streamline-emr/docker/statistics/Modules/ClinicalData/Resources/views/eye_glasses/create.blade.php

@extends('layouts.main')

@push('styles')
@endpush

@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">{{ __('clinical_data.add_opticals') }}</h4>
        </div>
        <div class="col-lg-9 col-sm-8 col-md-8 col-xs-12">
            <ol class="breadcrumb">
                <li><a href="{{ route('home') }}">Dashboard</a></li>
                <li><a href="/opticals/">{{ __('clinical_data.opticals') }}</a></li>
                <li class="active">Create</li>
            </ol>
        </div>
    </div>

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

    <div class="row">
        <div class="col-sm-12">
            <!--Flash messages at the top -->
            @include('flash::message')
            <div class="white-box">
                {{ Form::open(['route' => 'opticals.store' , 'data-toggle' => 'validator']) }}
                <div class="form-group">
                    {{ Form::label('name', 'Name') }}
                    {{ Form::text('name', '', ['class' => 'form-control compulsory', 'required']) }}
                    <div class="help-block with-errors"></div>
                </div>

                <div class="form-group">
                    {{ Form::label('price', 'Buying price') }}
                    {{ Form::number('price', '', ['class' => 'form-control compulsory', 'required']) }}
                    <div class="help-block with-errors"></div>
                </div>

                <div class="form-group non_insured_price_div">
                    {{ Form::label('non_insured_price', 'Cash Price') }}
                    {{ Form::number('non_insured_price', '', ['class' => 'form-control compulsory', 'required']) }}
                    <div class="help-block with-errors"></div>
                </div>

                <div class="form-group">
                    {{ Form::label('account_id', 'Income Account') }}
                    {{ Form::select('account_id', $chart_of_accounts, null, ['class' => 'form-control compulsory', 'required']) }}
                    <div class="help-block with-errors"></div>
                </div>

                <div class="form-group">
                    {{ Form::label('cost_of_goods_account', 'Cost of Goods Account') }}
                    {{ Form::select('cost_of_goods_account', $cost_of_goods_accounts, null, ['class' => 'form-control compulsory', 'required']) }}
                    <div class="help-block with-errors"></div>
                </div>

                <div class="form-group">
                    {{ Form::label('inventory_account', 'Inventory Asset Account') }}
                    {{ Form::select('inventory_account', $inventory_asset_accounts, null, ['class' => 'form-control compulsory', 'required']) }}
                    <div class="help-block with-errors"></div>
                </div>

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

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

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