{{ Form::label('food_allergies', __('messages.prescription.food_allergies').(':'), ['class' => 'form-label']) }} {{ Form::text('food_allergies', null, ['class' => 'form-control']) }}

{{ Form::label('tendency_bleed', __('messages.prescription.tendency_bleed').(':'), ['class' => 'form-label']) }} {{ Form::text('tendency_bleed', null, ['class' => 'form-control']) }}

{{ Form::label('heart_disease', __('messages.prescription.heart_disease').(':'), ['class' => 'form-label']) }} {{ Form::text('heart_disease', null, ['class' => 'form-control']) }}

{{ Form::label('high_blood_pressure', __('messages.prescription.high_blood_pressure').(':'), ['class' => 'form-label']) }} {{ Form::text('high_blood_pressure', null, ['class' => 'form-control']) }}

{{ Form::label('diabetic', __('messages.prescription.diabetic').(':'), ['class' => 'form-label']) }} {{ Form::text('diabetic', null, ['class' => 'form-control']) }}

{{ Form::label('surgery', __('messages.prescription.surgery').(':'), ['class' => 'form-label']) }} {{ Form::text('surgery', null, ['class' => 'form-control']) }}

{{ Form::label('accident', __('messages.prescription.accident').(':'), ['class' => 'form-label']) }} {{ Form::text('accident', null, ['class' => 'form-control']) }}

{{ Form::label('others', __('messages.prescription.others').(':'), ['class' => 'form-label']) }} {{ Form::text('others', null, ['class' => 'form-control']) }}

{{ Form::label('medical_history', __('messages.new_change.added_at').(':'), ['class' => 'form-label']) }} {{ Form::text('medical_history', null, ['class' => (getLoggedInUser()->thememode ? 'bg-light form-control' : 'bg-white form-control'),'id' => 'editPrescriptionAddedAt','autocomplete' => 'off']) }}

{{ Form::label('current_medication', __('messages.prescription.current_medication').(':'), ['class' => 'form-label']) }} {{ Form::text('current_medication', null, ['class' => 'form-control']) }}

{{ Form::label('female_pregnancy', __('messages.prescription.female_pregnancy').(':'), ['class' => 'form-label']) }} {{ Form::text('female_pregnancy', null, ['class' => 'form-control']) }}

{{ Form::label('breast_feeding', __('messages.prescription.breast_feeding').(':'), ['class' => 'form-label mb-3']) }} {{ Form::text('breast_feeding', null, ['class' => 'form-control']) }}

{{ Form::label('plus_rate', __('messages.prescription.plus_rate').(':'), ['class' => 'form-label']) }} {{ Form::text('plus_rate', null, ['class' => 'form-control']) }}

{{ Form::label('temperature', __('messages.prescription.temperature').(':'), ['class' => 'form-label']) }} {{ Form::text('temperature', null, ['class' => 'form-control']) }}

{{ Form::label('problem_description', __('messages.prescription.problem_description').(':'), ['class' => 'form-label']) }} {{ Form::textarea('problem_description', null, ['class' => 'form-control', 'rows' => 5]) }}