@extends('frontend.layouts.app') @section('title', 'Digital Blood Hub - Search') @section('content')
@include('frontend.layouts.include.message')
Search Right Blood Donor
Please let us know if you need the blood for yourself or someone else
For Myself
For Other
Details for Myself
Patient Name
*
Is this emergency?
*
Select Option
Yes
No
Contact Person Name
Relation With Patient
*
Country
*
Select Country
@foreach ($countries as $country)
id == $user->country_stay_id ? 'selected' : '' }}> {{ $country->name }}
@endforeach
City
*
Select City
@if (Auth::check()) @foreach ($cities as $city)
id == $user->city_id ? 'selected' : '' }}> {{ $city->name }}
@endforeach @endif
Province
*
Select Province
@foreach ($provinces as $province)
{{ $province->name }}
@endforeach
Hospital
*
Select Hospital
Require Date
*
Require Time
*
Gender
*
Select Gender
Male
Female
Other
Number Of Bottles
*
Select Quantity
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Do You Provide Pick Up?
*
No
Yes
Do You Provide Drop Off?
*
No
Yes
Why Do You Need Blood?
*
Select Option
@foreach ($bloodRequestReasons as $reason)
{{ $reason->reason }}: {{ $reason->description }}
@endforeach
Contact No 1
*
Contact No 2
Location (autocompete)
Blood Group
*
@foreach ($bloodGroups as $bloodGroup)
blood_group_id) == $bloodGroup->id) checked @endif>
{{ $bloodGroup->name }}ve
@endforeach
NEXT
NEXT
Details for Other
Patient Name
*
Is this emergency?
*
Select Option
Yes
No
Contact Person Name
Relation With Patient
*
Why Do You Need Blood?
*
Select Option
@foreach ($bloodRequestReasons as $reason)
{{ $reason->reason }}: {{ $reason->description }}
@endforeach
Gender
*
Select Gender
Male
Female
Other
Country
*
Select Country
@foreach ($countries as $country)
id == $defualtCountryid ? 'selected' : '' }}> {{ $country->name }}
@endforeach
City
*
Select City
@foreach ($cities as $city)
{{ $city->name }}
@endforeach
Province
*
Select Province
@foreach ($provinces as $province)
{{ $province->name }}
@endforeach
Hospital
*
Select Hospital
Require Date
*
Require Time
*
Number Of Bottles
*
Select Quantity
1
2
3
4
5
6
7
8
9
10
11
12
13
14
5
16
17
18
19
20
Do You Provide Pick Up?
*
No
Yes
Do You Provide Drop Off
*
No
Yes
Location
Contact 1
*
Contact 2
Blood Group
*
@foreach ($bloodGroups as $bloodGroup)
{{ $bloodGroup->name }}ve
@endforeach
NEXT
NEXT
@endsection @section('customJs') // @endsection
 }})