|
@@ -124,7 +124,7 @@
|
|
|
|
|
|
<hr class="m-negator-3 my-3">
|
|
<hr class="m-negator-3 my-3">
|
|
|
|
|
|
- <div class="d-flex align-items-center mt-3">
|
|
|
|
|
|
+ <div class="d-flex align-items-center mt-3 mb-2">
|
|
<div class="font-weight-bold">Contact Info</div>
|
|
<div class="font-weight-bold">Contact Info</div>
|
|
<span class="text-secondary mx-2">|</span>
|
|
<span class="text-secondary mx-2">|</span>
|
|
<div moe wide>
|
|
<div moe wide>
|
|
@@ -146,6 +146,27 @@
|
|
<input type="text" class="form-control form-control-sm" name="cellNumberMemo"
|
|
<input type="text" class="form-control form-control-sm" name="cellNumberMemo"
|
|
placeholder="Cell Number Memo" value="{{ $patient->cell_number_memo }}">
|
|
placeholder="Cell Number Memo" value="{{ $patient->cell_number_memo }}">
|
|
</div>
|
|
</div>
|
|
|
|
+
|
|
|
|
+ <div class="mb-2">
|
|
|
|
+ <label class="mb-1 text-secondary text-sm">Cell Phone Type</label>
|
|
|
|
+ <input type="text" class="form-control form-control-sm" name="cellPhoneType"
|
|
|
|
+ data-option-list autocomplete="off"
|
|
|
|
+ placeholder="Cell Phone Type" value="{{ $patient->cell_phone_type }}">
|
|
|
|
+ <div class="data-option-list">
|
|
|
|
+ <div>Android</div>
|
|
|
|
+ <div>iOS</div>
|
|
|
|
+ </div>
|
|
|
|
+ </div>
|
|
|
|
+ <div class="mb-2">
|
|
|
|
+ <label class="mb-1 text-secondary text-sm">Cell Phone Model</label>
|
|
|
|
+ <input type="text" class="form-control form-control-sm" name="cellPhoneModel"
|
|
|
|
+ placeholder="Cell Phone Model" value="{{ $patient->cell_phone_model }}">
|
|
|
|
+ </div>
|
|
|
|
+ <div class="mb-2">
|
|
|
|
+ <label class="mb-1 text-secondary text-sm">Available Video Apps</label>
|
|
|
|
+ <input type="text" class="form-control form-control-sm" name="availableVideoApps"
|
|
|
|
+ placeholder="Available Video Apps" value="{{ $patient->available_video_apps }}">
|
|
|
|
+ </div>
|
|
<div class="mb-2">
|
|
<div class="mb-2">
|
|
<label class="mb-1 text-secondary text-sm">Email Address</label>
|
|
<label class="mb-1 text-secondary text-sm">Email Address</label>
|
|
<input type="text" class="form-control form-control-sm" name="email" placeholder="Email Address"
|
|
<input type="text" class="form-control form-control-sm" name="email" placeholder="Email Address"
|
|
@@ -166,6 +187,15 @@
|
|
Cell Phone: <b>{{ $patient->cell_number }}</b> <span
|
|
Cell Phone: <b>{{ $patient->cell_number }}</b> <span
|
|
class="text-sm text-secondary ml-2">{{ $patient->cell_number_memo ? '(' . $patient->cell_number_memo . ')' : '' }}</span>
|
|
class="text-sm text-secondary ml-2">{{ $patient->cell_number_memo ? '(' . $patient->cell_number_memo . ')' : '' }}</span>
|
|
</div>
|
|
</div>
|
|
|
|
+ <div class="mb-1">
|
|
|
|
+ Cell Phone Type: <b>{{ $patient->cell_phone_type }}</b>
|
|
|
|
+ </div>
|
|
|
|
+ <div class="mb-1">
|
|
|
|
+ Cell Phone Model: <b>{{ $patient->cell_phone_model }}</b>
|
|
|
|
+ </div>
|
|
|
|
+ <div class="mb-1">
|
|
|
|
+ Available Video Apps: <b>{{ $patient->available_video_apps }}</b>
|
|
|
|
+ </div>
|
|
<div class="mb-1">
|
|
<div class="mb-1">
|
|
Email: <b>{{ $patient->email_address }}</b>
|
|
Email: <b>{{ $patient->email_address }}</b>
|
|
</div>
|
|
</div>
|