@extends('layouts.app')

@section('title', 'Tambah Registrasi')
@section('content')
<div class="container">
    <h1>Tambah Registrasi</h1>

    <form action="{{ route('tr_registrasi.store') }}" method="POST">
        @csrf
        <div class="mb-3">
            <label>Tanggal Registrasi</label>
            <input type="date" name="TanggalRegistrasi" class="form-control" required>
        </div>

        <div class="mb-3">
            <label>Pasien</label>
            <select name="MRPasien" class="form-control" required>
                <option value="">-- Pilih Pasien --</option>
                @foreach($pasiens as $pasien)
                    <option value="{{ $pasien->id }}">{{ $pasien->NamaPasien }}</option>
                @endforeach
            </select>
        </div>

        <div class="mb-3">
            <label>Nomor Kartu Asuransi</label>
            <input type="text" name="NomorKartuAsuransi" class="form-control" required>
        </div>

        <div class="mb-3">
            <label>Asuransi</label>
            <select name="IdAsuransi" class="form-control" required>
                <option value="">-- Pilih Asuransi --</option>
                @foreach($asuransis as $asuransi)
                    <option value="{{ $asuransi->id }}">{{ $asuransi->NamaAsuransi }}</option>
                @endforeach
            </select>
        </div>

        <div class="mb-3">
            <label>Pegawai</label>
            <select name="IdPegawai" class="form-control" required>
                <option value="">-- Pilih Pegawai --</option>
                @foreach($pegawais as $pegawai)
                    <option value="{{ $pegawai->id }}">{{ $pegawai->NamaPegawai }}</option>
                @endforeach
            </select>
        </div>

        <div class="mb-3">
            <label>Ruang Pelayanan</label>
            <select name="IdRuangPelayanan" class="form-control" required>
                <option value="">-- Pilih Ruang Pelayanan --</option>
                @foreach($ruangpelayanans as $ruang)
                    <option value="{{ $ruang->id }}">{{ $ruang->NamaRuangPelayanan }}</option>
                @endforeach
            </select>
        </div>

        <button type="submit" class="btn btn-success">Simpan</button>
        <a href="{{ route('tr_registrasi.index') }}" class="btn btn-secondary">Kembali</a>
    </form>
</div>
@endsection