TIF_E41201027/resources/views/backend/dokter/create.blade.php

193 lines
11 KiB
PHP

@extends('backend/layouts.template')
@section('content')
<main role="main" class="main-content">
<div class="container-fluid">
<div class="row justify-content-center">
<div class="col-12">
<div class="row align-items-center mb-2">
<div class="col">
<h2 class="h5 page-title">Welcome!</h2>
</div>
<div class="col-auto">
<form class="form-inline">
<div class="form-group d-none d-lg-inline">
<label for="reportrange" class="sr-only">Date Ranges</label>
<div id="reportrange" class="px-2 py-2 text-muted">
<span class="small"></span>
</div>
</div>
<div class="form-group">
<button type="button" class="btn btn-sm"><span class="fe fe-refresh-ccw fe-16 text-muted"></span></button>
<button type="button" class="btn btn-sm mr-2"><span class="fe fe-filter fe-16 text-muted"></span></button>
</div>
</form>
</div>
</div>
</div>
</div> <!-- .row -->
</div> <!-- .container-fluid -->
<div class="container-fluid">
<div class="row justify-content-center">
<div class="col-12">
<header class="panel-heading">
{{ isset($admin_lecturer) ? 'Mengubah' : 'Menambahkan' }} Dokter
</header>
@if ($errors->any())
<div class="alert alert-danger">
<strong>Whoops!</strong> There were some problems with your input.<br><br>
<ul>
@foreach ($errors->all() as $error)
<li>{{ $error }}</li>
@endforeach
</ul>
</div>
@endif
<h2 class="page-title">Form validation</h2>
<p class="text-muted">Provide valuable, actionable feedback to your users with HTML5 form validation</p>
<div class="card shadow">
<div class="card-header">
<strong class="card-title">Advanced Validation</strong>
</div>
<div class="card-body">
<form class="needs-validation" id="dokter_form" method="POST" enctype="multipart/form-data"
action="{{ isset($dtdokter) ? route('dtdokter.update',$dtdokter->id_dokter) :
route('dtdokter.store') }}">
{!! csrf_field() !!}
{!! isset($dtdokter) ? method_field('PUT') : '' !!}
<input type="hidden" name="id_dokter" value="{{ isset($dtdokter) ? $dtdokter->id_dokter : '' }}"> <br/>
<input type="hidden" name="sertifikasi" value="{{ isset($dtdokter) ? $dtdokter->sertifikasi : 'kosong' }}"> <br/>
<div class="form-row">
<div class="col-md-4 mb-2">
<label for="validationCustom3">Nama Lengkap</label>
<input class="form-control" id="nama" name="nama" minlength="5" type="text" placeholder="Masukkan nama"
value="{{ isset($dtdokter) ? $dtdokter->nama_dokter : '' }}"
required>
<div class="valid-feedback"> Looks good! </div>
</div>
</div> <!-- /.form-row -->
<div class="form-row">
<div class="col-md-4 mb-2">
<label for="exampleInputEmail2">Email address</label>
<input type="email" class="form-control" id="exampleInputEmail2" name="email" minlength="5" placeholder="Masukkan email" aria-describedby="Masukkan email"
value="{{ isset($dtdokter) ? $dtdokter->email : '' }}"
required>
<div class="invalid-feedback"> Please use a valid email </div>
<small id="emailHelp1" class="form-text text-muted">We'll never share your email with anyone else.</small>
</div>
</div>
<div class="form-row">
<div class="col-md-4 mb-2">
<label for="exampleInputJenisKelamin">Jenis Kelamin</label>
<input type="jenis_kelamin" class="form-control" id="exampleInputJenisKelamin" name="jenis_kelamin" minlength="5" placeholder="Masukkan Jenis Kelamin" aria-describedby="Masukkan jenis_kelamin"
value="{{ isset($dtdokter) ? $dtdokter->jenis_kelamin : '' }}"
required>
<div class="invalid-feedback"> Please use a valid jenis kelamin </div>
</div>
</div>
<div class="form-row">
<div class="col-md-6 mb-2">
<label for="exampleInputAlamat">Alamat</label>
<input type="alamat" class="form-control" id="exampleInputAlamat" name="alamat" minlength="5" placeholder="Masukkan Alamat" aria-describedby="Masukkan alamat"
value="{{ isset($dtdokter) ? $dtdokter->alamat : '' }}"
required>
<div class="invalid-feedback"> Please use a valid alamat </div>
</div>
</div>
<div class="form-row">
<div class="col-md-4 mb-2">
