Munawwirul Jamal
48 lines
1.3 KiB
Vue
48 lines
1.3 KiB
Vue
<script setup lang="ts">
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import Block from '~/components/pub/form/block.vue'
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import FieldGroup from '~/components/pub/form/field-group.vue'
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import Field from '~/components/pub/form/field.vue'
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import Label from '~/components/pub/form/label.vue'
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</script>
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<template>
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<form id="entry-form">
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<div class="mb-5 border-b border-b-slate-300 pb-3 text-lg xl:text-xl">
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<Icon name="i-lucide-user" class="me-2" />
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<span class="font-semibold">Tambah</span> Pasien
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</div>
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<div class="mb-5 border-b border-b-slate-300 pb-3 text-lg xl:text-xl">
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<Block>
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<FieldGroup :column="3">
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<Label>Nama</Label>
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<Field>
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<Input type="text" name="name" />
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</Field>
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</FieldGroup>
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<FieldGroup :column="3">
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<Label>Nama</Label>
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<Field>
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<Input type="text" name="name" />
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</Field>
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</FieldGroup>
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<FieldGroup :column="3">
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<Label>Nomor RM</Label>
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<Field>
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<Input type="text" name="name" />
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</Field>
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</FieldGroup>
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<FieldGroup>
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<Label dynamic>Alamat</Label>
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<Field>
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<Input type="text" name="name" />
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</Field>
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</FieldGroup>
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</Block>
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</div>
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<div class="my-2 flex justify-end py-2">
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<PubNavFooterCsd />
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</div>
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</form>
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</template>
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