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@@ -69,7 +69,7 @@
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<main role="main" class="col-md-9 ml-sm-auto col-lg-10 px-md-4">
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<div class="card mt-3">
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<div class=card-header>
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- <?
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+ <?php
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$thumbnail = $patient->profile_picture_base64;
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$initials = !$thumbnail ? substr($patient->name_first, 0, 1).substr($patient->name_last, 0, 1) : '';
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$online = $patient->is_online ? 'online' : '';
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@@ -125,7 +125,7 @@
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@else
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None provided.
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@endif
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- </a>
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+ </a>
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<form url="/api/client/putMcn">
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<input type="hidden" name="uid" value="{{$patient->uid}}">
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<input type="text" name="name_first" value="{{$patient->name_first}}">
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@@ -145,7 +145,7 @@
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<li><i class="fa fa-phone-alt" aria-hidden="true"></i> {{$confirmedCell}}</li>
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<li><i class="fa fa-envelope" aria-hidden="true"></i> {{$confirmedEmail}}</li>
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<li><i class="fa fa-map-marker-alt" aria-hidden="true"></i> {{$location}}</li>
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- </ul>
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+ </ul>
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<div class=separators>
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<div>Joined <?=$memberSince?></div>
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<div><label>PCP:</label> {{$mcpName}}</div>
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@@ -399,7 +399,7 @@
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<label for="" class="control-label text-left">Effective date</label>
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<input type="date" name="effectiveDateEST" class="form-control">
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</div>
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-
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+
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<div class="form-group">
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<label for="" class="control-label text-left">Effective time</label>
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<input type="time" name="effectiveTime" class="form-control">
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@@ -407,32 +407,32 @@
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</div>
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<div class="col-md-6">
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<div class="form-group">
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- <label for="" class="control-label">reason1</label>
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+ <label for="" class="control-label">reason1</label>
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<input type="text" name="reason1" class="form-control">
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</div>
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-
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+
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<div class="form-group">
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- <label for="" class="control-label">reason2</label>
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+ <label for="" class="control-label">reason2</label>
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<input type="text" name="reason2" class="form-control">
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</div>
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-
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+
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<div class="form-group">
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- <label for="" class="control-label">reason3</label>
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+ <label for="" class="control-label">reason3</label>
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<input type="text" name="reason3" class="form-control">
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</div>
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-
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+
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<div class="form-group">
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- <label for="" class="control-label">reason3Plus</label>
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+ <label for="" class="control-label">reason3Plus</label>
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<input type="text" name="reason3Plus" class="form-control">
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</div>
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-
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+
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<div class="form-group">
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- <label for="" class="control-label">serviceLocation</label>
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+ <label for="" class="control-label">serviceLocation</label>
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<input type="text" name="serviceLocation" class="form-control">
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</div>
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-
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+
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<div class="form-group">
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- <label for="" class="control-label">category</label>
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+ <label for="" class="control-label">category</label>
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<input type="text" name="category" class="form-control">
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</div>
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</div>
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