Server : Apache System : Linux server2.corals.io 4.18.0-348.2.1.el8_5.x86_64 #1 SMP Mon Nov 15 09:17:08 EST 2021 x86_64 User : corals ( 1002) PHP Version : 7.4.33 Disable Function : exec,passthru,shell_exec,system Directory : /home/corals/clinic.corals.io/resources/views/fronts/common/ |
<div class="form-widget p-sm-4 p-3" data-loader="button">
<div class="form-result"></div>
<form class="row mb-0" id="frontAppointmentBook" action="{{ route('front.appointment.book') }}" method="post">
@csrf
<div class="book-appointment-message"></div>
<div class="col-md-12 form-group text-start">
<div class="form-check">
<input type="checkbox" id="isPatientAccount" class="form-check-input" name="is_patient_account"
value="1">
<label class="form-check-label mb-0" for="isPatientAccount">
{{__('messages.web.already_have_patient_account')}}
</label>
</div>
</div>
<div class="col-md-6 form-group name-details text-start">
<label for="template-medical-first_name">{{ __('messages.patient.first_name') }}:</label><span
class="required text-danger">*</span>
<input type="text" id="template-medical-first_name" name="first_name"
class="form-control" value="{{ isset(session()->get('data')['first_name']) ? session()->get('data')['first_name'] : '' }}" placeholder="First Name">
</div>
<div class="col-md-6 form-group name-details text-start">
<label for="template-medical-last_name">{{ __('messages.patient.last_name') }}:</label><span
class="required text-danger">*</span>
<input type="text" id="template-medical-last_name" name="last_name"
class="form-control" value="{{ isset(session()->get('data')['last_name']) ? session()->get('data')['last_name'] : '' }}" placeholder="Last Name">
</div>
<div class="col-md-6 form-group text-start">
<label for="template-medical-email">{{ __('messages.patient.email') }}:</label><span
class="required text-danger">*</span>
<input type="email" id="template-medical-email" name="email"
class="form-control" value="{{ isset(session()->get('data')['email']) ? session()->get('data')['email'] : '' }}" placeholder="Email">
</div>
<div class="col-md-6 form-group d-none registered-patient text-start">
<label for="template-medical-first_name">{{ __('messages.web.patient_name') }}:</label>
<input type="text" id="patientName" readonly
class="form-control" value="" placeholder="Patient Name">
</div>
<div class="col-md-6 form-group text-start">
{{ Form::label('Doctor',__('messages.doctor.doctor').':') }}<span
class="required text-danger">*</span>
{{ Form::select('doctor_id', $appointmentDoctors, isset(session()->get('data')['doctor_id']) ? session()->get('data')['doctor_id'] : '',['class' => 'form-select', 'id' => 'doctorId', 'data-control'=>"select2",'placeholder' => 'Select Doctor']) }}
</div>
<div class="col-md-6 form-group text-start">
{{ Form::label('Service',__('messages.appointment.service').':') }}<span
class="required text-danger">*</span>
{{ Form::select('service_id', isset(session()->get('data')['service']) ? session()->get('data')['service'] : [] , isset(session()->get('data')['service_id']) ? session()->get('data')['service_id'] : '',['class' => 'form-select', 'data-control'=>"select2", 'id'=> 'serviceId','placeholder' => 'Select Service']) }}
</div>
<div class="col-md-6 form-group text-start">
<label for="templateAppointmentDate">{{ __('messages.appointment.appointment_date')}}: </label><span
class="required text-danger">*</span>
<input type="text" id="templateAppointmentDate" name="date" class="form-control"
value="{{ isset(session()->get('data')['date']) ? session()->get('data')['date'] : '' }}" placeholder="Select Date"
autocomplete="true" disabled readonly>
</div>
<div class="col-md-6 form-group text-start">
{{ Form::label('Payment Type',__('Payment Method').':') }}<span
class="required text-danger">*</span>
{{ Form::select('payment_type', \App\Models\Appointment::PAYMENT_METHOD, null,['class' => 'form-select', 'id'=>'paymentMethod', 'data-control'=>"select2",'placeholder' => 'Select Payment Method']) }}
</div>
@php
$styleCss = 'style';
@endphp
<div class="col-12 form-group text-start">
{{ Form::label('Available Slots',__('messages.appointment.available_slot').':' ,['class' => 'form-label text-gray-700 mb-3 required']) }}
<span class="required text-danger">*</span>
<div class="mb-0 d-inline-flex align-items-center ms-2">
<div {{ $styleCss }}="height: 10px;width: 10px;background-color: #DF4F4E"></div>
<span class="ms-2">{{__('messages.appointment.booked')}}</span>
<div class="ms-2" {{ $styleCss }}="height: 10px;width: 10px;background-color: #5659CF !important">
</div>
<span class="ms-2">{{__('messages.appointment.available')}}</span>
</div>
<div class="fc-timegrid-slot not-dark form-control form-control-solid h-300px overflow-auto">
{{ Form::hidden('from_time', null,['id'=>'timeSlot',]) }}
{{ Form::hidden('to_time', null,['id'=>'toTime',]) }}
<div class="text-center d-flex flex-wrap justify-content-center px-3 max-height-235px front-slot-data"
id="slotData"></div>
<span class="justify-content-center d-flex p-20 no-time-slot">{{__('messages.appointment.no_slot_found')}}</span>
</div>
</div>
<div class="text-center form-group">
<p class="text-uppercase mb-sm-4 mb-0 d-none"
id="payableAmountText">{{__('messages.appointment.payable_amount')}} : <span class="fw-bold"
id="payableAmount">{{__('messages.common.n/a')}}</span>
</p>
</div>
<div class="col-12 form-group text-center">
<button class="btn btn-secondary btn-lg booking-button" type="submit" id="saveBtn"
value="submit">{{__('messages.web.confirm_booking')}}
</button>
</div>
</form>
</div>
@section('front-js')
<script src="//js.stripe.com/v3/"></script>
<script>
let appointmentStripePaymentUrl = '{{ url('appointment-stripe-charge') }}';
let stripe = Stripe('{{ config('services.stripe.key') }}');
let manually = "{{\App\Models\Appointment::MANUALLY}}";
</script>
<script src="{{ asset('assets/js/bootstrap-datepicker/bootstrap-datepicker.js') }}"></script>
<script src="{{ mix('assets/js/custom/input_price_format.js') }}"></script>
<script src="{{mix('assets/js/fronts/appointments/book_appointment.js')}}"></script>
@endsection