@extends('layouts.website.website')
@section('content')
<section id="main-content">
    <section class="wrapper site-min-height">
        <!-- page start-->
        <section class="col-md-7 row">
            <header class="panel-heading">
                Add Bed Allotment            </header>
            <div class="panel-body">
                <div class="adv-table editable-table ">
                    <div class="clearfix">
                                                <form role="form" action="bed/addAllotment" class="clearfix row" method="post" enctype="multipart/form-data">

                            <div class="form-group col-md-12">
                                <label for="exampleInputEmail1">Bed Id</label>
                                <select class="form-control m-bot15" name="bed_id" value="">

                                </select>
                            </div>
                            <div class="form-group col-md-12">
                                <label for="exampleInputEmail1">Patient</label>
                                <select class="form-control m-bot15 select2-hidden-accessible" id="patientchoose" name="patient" value="" tabindex="-1" aria-hidden="true">

                                </select><span class="select2 select2-container select2-container--default" dir="ltr" style="width: 521px;"><span class="selection"><span class="select2-selection select2-selection--single" role="combobox" aria-haspopup="true" aria-expanded="false" tabindex="0" aria-labelledby="select2-patientchoose-container"><span class="select2-selection__rendered" id="select2-patientchoose-container"><span class="select2-selection__placeholder">Search Patient Name / ID</span></span><span class="select2-selection__arrow" role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper" aria-hidden="true"></span></span>
                            </div>

                           <div class="form-group col-md-12">
                                <label for="exampleInputEmail1">Alloted Time</label>
                                <div data-date="" class="input-group date form_datetime-meridian">
                                    <div class="input-group-btn">
                                        <button type="button" class="btn btn-info date-set"><i class="fa fa-calendar"></i></button>
                                        <button type="button" class="btn btn-danger date-reset"><i class="fa fa-times"></i></button>
                                    </div>
                                    <input type="text" class="form-control" readonly="" name="a_time" id="exampleInputEmail1" value="" placeholder="">
                                </div>
                            </div>

                            <div class="form-group col-md-12">
                                <label for="exampleInputEmail1">Discharge Time</label>
                                <div data-date="" class="input-group date form_datetime-meridian">
                                    <div class="input-group-btn">
                                        <button type="button" class="btn btn-info date-set"><i class="fa fa-calendar"></i></button>
                                        <button type="button" class="btn btn-danger date-reset"><i class="fa fa-times"></i></button>
                                    </div>
                                    <input type="text" class="form-control" name="d_time" id="exampleInputEmail1" value="" placeholder="">
                                </div>
                            </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>
@endsection