<label for="exampleInputTempat">Tempat</label>
<input type="tempat" class="form-control" id="exampleInputTempat" name="tempat" minlength="5" placeholder="Masukkan Tempat" aria-describedby="Masukkan tempat"
value="{{ isset($dtdokter) ? $dtdokter->tempat : '' }}"
required>
<div class="invalid-feedback"> Please use a valid tempat </div>
</div>
</div>
<div class="form-row">
<div class="col-md-4 mb-2">
<label for="exampleInputJenisTelpon">Telpon</label>
<input type="telpon" class="form-control" id="exampleInputTelpon" name="telpon" minlength="5" placeholder="Masukkan Telpon" aria-describedby="Masukkan telpon"
value="{{ isset($dtdokter) ? $dtdokter->telpon : '' }}"
required>
<div class="invalid-feedback"> Please use a valid telpon </div>
</div>
</div>
<div class="form-row">
<div class="col-md-4 mb-2">
<label for="validationCustom3">Foto</label>
<input type="hidden" name="nama_gambar" value="{{ isset($dtdokter) ? $dtdokter->foto : '' }}">
<td><img src="/data/data_dokter/{{ isset($dtdokter) ? $dtdokter->foto : '' }}" width="200"></td>
<input type="file" name="foto" id="foto" class="form-control {{ $errors->has('foto') ? 'is-invalid' : ''}}" value="{{ isset($dtdokter) ? $dtdokter->foto : '' }}">
@if ( $errors->has('foto'))
<span class="text-danger small">
<p>{{ $errors->first('foto') }}</p>
</span>
@endif
</div>
</div>
<div class="col-md-6 mb-3">
<label for="validationCustom3">Jabatan</label>
<input list="id_jabatan" class="form-control {{ $errors->has('id_jabatan') ? 'is-invalid' : ''}}" placeholder='Masukkan jabatan' value="{{ isset($dtdokter) ? $dtdokter->id_jabatan : '' }}" name="id_jabatan" >
@if ( $errors->has('id_jabatan'))
<span class="text-danger small">
<p>{{ $errors->first('id_jabatan') }}</p>
</span>
@endif
<datalist id="id_jabatan" name="id_jabatan">
<div class="form-select" id="default-select">
<select name="s_jabatan" class="form-control" id="exampleFormControlSelect1">
@foreach ($jabatan as $data_jabatan)
<option value="{{ $data_jabatan->id_jabatan }}" >{{ $data_jabatan->jabatan }}</option>
@endforeach
</select><br>
</div>
</div>
<div class="col-md-6 mb-3">
<div class="form-row">
<div class="col-md-8 mb-3">
<label for="exampleInputJadwalKerja">Jadwal Kerja</label>
<input type="jadwal_kerja" class="form-control" id="exampleInputJadwalKerja" name="jadwal_kerja" minlength="5" placeholder="Masukkan Jadwal Kerja" aria-describedby="Masukkan jadwal kerja"
value="{{ isset($dtdokter) ? $dtdokter->jadwal_kerja : '' }}"
required>
<div class="invalid-feedback"> Please use a valid jadwal kerja </div>
</div>
</div>
{{-- <div class="form-row">
<div class="col-md-4 mb-2">
<label for="validationCustomUsername">Username</label>
<div class="input-group">
<div class="input-group-prepend">
<span class="input-group-text" id="inputGroupPrepend">@</span>
</div>
<input type="text" class="form-control" id="validationCustomUsername" name="username" minlength="5" placeholder="Masukkan username" aria-describedby="inputGroupPrepend"
value="{{ isset($dtdokter) ? $dtdokter->username : '' }}"
required>
<div class="invalid-feedback"> Please choose a username. </div>
</div>
</div>
</div>
<!-- /.form-row -->
<div class="form-row">
<div class="col-md-4 mb-2">
<label for="validationCustomPassword">Password</label>
<div class="input-group">
<input type="password" class="form-control" id="validationCustomPassword" name="password" minlength="5" placeholder="Masukkan password" aria-describedby="inputGroupPrepend"
value="{{ isset($dtdokter) ? $dtdokter->password : '' }}"
required>
<div class="invalid-feedback"> Please choose a password. </div>
</div>
</div>
</div> --}}
<button class="btn btn-primary" type="submit">Save</button>
<a href="{{ route('dtdokter.index') }}"><button class="btn btn-default"
type="button">Cancel</button></a>
</form>
</div> <!-- /.card-body -->
</div> <!-- /.card -->
</div> <!-- /.col -->
</div> <!-- end section -->
</div> <!-- .container-fluid -->
</main> <!-- main -->
@endsection