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@@ -36,8 +36,8 @@
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</select>
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</div>
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<div class='form-group mb-3'>
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- <label class='control-label'>Date Of Birth </label>
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- <input class='form-control' type='date' name='dateOfBirth'>
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+ <label class='control-label'>Date Of Birth *</label>
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+ <input class='form-control' type='date' name='dateOfBirth' required>
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</div>
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<div class='form-group mb-3'>
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<label class='control-label'>Cell Number </label>
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@@ -48,8 +48,8 @@
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<input class='form-control' type='email' name='emailAddress'>
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</div>
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<div class='form-group mb-3'>
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- <label class='control-label'>Medicare Number </label>
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- <input class='form-control' type='text' name='medicareNumber'>
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+ <label class='control-label'>Medicare Number *</label>
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+ <input class='form-control' type='text' name='medicareNumber' required>
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</div>
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</form>
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</div>
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