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<?php $__env->startSection('title', 'Doctor | Prescription'); ?>

<?php $__env->startSection('content'); ?>
  
  <div class="main-content">
    <div class="main-content-inner">
      <div class="breadcrumbs ace-save-state" id="breadcrumbs">
        <?php echo $__env->make('layouts.header_menu', \Illuminate\Support\Arr::except(get_defined_vars(), ['__data', '__path']))->render(); ?>
      </div>

<div class="page-content">
          <div class="row">
              <div class="col-xs-12">
                
                <div class="space-8"></div>
                <form action="<?php echo e(route('insert_prescription')); ?>" method="post">
                  <?php echo csrf_field(); ?>
                  <div class="row">
                    <div class="col-sm-11">
                      <div class="form-inline">
                         <div class="radio">
                          <label>
                            <input id="new" name="form-field-radio" type="radio" class="ace">
                            <span class="lbl"> New</span>
                          </label>
                        </div>
                         
                        <div class="radio">
                          <label>
                            <input id="old" name="form-field-radio" type="radio" class="ace">
                            <span class="lbl"> Old</span>
                          </label>
                        </div>
                         
                        <div class="radio">
                          <label>
                            <input id="free" name="form-field-radio" type="checkbox" class="ace">
                            <span class="lbl"> Free</span>
                          </label>
                        </div>
                      
                        <input class="hidden" type="text" name="doctor_id" value="<?php echo e(Auth::user()->customer_id); ?>">

<select style="width: 70px;" name="patient_sex">
                          <option>Sex</option>
                          <option value="Male">Male</option>
                          <option value="Female">Female</option>
                          <option value="Child">Child</option>
                          <option value="Infant">Infant</option>
                        </select>

<input type="text" style="width: 230px;" id="address" name="patient_address" placeholder="Address">
                        
                        <input type="text" style="width: 100px;" name="visit_date" id="c_date" value="<?php echo e(date('Y-m-d')); ?>" placeholder="Date">

</div>
                    </div>
                    
                    <div class="col-sm-1">
                      <button class="btn btn-sm btn-danger btn-round">Save</button>
                    </div>
                  </div>
                  <hr>
                  <div class="row">
                    <div class="col-sm-3">
                      <div>
                        <div class="">
                          <textarea class="form-control" cols="50" style="min-height: 100px;" name="chief_complaints" placeholder="C/C"></textarea>
                        </div>

<li>
                              <a href="#tabs-3">Investigation</a>
                            </li>
                            <li>
                              <a href="#tabs-4">D/H</a>
                            </li>
                            <li>
                              <a href="#tabs-5">IX</a>
                            </li>
                          </ul>

