@extends('frontend.layouts.frontend_app')
@section('content')
    <section id="custom_dashboard">
        <div class="container" data-aos="fade-up">
            <div class="row">
                @include('frontend.pages.customer.includes.sidebar')
                <div class="col-lg-9">
                    <div class="card p-0 border-0">
                        <div class="card-header bg-transparent d-flex justify-content-between align-items-center">
                            <div class="card-title h4 m-0">{{__('pages.Add New Prescription')}}</div>
                            <a href="{{ route('customer.prescription') }}" class="btn btn-default">
                                {{__('pages.Back')}}
                            </a>
                        </div>
                        <div class="card-body">
                            <form method="post" action="{{ route('customer.prescription.store') }}" enctype="multipart/form-data">
                                @csrf
                                <div class="row justify-content-center">
                                    <div class="col-lg-6">
                                        <div class="col-lg-12 mb-3">
                                            <label for="name">{{__('pages.Name')}}</label>
                                            <input type="text" id="name" name="name" class="form-control"
                                                   placeholder="{{__('pages.Enter full name')}}">
                                            @error('name')
                                            <span class="text-danger">{{ $message  }}</span>
                                            @enderror
                                        </div>
                                        <div class="col-lg-12 mb-3">
                                            <label for="phone">{{__('pages.Phone')}} </label>
                                            <input type="text" id="phone" name="phone" class="form-control"
                                                   placeholder="{{__('pages.Enter phone')}}">
                                            @error('phone')
                                            <span class="text-danger">{{ $message  }}</span>
                                            @enderror
                                        </div>
                                        <div class="col-lg-12">
                                            <div class="form-group">
                                                <label for="exampleInputEmail1">{{__('pages.Prescription Photo')}}</label>
                                                <input type="file" class="form-control" name="prescription">
                                                @error('prescription')
                                                <span class="text-danger">{{ $message  }}</span>
                                                @enderror
                                            </div>
                                        </div>
                                        <div class="col-lg-12 mt-3">
                                            <button type="submit" class="btn btn-default px-5">{{__('pages.submit')}}</button>
                                        </div>
                                    </div>
                                </div>
                            </form>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </section>
@endsection