D7net
Home
Console
Upload
information
Create File
Create Folder
About
Tools
:
/
home
/
forge
/
hms.dentostock.com
/
storage
/
framework
/
views
/
Filename :
dd1ef7f0d810f9d1a253d8a12ec76b2a.php
back
Copy
<div id="add_diagnosis_categories_modal" class="modal fade" role="dialog" tabindex="-1" aria-hidden="true"> <div class="modal-dialog"> <!-- Modal content--> <div class="modal-content"> <div class="modal-header"> <h3 class="modal-title" id="exampleModalLabel"><?php echo e(__('messages.diagnosis_category.new_diagnosis_category')); ?></h3> <button type="button" class="btn-close" data-bs-dismiss="modal" aria-label="Close"></button> </div> <?php echo e(Form::open(['id'=>'addDiagnosisCatForm'])); ?> <div class="modal-body"> <div class="alert alert-danger d-none hide" id="diagnosisCatErrorsBox"></div> <div class="row"> <div class="form-group col-sm-12 mb-5"> <?php echo e(Form::label('name', __('messages.diagnosis_category.diagnosis_category').(':'), ['class' => 'form-label'])); ?> <span class="required"></span> <?php echo e(Form::text('name', null, ['id'=>'diagnosisCatName','class' => 'form-control','required'])); ?> </div> <div class="form-group col-sm-12"> <?php echo e(Form::label('description', __('messages.diagnosis_category.description').(':'),['class' => 'form-label'])); ?> <?php echo e(Form::textarea('description', '', ['class' => 'form-control', 'rows' => 5, 'id' => 'diagnosisCatDescription'])); ?> </div> </div> </div> <div class="modal-footer pt-0"> <?php echo e(Form::button(__('messages.common.save'), ['type' => 'submit','class' => 'btn btn-primary m-0','id' => 'diagnosisCatSave','data-loading-text' => "<span class='spinner-border spinner-border-sm'></span> Processing..."])); ?> <button type="button" class="btn btn-secondary" data-bs-dismiss="modal"><?php echo e(__('messages.common.cancel')); ?></button> </div> <?php echo e(Form::close()); ?> </div> </div> </div> <?php /**PATH /home/u827283894/domains/w-manage.org/public_html/hms/resources/views/diagnosis_categories/modal.blade.php ENDPATH**/ ?>