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@@ -15,11 +15,15 @@
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<form url="/api/clientInfoLine/create">
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<input type="hidden" name="clientUid" value="{{ $patient->uid }}">
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<input type="hidden" name="category" value="dx">
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- <div class="mb-2"><input type="text" class="form-control form-control-sm" name="ICD" value="" placeholder="ICD"></div>
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- <div class="mb-2"><input type="text" class="form-control form-control-sm" name="contentText" value="" placeholder="Title"></div>
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<div class="mb-2">
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- <select name="Chronic or Acute" class="form-control form-control-sm pl-1">
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- <option>Chronic or Acute (select one)</option>
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+ <input type="text" class="form-control form-control-sm" name="ICD" value="" placeholder="ICD *" required>
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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="contentText" value="" placeholder="Title *" required>
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+ </div>
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+ <div class="mb-2">
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+ <select name="Chronic or Acute" class="form-control form-control-sm pl-1" required>
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+ <option value="">Chronic or Acute (select one)</option>
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<option value="Chronic">Chronic</option>
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<option value="Acute">Acute</option>
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</select>
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@@ -40,7 +44,9 @@
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<form url="/api/clientInfoLine/createMultiple">
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<input type="hidden" name="clientUid" value="{{ $patient->uid }}">
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<input type="hidden" name="category" value="dx">
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- <div class="mb-2"><textarea class="form-control form-control-sm" rows="8" name="contentTexts" value="" placeholder="Dx & Focus Areas"></textarea></div>
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+ <div class="mb-2">
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+ <textarea class="form-control form-control-sm" rows="8" name="contentTexts" value="" placeholder="Dx & Focus Areas *" required></textarea>
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+ </div>
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<div class="d-flex align-items-center">
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<button class="btn btn-sm btn-primary mr-2" submit>Save</button>
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<button class="btn btn-sm btn-default mr-2 border" cancel>Cancel</button>
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@@ -94,14 +100,14 @@
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<input type="hidden" name="clientUid" value="{{ $patient->uid }}">
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<input type="hidden" name="category" value="dx">
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<div class="mb-2">
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- <input type="text" class="form-control form-control-sm" name="ICD" value="{{ getVal($line->contentDetail, "ICD") }}" placeholder="ICD">
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+ <input type="text" class="form-control form-control-sm" name="ICD" value="{{ getVal($line->contentDetail, "ICD") }}" placeholder="ICD *" required>
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</div>
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<div class="mb-2">
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- <input type="text" class="form-control form-control-sm" name="contentText" value="{{$line->contentText}}" placeholder="Title">
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+ <input type="text" class="form-control form-control-sm" name="contentText" value="{{$line->contentText}}" placeholder="Title *" required>
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</div>
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<div class="mb-2">
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- <select name="Chronic or Acute" class="form-control form-control-sm pl-1">
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- <option>Chronic or Acute (select one)</option>
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+ <select name="Chronic or Acute" class="form-control form-control-sm pl-1" required>
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+ <option value="">Chronic or Acute (select one)</option>
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<option {{ getVal($line->contentDetail, ("Chronic or Acute")) === 'Chronic' ? 'selected' : '' }} value="Chronic">Chronic</option>
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<option {{ getVal($line->contentDetail, ("Chronic or Acute")) === 'Acute' ? 'selected' : '' }} value="Acute">Acute</option>
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</select>
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