Untitled

@extends('layouts.app')
@include('layouts.navbar')


<html>

<!-- Meta data of the website-->

<head>
    <title>MedNet - New Clinical Case</title>

    <link rel="stylesheet" href= "{{ asset('css/style-navbar2.css') }}">
    <link rel="stylesheet" href="{{ asset('css/style_myfooter.css') }}">
    <link rel="stylesheet" href="{{ asset('css/style-login.css') }}">

    <meta charset="utf-8">
    <meta http-equiv="X-UA-Compatible" content="IE=edge">
    <meta name="viewport" content="width=device-width, initial-scale=1">
    <meta name="csrf-token" content="{{ csrf_token() }}">
</head>

<body>

@if (Auth::check())
<div class="top-content">

    <div class="inner-bg">
        <div class="container">


            <div class="row">
                <div class="register">
                    <div class="form-box">
                        <div class="form-top">
                            <div class="form-top-left">
                                <h1>New Clinical Case</h1>
                                <h4>Fill in the form below</h4>
                            </div>
                            <div class="form-top-right">
                                <i class="fa fa-pencil"></i>
                            </div>
                        </div>
                        <div class="form-bottom">
                            <form role="form" action="{{route('clinicalcase/create')}}" method="post" enctype="multipart/form-data" class="registration-form" name="title">
                                {{ csrf_field() }}
                                <div class="form-group">
                                    <label for="form-first-name">
                                        <h3>Title:*</h3>
                                    </label>
                                    <input type="text" name="title" placeholder="Insert the title" class="form-control" id="form-first-name" required
                                           pattern=".*[A-Za-zÀÁÂÄÃÅÇÈÊÉËÌÍÎÏÑÒÓÔÕÖØÙÚÛÜßàáâãäåçèéêëìíîñòóôõöùøúûüĆćČčŽžŠš]+" title="Alphabetic characters only">
                                </div>


                                <div class="form-group">
                                    <label for="form-first-name">
                                        <h3>Select one or more of the following tags:*</h3>
                                    </label>
                                    <br>

                                        @foreach($tags_names_array as $data)
                                            <label class="container_cb">
                                                <input type="checkbox" value="{{$data->name}}" >{{$data->name}}</input>
                                                <span class="checkmark"></span>
                                            </label>
                                        @endforeach


                                    <label for="form-first-name">
                                        <h3>Priority:*</h3>

                                        <label class="container_cb">
                                            <input type="radio" name="priority[0]" value="High">High</input>
                                            <span class="checkmark"></span>
                                        </label>
                                        <label class="container_cb">
                                            <input type="radio" name="priority[1]" value="Medium">Medium</input>
                                            <span class="checkmark"></span>
                                        </label>
                                        <label class="container_cb">
                                            <input type="radio" name="priority[2]" value="Low">Low</input>
                                            <span class="checkmark"></span>
                                        </label>

                                        <label for="form-first-name">
                                            <h3>Visibility:*</h3>
                                            <div class="onoffswitch">
                                                <input type="checkbox" name="onoffswitch" class="onoffswitch-checkbox" id="myonoffswitch" checked>
                                                <label class="onoffswitch-label" for="myonoffswitch">
                                                    <span class="onoffswitch-inner"></span>
                                                    <span class="onoffswitch-switch"></span>
                                                </label>
                                            </div>

                                            <label for="form-first-name">
                                                <h3>State:*</h3></label>

                                            <label class="container_cb">
                                                <input type="radio" name="state[0]" value="true">Solved</input>
                                                <span class="checkmark"></span>
                                            </label>
                                            <label class="container_cb">
                                                <input type="radio" name="state[1]" value="false">Open</input>
                                                <span class="checkmark"></span>
                                            </label>
                                </div>

                                <div class="form-group">
                                    <label for="pw">Description:*</label>
                                    <textarea name="description" cols="40" rows="10" placeholder="Enter the description" type="text" class="form-control fm_desc" style="width: 100%;
											resize:vertical;
											background: none repeat scroll 0 0 #fff;
											outline:none;"
                                              required pattern="(?=.*\d)(?=.*[a-z])(?=.*[A-Z]).{8,}";
                                              name="description"></textarea>
                                </div>


                                <label for="rptpw">Attach exam results:</label>

                                <form action="" enctype="multipart/form-data" method="post" >
                                    {{csrf_field()}}
                                    <input type="file" name="exam_result">
                                    <br>
                                    <br>

                                        <button  type="submit" class="btn btn-submit" style="
											background: none;
											cursor: pointer;
											padding: 10px 20px;
											text-transform: uppercase;
											letter-spacing: 1px;
											font-weight: 700;
											-webkit-transition: all 0.3s;
											-moz-transition: all 0.3s;
											transition: all 0.3s;
											border-radius: 30px;
											border: 2px solid #fff;
											color: #fff;
                                            width:100%;">Submit</button>
                                </form>


                                <br>
                                <br>


                                <div class=form-end>
                                    * Denotes an obligatory field
                                </div>
                            </form>
                        </div>
                    </div>

                </div>
            </div>

        </div>
    </div>

@include('layouts.footer')

    <!--[if lt IE 10]>
    <script src="assets/js/placeholder.js"></script>
    <![endif]-->
@else
        <script>window.location = "/permissiondenied";</script>
@endif
</body>