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/storage/framework/views/ |
<div class="row gx-10 mb-5">
<div class="col-lg-6">
<div class="mb-5">
<?php echo e(Form::label('first_name', __('messages.staff.first_name').':', ['class' => 'form-label required fs-6 fw-bolder text-gray-700 mb-3'])); ?>
<?php echo e(Form::text('first_name', isset($staff) ? $staff->first_name : null, ['class' => 'form-control form-control-solid', 'placeholder' => 'First Name', 'required'])); ?>
</div>
</div>
<div class="col-lg-6">
<div class="mb-5">
<?php echo e(Form::label('last_name', __('messages.staff.last_name').':', ['class' => 'form-label required fs-6 fw-bolder text-gray-700 mb-3'])); ?>
<?php echo e(Form::text('last_name', isset($staff) ? $staff->last_name : null, ['class' => 'form-control form-control-solid', 'placeholder' => 'Last Name', 'required'])); ?>
</div>
</div>
<div class="col-lg-6">
<div class="mb-5">
<?php echo e(Form::label('email', __('messages.staff.email').':', ['class' => 'form-label required fs-6 fw-bolder text-gray-700 mb-3'])); ?>
<?php echo e(Form::email('email', isset($staff) ? $staff->email : null, ['class' => 'form-control form-control-solid', 'placeholder' => 'Email', 'required'])); ?>
</div>
</div>
<div class="col-lg-6">
<div class="mb-5">
<?php echo e(Form::label('contact', __('messages.staff.contact_no').':', ['class' => 'form-label fs-6 fw-bolder text-gray-700 mb-3'])); ?>
<br>
<?php echo e(Form::tel('contact', isset($staff) ? $staff->contact : null, ['class' => 'form-control form-control-solid',
'placeholder' => 'Contact No','onkeyup' => 'if (/\D/g.test(this.value)) this.value = this.value.replace(/\D/g,"")','id'=>'phoneNumber'])); ?>
<?php echo e(Form::hidden('region_code',!empty($staff) ? $staff->region_code : null,['id'=>'prefix_code'])); ?>
<span id="valid-msg" class="hide">✓ Valid</span>
<span id="error-msg" class="hide"></span>
</div>
</div>
<div class="col-md-6 mb-5">
<div class="fv-row" data-kt-password-meter="true">
<div class="mb-1">
<?php echo e(Form::label('password',__('messages.staff.password').':' ,['class' => 'form-label fs-6 fw-bolder text-gray-700 mb-3'])); ?>
<span class="text-danger"><?php echo e(isset($staff) ? null : '*'); ?></span>
<span data-bs-toggle="tooltip"
title="Use 8 or more characters with a mix of letters, numbers & symbols."><i
class="fa fa-question-circle"></i></span>
<div class="position-relative mb-3">
<input class="form-control form-control-lg form-control-solid"
type="password" placeholder="Password" name="password" autocomplete="off">
<span class="btn btn-sm btn-icon position-absolute translate-middle top-50 end-0 me-n2"
data-kt-password-meter-control="visibility">
<i class="bi bi-eye-slash fs-2"></i>
<i class="bi bi-eye fs-2 d-none"></i>
</span>
</div>
</div>
<div class="d-flex align-items-center mb-3" data-kt-password-meter-control="highlight">
<div class="flex-grow-1 bg-secondary bg-active-success rounded h-5px me-2"></div>
<div class="flex-grow-1 bg-secondary bg-active-success rounded h-5px me-2"></div>
<div class="flex-grow-1 bg-secondary bg-active-success rounded h-5px me-2"></div>
<div class="flex-grow-1 bg-secondary bg-active-success rounded h-5px"></div>
</div>
</div>
</div>
<div class="col-md-6 mb-5">
<div class="fv-row" data-kt-password-meter="true">
<div class="mb-1">
<?php echo e(Form::label('confirmPassword',__('messages.staff.confirm_password').':' ,['class' => 'form-label fs-6 fw-bolder text-gray-700 mb-3'])); ?>
<span class="text-danger"><?php echo e(isset($staff) ? null : '*'); ?></span>
<span data-bs-toggle="tooltip"
title="Use 8 or more characters with a mix of letters, numbers & symbols."><i
class="fa fa-question-circle"></i></span>
<div class="position-relative mb-3">
