?>
<?php
echo $form->field($model, 'patient_im')->textInput(['maxlength' => true, 'class' => 'form-control inputuppercase']);
?>
<?php
echo $form->field($model, 'patient_ot')->textInput(['maxlength' => true, 'class' => 'form-control inputuppercase']);
?>
<?php
echo Proc::FilterFieldDate($form, $model, 'patient_dr');
?>
<?php
echo Proc::FilterFieldIntCondition($form, $model, 'patient_vozrast', ['min' => 1, 'max' => 120, 'step' => 1, 'decimals' => 0]);
?>
<?php
echo Proc::FilterFieldSelectSingle($form, $model, 'patient_pol', 'Выберете пол пациента');
?>
<div class="panel panel-<?php
echo Yii::$app->params['panelStyle'];
?>
panelblock">
<div class="panel-heading"><?php
echo Html::encode('Адрес пациента');
?>
</div>
<div class="panel-body">