mirror of
https://gitlab.com/signalytic/client-external/streamline/streamline-emr.git
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alec.turner
a424394109
The official image from streamline does not currently work for the arm64 platform. As a temporary measure, the source code and docker build scripts have been lifted from the official images and are used to build locally. Some additional modifications are made to reduce overall image size, these are documented in docker/README.md
195 lines
10 KiB
PHP
Executable File
195 lines
10 KiB
PHP
Executable File
@extends('layouts.main')
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@push('styles')
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<link href="{{ asset('elite/bower_components/bootstrap-datepicker/bootstrap-datepicker.min.css') }}" rel="stylesheet" type="text/css" />
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<link href="{{ asset('elite/bower_components/select2/select2.min.css') }}" rel="stylesheet" />
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@endpush
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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">{{ __('hospital_information.hospital_information') }}</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') }}">{{ __('hospital_information.dashboard') }}</a></li>
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<li><a href="/hospital_information/edit">{{ __('hospital_information.hospital_information') }}</a></li>
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<li class="active">{{ __('hospital_information.edit') }}</li>
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</ol>
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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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<!--Flash messages at the top -->
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@include('flash::message')
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<div class="white-box">
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@if (session()->has('streamline_setup'))
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<h3><font color="blue">Stre@mline {{ __('hospital_information.setup') }} ({{ __('hospital_information.step') }} 1 {{ __('hospital_information.of') }} 10)</font></h3>
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@endif
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{{ Form::open(['route' => 'hospital_information.store', 'data-toggle' => 'validator', 'files' => true]) }}
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<div class="row">
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<div class="col-md-6">
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<div class="form-group">
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{{ Form::label('name', __('hospital_information.hospital_name')) }}
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{{ Form::text('name', '', ['class' => 'form-control compulsory', 'required', 'data-error'=>'']) }}
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<div class="help-block with-errors"></div>
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</div>
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<div class="form-group">
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{{ Form::label('level', __('hospital_information.level')) }}
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{{ Form::text('level', '', ['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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<div class="form-group">
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{{ Form::label('code', __('hospital_information.code')) }}
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{{ Form::text('code', '', ['class' => 'form-control']) }}
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</div>
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<div class="form-group">
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{{ Form::label('parish', __('hospital_information.parish')) }}
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{{ Form::select('parish', $parishes, '', ['class' => 'form-control parish']) }}
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<div class="help-block with-errors"></div>
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</div>
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<div class="form-group">
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{{ Form::label('sub_county', __('hospital_information.sub_county')) }}
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{{ Form::select('sub_county', $subcounties, '', ['class' => 'form-control sub_county']) }}
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<div class="help-block with-errors"></div>
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</div>
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<div class="form-group">
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{{ Form::label('sub_district', __('hospital_information.health_sub_district')) }}
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{{ Form::text('sub_district', '', ['class' => 'form-control sub_district']) }}
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</div>
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<div class="form-group">
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{{ Form::label('address', __('hospital_information.address')) }}
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{{ Form::text('address', '', ['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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<div class="form-group">
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{{ Form::label('website', __('hospital_information.website')) }}
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{{ Form::text('website', '', ['class' => 'form-control']) }}
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</div>
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</div>
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<div class="col-md-6">
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<div class="form-group">
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{{ Form::label('phone_number', __('hospital_information.phone_number')) }}
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{{ Form::text('phone_number', '', ['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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<div class="form-group">
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{{ Form::label('email', __('hospital_information.email')) }}
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{{ Form::email('email', '', ['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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<div class="form-group">
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{{ Form::label('financial_year_start_date', 'Start of Financial Year') }}
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{{-- {{ Form::date('financial_year_start_date', '', ['class' => 'form-control', 'required']) }} --}}
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<select id="month" name="financial_year_start_date" class = "form-control compulsory">
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<option value="">-- Select --</option>
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<option value="01">January</option>
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<option value="02">February</option>
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<option value="03">March</option>
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<option value="04">April</option>
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<option value="05">May</option>
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<option value="06">June</option>
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<option value="07">July</option>
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<option value="08">August</option>
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<option value="09">September</option>
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<option value="10">October</option>
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<option value="11">November</option>
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<option value="12">December</option>
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</select>
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<div class="help-block with-errors"></div>
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</div>
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<div class="form-group">
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{{ Form::label('back_date', 'Back Dating Cutoff Days') }}
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{{ Form::number('back_date', '', ['class' => 'form-control compulsory', 'required','min' => 1]) }}
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<div class="help-block with-errors"></div>
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</div>
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<div class="form-group">
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{{ Form::label('district', __('hospital_information.district')) }}
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{{ Form::select('district', $districts, '', ['class' => 'form-control compulsory district']) }}
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<div class="help-block with-errors"></div>
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</div>
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<div class="form-group">
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{{ Form::label('country', __('hospital_information.country')) }}
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{{ Form::text('country', '', ['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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{{--<div class="form-group">
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{{ Form::label('app_name', 'App name') }}
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{{ Form::text('app_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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<div class="form-group">
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{{ Form::label('app_version', 'App version') }}
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{{ Form::number('app_version', '', ['class' => 'form-control compulsory', 'required', 'step' => 0.1]) }}
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<div class="help-block with-errors"></div>
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</div>--}}
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<div class="form-group">
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{{ Form::label('patient_number_abbr', __('hospital_information.patient_number_abbr')) }}
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{{ Form::text('patient_number_abbr', '', ['class' => 'form-control compulsory', 'required', 'max'=>'3']) }}
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<div class="help-block with-errors"></div>
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</div>
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<div class="form-group">
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{{ Form::label('logo', __('hospital_information.system_logo')) }}
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{{ Form::file('logo', null) }}
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{{ Form::text('current_logo', '', ['class' => 'form-control', 'hidden']) }}
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</div>
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<div class="form-group">
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{{ Form::label('stamp', __('hospital_information.stamp')) }}
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{{ Form::file('stamp', null) }}
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{{ Form::text('current_stamp', '', ['class' => 'form-control', 'hidden']) }}
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</div>
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<div class="form-group">
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{{ Form::label('lab_stamp', __('hospital_information.lab_stamp')) }}
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{{ Form::file('lab_stamp', null) }}
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{{ Form::text('current_lab_stamp', '', ['class' => 'form-control', 'hidden']) }}
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</div>
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</div>
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</div>
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{{ Form::button(__('hospital_information.next'),['type'=>'submit','class'=>'btn btn-success btn-lg waves-effect waves-light m-r-10']) }}
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{{--{{ Form::button('Skip',['type'=>'reset','class'=>'btn btn-default btn-lg 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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<script src="{{ asset('elite/bower_components/select2/select2.min.js') }}"></script>
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<script type="text/javascript">
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$(document).ready(function(){
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$('.parish,.sub_county,.district').select2({
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placeholder: "-- select --"
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});
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$('.select2-selection.select2-selection--single').css('height','calc(3.85rem)');
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$('.select2-selection.select2-selection--single').css('padding-top','5px');
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//$('.select2-selection.select2-selection--single').css('border-left', '3px solid #F08080');/*add compulsory class*/
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$('.select2-selection.select2-selection--single.sec_d').css('border-left', '3px solid #aaa');
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$('.select2-selection__arrow').css('top','3px');
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})
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</script>
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@endpush
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