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@extends('layouts.press_header') @section('title', 'Doctor | Prescription') @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"> <!-- PAGE CONTENT BEGINS --> <div class="space-8"></div> <form action="{{route('insert_prescription')}}" method="post"> @csrf <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="{{Auth::user()->customer_id}}"> <input type="text" style="width: 90px;" name="unique_patient_id" id="patient_search" placeholder="Search Patient"> <input type="text" style="width: 180px;" id="name" name="patient_name" placeholder="Patient Name" id="name" required> <input type="text" style="width: 80px;" id="age" name="patient_age" placeholder="Age"> <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" name="patient_mobile" id="mobile" placeholder="Mobile" maxlength="11"> <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="{{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> <div class="space-8"></div> <div id="tabs"> <ul> <li> <a href="#tabs-1">O/E</a> </li> <li> <a href="#tabs-2">D/X</a> </li> <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 class="form-control" cols="50" style="min-height: 100px;" name="dx" placeholder="Disease/Condition/Dx"></textarea> </div> <div id="tabs-3"> <label for="form-field-11">Pre Test</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> <textarea style="min-height: 100px;" name="ix" class="autosize-transition form-control"></textarea> </div> </div> </div> </div> <div class="col-sm-9"> <div class="col-xs-12" style="border: 1px solid #cbc4c4; padding: 10px;"> <div class="col-sm-3"> <input type="text" id="medicine" class="form-control" placeholder="Medicine"> </div> <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> @foreach($dose as $dose) <option value="{{$dose->doses}}">{{$dose->doses}}</option> @endforeach </select> </div> <div class="col-sm-2"> <select style="font-size: 12px;" class="chosen-select form-control" data-placeholder="Duration" id="duration" placeholder="Select Duration"> <option>Select Duration</option> @foreach($duration as $duration) <option value="{{$duration->duration}}">{{$duration->duration}}</option> @endforeach </select> </div> <div class="col-sm-5"> <div class="form-inline"> <div class="radio"> <label> <input id="before" name="form-field-radio" type="radio" class="ace"> <span class="lbl">খাবার আগে</span> </label> </div>   <div class="radio"> <label> <input id="after" name="form-field-radio" type="radio" class="ace"> <span class="lbl">খাবার পরে</span> </label> </div>   <input class="hidden" type="text" name="diet_rules" id="diet_rules"> <button type="button" id="addMedicine" onclick="addintobox()" class="btn btn-success btn-sm btn-round"> Add Medicine </button> </div> </div> </div> <div class="space-8"></div> <div class="col-xs-8" style="margin-top: 10px;"> <div> <textarea class="form-control" id="press_box" style="min-height: 300px; overflow: hidden;" spellcheck="false" name="prescription"></textarea> </div> <div class="space-8"></div> <div class="form-inline"> <input type="text" class="" name="revision" id="revision" placeholder="03"> <button class="btn-xs" type="button" onclick="rday()">দিন</button> <button class="btn-xs" type="button" onclick="rmonth()">মাস</button> <label class="">..............পর আবার আসবেন ।</label> <b>Paid (TK)</b> <input id="amount" style="width: 60px;" type="number" name="visit_fee"> <input type="text" class="hidden" id="patient" name="patient_type"> </div> </div> <div class="col-xs-4" style="margin-top: 10px;"> <div class=""> <select class="form-control" id="treatment"> <option>Select Treatment</option> @foreach($treatment as $treatment) <option value="{{$treatment->treatment}}">{{$treatment->template_name}}</option> @endforeach </select> <div class="space-2"></div> <button class="btn btn-warning btn-round btn-sm" id="treatment" type="button" onclick="treatmentbtn()">Add</button> </div> <div class="space-6"></div> <div class=""> <select class="form-control" id="advice"> <option>Select Advices</option> @foreach($advice as $advice) <option value="{{$advice->advices}}">{{$advice->template_name}}</option> @endforeach </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> <!-- PAGE CONTENT ENDS --> @endsection