{!! Form::horizondal_open()->id('ReferralSourceReportForm')->secure()->method('POST')->files('true')->enctype('multipart/form-data') !!}
{!! Form::select('search[referral_clinics.company_id]')->options(Company::companies(), user('admin.web')->current_comp)->disabled()->addGroupClass('form-group-sm')->label('Company')->id('company_ id')->placeholder('select company') !!}
{!! Form::select('search[referral_clinics.division_id]')->options(Company::divisions())->addGroupClass('form-group-sm')->label('Division')->id('division_id')->placeholder('select Division') !!}
{!! Form::select('search[referral_clinics.id]')->options(ReferralClinic::referral_Clinic())->addGroupClass('form-group-sm')->label('Hospital/Clinic')->placeholder('select Hospital/Clinic')->id('clinic_name') !!}
{!! Form::select('search[referral_doctors.doctor_department_id]')->options(ReferralClinic::doctor_departments())->addGroupClass('form-group-sm')->label('Doctor Department')->placeholder('select Doctor Department')->id('doctor_department_id') !!}
{!! Form::text('search[referral_doctors.name]')->addGroupClass('form-group-sm')->label('Dr. Name')->id('name')->placeholder('Enter Name') !!}
{!! Form::text('search[referral_doctors.mobile]')->id('mobile')->addGroupClass('form-group-sm')->label('Mobile')->placeholder('select Mobile') !!}
{{-- {!! Form::number('search[visit_count]')->id('visit_count')->addGroupClass('form-group-sm')->label('Visit Count')->placeholder('Enter Visit Count') !!} --}}
{!! Form::select('search[referral_clinics.user_id]')->id('user_id')->options(Company::allUsers())->addGroupClass('form-group-sm')->label('Executive Name')->placeholder('select Executive') !!}
{!! Form::close() !!}