{{ Form::label('test_name', __('messages.radiology_test.test_name') . ':', ['class' => 'form-label']) }} {{ Form::text('test_name', null, ['class' => 'form-control', 'required','placeholder'=>__('messages.radiology_test.test_name')]) }}

{{ Form::label('short_name', __('messages.radiology_test.short_name') . ':', ['class' => 'form-label']) }} {{ Form::text('short_name', null, ['class' => 'form-control', 'required','placeholder'=>__('messages.radiology_test.short_name')]) }}

{{ Form::label('test_type', __('messages.radiology_test.test_type') . ':', ['class' => 'form-label']) }} {{ Form::text('test_type', null, ['class' => 'form-control', 'required','placeholder'=>__('messages.radiology_test.test_type')]) }}

{{ Form::label('category_id', __('messages.radiology_test.category_name') . ':', ['class' => 'form-label']) }} {{ Form::select('category_id', $data['radiologyCategories'], null, ['class' => 'form-select radiologyCategories', 'required', 'id' => 'editRadiologyCategories', 'placeholder' => __('messages.medicine.select_category'), 'required']) }}

{{ Form::label('subcategory', __('messages.radiology_test.subcategory') . ':', ['class' => 'form-label']) }} {{ Form::text('subcategory', null, ['class' => 'form-control','placeholder'=>__('messages.radiology_test.subcategory')]) }}

{{ Form::label('report_days', __('messages.radiology_test.report_days') . ':', ['class' => 'form-label']) }} {{ Form::number('report_days', null, ['class' => 'form-control','placeholder'=>__('messages.radiology_test.report_days')]) }}

{{ Form::label('charge_category_id', __('messages.radiology_test.charge_category') . ':', ['class' => 'form-label ']) }} {{ Form::select('charge_category_id', $data['chargeCategories'], null, ['class' => 'form-select charge-category', 'required', 'id' => 'editChargeCategories', 'placeholder' => __('messages.pathology_category.select_charge_category'), 'required']) }}

{{ Form::label('charge_id', __('messages.bed.charge') . ':', ['class' => 'form-label']) }} {{ Form::select('charge_id', $data['chargeCodes'], null, ['class' => 'form-select charge-code', 'required', 'id' => 'chargeCode', 'placeholder' => __('messages.common.choose') . ' ' . __('messages.bed.charge'), 'required', 'data-control' => 'select2']) }}

{{ Form::label('standard_charge', __('messages.radiology_test.standard_charge') . ':', ['class' => 'form-label']) }} @if (getCurrencySymbol() != null) ({{ getCurrencySymbol() }}) @endif {{ Form::text('standard_charge', null, ['placeholder' => __('messages.radiology_test.standard_charge'),'class' => 'form-control price-input rtStandardCharge', 'id' => 'editRTStandardCharge', 'readonly', 'required']) }}