@include('components.header')
<div role="main">
<div class="col-md-12">
<div class="x_panel">
<div class="x_title">
<h2>Edit Medical Center</h2>
<div class="clearfix"></div>
</div>
<div class="x_content">
<form class="form-horizontal form-label-left" method="POST" action="{{ route('medicalCenters.update', $medicalCenter->id) }}"
enctype="multipart/form-data">
@csrf
@method('PUT')
@if ($errors->any())
<div class="alert alert-danger">
<ul>
@foreach ($errors->all() as $error)
<li>{{ $error }}</li>
@endforeach
</ul>
</div>
@endif
<div class="item form-group">
<div class="col-md-6 col-sm-6 col-xs-12">
<label class="control-label" for="name">Name <span class="required text-danger">*</span>
</label>
<input id="name" class="form-control" value="{{ $medicalCenter->name }}"
data-validate-length-range="6" data-validate-words="1" name="name" placeholder="Name"
required="required" type="text">
</div>
<div class="col-md-6 col-sm-6 col-xs-12">
<label class="control-label" for="city">City
</label>
<input id="city" class="form-control" value="{{ $medicalCenter->city }}"
data-validate-length-range="6" data-validate-words="1" name="city"
placeholder="City" type="text">
</div>
</div>
<div class="item form-group">
<div class="col-md-6 col-sm-6 col-xs-12">
<label class="control-label" for="phone">Phone Number
</label>
<input id="phone" class="form-control" value="{{ $medicalCenter->phone }}"
data-validate-length-range="6" data-validate-words="1" name="phone" placeholder="Phone"
type="text">
</div>
<div class="col-md-6 col-sm-6 col-xs-12">
<label class="control-label" for="contact_person">Contact Person
</label>
<input id="contact_person" class="form-control" value="{{ $medicalCenter->contact_person }}"
data-validate-length-range="6" data-validate-words="1" name="contact_person"
placeholder="Contact Person" type="text">
</div>
</div>
<div class="item form-group">
<div class="col-md-6 col-sm-6 col-xs-12">
<label class="control-label" for="fax">Fax
</label>
<input id="fax" class="form-control" value="{{ $medicalCenter->fax }}"
data-validate-length-range="6" data-validate-words="1" name="fax" placeholder="Fax"
type="text">
</div>
<div class="col-md-6 col-sm-6 col-xs-12">
<label class="control-label" for="email">Email <span
class="required text-danger">*</span>
</label>
<input id="email" class="form-control" value="{{ $medicalCenter->email }}"
data-validate-length-range="6" data-validate-words="1" name="email"
placeholder="Email" required="required" type="text">
</div>
</div>
<div class="item form-group">
<div class="col-md-6 col-sm-6 col-xs-12">
<label class="control-label" for="location">Location
</label>
<input id="location" class="form-control" value="{{ $medicalCenter->location }}"
data-validate-length-range="6" data-validate-words="1" name="location" placeholder="Location"
type="text">
</div>
<div class="col-md-6 col-sm-6 col-xs-12">
<label class="control-label" for="address">Address
</label>
<input id="address" class="form-control" value="{{ $medicalCenter->address }}"
data-validate-length-range="6" data-validate-words="1" name="address"
placeholder="Address" type="text">
</div>
</div>
<div class="ln_solid"></div>
<div class="form-group">
<div class="col-md-2 col-md-offset-5 d-flex">
<button type="submit" class="btn btn-success">Submit</button>
<a href="{{ route('medicalCenters') }}" class="btn btn-default border">Cancel</a>
</div>
</div>
</form>
</div>
</div>
</div>
</div>
@include('components.footer')