@extends('master')


@section('content')

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

            <div class="row">
                <div class="small-6 medium-6 large-6 columns">
                    <h5>Laboratories</h5>
                </div>
            </div>
        </div>
    </div>
    
<form action="{{{ URL::to('lab-reports/labs') }}}" method="post" data-abide>
	<input />
	<div class="row">
		<div class="small-12 medium-6 large-6 columns">
			<label>
	        	Preferred Lab
	        </label>
	        <select id="preferred_lab" name="preferred_lab">
				<option value="ARUP">ARUP</option>
				<option value="MEDTOX">MEDTOX</option>
				<option value="PACTOX">PACTOX</option>
				<option value="PALI">PALI</option>
				<option value="QDI-SAC">QDI-SAC</option>
				<option value="QDI-SJC">QDI-SJC</option>
				<option value="QDI-WH">QDI-WH</option>
			</select>
		</div>
	</div>

	<div class="row">
		<div class="small-12 medium-4 large-4 columns">
			<a href="{{URL::previous()}}" class="button expand">Return</a>
		</div>

		<div class="small-12 medium-4 large-4 end columns">
			<!-- <a href="{{{URL::to('lab-reports/labs')}}}" class="button expand">Send</a> -->
			<button class="expand">Send</button>
		</div>
	</div>

</form>

@stop