Client single - contact info page

resources/views/app/patient/demographics.blade.php

@@ -1,10 +1,56 @@
 @extends ('layouts.patient')
 
-
-@section('section-title')
-    Demographics
-@endsection
-
 @section('inner-content')
-    CONTENT
+    <div class="mb-1">
+        Phone: <b>{{ $patient->cell_number }}</b>
+    </div>
+    <div class="mb-1">
+        Email: <b>{{ $patient->email_address }}</b>
+    </div>
+    <div class="mb-1">
+        Home City: <b>{{ $patient->home_address_city }}</b>
+    </div>
+    <div class="mb-1">
+        Home State: <b>{{ $patient->home_address_state }}</b>
+    </div>
+    <div class="mt-3">
+        <div moe>
+            <a start show><i class="fa fa-edit"></i> Edit Info</a>
+            <form url="/api/client/putContactInfo" class="mcp-theme-1">
+                <input type="hidden" name="uid" value="{{$patient->uid}}">
+                <div class="mb-2">
+                    <input type="tel"
+                           class="form-control form-control-sm"
+                           name="cellNumber"
+                           placeholder="Phone Number"
+                           value="{{ $patient->cell_number }}">
+                </div>
+                <div class="mb-2">
+                    <input type="text"
+                           class="form-control form-control-sm"
+                           name="email"
+                           placeholder="Email"
+                           value="{{ $patient->email_address }}">
+                </div>
+                <div class="mb-2">
+                    <input type="text"
+                           class="form-control form-control-sm"
+                           name="city"
+                           placeholder="City"
+                           value="{{ $patient->home_address_city }}">
+                </div>
+                <div class="mb-2">
+                    <input type="text"
+                           class="form-control form-control-sm"
+                           name="state"
+                           placeholder="State"
+                           value="{{ $patient->home_address_state }}">
+                </div>
+                <div>
+                    <button submit class="btn btn-sm btn-primary mr-1">Submit</button>
+                    <button cancel class="btn btn-sm btn-default border">Cancel</button>
+                </div>
+            </form>
+        </div>
+    </div>
 @endsection

resources/views/layouts/patient.blade.php

@@ -44,6 +44,9 @@
                         <li class="nav-item">
                             <a class="nav-link" href="{{ route('patients.view.documents', ['patient' => $patient]) }}">Documents</a>
                         </li>
+                        <li class="nav-item">
+                            <a class="nav-link" href="{{ route('patients.view.demographics', ['patient' => $patient]) }}">Contact Info</a>
+                        </li>
                         {{--<li class="nav-item">
                             <a class="nav-link" href="/patients/view/{{ $patient->uid }}/intake">Intake</a>
                         </li>--}}
@@ -195,7 +198,7 @@
                                             @endif
                                         </div>
                                     </div>
-                                    <ul class=hbox>
+                                    {{--<ul class=hbox>
                                         <li><i class="fa fa-phone-alt" aria-hidden="true"></i> {{$confirmedCell}}</li>
                                         <li><i class="fa fa-envelope" aria-hidden="true"></i> {{$confirmedEmail}}</li>
                                         <li><i class="fa fa-map-marker-alt" aria-hidden="true"></i> {{$location}}</li>
@@ -239,7 +242,7 @@
                                                 </form>
                                             </div>
                                         </li>
-                                    </ul>
+                                    </ul>--}}
                                     <div class=separators>
                                         <div>Joined <?=$memberSince?></div>
                                         <div><label>PCP:</label> {{$mcpName}}</div>