@extends('master')

<script type="text/javascript">
	$(document).foundation();
</script>

@section('content')

	<div class="row">
        <div class="large-12 columns">
            <div class="row">
                <div class="small-12 medium-12 large-12 columns">
                    <h4>Laboratory Edit</h4>
                </div>
            </div>
        </div>
    </div>

    <form action="{{{ URL::to('lab/' . $lab->id ) }}}" method="POST" data-abide>
    	<input name="_method" type="hidden" value="PUT">
    	<div class="row">
    	
    			<div class="small-12 medium-12 large-12  columns">
    	
    				<div class="row">
    	            <div class="small-12 medium-12 large-12 columns">
    	              <label>Lab Name</label>
    	              <input type="text" id="lab_name" name="lab_name" placeholder="" value="{{{$lab->name}}}"  required/>
    	              <small class="error" data-error-message>Must be a string.</small>
    	              
    	            </div>
    	        </div>
    	
    	        <div class="row">
    	            <div class="small-12 medium-12 large-12 columns">
    	              <label>Description</label>
    	              <input type="text" id="description" name="description" value="{{{$lab->description}}}"  required/>
    	              <small class="error" data-error-message>Must be a string.</small>
    	              
    	            </div>
    	        </div>
    	
    	        <div class="row">
    	        	<div class="small-12 medium-4 large-4 columns">
    	        		<label>HL7 version</label>
    	        		<input type="text" id="HL7_version" name="HL7_version" value="{{{$lab->hl7_version}}}"  required/>
    	        		<small class="error" data-error-message>Must be a string.</small>
    	            	
    	        	</div>
    	        	<div class="small-12 medium-4 large-4 columns">
    	        		<label>Host</label>
    	        		<input type="text" id="host" name="host" value="{{{$lab->host}}}" required/>
    	        		<small class="error" data-error-message>Required.</small>
    	            	
    	        	</div>
    	        	<div class="small-12 medium-4 large-4 end columns">
    	        		<label>Port</label>
    	        		<input type="text" id="port" name="port" value="{{{$lab->port}}}"  required/>
    	        		<small class="error" data-error-message>Required.</small>
    	            	
    	        	</div>
    	        </div>
    	
    	        <div class="row">
    	            <div class="small-12 medium-12 large-12 columns">
    	              <label>Email</label>
    	              <input type="email" id="lab_email" name="lab_email" value="{{{$lab->email}}}"  required/>
    	              <small class="error" data-error-message>Must be a string.</small>
    	              
    	            </div>
    	        </div>
    	
    	        <div class="row">
    	            <div class="small-12 medium-12 large-12 columns">
    	              <label>Preferred</label>
    	              <input type="text" id="preferred" name="preferred" value="{{{$lab->preferred}}}"  required/>
    	              <small class="error" data-error-message>Must be a string.</small>
    	              
    	            </div>
    	        </div>
    	
    	        <div class="row">
    	            
    	            <div class="small-12 medium-6 large-6 end columns">
    	              <a href="{{{URL::to('lab/' . $lab->id)}}}" class="button expand">Return</a>
    	            </div>
    	
    	            <div class="small-12 medium-6 large-6 end columns">
    	              <button class="button expand">Save</button>
    	            </div>
    	        </div>
    	
    			</div>
    	
    			
    		</div>
    </form>


@stop