<div id="add_doctor_opd_charges_modal" class="modal fade" role="dialog" tabindex="-1" aria-hidden="true">
    <div class="modal-dialog">
        <!-- Modal content-->
        <div class="modal-content">
            <div class="modal-header">
                <h3 class="modal-title" id="exampleModalLabel">
                    {{ __('messages.doctor_opd_charge.new_doctor_opd_charge') }}</h3>
                <button type="button" class="btn-close" data-bs-dismiss="modal" aria-label="Close"></button>
            </div>
            {{ Form::open(['id' => 'addDoctorChargesForm']) }}
            {{ Form::hidden('currency_symbol', getCurrentCurrency(), ['class' => 'currencySymbol']) }}
            <div class="modal-body">
                <div class="alert alert-danger d-none hide" id="doctorChargesErrorsBox"></div>
                <div class="row">
                    <div class="col-md-12 mb-5">
                        {{ Form::label('doctor_id', __('messages.doctor_opd_charge.doctor') . ':', ['class' => 'form-label']) }}
                        <span class="required"></span>
                        {{ Form::select('doctor_id', $doctors, null, ['class' => 'form-select', 'required', 'id' => 'chargesDoctorId', 'placeholder' => __('messages.web_appointment.select_doctor')]) }}
                    </div>

                    <div class="col-md-12 mt-3">
                        {{ Form::label('standard_charge', __('messages.doctor_opd_charge.standard_charge') . ':', ['class' => 'form-label']) }}
                        <span class="required"></span>
                        {{ Form::text('standard_charge', null, ['class' => 'form-control price-input', 'autocomplete' => 'off', 'required', 'onkeyup' => 'if (/\D/g.test(this.value)) this.value = this.value.replace(/\D/g,"")']) }}
                    </div>
                </div>
            </div>
            <div class="modal-footer pt-0">
                {{ Form::button(__('messages.common.save'), ['type' => 'submit', 'class' => 'btn btn-primary m-0', 'id' => 'doctorChargesSave', 'data-loading-text' => "<span class='spinner-border spinner-border-sm'></span> Processing..."]) }}
                <button type="button" aria-label="Close" class="btn btn-secondary"
                    data-bs-dismiss="modal">{{ __('messages.common.cancel') }}</button>
            </div>
            {{ Form::close() }}
        </div>
    </div>
</div>
