{{ Form::hidden('currency_symbol', getCurrentCurrency(), ['class' => 'currencySymbol']) }}
{{ Form::label('patient_id', __('messages.ambulance_call.patient') . ':', ['class' => 'form-label']) }} {{ Form::select('patient_id', $patients, null, ['class' => 'form-select', 'required', 'id' => 'ambulanceCallPatientId', 'placeholder' => __('messages.document.select_patient'), 'data-control' => 'select2']) }}
{{ Form::label('ambulance_id', __('messages.ambulance_call.vehicle_model') . ':', ['class' => 'form-label']) }} {{ Form::select('ambulance_id', $ambulances, null, ['class' => 'form-select', 'required', 'id' => 'callAmbulanceId', 'placeholder' => __('messages.common.choose') . ' ' . __('messages.ambulance.ambulance'), 'data-control' => 'select2']) }}
{{ Form::label('date', __('messages.ambulance_call.date') . ':', ['class' => 'form-label']) }} {{ Form::text('date', null, ['id'=>'ambulanceCallDate', 'class' => (getLoggedInUser()->thememode ? 'bg-light form-control' : 'bg-white form-control'), 'required','autocomplete' => 'off','placeholder'=>__('messages.ambulance_call.date')]) }}
{{ Form::label('driver_name', __('messages.ambulance_call.driver_name') . ':', ['class' => 'form-label']) }} {{ Form::text('driver_name', null, ['class' => 'form-control', 'required', 'readonly', 'id' => 'ambulanceCallDriverName', 'placeholder' => __('messages.ambulance_call.driver_name')]) }}
{{ Form::label('amount', __('messages.ambulance_call.amount') . ':', ['class' => 'form-label']) }} {{ Form::number('amount', null, ['class' => 'form-control', 'required','placeholder'=>__('messages.ambulance_call.amount')]) }}
{{ Form::submit(__('messages.common.save'), ['class' => 'btn btn-primary me-2', 'id' => 'ambulanceCallSaveBtn']) }} {{ __('messages.common.cancel') }}