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@@ -117,13 +117,20 @@
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<form url="/api/client/putContactInfo" class="mcp-theme-1">
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<input type="hidden" name="uid" value="{{$patient->uid}}">
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<div class="mb-2">
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+ <label class="mb-1 text-secondary text-sm">Home Phone Number</label>
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<input type="tel" class="form-control form-control-sm" name="homeNumber" placeholder="Home Phone Number" value="{{ $patient->phone_home }}">
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</div>
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<div class="mb-2">
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- <input type="tel" class="form-control form-control-sm" name="cellNumber" placeholder="Cell Phone Number" value="{{ $patient->cell_number }}">
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+ <label class="mb-1 text-secondary text-sm">Cell Number</label>
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+ <input type="tel" class="form-control form-control-sm" name="cellNumber" placeholder="Cell Number" value="{{ $patient->cell_number }}">
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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="email" placeholder="Email" value="{{ $patient->email_address }}">
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+ <label class="mb-1 text-secondary text-sm">Cell Number Memo</label>
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+ <input type="text" class="form-control form-control-sm" name="cellNumberMemo" placeholder="Cell Number Memo" value="{{ $patient->cell_number_memo }}">
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+ </div>
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+ <div class="mb-2">
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+ <label class="mb-1 text-secondary text-sm">Email Address</label>
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+ <input type="text" class="form-control form-control-sm" name="email" placeholder="Email Address" value="{{ $patient->email_address }}">
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</div>
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<div>
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<button submit class="btn btn-sm btn-primary mr-1">Submit</button>
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@@ -137,7 +144,7 @@
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Home Phone: <b>{{ $patient->phone_home }}</b>
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</div>
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<div class="mb-1">
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- Cell Phone: <b>{{ $patient->cell_number }}</b>
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+ Cell Phone: <b>{{ $patient->cell_number }}</b> <span class="text-sm text-secondary ml-2">{{ $patient->cell_number_memo ? '(' . $patient->cell_number_memo . ')' : '' }}</span>
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</div>
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<div class="mb-1">
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Email: <b>{{ $patient->email_address }}</b>
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