@extends('layouts.app') @section('title', 'EndoCapture') @section('style') @endsection @section('content')
{{ Form::open(['url' => 'note']) }}
@if (@$patient->pic == '') @else pic") }}?a={{ date('Y-m-dH:i:s') }}" width="183px" /> @endif
@if (count($errors) > 0)
    @foreach ($errors->all() as $error)
  • {{ $error }}
    • @endforeach
@endif
@if (isset($patient->an)) {{ Form::text('an', $patient->an, ['class' => 'form-control', 'readonly', 'autocomplete' => 'off']) }} @else {{ Form::text('an', '', ['class' => 'form-control', 'autocomplete' => 'off']) }} @endif
@if (isset($patient->citizen)) {{ Form::text('citizen', $patient->citizen, ['class' => 'form-control', 'autocomplete' => 'off']) }} @else {{ Form::text('citizen', '', ['class' => 'form-control', 'autocomplete' => 'off']) }} @endif
@if (isset($patient->firstname)) @else @endif
@if (isset($patient->lastname)) @else @endif
@php if (@$patient->birthdate != '') { $birthDate = explode('-', $patient->birthdate); $age = date('md', date('U', mktime(0, 0, 0, $birthDate[1], $birthDate[0], $birthDate[2]))) > date('md') ? date('Y') + 543 - $birthDate[2] - 1 : date('Y') + 543 - $birthDate[2]; } @endphp
@if (isset($patient->phone)) {{ Form::text('phone', $patient->phone, ['class' => 'form-control']) }} @else {{ Form::text('phone', '', ['class' => 'form-control']) }} @endif
@if (isset($patient->allergic)) {{ Form::text('allergic', $patient->allergic, ['class' => 'form-control']) }} @else {{ Form::text('allergic', '', ['class' => 'form-control']) }} @endif
@if (isset($patient->emer_name)) {{ Form::text('emer_name', $patient->emer_name, ['class' => 'form-control']) }} @else {{ Form::text('emer_name', '', ['class' => 'form-control']) }} @endif
@if (isset($patient->email)) {{ Form::text('email', $patient->email, ['class' => 'form-control']) }} @else {{ Form::text('email', '', ['class' => 'form-control']) }} @endif
@if (isset($patient->congenital_disease)) {{ Form::text('congenital_disease', $patient->congenital_disease, ['class' => 'form-control']) }} @else {{ Form::text('congenital_disease', '', ['class' => 'form-control']) }} @endif
@if (isset($patient->emer_tel)) {{ Form::text('emer_tel', $patient->emer_tel, ['class' => 'form-control', '']) }} @else {{ Form::text('emer_tel', '', ['class' => 'form-control']) }} @endif
{{ Form::close() }}

@endsection @section('script') @endsection