@extends('AdminLte.template')

<!--Title-->
@section('title')
Pharmacy Bill - Receipt Unsettlement
@endsection
<!--Title Close-->

<!--External CSS-->
@section('ExternalCss')
@parent
@endsection
<!--External CSS Close--> 

@section('Content')

<div class="col-md-12 txtCenter">
    <h3>Bill - Receipt Unsettlement</h3>
    <br/>
    {{ Form::open(['action' => 'RegisterReportController@billReceiptUnsettlementData','autocomplete' => 'off','id' => 'billReceiptData']) }}
    <div class="col-md-12 txtCenter">
        <label class="inputType">IP ID : </label>
        <input type="number" size="10" id="ipId" name="ipId" class="input inputType borderNone borderBottom blue noPadding" required>
        &emsp;
        <input type="text" size="25" name="patientName" id="patientName" class="input inputType borderNone borderBottom blue noPadding readOnlyBackground" readonly>
        <br/><br/>
        <button name="Submit" id="btnSubmit" class="btn btn-success btn-sm">Submit</button>
    </div>
</div>
<br>
<div class="col-md-6">
    <br/><br/>    
    @php
    if(session()->get('messageType') == 'success'){
    $class = "alert-success";
    }else if(session()->get('messageType') == 'error'){
    $class = "alert-danger";
    }
    @endphp

    @if(session()->has('message'))
    <div id="transactionMessage" class="alert {{$class}} alert-dismissible fade in col-sm-10 col-sm-offset-7">
        <a href="#" class="close" data-dismiss="alert" aria-label="close">&times;</a>
        <span class="fontsize16">{{session()->get('message')}}</span> 
    </div>
    @endif
</div>
{{ Form::close() }}
@endsection

<!--Bootstrap Modals-->      
@section('BootstrapModals')
@endsection
<!--Bootstrap Modals Close-->

<!--External JS-->
@section('ExternalJs')
<script src="{{ asset ("/js/bill_receipt_unsettlement.js?$releaseVersion") }}"></script>
@endsection