    </div>
</div>

<div class="row">
    <div class="col-sm-12">
        @include('clinical_data::age_groups.menu')
    </div>
</div>


<div class="white-box">
    @include('flash::message')

    {{ Form::model($age_group, ['method' => 'PUT', 'route' => ['age_groups.update',$age_group], 'data-toggle' => 'validator']) }}

    <div class="row">
        <div class="col-md-6">
            <div class="form-group">
                {{ Form::label('name', __('age_groups.age_group')) }}
                {{ Form::text('name', $age_group->name, ['class' => 'form-control compulsory', 'required']) }}
            </div>

            <div class="form-group">
                {{ Form::label('from_age', __('age_groups.from_age')) }}
                {{ Form::number('from_age', $age_group->from_age, ['class' => 'form-control compulsory', 'required']) }}
            </div>
        </div>

        <div class="col-md-6">
            <div class="form-group">
                {{ Form::label('age_type', __('age_groups.age_type')) }}
                {{ Form::select('age_type', ['' => '--select--', 1 => 'Years', 2 => 'Months', 3 => 'Days'], $age_group->age_type, ['class' => 'form-control compulsory', 'required']) }}
            </div>

            <div class="form-group">
                {{ Form::label('to_age', __('age_groups.to_age')) }}
                {{ Form::number('to_age', $age_group->to_age, ['class' => 'form-control compulsory', 'required']) }}
            </div>
        </div>
    </div>

    {{ Form::button(__('age_groups.submit'),['type'=>'submit','class'=>'btn btn-success waves-effect waves-light m-r-10']) }}
    {{ Form::button(__('age_groups.cancel'),['type'=>'reset','class'=>'btn btn-default waves-effect waves-light']) }}

    {{ Form::close() }}
</div>
@endsection

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