{!! trans('patient::patient.label.id') !!}
{!! $patient['id'] !!}

{!! trans('patient::patient.label.branch_id') !!}
{!! $patient['branch_id'] !!}

{!! trans('patient::patient.label.physician_id') !!}
{!! $patient['physician_id'] !!}

{!! trans('patient::patient.label.source_id') !!}
{!! $patient['source_id'] !!}

{!! trans('patient::patient.label.primary_physician') !!}
{!! $patient['primary_physician'] !!}

{!! trans('patient::patient.label.referring_physician') !!}
{!! $patient['referring_physician'] !!}

{!! trans('patient::patient.label.title') !!}
{!! $patient['title'] !!}

{!! trans('patient::patient.label.email') !!}
{!! $patient['email'] !!}

{!! trans('patient::patient.label.password') !!}
{!! $patient['password'] !!}

{!! trans('patient::patient.label.first') !!}
{!! $patient['first'] !!}

{!! trans('patient::patient.label.middle') !!}
{!! $patient['middle'] !!}

{!! trans('patient::patient.label.last') !!}
{!! $patient['last'] !!}

{!! trans('patient::patient.label.suffix') !!}
{!! $patient['suffix'] !!}

{!! trans('patient::patient.label.preferred') !!}
{!! $patient['preferred'] !!}

{!! trans('patient::patient.label.type') !!}
{!! $patient['type'] !!}

{!! trans('patient::patient.label.insured') !!}
{!! $patient['insured'] !!}

{!! trans('patient::patient.label.speech') !!}
{!! $patient['speech'] !!}

{!! trans('patient::patient.label.tinnitus') !!}
{!! $patient['tinnitus'] !!}

{!! trans('patient::patient.label.gender') !!}
{!! $patient['gender'] !!}

{!! trans('patient::patient.label.dob') !!}
{!! $patient['dob'] !!}

{!! trans('patient::patient.label.languages') !!}
{!! $patient['languages'] !!}

{!! trans('patient::patient.label.phone') !!}
{!! $patient['phone'] !!}

{!! trans('patient::patient.label.mobile') !!}
{!! $patient['mobile'] !!}

{!! trans('patient::patient.label.status') !!}
{!! $patient['status'] !!}

{!! trans('patient::patient.label.api_token') !!}
{!! $patient['api_token'] !!}

{!! trans('patient::patient.label.photo') !!}
{!! $patient['photo'] !!}

{!! trans('patient::patient.label.referral_description') !!}
{!! $patient['referral_description'] !!}

{!! trans('patient::patient.label.employement') !!}
{!! $patient['employement'] !!}

{!! trans('patient::patient.label.employer') !!}
{!! $patient['employer'] !!}

{!! trans('patient::patient.label.occupation') !!}
{!! $patient['occupation'] !!}

{!! trans('patient::patient.label.student_status') !!}
{!! $patient['student_status'] !!}

{!! trans('patient::patient.label.school') !!}
{!! $patient['school'] !!}

{!! trans('patient::patient.label.maritial_status') !!}
{!! $patient['maritial_status'] !!}

{!! trans('patient::patient.label.previous_provider') !!}
{!! $patient['previous_provider'] !!}

{!! trans('patient::patient.label.previous_provider_phone') !!}
{!! $patient['previous_provider_phone'] !!}

{!! trans('patient::patient.label.notes') !!}
{!! $patient['notes'] !!}

{!! trans('patient::patient.label.custom_groups') !!}
{!! $patient['custom_groups'] !!}

{!! trans('patient::patient.label.remember_token') !!}
{!! $patient['remember_token'] !!}

{!! trans('patient::patient.label.permissions') !!}
{!! $patient['permissions'] !!}

{!! trans('patient::patient.label.deleted_at') !!}
{!! $patient['deleted_at'] !!}

{!! trans('patient::patient.label.created_at') !!}
{!! $patient['created_at'] !!}

{!! trans('patient::patient.label.updated_at') !!}
{!! $patient['updated_at'] !!}

{!! Form::select('branch_id') -> options(trans('patient::patient.options.branch_id')) -> label(trans('patient::patient.label.branch_id')) -> placeholder(trans('patient::patient.placeholder.branch_id'))!!}

{!! Form::select('physician_id') -> options(trans('patient::patient.options.physician_id')) -> label(trans('patient::patient.label.physician_id')) -> placeholder(trans('patient::patient.placeholder.physician_id'))!!}

{!! Form::select('source_id') -> options(trans('patient::patient.options.source_id')) -> label(trans('patient::patient.label.source_id')) -> placeholder(trans('patient::patient.placeholder.source_id'))!!}

{!! Form::select('primary_physician') -> options(trans('patient::patient.options.primary_physician')) -> label(trans('patient::patient.label.primary_physician')) -> placeholder(trans('patient::patient.placeholder.primary_physician'))!!}

