42 lines
1.7 KiB
PHP
42 lines
1.7 KiB
PHP
<div class="modal fade" id="add-penyakit" tabindex="-1" role="dialog" aria-labelledby="editUserModalLabel"
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aria-hidden="true">
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<div class="modal-dialog" role="document">
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<div class="modal-content">
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<div class="modal-header">
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<h5 class="modal-title" id="editUserModalLabel">Tambah Data Penyakit</h5>
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<button type="button" class="close" data-bs-dismiss="modal" aria-label="Close">
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<span aria-hidden="true">×</span>
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</button>
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</div>
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<div class="modal-body">
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<form action="{{ route('add-gejala') }}" class="needs-validation" novalidate="" method="POST" enctype="multipart/form-data">
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@csrf
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@method('POST')
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<div class="form-group">
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<label for="edit-name">Kode Penyakit</label>
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<input type="text" name="kode_penyakit" class="form-control" placeholder="Masukkan Kode Penyakit">
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</div>
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<div class="form-group">
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<label for="edit-email">Nama Penyakit</label>
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<input type="text" name="gejala" class="form-control" placeholder="Masukkan Nama Penyakit">
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</div>
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<div class="form-group">
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<label for="edit-area">Deskripsi Penyakit</label>
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<input type="text" name="deskripsi_penyakit" class="form-control" placeholder="Masukkan Deskripsi Penyakit">
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</div>
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<div class="form-group">
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<label for="edit-area">Solusi</label>
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<input type="text" name="Solusi" class="form-control" placeholder="Masukkan Solusi">
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</div>
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<div class="modal-footer">
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<button type="button" class="btn btn-secondary" data-bs-dismiss="modal">Close</button>
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<button type="submit" class="btn btn-primary">Tambah</button>
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</div>
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</form>
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</div>
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</div>
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</div>
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</div>
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