
@extends('plantilla')

@section('content')


<div class="content-wrapper"> 

    <section class="content-header"> 

        <h1> Crear Paciente:  </h1>

    </section>
    
    <div class="content"> 

            <div class="box"> 

                <div class="box-body"> 

                    <form method="POST">

                        @csrf

                        <div class="form-group"> 

                            <h2> Nombre y Apellido:</h2>
                            <input type="text" class="form-control input-lg" name="name" required>

                        </div>

                        <div class="form-group"> 

                            <h2> Documento:</h2>
                            <input type="text" class="form-control input-lg" name="documento" required>

                        </div>

                        <div class="form-group"> 

                            <h2> Email:</h2>

                            <input type="email" class="form-control input-lg" name="email" value="{{ old('email') }}">

                            @error('email')

                                <div class="alert alert-danger" >El email ya existe !!! </div>
                                
                            @enderror

                        </div>

                        <div class="form-group"> 

                            <h2> Contraseña:</h2>

                            <input type="text" class="form-control input-lg" name="password" required>

                        </div>   

                        <br>

                        <button type="submit"  class="btn btn-primary btn-lg">Agregar</button>

                    </form>
                    
                </div>
                
            </div>


    </div>

</div>

    
@endsection

