40 lines
1.4 KiB
PHP
40 lines
1.4 KiB
PHP
@extends('layouts.app')
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@section('content')
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<div class="container">
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<h1>Edit Pasien</h1>
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<form action="{{ route('pasien.update', $pasien->id) }}" method="POST">
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@csrf
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@method('PUT')
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<div class="mb-3">
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<label>Nama Pasien</label>
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<input type="text" name="nama_pasien" class="form-control" value="{{ $pasien->nama_pasien }}">
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</div>
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<div class="mb-3">
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<label>Jenis Kelamin</label>
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<select name="jenis_kelamin" class="form-control">
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<option value="Laki-Laki" {{ $pasien->jenis_kelamin == 'Laki-Laki' ? 'selected' : '' }}>Laki-Laki
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</option>
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<option value="Perempuan" {{ $pasien->jenis_kelamin == 'Perempuan' ? 'selected' : '' }}>Perempuan
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</option>
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</select>
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</div>
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<div class="mb-3">
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<label>Tanggal Lahir</label>
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<input type="date" name="tanggal_lahir" class="form-control" value="{{ $pasien->tanggal_lahir }}">
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</div>
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<div class="mb-3">
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<label>Nomor Telepon</label>
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<input type="text" name="nomor_telepon" class="form-control" value="{{ $pasien->nomor_telepon }}">
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</div>
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<button type="submit" class="btn btn-primary">Update Pasien</button>
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</form>
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</div>
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@endsection
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