<div class="wrapper wrapper-content">

    {$action = 'create'}
    {$title_action = $_L['Diary_Add_Module']}
    {if (!empty($diarys))}
        {$action = 'update'}
        {$title_action = $_L['Diary_Edit_Module']}
    {/if}

    <form class="form-horizontal" method="post" action="{$_url}module_med_scheduling/diary/{$action}">

        <div class="row">

            <div class="col-md-12">

                <div class="ibox float-e-margins">

                    <div class="ibox-title">
                        <h5>{$title_action}</h5>
                        <a href="{$_url}module_med_scheduling/diary/listDiary"
                           class="btn btn-xs btn-primary btn-rounded pull-right">
                            <i class="fa fa-bars"></i> {$_L['Diary_List']}
                        </a>
                    </div>

                    <div class="ibox-content" id="ibox_form">

                        <div class="row">

                            <div class="col-md-12 col-sm-12 col-xs-12">
                                {$diary = ''}
                                {if (!empty($diarys->diary))}
                                    {$diary = $diarys->diary}
                                {/if}
                                <label class="control-label" for="title">
                                    {$_L['Diary_Diary']} <small class="red">*</small>
                                </label>
                                <input type="text" name="diary" id="diary" class="form-control"
                                       value="{$diary}" required>
                            </div>

                        </div>

                        <div class="row">

                            <div class="col-md-12 col-sm-12 col-xs-12">
                                {$interval = ''}
                                {if (!empty($diarys->interval))}
                                    {$interval = $diarys->interval}
                                {/if}
                                <label class="control-label" for="title">{$_L['Diary_Interval']}</label>
                                <input name="interval" id="interval" class="form-control" value="{$interval}" required>
                            </div>

                        </div>

                        <div class="row">

                            <div class="col-md-12 col-sm-12 col-xs-12">
                                {$sim = ''}
                                {if (!empty($diarys->simultaneous))}
                                    {$sim = $diarys->simultaneous}
                                {/if}
                                <label class="control-label" for="title">{$_L['Diary_Simultaneous']}</label>
                                <input name="simultaneous" id="simultaneous" class="form-control" value="{$sim}">
                            </div>

                        </div>

                        <div class="row">

                            <div class="col-md-12 col-sm-12 col-xs-12">
                                <label class="control-label" for="title">
                                    {$_L['Doctor_Name']} <small class="red">*</small>
                                </label>
                                <select class="form-control doctor_select" multiple="multiple" name="doctor_id[]" id="doctor_id"
                                        style="width:100%">
                                    {if count($doctors) > 0}
                                        {foreach $doctors as $d}
                                            <option {if $d->id}selected{/if}
                                                    value="{$d->id}">{$d->name}</option>
                                        {/foreach}
                                    {/if}
                                </select>
                            </div>

                        </div>

                        <div class="row" style="margin-top:20px">
                            <div class=" col-md-12 form-group">
                                <div class="col-lg-10">
                                    {if !empty($diarys->id)}
                                        <input type="hidden" id="diaryId" name="id" value="{$diarys->id}">
                                    {/if}
                                    <button class="md-btn md-btn-primary waves-effect waves-light" type="submit" id="submit">
                                        <i class="fa fa-check"></i> {$_L['Submit']}
                                    </button>
                                    | <a href="{$_url}module_med_scheduling/diary/listDiary">{$_L['Or Cancel']}</a>
                                </div>
                            </div>
                        </div>

                    </div>

                </div>

            </div>

        </div>

    </form>

</div>