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@extends('layouts.app')

@section('title', 'Doctor | Assistant')

@section('content') 
	<div class="main-content">
  <div class="main-content-inner">
      <div class="breadcrumbs ace-save-state" id="breadcrumbs">
         @include('layouts.header_menu')
      </div>

<div class="page-content">
          <div class="row">
            <div class="col-xs-12">
              <div class="row">
                <div class="col-sm-3"></div>
                <div class="col-sm-6">
                  <div class="widget-box">
                    <div class="widget-header">
                      <h4 class="widget-title">Assistant Registration</h4>
                      <div class="widget-toolbar">
                        <a href="#" data-action="collapse">
                          <i class="ace-icon fa fa-chevron-up"></i>
                        </a>

<a href="#" data-action="close">
                          <i class="ace-icon fa fa-times"></i>
                        </a>
                      </div>
                    </div>
                    <div class="widget-body">
                      <div class="widget-main">
                        <form action="{{route('store_assistant')}}" method="post">
                          @csrf

<div class="form-group">
                            <input class="form-control" type="text" name="assistant_name" placeholder="Assistant Name">
                            @error('assistant_name')
                              <span class="invalid-feedback" role="alert">
                                  <strong style="color: red;">{{ $message }}</strong>
                              </span>
                            @enderror
                          </div>

<div class="form-group">
                            <input class="form-control" type="email" name="email" placeholder="Assistant Email">
                            @error('email')
                              <span class="invalid-feedback" role="alert">
                                  <strong style="color: red;">{{ $message }}</strong>
                              </span>
                            @enderror
                          </div>

<div class="form-group">
                            <input class="form-control" type="password" name="password" placeholder="Password">
                            @error('password')
                              <span class="invalid-feedback" role="alert">
                                  <strong style="color: red;">{{ $message }}</strong>
                              </span>
                            @enderror
                          </div>

<div class="form-group">
                            <input class="form-control" type="password" name="password_confirmation" placeholder="Confirm Password">
                            @error('password_confirmation')
                              <span class="invalid-feedback" role="alert">
                                  <strong style="color: red;">{{ $message }}</strong>
                              </span>
                            @enderror
                          </div>

<input type="hidden" name="customer_id" value="{{Request::segment(4)}}">
                          
                          <div class="form-action center">
                            <button class="btn btn-warning btn-round" type="submit" name="submit">Assistant Registration</button>
                          </div>
                          
                        </form>
                      </div>
                    </div>
                  </div>
                </div>
              <div class="col-sm-3"></div>
              </div>

@endsection