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@@ -137,15 +137,15 @@
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None provided.
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@endif
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</a>
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- <form url="/api/client/putMcn" class="mcp-theme-1">
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- <input type="hidden" name="uid" value="{{$patient->uid}}">
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+ <form url="/api/client/putMedicareInfo" class="mcp-theme-1">
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+ <input type="hidden" name="clientUid" value="{{$patient->uid}}">
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<div class="mb-2">
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- <input type="text" class="form-control form-control-sm" name="name_first"
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+ <input type="text" class="form-control form-control-sm" name="nameFirst"
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value="{{$patient->name_first}}"
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placeholder="First Name">
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</div>
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<div class="mb-2">
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- <input type="text" class="form-control form-control-sm" name="name_last"
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+ <input type="text" class="form-control form-control-sm" name="nameLast"
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value="{{$patient->name_last}}"
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placeholder="Last Name">
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</div>
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