<?php $__env->startSection('css'); ?>

<?php $__env->stopSection(); ?>

<?php $__env->startSection('title'); ?>
    المرضى
<?php $__env->stopSection(); ?>

<?php $__env->startSection('content'); ?>

    <div class="content-header">
        <h5>اضافه مريض جديد</h5>

    </div>

    <div class="row">
        <div class="col-12">
            <div class="card">

                <div class="card-body">

                    <form action="<?php echo e(route('patients.store')); ?>" method="POST">
                        <?php echo csrf_field(); ?>

                        <div class="row">

                            <div class="col-md-6 mb-3">
                                <label class="form-label">الاسم الأول *</label>
                                <input type="text" name="first_name"
                                       class="form-control" required>
                            </div>

                            <div class="col-md-6 mb-3">
                                <label class="form-label">اسم العائلة</label>
                                <input type="text" name="last_name"
                                       class="form-control">
                            </div>

                            <div class="col-md-6 mb-3">
                                <label class="form-label">الهاتف *</label>
                                <input type="text" name="phone"
                                       class="form-control" required>
                            </div>

                            <div class="col-md-6 mb-3">
                                <label class="form-label">هاتف إضافي</label>
                                <input type="text" name="phone_alt"
                                       class="form-control">
                            </div>

                            <div class="col-md-6 mb-3">
                                <label class="form-label">الجنس</label>
                                <select name="gender" class="form-select">
                                    <option value="">اختر</option>
                                    <option value="male">ذكر</option>
                                    <option value="female">أنثى</option>
                                </select>
                            </div>

                            <div class="col-md-6 mb-3">
                                <label class="form-label">تاريخ الميلاد</label>
                                <input type="date" name="birth_date"
                                       class="form-control">
                            </div>

                            <div class="col-md-12 mb-3">
                                <label class="form-label">العنوان</label>
                                <input type="text" name="address"
                                       class="form-control">
                            </div>

                            <div class="col-md-12 mb-3">
                                <label class="form-label">ملاحظات</label>
                                <textarea name="notes" rows="3" class="form-control"></textarea>
                            </div>

                        </div>

                        <button class="btn btn-primary">
                            حفظ المريض
                        </button>
                    </form>
                    <!--end::Table container-->
                </div>
            </div>
        </div>
    </div>
<?php $__env->stopSection(); ?>

<?php $__env->startSection('js'); ?>

<?php $__env->stopSection(); ?>

<?php echo $__env->make('admin.layouts.master', array_diff_key(get_defined_vars(), ['__data' => 1, '__path' => 1]))->render(); ?><?php /**PATH D:\jops\SassMedical\resources\views/admin/patients/create.blade.php ENDPATH**/ ?>