@extends('AdminLte.template')

<!--Title-->
@section('title')
{{__('Pharmacy Collection Report')}}
@endsection
<!--Title Close-->

<!--External CSS-->
@section('ExternalCss')
@parent
@endsection
<!--External CSS Close--> 
@section('Content')
<div class="col-md-12 txtCenter">
    <h3>{{__('Pharmacy Collection Report')}}</h3>
    {{ Form::open(['action' => 'RegisterReportController@patientwisedataCredit','autocomplete' => 'off','id' => 'patientdata']) }}
    <br/>
    <div class="col-md-12 txtCenter">
        <label class="inputType">{{__('From')}} : </label> 
        <input name="fromDate" id="fromDate" value="{{date('Y-m-d')}}" class="inputType borderNone borderBottom blue noPadding" type="date" required>
        <input name="fromTime" id="fromTime" value="" class="inputType borderNone borderBottom blue noPadding" type="time">
        &nbsp;
        <label class="inputType">{{__('To')}} : </label> 
        <input name="toDate" id="toDate" value="{{date('Y-m-d')}}" class="inputType borderNone borderBottom blue noPadding" type="date" required>
        <input name="toTime" id="toTime" value="" class="inputType borderNone borderBottom blue noPadding" type="time">
    </div>    
    <br/><br/>
    <div class="col-md-12">
            <!-- Payment Mode Dropdown -->
        <label class="inputType">{{__('Payment Mode')}} : </label> 
        <select name="paymentMode" class="inputType borderNone borderBottom blue noPadding">
            <option value="">{{__('ALL')}}</option>
            @foreach($paymentModes as $mode)
                <option value="{{ $mode->gm_description }}">{{ $mode->gm_description }}</option>
            @endforeach
        </select>

        &nbsp;&nbsp;&nbsp;

        <label class="inputType">{{__('User Id')}} : </label> 
        <select name="userId" class="inputType borderNone borderBottom blue noPadding">
            <option value="">{{__('ALL')}}</option>
            @foreach($user as $createdBy)
            <option value="{{$createdBy}}">{{$createdBy}}</option>
            @endforeach
        </select>
    </div>
    <br/><br/>
    <button style="margin-left:55px;" name="Submit"  id="btnSubmit" class="btn btn-success btn-sm">{{__('Submit')}}</button>
</div>
@endsection

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