<div class="row mt-5">
<form class="col col-6 mx-auto" wire:submit.prevent="save">
<div class="row">
<div class="col col-12 text-center">
<h3>Editar Médico</h3>
</div>
<div class="col mt-3">
<label for="name" class="form-label">Nombre</label>
<input id="name" class="form-control" wire:model="form.name">
</div>
<div class="col col-auto mt-3">
<div class="form-check mt-4">
<input class="form-check-input" type="radio" wire:model="form.active" id="active" value="{{ 1 }}">
<label class="form-check-label" for="active">
Activo
</label>
</div>
<div class="form-check">
<input class="form-check-input" type="radio" wire:model="form.active" id="inactive" value="{{ 0 }}">
<label class="form-check-label" for="inactive">
Inactivo
</label>
</div>
</div>
</div>
<div class="row mt-3">
<div class="col col-6">
<label for="middle" class="form-label">Apellido Paterno</label>
<input id="middle" class="form-control" wire:model="form.middle_name">
</div>
<div class="col col-6">
<label for="last" class="form-label">Apellido Materno</label>
<input id="last" class="form-control" wire:model="form.last_name">
</div>
</div>
<div class="row mt-5 text-center">
<div class="col">
<input type="checkbox" class="form-check-input" id="nutri" wire:model="form.specialities" value="{{ 1 }}">
<label class="form-check-label" for="nutri">Nutriólogo</label>
</div>
<div class="col">
<input type="checkbox" class="form-check-input" id="nutri" wire:model="form.specialities" value="{{ 2 }}">
<label class="form-check-label" for="nutri">Gastroenterólogo</label>
</div>
<div class="col">
<input type="checkbox" class="form-check-input" id="nutri" wire:model="form.specialities" value="{{ 3 }}">
<label class="form-check-label" for="nutri">Odontólogo</label>
</div>
<div class="col col-12 d-grid mt-5">
<button type="submit" class="btn btn-primary">Actualizar</button>
</div>
<div class="col col-12 d-grid mt-2">
<a href="/medicos" class="btn btn-secondary">Volver</a>
</div>
</div>
</form>
</div>
|
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