@php
    if (isset($input_disabled) && $input_disabled == true) {
        $disabled = ' disabled';
    } else {
        $disabled = '';
    }
@endphp
<div class="columns-1 md:columns-2">
    <div class="p-6 pt-0 text-gray-900">
        <x-input-label for="prenom" :value="__('Prénom')" />
        <x-text-input id="prenom" name="prenom" type="text" class="mt-1 block w-full"
            value="{{ old('prenom', $patient->prenom) }}" :disabled="$disabled" />
    </div>
    <div class="p-6 pt-0 text-gray-900">
        <x-input-label for="nom" :value="__('Nom')" />
        <x-text-input id="nom" name="nom" type="text" class="mt-1 block w-full"
            value="{{ old('nom', $patient->nom) }}" :disabled="$disabled" />
    </div>
</div>
<div class="columns-1 md:columns-2">
    <div class="p-6 pt-0 text-gray-900">
        <x-input-label for="email" :value="__('Email')" />
        <x-text-input id="email" name="email" type="email" class="mt-1 block w-full"
            value="{{ old('email', $patient->email) }}" :disabled="$disabled" />
    </div>
    <div class="p-6 pt-0 text-gray-900">
        <x-input-label for="birth_date" :value="__('Date de naissance')" />
        <x-text-input id="birth_date" name="birth_date" type="date" class="mt-1 block w-full"
            value="{{ old('birth_date', $patient->birth_date) }}" :disabled="$disabled" />
    </div>
</div>
<div class="columns-1 md:columns-2">
    <div class="p-6 pt-0 text-gray-900">
        <x-input-label for="phone" :value="__('Téléphone')" />
        <x-text-input id="phone" name="phone" type="tel" class="mt-1 block w-full"
            value="{{ old('phone', $patient->phone) }}" :disabled="$disabled" />
    </div>
    <div class="p-6 pt-0 text-gray-900">
        <x-input-label for="phone_detail" :value="__('Détail téléphone')" />
        <x-text-input id="phone_detail" name="phone_detail" type="text" class="mt-1 block w-full" placeholder="Exple: N° de la mère (laisser vide si n° du patient)"
            value="{{ old('phone_detail', $patient->phone_detail) }}" :disabled="$disabled" />
    </div>
</div>
<div class="columns-1 md:columns-2">
    <div class="p-6 pt-0 text-gray-900">
        <x-input-label for="city" :value="__('Ville')" />
        <x-text-input id="city" name="city" type="text" class="mt-1 block w-full"
            value="{{ old('city', $patient->city) }}" :disabled="$disabled" />
    </div>
    <div class="p-6 pt-0 text-gray-900">
        <x-input-label for="job" :value="__('Profession')" />
        <x-text-input id="job" name="job" type="text" class="mt-1 block w-full"
            value="{{ old('job', $patient->job) }}" :disabled="$disabled" />
    </div>
</div>