{{ Form::label('report_type', __('messages.ipd_patient_diagnosis.report_type').':',['class' => 'form-label']) }} {{ Form::text('report_type', null, ['class' => 'form-control','required', 'id' => 'editIpdDiagnosisReportType']) }}

{{ Form::label('report_date', __('messages.ipd_patient_diagnosis.report_date').':',['class' => 'form-label']) }} {{ Form::text('report_date', null, ['class' => (getLoggedInUser()->thememode ? 'bg-light form-control' : 'bg-white form-control'),'id' => 'editIpdDiagnosisReportDate','autocomplete' => 'off', 'required']) }}

{{ Form::label('description', __('messages.ipd_patient_diagnosis.description').':',['class' => 'form-label']) }} {{ Form::textarea('description', null, ['class' => 'form-control', 'rows' => 4, 'id' => 'editIpdDiagnosisDescription']) }}

{{ Form::label('document', __('messages.ipd_patient_diagnosis.document').':',['class' => 'form-label']) }}

{{ Form::file('file',['id'=>'editIpdDiagnosisDocumentImage','class' => 'image-upload d-none','accept' => 'image/*']) }}