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<?xml version="1.0" encoding="utf-8" ?>
<odoo>
<!-- Patient booking template-->
<template id="patient_booking_form">
<t t-call="website.layout">
<div id="booking_form">
<section
class="s_title parallax s_parallax_is_fixed bg-black-50 pt24 pb24"
data-vcss="001" data-snippet="s_title"
data-scroll-background-ratio="1">
<span class="s_parallax_bg oe_img_bg"
style="background-image: url('/web/image/website.s_banner_default_image'); background-position: 50% 0;"/>
<div class="o_we_bg_filter bg-black-50"/>
<div class="container-fluid">
<h1 class="container">Patient Booking</h1>
</div>
</section>
<section class="p-3">
<div class="container">
<form action="/patient_booking/success"
method="post" enctype="multipart/form-data">
<div class="row">
<div class="mb-3 col-8">
<label for="name"
class="form-label">Patient Name
</label>
<input type="text"
t-attf-value="{{user}}"
class="form-control"/>
</div>
</div>
<div class="row">
<div class="mb-3 col-2">
<label for="qty"
class="form-label">Booking Date
</label>
<input class="form-control" type="date"
id="booking_date" name="date" t-attf-value="{{date}}"
required="True"/>
</div>
<div class="mb-3 col-3">
<label for="qty"
class="form-label">Department
</label>
<select name="doctor-department"
id="doctor-department"
class="form-control link-style">
<option/>
<t t-foreach="departments" t-as="dep">
<option t-att-value="dep[0]">
<t t-esc="dep[1]"/>
</option>
</t>
</select>
</div>
<div class="mb-3 col-3">
<label for="qty"
class="form-label">Doctor
</label>
<select name="doctor-name"
id="doctor-name"
required="True"
class="form-control link-style">
</select>
</div>
</div>
<div class="row">
<div class="mb-3 col-8">
<label for="description"
class="form-label">Reason For
Visit
</label>
<textarea
class="form-control s_website_form_input"
name="reason" id="reason"
rows="4"/>
</div>
</div>
<div class="row">
<div class="mb-3 col-8">
<button type="submit"
class="btn btn-primary">
Submit
</button>
<t t-if="card">
<a t-attf-href="/web/content/{{attachment_id}}?download=true&amp;access_token="
style="text-decoration:underline; margin-left:10px;">
Download Patient Card
</a>
</t>
</div>
</div>
</form>
</div>
</section>
</div>
</t>
</template>
</odoo>