64 lines
2.6 KiB
PHP
64 lines
2.6 KiB
PHP
@extends('layouts.app')
|
|
|
|
@section('title', 'Edit Registrasi')
|
|
@section('content')
|
|
<div class="container">
|
|
<h1>Edit Registrasi</h1>
|
|
|
|
<form action="{{ route('tr_registrasi.update', $registrasi) }}" method="POST">
|
|
@csrf
|
|
@method('PUT')
|
|
<div class="mb-3">
|
|
<label>Tanggal Registrasi</label>
|
|
<input type="date" name="TanggalRegistrasi" class="form-control" value="{{ $registrasi->TanggalRegistrasi }}" required>
|
|
</div>
|
|
<div class="mb-3">
|
|
<label>MRPasien</label>
|
|
<select name="MRPasien" class="form-control" required>
|
|
@foreach($pasiens as $pasien)
|
|
<option value="{{ $pasien->id }}" {{ $registrasi->MRPasien == $pasien->id ? 'selected' : '' }}>
|
|
{{ $pasien->NamaPasien }}
|
|
</option>
|
|
@endforeach
|
|
</select>
|
|
</div>
|
|
<div class="mb-3">
|
|
<label>Nomor Kartu Asuransi</label>
|
|
<input type="text" name="NomorKartuAsuransi" class="form-control" value="{{ $registrasi->NomorKartuAsuransi }}" required>
|
|
</div>
|
|
<div class="mb-3">
|
|
<label>ID Asuransi</label>
|
|
<select name="IdAsuransi" class="form-control" required>
|
|
@foreach($asuransis as $asuransi)
|
|
<option value="{{ $asuransi->id }}" {{ $registrasi->IdAsuransi == $asuransi->id ? 'selected' : '' }}>
|
|
{{ $asuransi->NamaAsuransi }}
|
|
</option>
|
|
@endforeach
|
|
</select>
|
|
</div>
|
|
<div class="mb-3">
|
|
<label>ID Pegawai</label>
|
|
<select name="IdPegawai" class="form-control" required>
|
|
@foreach($pegawais as $pegawai)
|
|
<option value="{{ $pegawai->id }}" {{ $registrasi->IdPegawai == $pegawai->id ? 'selected' : '' }}>
|
|
{{ $pegawai->NamaPegawai }}
|
|
</option>
|
|
@endforeach
|
|
</select>
|
|
</div>
|
|
<div class="mb-3">
|
|
<label>ID Ruang Pelayanan</label>
|
|
<select name="IdRuangPelayanan" class="form-control" required>
|
|
@foreach($ruangPelayanans as $ruang)
|
|
<option value="{{ $ruang->id }}" {{ $registrasi->IdRuangPelayanan == $ruang->id ? 'selected' : '' }}>
|
|
{{ $ruang->NamaRuangPelayanan }}
|
|
</option>
|
|
@endforeach
|
|
</select>
|
|
</div>
|
|
<button type="submit" class="btn btn-primary">Update</button>
|
|
<a href="{{ route('tr_registrasi.index') }}" class="btn btn-secondary">Kembali</a>
|
|
</form>
|
|
</div>
|
|
@endsection
|