{{ __('messages.death_report.new_death_report') }}

{{ Form::open(['id' => 'addDeathReportForm']) }}
{{ Form::label('case_id', __('messages.case.case') . ':', ['class' => 'form-label']) }} {{ Form::select('case_id', $cases, null, ['class' => 'form-select', 'required', 'id' => 'deathCaseId', 'placeholder' => __('messages.common.choose') . ' ' . __('messages.case.case')]) }}
@if (Auth::user()->hasRole('Doctor')) @else
{{ Form::label('doctor_name', __('messages.case.doctor') . ':', ['class' => 'form-label']) }} {{ Form::select('doctor_id', $doctors, null, ['class' => 'form-select', 'required', 'id' => 'deathDoctorId', 'placeholder' => __('messages.web_appointment.select_doctor')]) }}
@endif
{{ Form::label('date', __('messages.death_report.date') . ':', ['class' => 'form-label']) }} {{ Form::text('date', null, ['id'=>'deathDate', 'class' => (getLoggedInUser()->thememode ? 'bg-light form-control' : 'bg-white form-control'), 'required','autocomplete' => 'off','placeholder'=>__('messages.death_report.date')]) }}
{{ Form::label('description', __('messages.death_report.description').(':'), ['class' => 'form-label']) }} {{ Form::textarea('description', null, ['class' => 'form-control', 'rows' => 4,'placeholder'=>__('messages.death_report.description')]) }}
{{ Form::button(__('messages.common.save'), ['type' => 'submit', 'class' => 'btn btn-primary m-0', 'id' => 'deathReportSave', 'data-loading-text' => " Processing..."]) }}
{{ Form::close() }}