{{ Form::label('first_name', __('messages.user.first_name').':', ['class' => 'form-label']) }} {{ Form::text('first_name', null, ['class' => 'form-control', 'required', 'tabindex' => '1']) }}

{{ Form::label('last_name', __('messages.user.last_name').':', ['class' => 'form-label']) }} {{ Form::text('last_name', null, ['class' => 'form-control', 'required', 'tabindex' => '2']) }}

{{ Form::label('email', __('messages.user.email').':', ['class' => 'form-label']) }} {{ Form::email('email', null, ['class' => 'form-control', 'required', 'tabindex' => '3']) }}

{{ Form::label('dob', __('messages.user.dob').':', ['class' => 'form-label']) }} {{ Form::text('dob', null, ['class' => (getLoggedInUser()->theme_mode) ? 'form-control bg-light patientBirthDate' : 'form-control bg-white patientBirthDate', 'id' => 'birthDate', 'autocomplete' => 'off', 'tabindex' => '4']) }}

{{ Form::label('phone', __('messages.user.phone').':', ['class' => 'form-label']) }}
{{ Form::tel('phone', isset($user->phone) ? $user->region_code.$user->phone : null , ['class' => 'form-control phoneNumber','id' => 'phoneNumber', 'required', 'onkeyup' => 'if (/\D/g.test(this.value)) this.value = this.value.replace(/\D/g,"")', 'tabindex' => '5']) }} {{ Form::hidden('prefix_code',null,['class'=>'prefix_code']) }} {{ Form::hidden('country_iso', null, ['class' => 'country_iso']) }}

{{ Form::label('gender', __('messages.user.gender').':', ['class' => 'form-label']) }}

{{ __('messages.user.male') }} {{ Form::radio('gender', '0', true, ['class' => 'form-check-input', 'tabindex' => '6','id'=>'malePatient']) }}

{{ __('messages.user.female') }} {{ Form::radio('gender', '1', false, ['class' => 'form-check-input', 'tabindex' => '7','id'=>'femalePatient']) }}

{{ Form::label('status', __('messages.common.status').':', ['class' => 'form-label']) }}

status === 1) ? 'checked' : '' }}>

{{ Form::label('blood_group', __('messages.user.blood_group').':', ['class' => 'form-label']) }} {{ Form::select('blood_group', $bloodGroup, null, ['class' => 'form-select', 'id' => 'bloodGroupPatient', 'placeholder' => __('messages.user.select_blood_group'), 'data-control' => 'select2', 'tabindex' => "9"]) }}

{{ Form::label('image', __('messages.profile.profile').':', ['class' => 'form-label']) }}

{{ Form::file('image',['class' => 'image-upload d-none','accept' => 'image/*']) }}

{{ Form::label('address1', __('messages.user.address1').':', ['class' => 'form-label']) }} {{ Form::text('address1', $patient->address->address1 ?? null, ['class' => 'form-control']) }}

{{ Form::label('address2', __('messages.user.address2').':', ['class' => 'form-label']) }} {{ Form::text('address2', $patient->address->address2 ?? null, ['class' => 'form-control']) }}

{{ Form::label('city', __('messages.user.city').':', ['class' => 'form-label']) }} {{ Form::text('city', $patient->address->city ?? null, ['class' => 'form-control']) }}

{{ Form::label('zip', __('messages.user.zip').':', ['class' => 'form-label']) }} {{ Form::text('zip', $patient->address->zip ?? null, ['class' => 'form-control', 'maxlength' => '6','minlength' => '6']) }}

{{ Form::label('facebook_url', __('messages.facebook_url').':', ['class' => 'form-label']) }} {{ Form::text('facebook_url', null, ['class' => 'form-control patientFacebookUrl', 'onkeypress' => 'return avoidSpace(event);']) }}

{{ Form::label('twitter_url', __('messages.twitter_url').':', ['class' => 'form-label']) }} {{ Form::text('twitter_url', null, ['class' => 'form-control patientTwitterUrl', 'onkeypress' => 'return avoidSpace(event);']) }}

{{ Form::label('instagram_url', __('messages.instagram_url').':', ['class' => 'form-label']) }} {{ Form::text('instagram_url', null, ['class' => 'form-control patientInstagramUrl', 'onkeypress' => 'return avoidSpace(event);']) }}

{{ Form::label('linkedIn_url', __('messages.linkedIn_url').':', ['class' => 'form-label']) }} {{ Form::text('linkedIn_url', null, ['class' => 'form-control patientLinkedInUrl', 'onkeypress' => 'return avoidSpace(event);']) }}

{{ __('messages.user.address_details') }}

{{ __('messages.setting.social_details') }}