@extends('layouts.website.website')
@section('content')
    <!--main content start-->
    <section id="main-content">
        <section class="wrapper site-min-height">
            <!-- page start-->
            <section class="col-md-7">
                <header class="panel-heading">
                    Create Payment Procedure
                </header>
                <div class="panel-body">
                    <div class="adv-table editable-table">
                        <div class="clearfix">
                            <form role="form" action="{{ route('website_paymentCategoryStore') }}" class="clearfix" method="post" enctype="multipart/form-data">
                                @csrf
                                <div class="form-group">
                                    <label for="exampleInputEmail1">Category Name</label>
                                    <input type="text" class="form-control" name="name" id="exampleInputEmail1" value="" placeholder="" />
                                </div>

                                <div class="form-group">
                                    <label for="exampleInputEmail1">Description</label>
                                    <input type="text" class="form-control" name="description" id="exampleInputEmail1" value="" placeholder="" />
                                </div>
                                <div class="form-group">
                                    <label for="exampleInputEmail1">Category Price</label>
                                    <input type="text" class="form-control" name="price" id="exampleInputEmail1" value="" placeholder="" />
                                </div>
                                <div class="form-group">
                                    <label for="exampleInputEmail1">Doctors Commission Rate (%)</label>
                                    <input type="text" class="form-control" name="doctor_comision" id="exampleInputEmail1" value="" placeholder="" />
                                </div>

                                <div class="form-group">
                                    <label for="exampleInputEmail1">Type</label>
                                    <select class="form-control m-bot15" name="type" value="">
                                        <option value="diagnostic"> Diagnostic Test </option>
                                        <option value="others"> Others </option>
                                    </select>
                                </div>

                                <input type="hidden" name="id" value="" />

                                <div class="form-group col-md-12">
                                    <button type="submit" name="submit" class="btn btn-info pull-right">Submit</button>
                                </div>
                            </form>
                        </div>
                    </div>
                </div>
            </section>
            <!-- page end-->
        </section>
    </section>
    <!--main content end-->
@endsection
