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@@ -1,5 +1,5 @@
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<div class="bg-light border p-4 mb-4" id="formComponent">
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<div class="bg-light border p-4 mb-4" id="formComponent">
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- <form class="" action="{{ route('physicians.submit-order-ligators') }}" method="post" autocomplete="off">
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+ <form class="" action="{{ route('physicians.submit-order-ligators') }}" method="post" autocomplete="off" id="order-form">
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@csrf
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@csrf
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<div class="row">
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<div class="row">
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<div class="col-12">
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<div class="col-12">
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@@ -54,7 +54,7 @@
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</div>
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</div>
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<div class="row">
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<div class="row">
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<div class="col-lg-6 form-group mb-4">
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<div class="col-lg-6 form-group mb-4">
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- <label>Order physician name: <span class="text-danger">*</span></label>
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+ <label>Ordering physician name: <span class="text-danger">*</span></label>
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<input type="text" class="form-control rounded-0 py-3" name="order_phyisician_name" required value="{{ old('order_phyisician_name') }}">
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<input type="text" class="form-control rounded-0 py-3" name="order_phyisician_name" required value="{{ old('order_phyisician_name') }}">
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@error('order_phyisician_name')
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@error('order_phyisician_name')
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<small class="text-warning">{{$message}}</small>
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<small class="text-warning">{{$message}}</small>
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@@ -161,10 +161,17 @@
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<small class="text-warning">{{$message}}</small>
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<small class="text-warning">{{$message}}</small>
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@enderror
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@enderror
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</td>
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</td>
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- <td class="p-3 v-center">$70.00 per unit</td>
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+ <td class="p-3 v-center">
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+ <div class="mb-2" style="text-decoration: line-through">
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+ $70 per unit
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+ </div>
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+ <div style="font-weight: bold">
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+ $35.00 per unit
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+ </div>
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+ </td>
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<td class="p-3 v-center">
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<td class="p-3 v-center">
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<div class="d-flex align-items-baseline">
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<div class="d-flex align-items-baseline">
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- <span>$</span> <input type="text" name="total" disabled class="form-control border-0 bg-transparent text-center rounded-0 border-bottom border-dark" :value="quantity * 70 || ''">
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+ <span>$</span> <input type="text" name="total" disabled class="form-control border-0 bg-transparent text-center rounded-0 border-bottom border-dark" :value="quantity * 35 || ''">
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</div>
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</div>
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</td>
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</td>
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</tr>
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</tr>
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