@if (!$referral_clinic->id) {!! Form::select('division_id')->required()->options(Company::divisions(), user('admin.web')->division_id)->label(trans('referral_clinic::referral_clinics.label.division_id'))->placeholder(trans('referral_clinic::referral_clinics.placeholder.division_id'))->addGroupClass('form-group-sm') !!} @else {!! Form::select('division_id')->required()->options(Company::divisions(), $referral->division_id)->value($referral_clinic->division_id)->label(trans('referral_clinic::referral_clinics.label.division_id'))->placeholder(trans('referral_clinic::referral_clinics.placeholder.division_id'))->addGroupClass('form-group-sm') !!} @endif {!! Form::text('clinic_name')->required()->label(trans('referral_clinic::referral_clinics.label.clinic_name'))->placeholder(trans('referral_clinic::referral_clinics.placeholder.clinic_name'))->addGroupClass('form-group-sm') !!} {!! Form::text('clinic_location')->value($referral_clinic->clinic_location)->disabled()->label(trans('referral_clinic::referral_clinics.label.clinic_location'))->placeholder(trans('referral_clinic::referral_clinics.placeholder.clinic_location'))->addGroupClass('form-group-sm') !!} {!! Form::select('status')->options(trans('referral_clinic::referral_clinics.options.status'))->id('status')-> label('Status')-> addGroupClass('form-group-sm')!!} {!! Form::textarea('address')->label(trans('referral_clinic::referral_clinics.label.address'))->placeholder(trans('referral_clinic::referral_clinics.placeholder.address'))->addGroupClass('form-group-sm') !!} {!! Form::textarea('remarks')->label(trans('referral_clinic::referral_clinics.label.remarks'))->placeholder(trans('referral_clinic::referral_clinics.placeholder.remarks'))->addGroupClass('form-group-sm') !!} {!! Form::hidden('doctor_data', '', ['id' => 'doctor_data']) !!}

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