<!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">Patient Information</h4>
                        <div class="row">
                            <div class="col-md-4">
                                <div class="form-group row">
                                    <label for="patient_name" class="col-sm-5 col-form-label">Patient Name</label>
                                    <select class="form-control form-control-sm col-sm-7" id="patient_name">
                                        <option value="none">Select</option>
                                        <option>Mr A</option>
                                        <option>Mr B</option>
                                    </select>
                                </div>
                            </div>
                            <div class="col-md-4">
                                <div class="form-group row">
                                    <label for="labid" class="col-sm-5 col-form-label">Lab ID</label>
                                    <select class="form-control form-control-sm col-sm-7" id="lab_id">
                                        <option value="none">Select</option>
                                        <option>001-30082022</option>
                                        <option>002-30082022</option>
                                    </select>
                                </div>
                            </div>
                            <div class="col-md-4">
                                <div class="form-group row">
                                    <label for="status" class="col-sm-5 col-form-label">Status</label>
                                    <select class="form-control form-control-sm col-sm-7" id="sample_status">
                                        <option value="none">All</option>
                                        <option>In progress</option>
                                        <option>Completed</option>
                                    </select>
                                </div>
                            </div>
                            <div class="col-md-4">
                                <div class="form-group row">
                                    <label for="phonenumber" class="col-sm-5 col-form-label">Phone Number</label>
                                    <input type="text" class="form-control form-control-sm col-sm-7" id="phone_number" placeholder="Phone number">
                                </div>
                            </div>
                            <div class="col-md-4">
                                <div class="form-group row">
                                    <label for="example" class="col-sm-5 col-form-label">Request Date:</label>
                                    <input type="text" class="form-control form-control-sm col-sm-7" id="request_date" placeholder="">
                                </div>
                            </div>
                            <div class="col-md-4">
                                <div class="form-group row">
                                    <label for="exampleInputUsername2" class="col-sm-5 col-form-label">Doctor</label>
                                    <select class="form-control form-control-sm col-sm-7" id="doctor">
                                        <option value="">Select</option>
                                        <option>Dr. A</option>
                                        <option>Dr. B</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-search btn-icon-prepend"></i>
                                    Search
                                </button>
                            </div>
                        </div>
                    </div>
                </div>
            </div>
          </div>
          <div class="row">
            <div class="col-md-12">
              <div class="card">
                <div class="table-responsive pt-3">
                  <table class="table table-striped project-orders-table">
                    <thead>
                      <tr>
                        <th>Patient ID</th>
                        <th>Lab ID</th>
                        <th>Patient Name</th>
                        <th>Age</th>
                        <th>Sex</th>
                        <th>Request Date</th>
                        <th>Telephone</th>
                        <th>Request by</th>
                        <th>Status</th>
                        <th>Price (Riel)</th>
                        <th>Price ($)</th>
                        <th>Action</th>
                      </tr>
                    </thead>
                    <tbody>
                      <tr>
                        <td>210222004</td>
                        <td>220221-01091</td>
                        <td>ALY KRIYA</td>
                        <td>26y</td>
                        <td>Male</td>
                        <td>21-Feb-2022</td>
                        <td>098898989</td>
                        <td>Chomnor Dara</td>
                        <td><label class="badge badge-success">COMPLETED</label></td>
                        <td></td>
                        <td>19$</td>
                        <td>
                            <div class="btn-group" role="group" aria-label="Basic example" >
                                <button type="button" class="btn btn-sm btn-info " title="Edit">
                                  <i class="typcn typcn-edit"></i>
                                </button>
                                <button type="button" class="btn btn-sm btn-info "  title="Prview Result">
                                  <i class="typcn typcn-eye"></i>
                                </button>
                                <button type="button" class="btn btn-sm btn-warning " title="Enter Result">
                                  <i class="typcn typcn-plus"></i>
                                </button>
                                <button type="button" class="btn btn-sm btn-danger " title="Delete">
                                    <i class="typcn typcn-delete-outline"></i>
                                </button>
                            </div>

                        </td>
                      </tr>
                      <tr>
                        <td>210222004</td>
                        <td>220221-01091</td>
                        <td>ALY KRIYA</td>
                        <td>26y</td>
                        <td>Male</td>
                        <td>21-Feb-2022</td>
                        <td>098898989</td>
                        <td>Chomnor Dara</td>
                        <td><label class="badge badge-primary">In progress</label></td>
                        <td></td>
                        <td>19$</td>
                        <td>
                            <div class="btn-group" role="group" aria-label="Basic example" >
                                <button type="button" class="btn btn-sm btn-info " title="Edit">
                                  <i class="typcn typcn-edit"></i>
                                </button>
                                <button type="button" class="btn btn-sm btn-info "  title="Prview Result">
                                  <i class="typcn typcn-eye"></i>
                                </button>
                                <button type="button" class="btn btn-sm btn-warning " title="Enter Result">
                                  <i class="typcn typcn-plus"></i>
                                </button>
                                <button type="button" class="btn btn-sm btn-danger " title="Delete">
                                    <i class="typcn typcn-delete-outline"></i>
                                </button>
                            </div>

                        </td>
                      </tr>
                    </tbody>
                  </table>
                </div>
              </div>
            </div>
          </div>
        </div>
        @include('layout.footer')
      </div>
    </div>
  </div>
  @include('layout.common_script')
</body>

</html>

