isaaccladandCursor
6c9c742ed8
Deploy Ladill Care / deploy (push) Failing after 13s
Healthcare management app: patients, appointments, consultations, lab, pharmacy inventory, billing, and reports at care.ladill.com. Co-authored-by: Cursor <cursoragent@cursor.com>
57 lines
2.8 KiB
PHP
57 lines
2.8 KiB
PHP
@php
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$isWalkIn = $isWalkIn ?? false;
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@endphp
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<div class="grid gap-4 sm:grid-cols-2">
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<div>
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<label class="block text-sm font-medium text-slate-700">Branch</label>
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<select name="branch_id" required class="mt-1 w-full rounded-lg border-slate-300 text-sm">
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@foreach ($branches as $branch)
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<option value="{{ $branch->id }}" @selected(old('branch_id', $defaultBranch) == $branch->id)>{{ $branch->name }}</option>
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@endforeach
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</select>
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</div>
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<div>
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<label class="block text-sm font-medium text-slate-700">Patient</label>
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<select name="patient_id" required class="mt-1 w-full rounded-lg border-slate-300 text-sm">
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<option value="">Select patient…</option>
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@foreach ($patients as $patient)
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<option value="{{ $patient->id }}" @selected(old('patient_id') == $patient->id)>{{ $patient->fullName() }} ({{ $patient->patient_number }})</option>
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@endforeach
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</select>
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</div>
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<div>
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<label class="block text-sm font-medium text-slate-700">Practitioner</label>
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<select name="practitioner_id" class="mt-1 w-full rounded-lg border-slate-300 text-sm">
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<option value="">Any / unassigned</option>
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@foreach ($practitioners as $practitioner)
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<option value="{{ $practitioner->id }}" @selected(old('practitioner_id') == $practitioner->id)>{{ $practitioner->name }}</option>
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@endforeach
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</select>
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</div>
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<div>
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<label class="block text-sm font-medium text-slate-700">Department</label>
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<select name="department_id" class="mt-1 w-full rounded-lg border-slate-300 text-sm">
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<option value="">—</option>
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@foreach ($departments as $department)
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<option value="{{ $department->id }}" @selected(old('department_id') == $department->id)>{{ $department->name }}</option>
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@endforeach
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</select>
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</div>
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@unless ($isWalkIn)
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<div class="sm:col-span-2">
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<label class="block text-sm font-medium text-slate-700">Scheduled date & time</label>
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<input type="datetime-local" name="scheduled_at" value="{{ old('scheduled_at') }}" required
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class="mt-1 w-full rounded-lg border-slate-300 text-sm">
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</div>
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@endunless
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<div class="sm:col-span-2">
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<label class="block text-sm font-medium text-slate-700">Reason for visit</label>
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<input type="text" name="reason" value="{{ old('reason') }}" class="mt-1 w-full rounded-lg border-slate-300 text-sm">
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</div>
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<div class="sm:col-span-2">
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<label class="block text-sm font-medium text-slate-700">Notes</label>
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<textarea name="notes" rows="3" class="mt-1 w-full rounded-lg border-slate-300 text-sm">{{ old('notes') }}</textarea>
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</div>
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</div>
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