
<?php $__env->startSection('content'); ?>
  <!-- Content Wrapper. Contains page content -->
  <div class="content-wrapper">
    <!-- Content Header (Page header) -->
    <section class="content-header">
      <div class="container-fluid">
        <div class="row mb-2">
          <div class="col-sm-6">
            <h1>Bill upload</h1>
          </div>
          <div class="col-sm-6">
            <ol class="breadcrumb float-sm-right">
              <li class="breadcrumb-item"><a href="#">Home</a></li>
              <li class="breadcrumb-item active">Bill upload</li>
            </ol>
          </div>
        </div>
      </div><!-- /.container-fluid -->
    </section>
    <!-- Main content -->
    <section class="content">
      <div class="container-fluid">
        <div class="row">
          <div class="col-md-6">
            <div class="card">
              <div class="card-header">
                <h3 class="card-title">Bill Upload </h3>
              </div>
              <!-- /.card-header -->
              <div class="card-body">
            
              <?php if($message = Session::get('success')): ?>

        <div class="alert alert-success alert-block">

            <button type="button" class="close" data-dismiss="alert">×</button>

                <strong><?php echo e($message); ?></strong>

        </div>

        <img src="images/<?php echo e(Session::get('image')); ?>">

        <?php endif; ?>


        <form action="<?php echo e(route('image.save')); ?>" method="POST" enctype="multipart/form-data">

            <?php echo csrf_field(); ?>

    <select  name = "hospital_id" class="form-control" id="hospital_id" required>
                        
                              <option value =  ""  > Select</option>
                        
                              <?php $__currentLoopData = $hospitalArray; $__env->addLoop($__currentLoopData); foreach($__currentLoopData as $value): $__env->incrementLoopIndices(); $loop = $__env->getLastLoop(); ?>
                        
                              <option value =  "<?php echo e($value['id']); ?>"  > <?php echo e($value['hospital_name']); ?> </option>
                        
                              <?php endforeach; $__env->popLoop(); $loop = $__env->getLastLoop(); ?>  
                              
                        </select> 

            <div class="mb-3">

                <label class="form-label" for="inputImage">Image:</label>

                <input 

                    type="file" 

                    name="image" 

                    id="inputImage"

                    class="form-control <?php $__errorArgs = ['image'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?> is-invalid <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?>">

  

                <?php $__errorArgs = ['image'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?>

                    <span class="text-danger"><?php echo e($message); ?></span>

                <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?>

            </div>

   

            <div class="mb-3">

                <button type="submit" class="btn btn-success">Submit</button>

            </div>

       

        </form>

      
              </div>
              <!-- /.card-body -->
              
            </div>
            <!-- /.card -->

           
            <!-- /.card -->
          </div>
          <!-- /.col -->
        
          <!-- /.col -->
        </div>
        <!-- /.row -->
       
        <!-- /.row -->
        <!-- /.row -->
        <!-- /.row -->
        <!-- /.row -->
      </div><!-- /.container-fluid -->
    </section>
    <!-- /.content -->
  </div>
<?php $__env->stopSection(); ?>
<?php echo $__env->make('layouts.main', \Illuminate\Support\Arr::except(get_defined_vars(), ['__data', '__path']))->render(); ?><?php /**PATH /home/hpinfome/public_html/mirs/resources/views/layouts/bill_upload.blade.php ENDPATH**/ ?>