![]() 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="form-widget p-sm-4 p-3" data-loader="button"> <div class="form-result"></div> <form class="row mb-0" id="frontAppointmentBook" action="<?php echo e(route('front.appointment.book')); ?>" method="post"> <?php echo csrf_field(); ?> <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"> <?php echo e(__('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"><?php echo e(__('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="<?php echo e(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"><?php echo e(__('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="<?php echo e(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"><?php echo e(__('messages.patient.email')); ?>:</label><span class="required text-danger">*</span> <input type="email" id="template-medical-email" name="email" class="form-control" value="<?php echo e(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"><?php echo e(__('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"> <?php echo e(Form::label('Doctor',__('messages.doctor.doctor').':')); ?><span class="required text-danger">*</span> <?php echo e(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"> <?php echo e(Form::label('Service',__('messages.appointment.service').':')); ?><span class="required text-danger">*</span> <?php echo e(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"><?php echo e(__('messages.appointment.appointment_date')); ?>: </label><span class="required text-danger">*</span> <input type="text" id="templateAppointmentDate" name="date" class="form-control" value="<?php echo e(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"> <?php echo e(Form::label('Payment Type',__('Payment Method').':')); ?><span class="required text-danger">*</span> <?php echo e(Form::select('payment_type', \App\Models\Appointment::PAYMENT_METHOD, null,['class' => 'form-select', 'id'=>'paymentMethod', 'data-control'=>"select2",'placeholder' => 'Select Payment Method'])); ?> </div> <?php $styleCss = 'style'; ?> <div class="col-12 form-group text-start"> <?php echo e(Form::label('Available Slots',__('messages.appointment.available_slot').':' ,['class' => 'form-label text-gray-700 mb-3 required'])); ?> <span class="required text-danger">*</span> <div class="mb-0 d-inline-flex align-items-center ms-2"> <div <?php echo e($styleCss); ?>="height: 10px;width: 10px;background-color: #DF4F4E"></div> <span class="ms-2"><?php echo e(__('messages.appointment.booked')); ?></span> <div class="ms-2" <?php echo e($styleCss); ?>="height: 10px;width: 10px;background-color: #5659CF !important"> </div> <span class="ms-2"><?php echo e(__('messages.appointment.available')); ?></span> </div> <div class="fc-timegrid-slot not-dark form-control form-control-solid h-300px overflow-auto"> <?php echo e(Form::hidden('from_time', null,['id'=>'timeSlot',])); ?> <?php echo e(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"><?php echo e(__('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"><?php echo e(__('messages.appointment.payable_amount')); ?> : <span class="fw-bold" id="payableAmount"><?php echo e(__('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"><?php echo e(__('messages.web.confirm_booking')); ?> </button> </div> </form> </div> <?php $__env->startSection('front-js'); ?> <script src="//js.stripe.com/v3/"></script> <script> let appointmentStripePaymentUrl = '<?php echo e(url('appointment-stripe-charge')); ?>'; let stripe = Stripe('<?php echo e(config('services.stripe.key')); ?>'); let manually = "<?php echo e(\App\Models\Appointment::MANUALLY); ?>"; </script> <script src="<?php echo e(asset('assets/js/bootstrap-datepicker/bootstrap-datepicker.js')); ?>"></script> <script src="<?php echo e(mix('assets/js/custom/input_price_format.js')); ?>"></script> <script src="<?php echo e(mix('assets/js/fronts/appointments/book_appointment.js')); ?>"></script> <?php $__env->stopSection(); ?> <?php /**PATH /home/corals/clinic.corals.io/resources/views/fronts/common/book_appointment.blade.php ENDPATH**/ ?>