{{-- resources/views/patients/_form.blade.php --}}
<div class="grid grid-cols-2 gap-4">
    <div>
        <label class="block text-sm font-medium">পূর্ণ নাম *</label>
        <input type="text" name="name" value="{{ old('name', $patient->name ?? '') }}"
            class="w-full border-gray-300 rounded-md">
        @error('name') <p class="text-red-500 text-xs">{{ $message }}</p> @enderror
    </div>

    <div>
        <label class="block text-sm font-medium">লিঙ্গ *</label>
        <select name="gender" class="w-full border-gray-300 rounded-md">
            @foreach (['male'=>'পুরুষ','female'=>'মহিলা','other'=>'অন্যান্য'] as $val => $label)
            <option value="{{ $val }}" @selected(old('gender', $patient->gender ?? '')==$val)>{{ $label }}</option>
            @endforeach
        </select>
    </div>

    <div>
        <label class="block text-sm font-medium">জন্ম তারিখ</label>
        <input type="date" name="dob" value="{{ old('dob', isset($patient) ? $patient->dob?->format('Y-m-d') : '') }}"
            class="w-full border-gray-300 rounded-md">
    </div>

    <div>
        <label class="block text-sm font-medium">ফোন *</label>
        <input type="text" name="phone" value="{{ old('phone', $patient->phone ?? '') }}"
            class="w-full border-gray-300 rounded-md">
        @error('phone') <p class="text-red-500 text-xs">{{ $message }}</p> @enderror
    </div>

    <div>
        <label class="block text-sm font-medium">ইমেইল</label>
        <input type="email" name="email" value="{{ old('email', $patient->email ?? '') }}"
            class="w-full border-gray-300 rounded-md">
    </div>

    <div>
        <label class="block text-sm font-medium">ব্লাড গ্রুপ</label>
        <input type="text" name="blood_group" value="{{ old('blood_group', $patient->blood_group ?? '') }}"
            placeholder="যেমন: O+" class="w-full border-gray-300 rounded-md">
    </div>

    <div>
        <label class="block text-sm font-medium">রোগীর ধরন *</label>
        <select name="type" class="w-full border-gray-300 rounded-md">
            <option value="opd" @selected(old('type', $patient->type ?? '')=='opd')>OPD (আউটডোর)</option>
            <option value="ipd" @selected(old('type', $patient->type ?? '')=='ipd')>IPD (ভর্তি)</option>
        </select>
    </div>

    <div>
        <label class="block text-sm font-medium">জরুরি যোগাযোগ</label>
        <input type="text" name="emergency_contact" value="{{ old('emergency_contact', $patient->emergency_contact ?? '') }}"
            class="w-full border-gray-300 rounded-md">
    </div>

    <div class="col-span-2">
        <label class="block text-sm font-medium">অভিভাবকের নাম</label>
        <input type="text" name="guardian_name" value="{{ old('guardian_name', $patient->guardian_name ?? '') }}"
            class="w-full border-gray-300 rounded-md">
    </div>

    <div class="col-span-2">
        <label class="block text-sm font-medium">ঠিকানা</label>
        <textarea name="address" class="w-full border-gray-300 rounded-md">{{ old('address', $patient->address ?? '') }}</textarea>
    </div>
</div>