<div id="tabs-1">
                            <div class="input-group">
                              <lebel class="col-sm-4 oe_title">BP</lebel>
                              <div>
                                <input class="col-sm-8" type="text" id="form-field-1" name="bp" placeholder="120/80 mmgh">
                              </div>
                            </div>
                            <div class="input-group">
                              <lebel class="col-sm-4 oe_title">Weight</lebel>
                              <div>
                                <input class="col-sm-8" type="text" id="form-field-1" name="weight" placeholder="70 kg">
                              </div>
                            </div>
                            <div class="input-group">
                              <lebel class="col-sm-4 oe_title">Temp</lebel>
                              <div>
                                <input class="col-sm-8" type="text" id="form-field-1" name="temp" placeholder="99 F">
                              </div>
                            </div>
                            <div class="input-group">
                              <lebel class="col-sm-4 oe_title">Pulse</lebel>
                              <div>
                                <input class="col-sm-8" type="text" id="form-field-1" name="pulse" placeholder="80 bpm">
                              </div>
                            </div>
                            <div class="input-group">
                              <lebel class="col-sm-4 oe_title">Heart</lebel>
                              <div>
                                <input class="col-sm-8" type="text" id="form-field-1" name="heart" placeholder="Heart">
                              </div>
                            </div>
                            <div class="input-group">
                              <lebel class="col-sm-4 oe_title">Lungs</lebel>
                              <div>
                                <input class="col-sm-8" type="text" id="form-field-1" name="lungs" placeholder="Lungs">
                              </div>
                            </div>
                            <div class="input-group">
                              <lebel class="col-sm-4 oe_title">Abd</lebel>
                              <div>
                                <input class="col-sm-8" type="text" id="form-field-1" name="abd" placeholder="Soft, Non- Tender">
                              </div>
                            </div>
                            <div class="input-group">
                              <lebel class="col-sm-4 oe_title">Anaemia</lebel>
                              <div>
                                <input class="col-sm-8" type="text" id="form-field-1" name="anaemia" placeholder="Absent">
                              </div>
                            </div>
                            <div class="input-group">
                              <lebel class="col-sm-4 oe_title">Jaundice</lebel>
                              <div>
                                <input class="col-sm-8" type="text" id="form-field-1" name="jaundice" placeholder="Absent">
                              </div>
                            </div>
                            <div class="input-group">
                              <lebel class="col-sm-4 oe_title">Cyanosis</lebel>
                              <div>
                                <input class="col-sm-8" type="text" id="form-field-1" name="cyanosis" placeholder="Absent">
                              </div>
                            </div>
                            <div class="input-group">
                              <lebel class="col-sm-4 oe_title">Oedema</lebel>
                              <div>
                                <input class="col-sm-8" type="text" id="form-field-1" name="oedema" placeholder="Absent">
                              </div>
                            </div>
                            <div class="input-group">
                              <lebel class="col-sm-4 oe_title">RR</lebel>
                              <div>
                                <input class="col-sm-8" type="text" id="form-field-1" name="rr" placeholder="Absent">
                              </div>
                            </div>
                            <div class="input-group">
                              <lebel class="col-sm-4 oe_title">SP02</lebel>
                              <div>
                                <input class="col-sm-8" type="text" id="form-field-1" name="sp" placeholder="Absent">
                              </div>
                            </div>
                            <div class="input-group">
                              <lebel class="col-sm-4 oe_title">LMP</lebel>
                              <div>
                                <input class="col-sm-8" type="text" id="l_date" name="lmp" placeholder="Select Date">
                              </div>
                            </div>
                            <div class="input-group">
                              <lebel class="col-sm-4 oe_title">EDD</lebel>
                              <div>
                                <input class="col-sm-8" type="text" id="e_date" name="edd" placeholder="Select Date">
                              </div>
                            </div>
                            <div class="input-group">
                              <lebel class="col-sm-4 oe_title">FM</lebel>
                              <div>
                                <input class="col-sm-8" type="text" name="fm" placeholder="Present/Absent">
                              </div>
                            </div>
                            <div class="input-group">
                              <lebel class="col-sm-4 oe_title">FHR</lebel>
                              <div>
                                  <input class="col-sm-8" type="text" id="form-field-1" name="fhr" placeholder="Absent">
                              </div>
                            </div>
                            <div class="input-group">
                              <lebel class="col-sm-4 oe_title">GRAVIDA</lebel>
                              <div>
                                <input class="col-sm-8" type="text" id="form-field-1" name="gravida" placeholder="1st/2nd/Priemi">
                              </div>
                            </div>
                          </div>
                          <div id="tabs-2">
                            <label for="form-field-11">D/X</label>

<textarea style="min-height: 100px;" name="investigation" class="autosize-transition form-control"></textarea>
                          </div>
                          <div id="tabs-4">
                            <label for="form-field-11">Drug History</label>

<textarea style="min-height: 100px;" name="drug_history" class="autosize-transition form-control">According to patients statement some oral medication are taken eg:</textarea>
                          </div>
                          <div id="tabs-5">
                            <label for="form-field-11">lx</label>

<div class="col-sm-2">
                          <select style="font-size: 12px;" class="chosen-select form-control" data-placeholder="Dose" id="doses" placeholder="Select Dose">
                            <option>Select Dose</option>
                           <?php $__currentLoopData = $dose; $__env->addLoop($__currentLoopData); foreach($__currentLoopData as $dose): $__env->incrementLoopIndices(); $loop = $__env->getLastLoop(); ?>                          
                              <option value="<?php echo e($dose->doses); ?>"><?php echo e($dose->doses); ?></option>
                            <?php endforeach; $__env->popLoop(); $loop = $__env->getLastLoop(); ?>
                          </select>
                        </div>

