mirror of
https://gitlab.com/signalytic/client-external/streamline/streamline-emr.git
synced 2026-09-11 18:51:31 +00:00
48 lines
1.8 KiB
PHP
Executable File
48 lines
1.8 KiB
PHP
Executable File
@extends('layouts.main')
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@section('content')
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<div class="row bg-title">
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<div class="col-lg-3 col-md-4 col-sm-4 col-xs-12">
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<h4 class="page-title">{{ __('referral_hospitals.edit_referral_hospital') }}</h4>
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</div>
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<div class="col-lg-9 col-sm-8 col-md-8 col-xs-12">
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<ol class="breadcrumb">
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<li><a href="{{ route('home') }}">{{ __('referral_hospitals.dashboard') }}</a></li>
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<li><a href="/referral_hospitals/">{{ __('referral_hospitals.referral_hospital') }}</a></li>
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<li class="active">{{ __('referral_hospitals.edit') }}</li>
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</ol>
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</div>
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<!-- /.col-lg-12 -->
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</div>
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<div class="row">
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<div class="col-sm-12">
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@include('clinical_data::referral_hospitals.menu')
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</div>
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</div>
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<div class="row">
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<div class="col-sm-12">
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@include('flash::message')
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<div class="white-box">
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{{ Form::model($referral_hospital, ['method' => 'PUT', 'route' => ['referral_hospitals.update',$referral_hospital] , 'data-toggle' => 'validator']) }}
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<div class="form-group">
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{{ Form::label('name', __('referral_hospitals.hospital_name')) }}
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{{ Form::text('name', $referral_hospital->name, ['class' => 'form-control compulsory','required']) }}
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<div class="help-block with-errors"></div>
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</div>
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{{ Form::button(__('referral_hospitals.submit'),['type'=>'submit','class'=>'btn btn-success waves-effect waves-light m-r-10']) }}
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{{ Form::button(__('referral_hospitals.cancel'),['type'=>'reset','class'=>'btn btn-default waves-effect waves-light']) }}
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{{ Form::close() }}
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</div>
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</div>
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</div>
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@endsection
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@push('scripts')
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<script src="{{ asset('elite/js/validator.js') }}"></script>
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@endpush
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