{{ Form::label('patient_id',__('messages.ipd_patient.patient_id').':', ['class' => 'form-label']) }} {{ Form::hidden('currency_symbol', getCurrentCurrency(), ['class' => 'currencySymbol']) }} {{ Form::select('patient_id', $data['patients'], null, ['class' => 'form-select', 'required', 'id' => 'editOpdPatientId', 'placeholder' => 'Select Patient', 'data-control' => 'select2']) }}

{{ Form::label('case_id', __('messages.ipd_patient.case_id').':', ['class' => 'form-label']) }} {{ Form::select('case_id', [null], null, ['class' => 'form-select', 'required', 'id' => 'editOpdCaseId', 'disabled', 'data-control' => 'select2', 'placeholder' => 'Choose Case']) }} {{ Form::hidden('patient_case_id', !empty($opdPatientDepartment->patientCase) ? $opdPatientDepartment->patientCase->case_id : '', ['class' => 'patientCaseId']) }}

{{ Form::label('opd_number', __('messages.opd_patient.opd_number').':', ['class' => 'form-label']) }} {{ Form::text('opd_number', null, ['class' => 'form-control', 'readonly']) }}

{{ Form::label('height', __('messages.ipd_patient.height').':', ['class' => 'form-label']) }} {{ Form::number('height', null, ['class' => 'form-control', 'max' => '7', 'step' => '.01']) }}

{{ Form::label('weight', __('messages.ipd_patient.weight').':', ['class' => 'form-label']) }} {{ Form::number('weight', null, ['class' => 'form-control', 'max' => '200', 'step' => '.01']) }}

{{ Form::label('bp', __('messages.ipd_patient.bp').':', ['class' => 'form-label']) }} {{ Form::text('bp', null, ['class' => 'form-control']) }}

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

{{ Form::label('doctor_id',__('messages.ipd_patient.doctor_id').':', ['class' => 'form-label']) }} {{ Form::select('doctor_id', $data['doctors'], null, ['class' => 'form-select', 'required', 'id' => 'editOpdDoctorId', 'placeholder' => 'Select Doctor', 'data-control' => 'select2']) }}

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

{{ Form::text('standard_charge', null , ['class' => 'form-control price-input', 'id' => 'editOpdStandardCharge', 'required']) }}

{{ Form::label('payment_mode', __('messages.ipd_payments.payment_mode').':', ['class' => 'form-label']) }} {{ Form::select('payment_mode', $data['paymentMode'], null, ['class' => 'form-select', 'required', 'id' => 'editOpdPaymentMode', 'data-control' => 'select2', 'placeholder' => 'Choose Payment']) }}

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

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

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

is_old_patient) ? 'checked' : '' }}>