<input class="form-control form-control-lg form-control-solid"
type="password" placeholder="Confirm Password" name="password_confirmation"
autocomplete="off">
<span class="btn btn-sm btn-icon position-absolute translate-middle top-50 end-0 me-n2"
data-kt-password-meter-control="visibility">
<i class="bi bi-eye-slash fs-2"></i>
<i class="bi bi-eye fs-2 d-none"></i>
</span>
</div>
</div>
<div class="d-flex align-items-center mb-3" data-kt-password-meter-control="highlight">
<div class="flex-grow-1 bg-secondary bg-active-success rounded h-5px me-2"></div>
<div class="flex-grow-1 bg-secondary bg-active-success rounded h-5px me-2"></div>
<div class="flex-grow-1 bg-secondary bg-active-success rounded h-5px me-2"></div>
<div class="flex-grow-1 bg-secondary bg-active-success rounded h-5px"></div>
</div>
</div>
</div>
<div class="col-lg-6">
<div class="mb-5">
<?php echo e(Form::label('role', __('messages.staff.role').':', ['class' => 'form-label required fs-6 fw-bolder text-gray-700 mb-3'])); ?>
<?php echo e(Form::select('role', $roles, isset($staff) ? $staff->roles->first()->id : null, ['class' => 'form-select form-select-solid form-select-lg fw-bold','required','data-control'=>'select2','placeholder' => 'Select role'])); ?>
</div>
</div>
<div class="col-lg-6">
<div class="mb-5">
<?php echo e(Form::label('gender', __('messages.staff.gender').':', ['class' => 'form-label required fs-6 fw-bolder text-gray-700 mb-3'])); ?>
<span class="form-check form-check-custom form-check-solid is-valid">
<div class="align-items-baseline">
<label class="form-label fs-6 fw-bolder text-gray-700 mr-3"><?php echo e(__('messages.staff.male')); ?></label>
<input class="form-check-input" checked type="radio" name="gender" value="1"
<?php echo e(!empty($staff) && $staff->gender === 1 ? 'checked' : ''); ?> required>
<label class="form-label fs-6 fw-bolder text-gray-700 mx-3"><?php echo e(__('messages.staff.female')); ?></label>
<input class="form-check-input" type="radio" name="gender" value="2"
<?php echo e(!empty($staff) && $staff->gender === 2 ? 'checked' : ''); ?> required>
</div>
</span>
</div>
</div>
<div class="col-lg-6 mb-7">
<div class="justify-content-center">
<label class="col-form-label fw-bold fs-6">
<span><?php echo e(__('messages.patient.profile')); ?>: </span>
<i class="fa fa-question-circle ms-1 fs-7" data-bs-toggle="tooltip"
title="Best resolution for this profile will be 150X150"
data-bs-original-title="Phone number must be active"
aria-label="Phone number must be active"></i>
</label>
</div>
<?php $styleCss = 'style'; ?>
<div class="image-input image-input-outline" data-kt-image-input="true">
<div class="image-input-wrapper w-125px h-125px" id="bgImage"
<?php echo e($styleCss); ?>="background-image: url(<?php echo e(!empty($staff->profile_image) ? $staff->profile_image : asset('web/media/avatars/male.png')); ?>)">
</div>
<label class="btn btn-icon btn-circle btn-active-color-primary w-25px h-25px bg-white shadow"
data-kt-image-input-action="change" data-bs-toggle="tooltip" title=""
data-bs-original-title="Change profile">
<i class="bi bi-pencil-fill fs-7">
<input type="file" name="profile" accept=".png, .jpg, .jpeg">
</i>
<input type="file" name="avatar" accept=".png, .jpg, .jpeg">
<input type="hidden" name="avatar_remove">
</label>
</div>
<div class="form-text"><?php echo e(__('messages.doctor.allowed_img')); ?></div>
</div>
<div class="d-flex">
<?php echo e(Form::submit(__('messages.common.save'),['class' => 'btn btn-primary me-2'])); ?>
<a href="<?php echo e(route('staff.index')); ?>" type="reset"
class="btn btn-light btn-active-light-primary"><?php echo e(__('messages.common.discard')); ?></a>
</div>
</div>
<?php /**PATH /home/corals/clinic.corals.io/resources/views/staffs/fields.blade.php ENDPATH**/ ?>