@extends('app')
@section('content')
    <style type="text/css">
        .box.box-solid.box-info > .box-header {
            color: #ffffff;
            background: #0a5077;
            background-color: #0a5077;
        }

        .box.box-solid.box-info {
            border: 1px solid #0a5077;
        }

        .box.box-solid.box-danger {
            border: 1px solid #0a5077;
        }

        .submit-button {
            padding-right: 113px;
        }
    </style>
    <!-- Content Header (Page header) -->
    <section class="content-header">
        <h1>
            Edit Prescription Template
            <small>Preview</small>
        </h1>
        <ol class="breadcrumb">
            <li><a href="{{url('/')}}"><i class="fa fa-dashboard"></i> Home</a></li>
            <li class="">Setup</li>
            <li class="active">Edit Prescription Template</li>

        </ol>
    </section>
    <!-- Main content -->
    <section class="content">
        <!-- SELECT2 EXAMPLE -->
        <div class="box box-default">
            <!-- /.box-header -->
            <div class="box-body">
                <form action="{{route('settings.update-prescription-template.post')}}" id="myForm" role="form"
                      data-toggle="validator" method="post" accept-charset="utf-8" novalidate="true">
                    <!-- SmartWizard html -->
                    <div class="form-group">
                        <div class="col-md-12">
                            <label for="department_name" class="col-md-3 required">Template Name:</label>
                            <div class="col-md-8">
                                <input type="hidden" class="form-control" name="id"
                                       value="{{$prescriptionTemplate->id}}"
                                       required="">
                                <input type="text" class="form-control" name="name"
                                       placeholder="Template Name" value="{{$prescriptionTemplate->name}}" required="">
                                {{csrf_field()}}
                                <div class="help-block with-errors"></div>
                            </div>
                            <div class="col-md-4">
                                <table class="table-bordered">
                                    <thead>
                                    <tr>
                                        <th>Code</th>
                                        <th>Purpose</th>
                                    </tr>
                                    </thead>
                                    <tbody>
                                    <tr>
                                        <td><code>{patient_name}</code></td>
                                        <td>Patient name</td>
                                    </tr>
                                    <tr>
                                        <td><code>{patient_age}</code></td>
                                        <td>Patient age</td>
                                    </tr>
                                    <tr>
                                        <td><code>{patient_gender}</code></td>
                                        <td>Patient gender</td>
                                    </tr>
                                    <tr>
                                        <td><code>{date}</code></td>
                                        <td>Current Date</td>
                                    </tr>
                                    <tr>
                                        <td><code>{doctor}</code></td>
                                        <td>Doctor Details</td>
                                    </tr>
                                    <tr>
                                        <td><code>{hospital}</code></td>
                                        <td>Hospital Details</td>
                                    </tr>
                                    </tbody>
                                </table>
                            </div>
                        </div>
                    </div>
                    <div class="form-group">
                        <div class="col-md-12">
                            <label for="department_name" class="col-md-3 required"> Template:</label>
                            <div class="col-md-8">
                                <textarea class="form-control" id="editor1"
                                          name="template">{!!$prescriptionTemplate->template!!}</textarea>

                                <div class="help-block with-errors"></div>
                            </div>
                        </div>
                    </div>
                    <div class="form-group submit-button">
                        <button type="submit" class="btn btn-success pull-right">Update</button>
                    </div>
                </form>
            </div>
        </div>
    </section>
@endsection

@section('script')
    <script src="{{ asset('assets/bower_components/ckeditor/ckeditor.js') }}"></script>
@endsection