Style MCN edit modals

resources/views/layouts/patient.blade.php

@@ -129,15 +129,31 @@
                                                             None provided.
                                                         @endif
                                                     </a>
-                                                    <form url="/api/client/putMcn">
+                                                    <form url="/api/client/putMcn" class="mcp-theme-1">
                                                         <input type="hidden" name="uid" value="{{$patient->uid}}">
-                                                        <input type="text" name="name_first" value="{{$patient->name_first}}">
-                                                        <input type="text" name="name_last" value="{{$patient->name_last}}">
-                                                        <input type="text" name="dob" value="{{$patient->dob}}">
-                                                        <input type="text" name="mcn" value="{{$patient->mcn}}">
+                                                        <div class="mb-2">
+                                                            <input type="text" class="form-control form-control-sm" name="name_first"
+                                                                   value="{{$patient->name_first}}"
+                                                                   placeholder="First Name">
+                                                        </div>
+                                                        <div class="mb-2">
+                                                            <input type="text" class="form-control form-control-sm" name="name_last"
+                                                                   value="{{$patient->name_last}}"
+                                                                   placeholder="Last Name">
+                                                        </div>
+                                                        <div class="mb-2">
+                                                            <input type="date" class="form-control form-control-sm" name="dob"
+                                                                   value="{{$patient->dob}}"
+                                                                   placeholder="Date of Birth">
+                                                        </div>
+                                                        <div class="mb-2">
+                                                            <input type="text" class="form-control form-control-sm" name="mcn"
+                                                                   value="{{$patient->mcn}}"
+                                                                   placeholder="Medicare Number">
+                                                        </div>
                                                         <div>
-                                                            <button submit>Submit</button>
-                                                            <button cancel>Cancel</button>
+                                                            <button submit class="btn btn-sm btn-primary mr-2">Submit</button>
+                                                            <button cancel class="btn btn-sm btn-default border">Cancel</button>
                                                         </div>
                                                     </form>
                                                 </div>
@@ -389,16 +405,14 @@
                                         @if(!$patient->was_medicare_validation_successful)
                                             <div moe>
                                                 <a href="" start show><i class="fas fa-edit"></i></a>
-                                                <form url="/api/client/putMcn">
+                                                <form url="/api/client/putMcn" class="mcp-theme-1">
                                                     <input type="hidden" name="uid" value="{{$patient->uid}}">
                                                     <div class="form-group">
-                                                        <input type="text" name="mcn" value="{{$patient->mcn}}">
+                                                        <input type="text" class="form-control form-control-sm" name="mcn" value="{{$patient->mcn}}">
                                                     </div>
-                                                    <div class="form-group">
-                                                        <button class="btn btn-success btn-sm" submit>Submit
-                                                        </button>
-                                                        <button class="btn btn-secondary btn-sm" cancel>Cancel
-                                                        </button>
+                                                    <div>
+                                                        <button submit class="btn btn-sm btn-primary mr-2">Submit</button>
+                                                        <button cancel class="btn btn-sm btn-default border">Cancel</button>
                                                     </div>
                                                 </form>
                                             </div>