113 lines
5.0 KiB
PHP
113 lines
5.0 KiB
PHP
<div class="card-body">
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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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<label>{{ __('label.hospital_form_name') }} <span class="text-danger">*</span></label>
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{{ Form::text('name',null,['class' => $errors->has('name') ? 'form-control is-invalid' : 'form-control']) }}
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@error('name')
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<div class="invalid-feedback">{{ $message }}</div>
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@enderror
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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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<label>{{ __('label.hospital_form_contact') }} <span class="text-danger">*</span></label>
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{{ Form::text('contact_name',null,['class' => $errors->has('contact_name') ? 'form-control is-invalid' : 'form-control']) }}
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@error('contact_name')
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<div class="invalid-feedback">{{ $message }}</div>
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@enderror
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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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<label>{{ __('label.hospital_form_email') }} <span class="text-danger">*</span></label>
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{{ Form::email('email',null,['class' => $errors->has('email') ? 'form-control is-invalid' : 'form-control']) }}
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@error('email')
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<div class="invalid-feedback">{{ $message }}</div>
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@enderror
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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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<label>{{ __('label.hospital_form_alter_email') }}</label>
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{{ Form::email('alter_email',null,['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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<label>{{ __('label.hospital_form_photo') }} <span class="text-danger">*</span></label><br/>
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{{ Form::file('photo',null,['class' => $errors->has('photo') ? 'form-control is-invalid' : 'form-control']) }}
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@error('photo')
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<div class="invalid-feedback">{{ $message }}</div>
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@enderror
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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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<label>{{ __('label.hospital_form_number') }} <span class="text-danger">*</span></label>
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{{ Form::text('number',null,['class' => $errors->has('number') ? 'form-control is-invalid' : 'form-control']) }}
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@error('number')
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<div class="invalid-feedback">{{ $message }}</div>
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@enderror
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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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<label>{{ __('label.hospital_form_city') }} <span class="text-danger">*</span></label>
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{{ Form::text('city',null,['class' => $errors->has('city') ? 'form-control is-invalid' : 'form-control']) }}
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@error('city')
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<div class="invalid-feedback">{{ $message }}</div>
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@enderror
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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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<label>{{ __('label.hospital_form_state') }} <span class="text-danger">*</span></label>
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{{ Form::text('state',null,['class' => $errors->has('state') ? 'form-control is-invalid' : 'form-control']) }}
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@error('state')
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<div class="invalid-feedback">{{ $message }}</div>
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@enderror
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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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<label>{{ __('label.area') }} <span class="text-danger">*</span></label>
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{{ Form::text('area',null,['class' => $errors->has('area') ? 'form-control is-invalid' : 'form-control']) }}
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@error('area')
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<div class="invalid-feedback">{{ $message }}</div>
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@enderror
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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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<label>{{ __('label.hospital_form_address') }} <span class="text-danger">*</span></label>
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{{ Form::textarea('address',null,['class' => $errors->has('name') ? 'form-control is-invalid' : 'form-control']) }}
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@error('address')
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<div class="invalid-feedback">{{ $message }}</div>
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@enderror
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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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<label>{{ __('label.hospital_form_benefits') }}</label>
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{{ Form::textarea('benefits',null,['class' => 'form-control']) }}
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</div>
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</div>
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</div>
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</div>
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<div class="card-footer">
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<button type="submit" name="save" value="save" class="btn btn-primary mr-2">
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@if(\Request::route()->getName() == 'admin.hospitals.edit')
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{{ __('buttons.update') }}
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@else
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{{ __('buttons.save') }}
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@endif
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</button>
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<a href="{{ route('admin.hospitals.index') }}" class="btn btn-secondary">{{ __('buttons.cancel') }}</a>
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</div>
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