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@@ -160,53 +160,48 @@
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<div><label>Next Appt:</label> {{$patient->mcp_onboarding_visit_date}}</div>
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<div><label>Next Appt:</label> {{$patient->mcp_onboarding_visit_date}}</div>
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</section>
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</section>
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<section class=vbox>
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<section class=vbox>
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- <div moe>
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+ <div moe relative class="mcp-theme-1">
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<a start show>
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<a start show>
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<!-- <i class="fa fa-plus-circle"></i> -->
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<!-- <i class="fa fa-plus-circle"></i> -->
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<button>+ Note</button>
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<button>+ Note</button>
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</a>
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</a>
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<form url="/api/note/createUsingFreeTextHtml" right>
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<form url="/api/note/createUsingFreeTextHtml" right>
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<input type="hidden" name="clientUid" value="{{$patient->uid}}">
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<input type="hidden" name="clientUid" value="{{$patient->uid}}">
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- <div>
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- <label for="" class="control-label">HCP Pro</label>
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- <select name="hcpProUid">
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- <option value="">-- select hcp pro --</option>
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+ <div class="mb-2">
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+ <select name="hcpProUid" class="form-control form-control-sm">
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+ <option value="">-- Select HCP Pro --</option>
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@foreach ($pros as $pro)
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@foreach ($pros as $pro)
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<option
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<option
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value="{{$pro->uid}}">{{$pro->name_display}}</option>
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value="{{$pro->uid}}">{{$pro->name_display}}</option>
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@endforeach
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@endforeach
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</select>
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</select>
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</div>
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</div>
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- <div>
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- <label for="">Ally Pro</label>
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- <select name="allyProUid">
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- <option value="">-- select ally pro --</option>
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+ <div class="mb-2">
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+ <select name="allyProUid" class="form-control form-control-sm">
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+ <option value="">-- Select Ally Pro --</option>
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@foreach ($pros as $pro)
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@foreach ($pros as $pro)
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<option
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<option
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value="{{$pro->uid}}">{{$pro->name_display}}</option>
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value="{{$pro->uid}}">{{$pro->name_display}}</option>
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@endforeach
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@endforeach
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</select>
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</select>
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</div>
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</div>
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- <div>
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- <label for="" class="control-label text-left">Title</label>
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- <input type="text" name="title">
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+ <div class="mb-2">
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+ <input type="text" name="title" placeholder="Title" class="form-control form-control-sm">
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</div>
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</div>
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- <div>
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- <label for="" class="control-label text-left">Effective date</label>
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- <input type="date" name="effectiveDateEST">
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+ <div class="mb-2">
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+ <label class="text-secondary text-sm">Effective Date</label>
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+ <input type="date" name="effectiveDateEST" placeholder="Effective Date" class="form-control form-control-sm">
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</div>
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</div>
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-
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- <div>
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- <label for="" class="control-label text-left">Effective time</label>
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- <input type="time" name="effectiveTime">
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+ <div class="mb-2">
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+ <label class="text-secondary text-sm">Effective Time</label>
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+ <input type="time" name="effectiveTime" placeholder="Effective Time" class="form-control form-control-sm">
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</div>
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</div>
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- <div>
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- <label for="" class="control-label text-left">Content</label>
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- <textarea name="freeTextHtml" id="" cols="30" rows="10"></textarea>
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+ <div class="mb-2">
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+ <textarea name="freeTextHtml" id="" cols="30" rows="5" placeholder="Content" class="form-control form-control-sm"></textarea>
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</div>
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</div>
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<div>
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<div>
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- <button submit>Submit</button>
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- <button cancel>Cancel</button>
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+ <button submit class="btn btn-sm btn-primary mr-1">Submit</button>
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+ <button cancel class="btn btn-sm btn-default">Cancel</button>
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</div>
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</div>
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</form>
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</form>
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</div>
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</div>
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