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

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

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

{{ Form::label('category_id', __('messages.radiology_test.category_name') . ':', ['class' => 'form-label']) }} {{ Form::select('category_id', $data['radiologyCategories'], null, ['class' => 'form-select radiology-categories-name', 'required', 'id' => 'editCategoryName', 'placeholder' => 'Select Category', 'required']) }}

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

{{ Form::label('report_days', __('messages.radiology_test.report_days') . ':', ['class' => 'form-label']) }} {{ Form::number('report_days', null, ['class' => 'form-control']) }}

{{ Form::label('charge_category_id', __('messages.radiology_test.charge_category') . ':', ['class' => 'form-label']) }} {{ Form::select('charge_category_id', $data['chargeCategories'], null, ['class' => 'form-select charge-category', 'required', 'id' => 'chargeCategory', 'placeholder' => __('messages.pathology_category.select_charge_category'), 'required']) }}

{{ Form::label('charge_id', __('Charge') . ':', ['class' => 'form-label']) }} {{ Form::select('charge_id', $data['chargeCodes'], null, ['class' => 'form-select charge-code', 'required', 'id' => 'chargeCode', 'placeholder' => __('Select Charge'), 'required']) }}

{{ Form::label('standard_charge', __('messages.radiology_test.standard_charge') . ':', ['class' => 'form-label']) }} @if(getCurrencySymbol() != null) ({{ getCurrencySymbol() }}) @endif {{ Form::text('standard_charge', null, ['class' => 'form-control price-input rd-test-standard-charge', 'id' => 'editRdTestStandardCharge', 'readonly', 'required']) }}