Added email & note fields

resources/views/app/patient/intake-data/grid-patient-intake-data-form.blade.php

@@ -8,6 +8,8 @@
 		'diabetes' => 'Diabetes',
 		'copd' => 'COPD',
 		'arthritis' => 'Arthritis',
+		'email_address' => 'Email Address',
+		'note' => 'Sticky Note'
 	];
 	$patientCanvasData = json_decode($patient->canvas_data ?? null);
 	$patientIntakeData = null;
@@ -28,10 +30,22 @@
 			<input type="hidden" name="data">
 			<div class="row">
 				@foreach($intakeDataFields as $key=>$label)
-				<div class="col-md-6 mb-2">
-					<label class="text-secondary text-sm font-weight-bold">{{ $label }}</label>
-					<input name="{{$key}}" class="form-control" value="{{ $patientIntakeData ? @$patientIntakeData->{$key}:'' }}" />
-				</div>
+					@if($key == 'note')
+					<div class="col-md-12 mb-2">
+						<label class="text-secondary text-sm font-weight-bold">{{ $label }}</label>
+						<textarea name="{{$key}}" class="form-control">{{ $patientIntakeData ? @$patientIntakeData->{$key}:'' }}</textarea>
+					</div>
+					@elseif($key == 'email_address')
+					<div class="col-md-12 mb-2">
+						<label class="text-secondary text-sm font-weight-bold">{{ $label }}</label>
+						<input name="{{$key}}" class="form-control" value="{{ $patientIntakeData ? @$patientIntakeData->{$key}:'' }}" />
+					</div>
+					@else
+					<div class="col-md-6 mb-2">
+						<label class="text-secondary text-sm font-weight-bold">{{ $label }}</label>
+						<input name="{{$key}}" class="form-control" value="{{ $patientIntakeData ? @$patientIntakeData->{$key}:'' }}" />
+					</div>
+					@endif
 				@endforeach
 			</div>
 

resources/views/app/patient/intake-data/patient-intake-data-form.blade.php

@@ -8,6 +8,8 @@
 		'diabetes' => 'Diabetes',
 		'copd' => 'COPD',
 		'arthritis' => 'Arthritis',
+		'email_address' => 'Email Address',
+		'note' => 'Sticky Note'
 	];
 	$patientCanvasData = json_decode($patient->canvas_data ?? null);
 	$patientIntakeData = null;
@@ -38,10 +40,22 @@
 			<input type="hidden" name="data">
 			<div class="row">
 				@foreach($intakeDataFields as $key=>$label)
-				<div class="col-md-6 mb-2">
-					<label class="text-secondary text-sm font-weight-bold">{{ $label }}</label>
-					<input name="{{$key}}" class="form-control" value="{{ $patientIntakeData ? @$patientIntakeData->{$key}:'' }}" />
-				</div>
+					@if($key == 'note')
+					<div class="col-md-12 mb-2">
+						<label class="text-secondary text-sm font-weight-bold">{{ $label }}</label>
+						<textarea name="{{$key}}" class="form-control">{{ $patientIntakeData ? @$patientIntakeData->{$key}:'' }}</textarea>
+					</div>
+					@elseif($key == 'email_address')
+					<div class="col-md-12 mb-2">
+						<label class="text-secondary text-sm font-weight-bold">{{ $label }}</label>
+						<input name="{{$key}}" class="form-control" value="{{ $patientIntakeData ? @$patientIntakeData->{$key}:'' }}" />
+					</div>
+					@else
+					<div class="col-md-6 mb-2">
+						<label class="text-secondary text-sm font-weight-bold">{{ $label }}</label>
+						<input name="{{$key}}" class="form-control" value="{{ $patientIntakeData ? @$patientIntakeData->{$key}:'' }}" />
+					</div>
+					@endif
 				@endforeach
 			</div>