{{ Form::hidden('discharge',null)}}
{{ Form::label('patient_id', __('messages.ipd_patient.patient_id') . ':', ['class' => 'form-label']) }}
{{ Form::select('patient_id', $data['patients'], null, ['class' => 'form-select ipdPatientId', 'required', 'id' => 'editIpdPatientId', 'placeholder' => __('messages.document.select_patient'), 'data-control' => 'select2',($ipdPatientDepartment->discharge == 1) ? 'disabled' : '']) }}
{{ Form::label('case_id', __('messages.ipd_patient.case_id') . ':', ['class' => 'form-label']) }}
@if ($ipdPatientDepartment->discharge == 1)
{{ Form::select('case_id', $data['case_id'], $ipdPatientDepartment->case_id, ['class' => 'form-select', 'data-control' => 'select2', 'placeholder' => __('messages.common.choose') . __('messages.cases'),($ipdPatientDepartment->discharge == 1) ? 'disabled' : '']) }}
@else
{{ Form::select('case_id', [null], null, ['class' => 'form-select ipdDepartmentCaseId', 'id' => 'editIpdDepartmentCaseId', 'disabled', 'data-control' => 'select2', 'placeholder' => __('messages.common.choose') . __('messages.cases')]) }}
@endif
{{ Form::label('ipd_number', __('messages.ipd_patient.ipd_number') . ':', ['class' => 'form-label']) }}
{{ Form::text('ipd_number', null, ['class' => 'form-control', 'readonly', 'placeholder' => __('messages.ipd_patient.ipd_number')]) }}
{{ Form::label('height', __('messages.ipd_patient.height') . ':', ['class' => 'form-label']) }}
{{ Form::number('height', null, ['placeholder' => __('messages.ipd_patient.height'),'class' => 'form-control ipdDepartmentFloatNumber', 'max' => '7', 'step' => '.01']) }}
{{ Form::label('weight', __('messages.ipd_patient.weight') . ':', ['class' => 'form-label']) }}
{{ Form::number('weight', null, ['placeholder' => __('messages.ipd_patient.weight') ,'class' => 'form-control ipdDepartmentFloatNumber', 'data-mask' => '##0,00', 'max' => '200', 'step' => '.01', 'tabindex' => '3']) }}
{{ Form::label('bp', __('messages.ipd_patient.bp') . ':', ['class' => 'form-label']) }}
{{ Form::number('bp', null, ['placeholder' => __('messages.ipd_patient.bp'),'class' => 'form-control', 'tabindex' => '4']) }}
{{ Form::label('admission_date', __('messages.ipd_patient.admission_date') . ':', ['class' => 'form-label']) }}
{{ Form::text('admission_date', null, ['placeholder' => __('messages.ipd_patient.admission_date'),'class' => getLoggedInUser()->thememode ? 'bg-light ipdAdmissionDate form-control' : 'bg-white ipdAdmissionDate form-control', 'id' => 'editIpdAdmissionDate', 'autocomplete' => 'off', 'required', 'tabindex' => '5']) }}
{{ Form::label('doctor_id', __('messages.ipd_patient.doctor_id') . ':', ['class' => 'form-label']) }}
{{ Form::select('doctor_id', $data['doctors'], null, ['class' => 'form-select', 'required', 'id' => 'editIpdDoctorId', 'placeholder' => __('messages.web_home.select_doctor'), 'data-control' => 'select2', 'tabindex' => '6']) }}
{{ Form::label('bed_type_id', __('messages.ipd_patient.bed_type_id') . ':', ['class' => 'form-label']) }}
{{ Form::select('bed_type_id', $data['bedTypes'], null, ['class' => 'form-select ipdBedTypeId', 'required', 'id' => 'editIpdBedTypeId', 'placeholder' => __('messages.bed.select_bed_type'), 'data-control' => 'select2', 'tabindex' => '7', ($ipdPatientDepartment->discharge == 1) ? 'disabled' : '']) }}
{{ Form::label('bed_id', __('messages.ipd_patient.bed_id') . ':', ['class' => 'form-label']) }}
@if($ipdPatientDepartment->discharge == 1)
{{ Form::select('bed_id', $data['bed'], $ipdPatientDepartment->bed_id, ['class' => 'form-select', 'data-control' => 'select2', 'placeholder' => __('messages.common.choose').' '.__('messages.ipd_patient.bed_id'), ($ipdPatientDepartment->discharge == 1) ? 'disabled' : '']) }}
@else
{{ Form::select('bed_id', [null], null, ['class' => 'form-select bedId', 'required', 'id' => 'editIpdBedId', 'disabled', 'data-control' => 'select2', 'placeholder' => __('messages.common.choose').' '.__('messages.ipd_patient.bed_id')]) }}
@endif
@if (count($customField) >= 0)
@foreach ($customField as $field)
@php
$field_values = explode(',',$field['values']);
$dateType = ($field['field_type'] == 6) ? 'customFieldDate' : 'customFieldDateTime';
$field_type = \App\Models\AddCustomFields::FIELD_TYPE_ARR[$field['field_type']];
$fieldName = 'field'.$field['id'];
$fieldData = isset($ipdPatientDepartment->custom_field[$fieldName]) ? $ipdPatientDepartment->custom_field[$fieldName] : null;
@endphp
{{ Form::label($field['field_name'], $field['field_name'] . ':', ['class' => $field['is_required'] == 1 ? 'form-label dynamic-field' : 'form-label']) }}
@if ($field['is_required'] == 1)
@endif
@if ($field_type == 'date' || $field_type == 'date & Time' )
{{ Form::text($fieldName, ($fieldData == 'y-m-d' ? $fieldData : null), ['id'=>$dateType,'class' => getLoggedInUser()->thememode || $field['is_required'] == 1 ? 'bg-light form-control dynamic-field' : 'bg-white form-control', 'autocomplete' => 'off','placeholder' => $field['field_name'],$field['is_required'] == 1 ? 'required' : '']) }}
@elseif ($field_type == 'toggle')
@elseif ($field_type == 'select')
{{ Form::select($fieldName,$field_values, $fieldData, ['class' => $field['is_required'] == 1 ? 'form-select dynamic-field' : 'form-select', 'placeholder' =>$field['field_name'], 'data-control' => 'select2',$field['is_required'] == 1 ? 'required' : '' ]) }}
@elseif ($field_type == 'multiSelect')
{{ Form::select($fieldName.'[]', $field_values, $fieldData, ['class' => $field['is_required'] == 1 ? 'form-select ipd-multi-select dynamic-field' : 'form-select ipd-multi-select', 'placeholder' => $field['field_name'], 'data-control' => 'select2', 'multiple' => true,$field['is_required'] == 1 ? 'required' : '']) }}
@else
{{ Form::$field_type($fieldName, $fieldData, ['class' => $field['is_required'] == 1 ? 'form-control dynamic-field' : 'form-control', 'placeholder' => $field['field_name'],$field['is_required'] == 1 ? 'required' : '','rows' => $field_type == 'textarea' ? 4 : '' ]) }}
@endif
{{ Form::label('symptoms', __('messages.ipd_patient.symptoms') . ':', ['class' => 'form-label']) }}
{{ Form::textarea('symptoms', null, ['placeholder' => __('messages.ipd_patient.symptoms'),'class' => 'form-control', 'rows' => 4]) }}
{{ Form::label('notes', __('messages.ipd_patient.notes') . ':', ['class' => 'form-label']) }}
{{ Form::textarea('notes', null, ['placeholder' => __('messages.ipd_patient.notes'),'class' => 'form-control', 'rows' => 4]) }}