streamline-emr/docker/streamline-src/Modules/Patients/Resources/views/patient_documents/create.blade.php

@extends('layouts.main')

@push('styles')
<link href="{{ asset('elite/bower_components/bootstrap-datepicker/bootstrap-datepicker.min.css') }}" rel="stylesheet" type="text/css" />
@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">{{ __('patient_documents.upload') }} <strong>@if(isset($patient->last_name)){{$patient->last_name}}'s @endif</strong> {{ __('patient_documents.document') }}</h4>
    </div>
    <div class="col-lg-9 col-sm-8 col-md-8 col-xs-12">
        <ol class="breadcrumb">
            <li><a href="{{ route('home') }}">{{ __('patient_documents.dashboard') }}</a></li>
            <li><a href="{{ route('patients.index') }}">{{ __('patient_documents.patient') }}</a></li>
            <li class="active">{{ __('patient_documents.document') }}</li>
        </ol>
    </div>
    <!-- /.col-lg-12 -->
</div>

<div class="row">
    <div class="col-sm-12">
        @include('patients::allergies.header')
    </div>
</div>

<!-- .row -->
<div class="row">
    <div class="col-sm-12">
        <!--Flash messages at the top -->
        @include('flash::message')
        @foreach ($errors->all() as $error)
            <div>{{ $error }}</div>
        @endforeach
        <div class="white-box">
            {{ Form::open(['route' => 'patient_documents.store','data-toggle'=>'validator','files'=>'true']) }}
            <div class="row">
                <div class="col-sm-6">
                    <div class="form-group">
                        {{ Form::label('patientnumber',__('patient_documents.patient_number')) }}
                        {{ Form::text('patientnumber',$patient->number,['class' => 'form-control compulsory', 'required', 'data-error'=>'','readonly'=>'true']) }}
                        <div class="help-block with-errors"></div>
                    </div>

                    <div class="form-group">
                        {{ Form::label('documenttitle',__('patient_documents.document_title')) }}
                        {{ Form::text('documenttitle','',['class' => 'form-control compulsory', 'required', 'data-error'=>'']) }}
                        <div class="help-block with-errors"></div>
                    </div>

                    <div class="form-group">
                        {{ Form::label('description',__('patient_documents.description')) }}
                        {{ Form::textArea('description','',['class' => 'form-control']) }}
                    </div>
                </div>

                <div class="col-sm-6">
                    <div class="form-group">
                        {{ Form::label('documentdate',__('patient_documents.date_of_document')) }}
                        <div class="input-group">
                            {{ Form::text('documentdate',date('d/m/Y'),['class' => 'form-control compulsory', 'required','readonly','id'=>'datepicker-autoclose']) }}
                            <span class="input-group-addon"><i class="icon-calender"></i></span>                   
                        </div>
                        <div class="help-block with-errors"></div>
                    </div>

                    <div class="form-group">
                        {{ Form::label('document',__('patient_documents.document')) }}
                        {{ Form::file('document',['class' => 'form-control compulsory', 'required']) }}
                        <div class="help-block with-errors"></div>
                    </div>
                </div>
                <div class="col-md-6"><hr></div>
                <div class="col-md-4">
                    {{ Form::button(__('patient_documents.submit'),['type'=>'submit','class'=>'btn btn-success waves-effect waves-light m-r-10']) }}
                    {{ Form::button(__('patient_documents.cancel'),['type'=>'reset','class'=>'btn btn-default waves-effect waves-light']) }}
                </div>
            </div>
            {{ Form::close() }}
        </div>
    </div>
</div>
<!-- /.row -->
@endsection
@push('scripts')
<script src="{{ asset('elite/js/validator.js') }}"></script>
<!-- Date Picker Plugin JavaScript -->
<script src="{{ asset('elite/bower_components/bootstrap-datepicker/bootstrap-datepicker.min.js') }}"></script>
<script src="{{ asset('js/patients/create.js') }}"></script>
<script src="{{ asset('elite/js/mask.js') }}"></script>

<script type="text/javascript">
jQuery('#datepicker-autoclose').datepicker({
    autoclose: true,
    todayHighlight: true,
    format: 'dd/mm/yyyy',
});

$("#datepicker-autoclose").on('change', function () {
    var today = new Date();
    var documentDate = $(this).val();
    var temp_date = documentDate.split("/");
    documentDate = new Date(temp_date[2], (temp_date[1] - 1), temp_date[0]);
    //calculate years
    var age = today.getFullYear() - documentDate.getFullYear();
    age = parseInt(age);
    var m = today.getMonth() - documentDate.getMonth();
    if (m < 0 || (m === 0 && today.getDate() < documentDate.getDate())) {
        age--;
    }
    //calculate months
    var monthDocument = documentDate.getMonth() + 1;
    var monthToday = today.getMonth() + 1;
    if (monthToday > monthDocument) {
        var months = monthToday - monthDocument;
    } else if (monthToday == monthDocument) {
        var months = 0;
    } else if (monthToday < monthDocument) {
        var months = monthToday - monthDocument;
        months = months + 12;
    }
    if (months < 10) {
        months = '0' + months;
    }
    //set the values
    $('#age_in_years').val(age);
    $('#age_in_months').val(months);
});

</script>
@endpush