@extends('layouts.template')

@section('title')
Tambah Master Poliklinik | SIMRS
@endsection

@section('pagetitle')
Tambah Master Poliklinik
@endsection

@section('breadcumb')
<nav aria-label="breadcrumb" role="navigation" class="breadcrumb">
    <ol class="breadcrumb">
        <li class="breadcrumb-item"><a href="#">Beranda</a></li>
        <li class="breadcrumb-item"><a href="#">Data Master</a></li>
        <li class="breadcrumb-item"><a href="#">Poliklinik</a></li>
        <li class="breadcrumb-item active" aria-current="page">Tambah Data Master Poliklinik</li>
    </ol>
</nav>
@endsection

@section('content')

<style>
    .form-group label {
        margin-top: 20px;
    }
</style>
<div class="container-fluid">
    <div class="row">
        <div class="col-md-6 col-md-offset-3">
            <div class="card">
                <form method="post" action="{{Route('dmspoli')}}">
                    @csrf
                    <div class="card-header">
                        <h4 class="card-title">
                            <strong>Form Tambah Poliklinik</strong>
                        </h4>
                    </div>
                    <br>
                    <div class="card-content">

                        <div class="form-group">
                            <div class="row">
                                <div class="col-md-12">
                                    <label for="poli_kode">Kode Poliklinik</label>
                                    <input type="text" class="form-control" id="poli_kode" name="poli_kode">
                                    <label for="poli_nama">Nama Poliklinik</label>
                                    <input type="text" class="form-control" id="poli_nama" name="poli_nama">
                                    @error('poli_nama')
                                        <div class="alert alert-danger">{{ $message }}</div>
                                    @enderror
                                </div>
                            </div>
                        </div>
                        <div style="display: flex; justify-content: flex-end">
                            <button type="cancel" class="btn btn-fill btn-danger">Cancel</button>
                            <button type="submit" class="btn btn-fill btn-info">Submit</button>
                        </div>
                    </div>
                </form>
            </div> <!-- end card -->
        </div> <!--  end col-md-6  -->
    </div>
</div>
@endsection