{% extends 'blank.html' %}


{% block content %}
<h1 class="section-title" id="services">
	<span>Xray</span>
</h1><!-- End Title -->
	
<!--breadcrum start-->
<ol class="breadcrumb text-left">
  <li><a href=" {% url 'index' %} ">Dashboard</a></li>
  <li class="active">Xray</li>
</ol><!--breadcrum end-->
<div class="no-table-blank-state row">
		<!--no table found blank state-->
		<div class="col-lg-12 col-md-12 col-sm-12 col-xs-12">
			<form action="xray" method="post">
				{% csrf_token %}
				<label for="fname">Patient ID:</label>
				<input type="text" id="fname" name="PID"><br><br>
				<label for="lname">Date/Time:</label>
				<input type="datetime-local" id="lname" name="DateTime"><br><br>
				<label for="img">Upload X-Ray:</label>
				<input type="file" id="img" name="img" accept="image/*">
				<input type="submit">
			</form>
			{{type}}

		</div><!-- end no table found blank state-->

</div>
{% endblock %}