<!DOCTYPE html>
<html lang="{{ str_replace('_', '-', app()->getLocale()) }}">
<head>
  @include('layout.header')
</head>
<body>
  <div class="row" id="x" style="display: none;">
    <div class="col-12">
      <span class="d-flex align-items-center purchase-popup">
        <i class="typcn typcn-delete-outline" id="bannerClose"></i>
      </span>
    </div>
  </div>
  <div class="container-scroller">
    @include('layout.navbar')
    <!-- partial -->
    @include('layout.breadscrum')
    <div class="container-fluid page-body-wrapper">

      @include('layout.sidebar')

      <!-- partial -->
      <div class="main-panel">
        <div class="content-wrapper">
          <div class="row">
            <div class="col-md-12 grid-margin stretch-card">
                <div class="card">
                    <div class="card-body">
                        <h4 class="card-title">Bacteriology Report</h4>
                        <div class="row">
                            <div class="col-md-6">
                                <div class="form-group row">
                                    <label for="start_date" class="col-sm-5 col-form-label">Start Date (dd/mm/yyyy)</label>
                                    <input type="text" class="form-control form-control-sm col-sm-7" id="start_date" placeholder="">
                                </div>
                            </div>
                            <div class="col-md-6">
                                <div class="form-group row">
                                    <label for="end_date" class="col-sm-5 col-form-label">End Date (dd/mm/yyyy)</label>
                                    <input type="text" class="form-control form-control-sm col-sm-7" id="end_date" placeholder="">
                                </div>
                            </div>
                            <div class="col-md-6">
                                <div class="form-group row">
                                    <label for="sample_source" class="col-sm-5 col-form-label">Sample Type</label>
                                    <select class="form-control form-control-sm col-sm-7" id="sample_source">
                                        <option value="none">Select</option>
                                        <option>Blood Culture</option>
                                        <option>Urine</option>
                                    </select>
                                </div>
                            </div>
                            <div class="col-md-6">
                                <div class="form-group row">
                                    <label for="physician_name" class="col-sm-5 col-form-label">Organism</label>
                                    <select class="form-control form-control-sm col-sm-7" id="physician_name">
                                        <option value="none">Select</option>
                                        <option>Burkhudorial</option>
                                    </select>
                                </div>
                            </div>
                        </div>
                        <div class="row float-right">
                            <div class="col-md-12">
                                <button type="button" class="btn btn-info btn-icon-text">
                                    <i class="typcn typcn-eye btn-icon-prepend"></i>
                                    Preview
                                </button>
                                <button type="button" class="btn btn-info btn-icon-text">
                                    <i class="typcn typcn-printer btn-icon-prepend"></i>
                                    Print
                                </button>

                                <button type="button" class="btn btn-warning btn-icon-text">
                                    <i class="typcn typcn-refresh-outline btn-icon-prepend"></i>
                                    Reset
                                </button>
                            </div>
                        </div>
                    </div>
                </div>
            </div>
          </div>
        </div>
        @include('layout.footer')
      </div>
    </div>
  </div>
  @include('layout.common_script')
</body>

</html>

