{% extends 'doctor_base.html' %}
{% load static %}


<!--content area start-->
{% block content %}
<!--tab start-->
<div class="container-fluid full-width-container">


	<div class="section section-custom billinfo"> 
		<!--section-title -->
		<h2>Basic Form</h2><!--section-title end -->
		<!-- section content start-->
		<form id="validationForm" method="post">
			{% csrf_token %}
			<div class="pmd-card pmd-z-depth">
				<div class="pmd-card-body">
					<div class="group-fields clearfix row">
						<div class="col-lg-4 col-md-4 col-sm-4 col-xs-12">
							<div class="form-group pmd-textfield pmd-textfield-floating-label">
								<label for="regular1" class="control-label">
									Patient ID
								</label>
								<input type="text" name="patientid" class="form-control">
							</div>
						</div>
					</div>
				</div>		
				<div class="pmd-card-actions">
					<input type="Submit" class="btn btn-primary next">
				</div>
			</div> <!-- section content end -->  
		</form>
	</div>
	
	
</div><!-- content area end -->
{% endblock %}