{!! Form::numeric('visit_by') -> label(trans('reference::visit.label.visit_by')) -> placeholder(trans('reference::visit.placeholder.visit_by'))!!}

{!! Form::numeric('visit_to') -> label(trans('reference::visit.label.visit_to')) -> placeholder(trans('reference::visit.placeholder.visit_to'))!!}

{!! Form::text('visit_type') -> label(trans('reference::visit.label.visit_type')) -> placeholder(trans('reference::visit.placeholder.visit_type'))!!}

{!!trans('reference::visit.label.visit_date')!!}

{!! Form::text('visit_date') -> placeholder(trans('reference::visit.placeholder.visit_date')) -> addClass('pickdatetime') ->raw()!!}