{{ Form::label('first_name', 'First Name', []) }} * {{ Form::text('first_name', $patient->first_name, ['class' => 'form-control', 'id' => 'first_name', 'autocomplete' => 'off', 'placeholder' => 'First Name', 'required']) }}

{{ Form::label('last_name', 'Last Name', []) }} * {{ Form::text('last_name', $patient->last_name, ['class' => 'form-control', 'id' => 'last_name', 'autocomplete' => 'off', 'placeholder' => 'Last Name', 'required']) }}

{{ Form::label('other_names', 'Other Names', []) }} {{ Form::text('other_names', $patient->other_names, ['class' => 'form-control', 'id' => 'other_names', 'autocomplete' => 'off', 'placeholder' => 'Other Names']) }}

{{ Form::label('dob', 'Date of Birth', []) }} * {{ Form::text('dob', $patient->dob, ['class' => 'form-control', 'id' => 'dob', 'autocomplete' => 'off', 'placeholder' => 'YYYY-mm-dd', 'required']) }}

{{ Form::label('gender', 'Gender', []) }} * {{ Form::select( //SELECT FORM 'gender', //name array( //options '' => '~~SELECT~~', 'MALE' => 'Male', 'FEMALE' => 'Female', ), $patient->gender, //value ['id' => 'gender', 'class' => 'form-control', 'required'] //attributes ) }}

{{ Form::label('email', 'Email', []) }} * {{ Form::email('email', $patient->email, ['class' => 'form-control', 'id' => 'email', 'autocomplete' => 'off', 'placeholder' => 'Email', 'required']) }}

{{ Form::label('nationality', 'Nationality', []) }} * {{ Form::select( //SELECT FORM 'nationality', //name $nationalitiesList, $patient->nationality, //value ['id' => 'nationality', 'class' => 'form-control', 'data-toggle' => 'select2', 'required'] //attributes ) }}

{{ Form::label('identification_document', 'Identification Document', []) }} * {{ Form::select( //SELECT FORM 'identification_document', //name array( //options '' => '~~SELECT~~', 'PASSPORT' => 'PASSPORT', 'NRC' => 'NRC', 'DRIVERS LICENSE' => 'DRIVERS LICENSE', ), $patient->identification_document, //value ['id' => 'identification_document', 'class' => 'form-control', 'required'] //attributes ) }}

{{ Form::label('identification_number', 'Identification Number', []) }} * {{ Form::text('identification_number', $patient->identification_number, ['class' => 'form-control', 'id' => 'identification_number', 'autocomplete' => 'off', 'placeholder' => 'Identification Number', 'required']) }}