streamline-emr/docker/streamline-src/Modules/Investigations/Resources/views/radiologies/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" />
    <link href="{{ asset('elite/bower_components/select2/select2.min.css') }}" rel="stylesheet" />
@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_radiology') }}</h4>
        </div>
        <div class="col-lg-9 col-sm-8 col-md-8 col-xs-12">
            <ol class="breadcrumb">
                <li><a href="{{ route('home') }}">{{ __('clinical_data.dashboard') }}</a></li>
                <li><a href="{{ route('radiology.index') }}">{{ __('clinical_data.radiologies') }}</a></li>
                <li class="active">{{ __('clinical_data.create') }}</li>
            </ol>
        </div>
    </div>

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

    <div class="white-box">
        {{ Form::open(['route' => 'radiology.store', 'data-toggle' => 'validator']) }}

        <div class="row">
            <div class="col-md-6">
                <div class="form-group">
                    {{ Form::label('name',__('clinical_data.name')) }}
                    {{ Form::text('name','',['class' => 'form-control compulsory', 'required']) }}
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    {{ Form::label('cost_price',__('clinical_data.item_cost_price')) }}
                    {{ Form::text('cost_price','',['class' => 'form-control compulsory', 'required']) }}
                </div>
            </div>
        </div>   
        <div class="row">
            <div class="col-md-6">
                <div class="form-group">
                    {{ Form::label('payables_account_id', __('clinical_data.payables_account')) }}
                    {{ Form::select('payables_account_id', $payables_accounts, null, ['class' => 'form-control']) }}
                    <div class="help-block with-errors"></div>
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    {{ Form::label('expenses_account_id', __('clinical_data.expenses_account')) }}
                    {{ Form::select('expenses_account_id', $expense_accounts, null, ['class' => 'form-control']) }}
                    <div class="help-block with-errors"></div>
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    {{ Form::label('re_order_level_id', __('labs.reorder_level') ) }}
                    {{ Form::number('re_order_level', null, ['class' => 'form-control ']) }}
                    <div class="help-block with-errors"></div>
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    {{ Form::label('form_id', __('labs.form')) }}
                    {{ Form::select('form', $forms, null, ['class' => 'form-control']) }}
                    <div class="help-block with-errors"></div>
                </div>
            </div>
        </div>
   
        {{ Form::button(__('clinical_data.submit'),['type'=>'submit','class'=>'btn btn-success waves-effect waves-light m-r-10 submit-btn']) }}
        {{ Form::button(__('clinical_data.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