{{ Form::label('patient_id', __('messages.vaccinated_patient.patient') . ':', ['class' => 'form-label']) }} {{ Form::select('patient_id', $patients, null, ['class' => 'form-control', 'required', 'id' => 'editVPatientName', 'placeholder' => __('messages.document.select_patient'), 'data-control' => 'select2']) }}

{{ Form::label('vaccination_id', __('messages.vaccinated_patient.vaccine') . ':', ['class' => 'form-label']) }} {{ Form::select('vaccination_id', $vaccinations, null, ['class' => 'form-control', 'required', 'id' => 'editVPatientVaccinationName', 'placeholder' => 'Select Vaccination', 'data-control' => 'select2']) }}

{{ Form::label('vaccination_serial_number', __('messages.vaccinated_patient.serial_no') . ':', ['class' => 'form-label']) }} {{ Form::text('vaccination_serial_number', '', ['id' => 'editVPatientSerialNo', 'class' => 'form-control','placeholder'=>__('messages.vaccinated_patient.serial_no')]) }}

{{ Form::label('dose_number', __('messages.vaccinated_patient.does_no') . ':', ['class' => 'form-label']) }} {{ Form::number('dose_number', '', ['id' => 'editVPatientDoseNumber', 'class' => 'form-control', 'min' => '1', 'max' => '50', 'minlength' => '1', 'maxlength' => '2', 'required','placeholder'=>__('messages.vaccinated_patient.does_no')]) }}

{{ Form::label('dose_given_date', __('messages.vaccinated_patient.dose_given_date') . ':', ['class' => $currentLang == 'es' ? 'label-display form-label mb-3' : 'form-label mb-3']) }} {{ Form::text('dose_given_date', '', ['id' => 'editVPatientDoesGivenDate', 'class' => getLoggedInUser()->thememode ? 'bg-light form-control' : 'bg-white form-control', 'required', 'autocomplete' => 'off','placeholder'=>__('messages.vaccinated_patient.dose_given_date')]) }}

{{ Form::label('description', __('messages.document.notes') . ':', ['class' => 'form-label fs-6 mb-3']) }} {{ Form::textarea('description', null, ['class' => 'form-control', 'rows' => 4, 'id' => 'editVPatientDescription','placeholder'=>__('messages.document.notes')]) }}