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+<div class="d-flex px-3 py-2 bg-light align-items-baseline border-bottom">
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+ <h4 class="font-weight-bold text-nowrap m-0">Shipment To Patient</h4>
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+ <div moe class="ml-3">
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+ <a start show href="#"><i class="fa fa-edit"></i> Edit</a>
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+ <form url="/api/client/updateWatchPatShipmentToPatient" hook="refreshSleepStudyStep">
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+ <input type="hidden" name="uid" value="{{$patient->uid}}">
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+ <div class="font-weight-bold font-size-14 text-secondary border-bottom pb-2 mb-2 text-nowrap">Shipment To Patient</div>
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+
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+ <div class="mb-2">
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+ <div class="mb-1">Is WatchPat Shipped To Patient:</div>
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+ <select name="isWatchPatShippedToPatient" class="form-control form-control-sm">
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+ <option value="">-- select --</option>
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+ <option value="1" {{$patient->is_watch_pat_shipped_to_patient == '1' ? 'selected' : ''}}>Yes</option>
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+ <option value="0" {{$patient->is_watch_pat_shipped_to_patient == '0' ? 'selected' : ''}}>No</option>
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+ </select>
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+ </div>
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+
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+ <div class="mb-2">
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+ <div class="mb-1">FedEx #:</div>
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+ <input type="text" value="{{$patient->watch_pat_shipment_to_patient_fed_ex_number}}" name="watchPatShipmentToPatientFedExNumber" class="form-control form-control-sm d-inline-block flex-grow-1">
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+ </div>
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+
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+ <div class="mb-2">
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+ <div class="mb-1">Memo:</div>
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+ <input type="text" value="{{$patient->watch_pat_shipment_to_patient_memo}}" name="watchPatShipmentToPatientMemo" class="form-control form-control-sm d-inline-block flex-grow-1">
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+ </div>
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+
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+ <div class="mb-2">
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+ <div class="mb-1">Effective As Of:</div>
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+ <input type="date" value="{{$patient->watch_pat_shipment_to_patient_effective_as_of}}" name="watchPatShipmentToPatientEffectiveAsOf" class="form-control form-control-sm d-inline-block flex-grow-1">
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+ </div>
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+
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+ <div class="mt-2 border-top pt-2 text-center">
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+ <button class="btn btn-primary btn-sm" submit>Submit</button>
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+ <button class="btn btn-default border btn-sm" cancel>Cancel</button>
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+ </div>
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+ </form>
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+ </div>
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+</div>
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+
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+<div class="px-3 pt-2 pb-1">
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+ Is WatchPat Shipped To Patient: <b>{{+$patient->is_watch_pat_shipped_to_patient ? 'Yes' : 'No'}}</b>
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+</div>
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+
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+<div class="px-3 py-1">
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+ FedEx #: <b>{{$patient->watch_pat_shipment_to_patient_fed_ex_number ?: '-'}}</b>
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+</div>
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+
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+<div class="px-3 py-1">
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+ Memo: <b>{{$patient->watch_pat_shipment_to_patient_memo ?: '-'}}</b>
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+</div>
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+
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+<div class="px-3 py-1">
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+ Effective As Of: <b>{{$patient->watch_pat_shipment_to_patient_effective_as_of ?: '-'}}</b>
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+</div>
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