{{ Form::label('patient_id', __('messages.patient_diagnosis_test.patient') . ':', ['class' => 'form-label']) }}
{{ Form::select('patient_id', $patients, isset($patientDiagnosisTest) ? $patientDiagnosisTest->patient_id : null, ['class' => 'form-select', 'required', 'id' => 'diagnosisTestPatientId', 'placeholder' => __('messages.document.select_patient'), 'data-control' => 'select2']) }}
@if (Auth::user()->hasRole('Doctor'))
@else
{{ Form::label('doctor_id', __('messages.patient_diagnosis_test.doctor') . ':', ['class' => 'form-label']) }}
{{ Form::select('doctor_id', $doctors, isset($patientDiagnosisTest) ? $patientDiagnosisTest->doctor_id : null, ['class' => 'form-select', 'required', 'id' => 'diagnosisTestdoctorId', 'placeholder' => __('messages.web_appointment.select_doctor'), 'data-control' => 'select2']) }}
@endif
{{ Form::label('category_id', __('messages.patient_diagnosis_test.diagnosis_category') . ':', ['class' => 'form-label']) }}
{{ Form::select('category_id', $diagnosisCategory, isset($patientDiagnosisTest) ? $patientDiagnosisTest->category_id : null, ['class' => 'form-select', 'required', 'id' => 'diagnosisTestCategoryId', 'data-control' => 'select2', 'placeholder' => __('messages.common.choose') . ' ' . __('messages.patient_diagnosis_test.diagnosis_category')]) }}
{{ Form::label('report_number', __('messages.patient_diagnosis_test.report_number') . ':', ['class' => 'form-label']) }}
{{ Form::text('report_number', isset($patientDiagnosisTest) ? $patientDiagnosisTest->report_number : $reportNumber, ['class' => 'form-control', 'readonly']) }}
{{ Form::label('age', __('messages.patient_diagnosis_test.age').':', ['class' => 'form-label']) }}
{{ Form::number('age', null, ['class' => 'form-control', 'min' => '1', 'max' => '100','placeholder'=>__('messages.patient_diagnosis_test.age')]) }}
{{ Form::label('height', __('messages.patient_diagnosis_test.height').':', ['class' => 'form-label']) }}
{{ Form::number('height', null, ['class' => 'form-control floatNumber', 'max' => '7', 'min' => '1' , 'step' => '.01','placeholder'=>__('messages.patient_diagnosis_test.height')]) }}
{{ Form::label('weight', __('messages.patient_diagnosis_test.weight').':', ['class' => 'form-label']) }}
{{ Form::number('weight', null, ['class' => 'form-control floatNumber', 'data-mask'=>'##0,00', 'min' => '1' , 'max' => '200', 'step' => '.01','placeholder'=>__('messages.patient_diagnosis_test.weight')]) }}
{{ Form::label('average_glucose', __('messages.patient_diagnosis_test.average_glucose').':', ['class' => 'form-label']) }}
{{ Form::text('average_glucose', null, ['class' => 'form-control','placeholder'=>__('messages.patient_diagnosis_test.average_glucose')]) }}
{{ Form::label('fasting_blood_sugar', __('messages.patient_diagnosis_test.fasting_blood_sugar').':', ['class' => 'form-label']) }}
{{ Form::text('fasting_blood_sugar', null, ['class' => 'form-control','placeholder'=>__('messages.patient_diagnosis_test.fasting_blood_sugar')]) }}
{{ Form::label('urine_sugar', __('messages.patient_diagnosis_test.urine_sugar').':', ['class' => 'form-label']) }}
{{ Form::text('urine_sugar', null, ['class' => 'form-control','placeholder'=>__('messages.patient_diagnosis_test.urine_sugar')]) }}
{{ Form::label('blood_pressure', __('messages.patient_diagnosis_test.blood_pressure').':', ['class' => 'form-label']) }}
{{ Form::number('blood_pressure', null, ['class' => 'form-control','placeholder'=>__('messages.patient_diagnosis_test.blood_pressure')]) }}
{{ Form::label('diabetes', __('messages.patient_diagnosis_test.diabetes').':', ['class' => 'form-label']) }}
{{ Form::text('diabetes', null, ['class' => 'form-control','placeholder'=>__('messages.patient_diagnosis_test.diabetes')]) }}
{{ Form::label('cholesterol', __('messages.patient_diagnosis_test.cholesterol').':', ['class' => 'form-label']) }}
{{ Form::text('cholesterol', null, ['class' => 'form-control','placeholder'=>__('messages.patient_diagnosis_test.cholesterol')]) }}
{{ __('messages.patient_diagnosis_test.add_other_diagnosis_property') }}
# |
{{ __('messages.patient_diagnosis_test.diagnosis_property_name') }}
|
{{ __('messages.patient_diagnosis_test.diagnosis_property_value') }}
|
|
{!! Form::submit(__('messages.common.save'), [
'class' => 'btn btn-primary me-2 saveBtn',
'id' => 'diagnosisTestSave',
]) !!}
{!! __('messages.common.cancel') !!}