{!! Form::select('referring_physician') -> options(trans('patient::patient.options.referring_physician')) -> label(trans('patient::patient.label.referring_physician')) -> placeholder(trans('patient::patient.placeholder.referring_physician'))!!}

{!! Form::text('title') -> label(trans('patient::patient.label.title')) -> placeholder(trans('patient::patient.placeholder.title'))!!}

{!! Form::email('email') -> label(trans('patient::patient.label.email')) -> placeholder(trans('patient::patient.placeholder.email'))!!}

{!! Form::password('password') -> label(trans('patient::patient.label.password')) -> placeholder(trans('patient::patient.placeholder.password'))!!}

{!! Form::text('first') -> label(trans('patient::patient.label.first')) -> placeholder(trans('patient::patient.placeholder.first'))!!}

{!! Form::text('middle') -> label(trans('patient::patient.label.middle')) -> placeholder(trans('patient::patient.placeholder.middle'))!!}

{!! Form::text('last') -> label(trans('patient::patient.label.last')) -> placeholder(trans('patient::patient.placeholder.last'))!!}

{!! Form::select('suffix') -> options(trans('patient::patient.options.suffix')) -> label(trans('patient::patient.label.suffix')) -> placeholder(trans('patient::patient.placeholder.suffix'))!!}

{!! Form::text('preferred') -> label(trans('patient::patient.label.preferred')) -> placeholder(trans('patient::patient.placeholder.preferred'))!!}

{!! Form::select('type') -> options(trans('patient::patient.options.type')) -> label(trans('patient::patient.label.type')) -> placeholder(trans('patient::patient.placeholder.type'))!!}

{!! Form::inline_radios('insured') -> radios(trans('patient::patient.options.insured')) -> label(trans('patient::patient.label.insured'))!!}

{!! Form::inline_radios('speech') -> radios(trans('patient::patient.options.speech')) -> label(trans('patient::patient.label.speech'))!!}

{!! Form::inline_radios('tinnitus') -> radios(trans('patient::patient.options.tinnitus')) -> label(trans('patient::patient.label.tinnitus'))!!}

{!! Form::inline_radios('gender') -> radios(trans('patient::patient.options.gender')) -> label(trans('patient::patient.label.gender'))!!}

{!!trans('patient::patient.label.dob')!!}

{!! Form::text('dob') -> placeholder(trans('patient::patient.placeholder.dob')) ->raw()!!}

{!! Form::text('languages') -> label(trans('patient::patient.label.languages')) -> placeholder(trans('patient::patient.placeholder.languages'))!!}

{!! Form::text('phone') -> label(trans('patient::patient.label.phone')) -> placeholder(trans('patient::patient.placeholder.phone'))!!}

{!! Form::text('mobile') -> label(trans('patient::patient.label.mobile')) -> placeholder(trans('patient::patient.placeholder.mobile'))!!}

{!! $patient->files('image') ->url($patient->getUploadUrl('image')) ->mime(config('filer.image_extensions')) ->dropzone()!!}

{!! $patient->files('image') ->editor()!!}

{!! Form::textarea ('referral_description') -> label(trans('patient::patient.label.referral_description')) -> placeholder(trans('patient::patient.placeholder.referral_description'))!!}

{!! Form::inline_radios('employement') -> radios(trans('patient::patient.options.employement')) -> label(trans('patient::patient.label.employement'))!!}

{!! Form::text('employer') -> label(trans('patient::patient.label.employer')) -> placeholder(trans('patient::patient.placeholder.employer'))!!}

{!! Form::text('occupation') -> label(trans('patient::patient.label.occupation')) -> placeholder(trans('patient::patient.placeholder.occupation'))!!}

{!! Form::inline_radios('student_status') -> radios(trans('patient::patient.options.student_status')) -> label(trans('patient::patient.label.student_status'))!!}

{!! Form::text('school') -> label(trans('patient::patient.label.school')) -> placeholder(trans('patient::patient.placeholder.school'))!!}

{!! Form::inline_radios('maritial_status') -> radios(trans('patient::patient.options.maritial_status')) -> label(trans('patient::patient.label.maritial_status'))!!}

{!! Form::select('previous_provider') -> options(trans('patient::patient.options.previous_provider')) -> label(trans('patient::patient.label.previous_provider')) -> placeholder(trans('patient::patient.placeholder.previous_provider'))!!}

{!! Form::text('previous_provider_phone') -> label(trans('patient::patient.label.previous_provider_phone')) -> placeholder(trans('patient::patient.placeholder.previous_provider_phone'))!!}

{!! Form::textarea ('notes') -> label(trans('patient::patient.label.notes')) -> placeholder(trans('patient::patient.placeholder.notes'))!!}

{!! Form::text('custom_groups') -> label(trans('patient::patient.label.custom_groups')) -> placeholder(trans('patient::patient.placeholder.custom_groups'))!!}