{% extends 'base.html' %}
{% load bootstrap %}

{% block title %}Patient registration{% endblock %}


{% block content %}

<div class="container">

<div class="row justify-content-center">

                <div class="col-lg-5 mb-5 mb-lg-0">
                    <center> <h3>Patient Registration</h3></center>

                    <form action="" method="POST">{% csrf_token %}
                        {% for field in form %}
                    {% if field.name == 'gender' %}

                        <div class="form-group">
                            <label for="gender">Gender</label>
                            <br>
                            <div class="form-check form-check-inline">
                                <input class="form-check-input" type="radio" name="gender" id="male gender"
                                       value="male">
                                <label class="form-check-label" for="male">Male</label>
                            </div>
                            <div class="form-check form-check-inline">
                                <input class="form-check-input" type="radio" name="gender" id="female"
                                       value="female">
                                <label class="form-check-label" for="female">Female</label>
                            </div>
                        </div>

                    {% else %}

                        <div class="form-group">
                            <label for="id_{{ field.name }}">{{ field.label }}</label>
                            <input type="{{ field.field.widget.input_type }}"
                                   class="form-control"
                                   name="{{ field.name }}"
                                   id="id_{{ field.name }}"
                                   placeholder="{{ field.field.widget.attrs.placeholder }}">
                        </div>

                          {% endif %}
                {% endfor %}

                        <div class="row form-group">
                            <div class="col-md-12">
                                <input type="submit" value="Register" class="btn btn-primary btn-md text-white">
                            </div>
                        </div>


                    </form>
                </div>

            </div>
        </div>

{% endblock %}