Basic Information

Name ^*

User Name ^*

Father Name

Mother Name

Phone Number ^*

DOB

Gender

{!! Form::select('gender', [ '1'=>'Male', '2'=>'Female', '3'=>'Other', ] ,null, ['class'=> 'form-control gender','required','placeholder'=> 'Please Select Gender']) !!}

Profile Image

Signature

Doctor Profile

Designation

{!! Form::select('designation', $designations ,null, ['class'=> 'form-control designation','required', 'placeholder'=> 'Please Select Designation']) !!}

Department

{!! Form::select('department', $departments ,null, ['class'=> 'form-control','placeholder'=> 'Please Select Department']) !!}

Education

{!! Form::select('educational_qualification', $educational_qualifications ,null, ['class'=> 'form-control educational_qualification', 'required', 'placeholder'=> 'Please Select Designation']) !!}

Medical Degree

{!! Form::select('medical_degree[]', $medical_degrees ,null, ['class'=> 'form-control']) !!}

Speciality

Prescription Fee

Allow Prescription Fees

Prescription Fee

Appointment

Received By Hospital

Received By Doctor

Doctor Commission ^*

Percentage Commission

Custom Commission

Percentage Fee

Email ^*

Password ^*

Confirm Password ^*

Add Doctor