<div class="col-sm-2">
                          <select style="font-size: 12px;" class="chosen-select form-control" data-placeholder="Duration" id="duration" placeholder="Select Duration">
                            <option>Select Duration</option>
                             <?php $__currentLoopData = $duration; $__env->addLoop($__currentLoopData); foreach($__currentLoopData as $duration): $__env->incrementLoopIndices(); $loop = $__env->getLastLoop(); ?>                           
                              <option value="<?php echo e($duration->duration); ?>"><?php echo e($duration->duration); ?></option>
                            <?php endforeach; $__env->popLoop(); $loop = $__env->getLastLoop(); ?>
                          </select>
                        </div>
                        <div class="col-sm-5">
                          <div class="form-inline">
                            <div class="radio">
                              <label>
                                <input id="before" name="form-field-radio" type="radio" class="ace">
                                <span class="lbl">খাবার আগে</span>
                              </label>
                            </div>
                              
                            <div class="radio">
                              <label>
                                <input id="after" name="form-field-radio" type="radio" class="ace">
                                <span class="lbl">খাবার পরে</span>
                              </label>
                            </div>
                             
                            <input class="hidden" type="text" name="diet_rules" id="diet_rules">
                            <button type="button" id="addMedicine" onclick="addintobox()" class="btn btn-success btn-sm btn-round">
                             Add Medicine
                            </button>
                          </div>
                        </div>
                      </div>  
                      
                      <div class="space-8"></div>

<button class="btn-xs" type="button" onclick="rday()">দিন</button>
                          <button class="btn-xs" type="button" onclick="rmonth()">মাস</button>
                          <label class="">..............পর আবার আসবেন ।</label> 
                          <b>Paid (TK)</b> <input id="amount" style="width: 60px;" type="number" name="visit_fee">
                          
                          <input type="text" class="hidden" id="patient" name="patient_type">
                        </div>
                      </div>

<div class="col-xs-4" style="margin-top: 10px;">
                        <div class="">
                          <select class="form-control" id="treatment">
                            <option>Select Treatment</option>
                            <?php $__currentLoopData = $treatment; $__env->addLoop($__currentLoopData); foreach($__currentLoopData as $treatment): $__env->incrementLoopIndices(); $loop = $__env->getLastLoop(); ?>                   
                            <option value="<?php echo e($treatment->treatment); ?>"><?php echo e($treatment->template_name); ?></option>
                            <?php endforeach; $__env->popLoop(); $loop = $__env->getLastLoop(); ?>
                          </select>
                          <div class="space-2"></div>
                          <button class="btn btn-warning btn-round btn-sm" id="treatment" type="button" onclick="treatmentbtn()">Add</button>
                        </div>
                        <div class="space-6"></div>
                        <div class="">
                          <select class="form-control" id="advice">
                              <option>Select Advices</option>
                              <?php $__currentLoopData = $advice; $__env->addLoop($__currentLoopData); foreach($__currentLoopData as $advice): $__env->incrementLoopIndices(); $loop = $__env->getLastLoop(); ?>                   
                              <option value="<?php echo e($advice->advices); ?>"><?php echo e($advice->template_name); ?></option>
                              <?php endforeach; $__env->popLoop(); $loop = $__env->getLastLoop(); ?>
                          </select>
                          <div class="space-2"></div>
                          <button class="btn btn-warning btn-round btn-sm" id="advices" type="button" onclick="advicebtn()">Add</button>
                        </div>
                      </div>
                      
                    </div>
                  </div>
                </form>
              </div>
                
                
<?php $__env->stopSection(); ?>

<?php echo $__env->make('layouts.press_header', \Illuminate\Support\Arr::except(get_defined_vars(), ['__data', '__path']))->render(); ?><?php /**PATH /home/rejoandoctor/public_html/resources/views/Prescribe/doctor/add_prescription.blade.php ENDPATH**/ ?>