This commit is contained in:
Olusesan Ameye
2021-02-20 20:41:46 -05:00
parent c9e4228bdd
commit 25bd22d245
3 changed files with 114 additions and 36 deletions
@@ -21,7 +21,7 @@
<div class="card card-statistics h-100 mb-0">
<div class="card-header d-flex justify-content-between">
<div class="card-heading">
<h4 class="card-title">New Patient</h4>
<h4 class="card-title">New Patient - <?= $account_message ?> </h4>
</div>
<div class="dropdown">
<!-- a class="btn btn-round btn-inverse-primary btn-xs" href="#">View all </a -->
@@ -53,11 +53,11 @@
<div class="form-group col-md-6">
<label for="inputPassword4">Gendar</label>
<select class="form-control" aria-label="Default select example">
<option selected>Open this select menu</option>
<option value="1">One</option>
<option value="2">Two</option>
<option value="3">Three</option>
<select class="form-control" aria-label="Select Gender" name ="gender">
<option selected>Select</option>
<option value="M">Male</option>
<option value="F">Female</option>
<option value="U">Unknown</option>
</select>
</div>
@@ -102,13 +102,13 @@
<input type="text" class="form-control" id="zipcode" name="zipcode" value="<?= $zipcode ?>">
</div>
</div>
<div class="form-group">
<!-- div class="form-group">
<div class="form-check">
<label class="form-check-label">
<?= $account_message ?>
</label>
</div>
</div>
</!-->
<div class="form-row">
<div class="form-group col-md-9">