Template
init
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@@ -7,14 +7,14 @@
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<div class="row justify-content-center">
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<div class="col-lg-7">
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<div class="card shadow-lg border-0 rounded-lg mt-5">
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<div class="card-header"><h3 class="text-center font-weight-light my-4">New Order</h3></div>
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<div class="card-header"><h3 class="text-center font-weight-light my-4">Tambahkan Pasien Lama</h3></div>
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<div class="card-body">
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<form method="POST" action="{{url('/insert-new-order') }}" enctype="multipart/form-data">
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@csrf
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<div class="form-row">
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<div class="col-md-6">
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<div class="form-group">
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<label class="small mb-1" for="inputFirstName">Customer Name</label>
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<label class="small mb-1" for="inputFirstName">Nama Pasien</label>
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<select id="name" name="name" class="form-control">
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<option selected>Choose...</option>
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@foreach($customers as $c)
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@@ -50,7 +50,7 @@
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</div>
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<div class="col-md-6">
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<div class="form-group">
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<label class="small mb-1" for="inputState">Product Code</label>
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<label class="small mb-1" for="inputState">Nomor Rekam Medis</label>
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<select id="inputState" name="code" class="form-control">
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<option selected>Choose...</option>
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@foreach($products as $row)
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@@ -63,7 +63,20 @@
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</div>
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<div class="col-md-6">
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<div class="form-group">
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<label class="small mb-1" for="inputState">Product Name</label>
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<label class="small mb-1" for="inputState">Nama Dokter</label>
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<select id="inputState" name="name" class="form-control">
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<option selected>Choose...</option>
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@foreach($products as $row)
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@if( $row->stock > 1)
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<option value="{{$row->product_code}}">{{ $row->name }}</option>
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@endif
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@endforeach
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</select>
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</div>
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</div>
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<div class="col-md-6">
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<div class="form-group">
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<label class="small mb-1" for="inputState">Nama Poliklinik</label>
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<select id="inputState" name="name" class="form-control">
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<option selected>Choose...</option>
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@foreach($products as $row)
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@@ -77,10 +90,18 @@
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<div class="col-md-6">
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<div class="form-group">
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<label class="small mb-1" for="inputLastName">Quantity</label>
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<input class="form-control py-4" name="quantity" type="text" />
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<label class="small mb-1" for="inputState">Penjamin</label>
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<select id="inputState" name="name" class="form-control">
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<option selected>Choose...</option>
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@foreach($products as $row)
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@if( $row->stock > 1)
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<option value="{{$row->product_code}}">{{ $row->name }}</option>
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@endif
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@endforeach
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</select>
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</div>
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</div>
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</div>
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<div class="form-group mt-4 mb-0"><button class="btn btn-primary btn-block">Submit</button></div>
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@@ -107,19 +128,19 @@ $("#name").change(function() {
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},
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success: function(data) {
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console.log(data);
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$("#email").html('<label class="small mb-1" for="inputFirstName">Customer Email</label>');
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$("#email").html('<label class="small mb-1" for="inputFirstName">Email</label>');
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var x = '<input class="form-control py-4" name="email" value="'+data.customer.email+'" type="text"/>';
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$("#email").append(x);
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$("#company").html('<label class="small mb-1" for="inputFirstName">Customer company</label>');
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$("#company").html('<label class="small mb-1" for="inputFirstName">BPJS</label>');
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var x = '<input class="form-control py-4" name="company" value="'+data.customer.company+'" type="text"/>';
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$("#company").append(x);
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$("#phone").html('<label class="small mb-1" for="inputFirstName">Customer Phone</label>');
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$("#phone").html('<label class="small mb-1" for="inputFirstName">Nomor Telepon</label>');
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var x = '<input class="form-control py-4" name="phone" value="'+data.customer.phone+'" type="text"/>';
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$("#phone").append(x);
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$("#address").html('<label class="small mb-1" for="inputFirstName">Customer Address</label>');
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$("#address").html('<label class="small mb-1" for="inputFirstName">Alamat</label>');
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var x = '<input class="form-control py-4" name="address" value="'+data.customer.address+'" type="text"/>';
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$("#address").append(x);
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}
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