{% set userData = app.session.get('userData') %}
<form method="POST" id="form-scheduleCalendar">
    <div class="row">
        <div class="large-6 columns">
            <div class="row large-text-center">
                <div class="large-3 large-text-right columns">
                    {{ form_label(form.referringProvider_fullName) }}
                </div>
                <div class="large-9 columns">
                    {{ form_widget(form.referringProvider_fullName) }}
                    {{ form_widget(form.referringProvider) }}
                </div>
            </div>
            <div class="row large-text-center">
                <div class="large-3 large-text-right columns">
                    {{ form_label(form.referringHealthFacility_desc) }}
                </div>
                <div class="large-9 columns">
                    {{ form_widget(form.referringHealthFacility_desc) }}
                    {{ form_widget(form.referringHealthFacility) }}
                </div>
            </div>
            <div class="row large-text-center">
                <div class="large-3 large-text-right columns">
                    {{ form_label(form.contactPerson) }}
                </div>
                <div class="large-9 columns">
                    {{ form_widget(form.contactPerson) }}
                </div>
            </div>
            <div class="row large-text-center">
                <div class="large-3 large-text-right columns">
                    {{ form_label(form.health_facility_desc) }}
                </div>
                <div class="large-9 columns">
                    {{ form_widget(form.health_facility_desc) }}
                    {{ form_widget(form.health_facility) }}
                </div>
            </div>
            <div class="row large-text-center">
                <div class="large-3 large-text-right columns">
                    {{ form_label(form.marketingStaff_fullName) }}
                </div>
                <div class="large-9 columns">
                    {{ form_widget(form.marketingStaff_fullName) }}
                    {{ form_widget(form.marketingStaff) }}
                </div>
            </div>
            <div class="row large-text-center">
                <div class="large-3 large-text-right columns">
                    {{ form_label(form.chartType_desc) }}
                </div>
                <div class="large-9 columns">
                    {{ form_widget(form.chartType_desc) }}
                    {{ form_widget(form.chartType) }}
                </div>
            </div>
            <div class="row large-text-center">
                <div class="large-3 large-text-right columns">
                    {{ form_label(form.marketingStaffScheduleStatus) }}
                </div>
                <div class="large-9 columns">
                    {{ form_widget(form.marketingStaffScheduleStatus) }}
                </div>
            </div>
            {% if action == 'u' %}
                <div class="row large-text-center">
                    <div class="large-3 large-text-right columns">
                        <label>Updated </label>
                    </div>
                    <div class="large-9 columns" style="text-align: left">
                        {{ schedule.updatedAt|date('m/d/Y') }} [ {{ schedule.updatedBy }} ]
                    </div>
                </div>
                <div class="row large-text-center">
                    <div class="large-3 large-text-right columns">
                        <label>Created </label>
                    </div>
                    <div class="large-9 columns" style="text-align: left">
                        {{ schedule.createdAt|date('m/d/Y') }} [ {{ schedule.createdBy }} ]
                    </div>
                </div>
                <div class="row large-text-center">
                    <div class="large-3 large-text-right columns">
                        <label>Notes </label>
                    </div>
                    <div class="large-9 columns" style="text-align: left">
                        {{ schedule.note|raw }}
                    </div>
                </div>
            {% endif %}
            {#{% if action == 'u' %}#}
            {#<div class="row large-text-center">#}
            {#<div class="large-3 large-text-right columns">#}
            {#<label>Created </label>#}
            {#</div>#}
            {#<div class="large-9 columns" style="text-align: left">#}
            {#{{ schedule.createdAt|date('m/d/Y') }} ( {{ schedule.createdAt }} )#}
            {#</div>#}
            {#</div>#}
            {#{% endif %}#}
        </div>
        <div class="large-6 columns" style="padding: 0;">
            <div class="row large-text-center">
                <div class="large-3 large-text-right columns">
                    {{ form_label(form.schedule_date) }}
                </div>
                <div class="large-9 columns">
                    {{ form_widget(form.schedule_date) }}
                </div>
            </div>
            <div class="row large-text-center">
                <div class="large-3 large-text-right columns">
                    <label class="required">Start Time</label>
                </div>
                <div class="large-3 columns">
                    {{ form_widget(form.start_time_hour) }}
                </div>
                <div class="large-3 columns">
                    {{ form_widget(form.start_time_minute) }}
                </div>
                <div class="large-3 columns">
                    {{ form_widget(form.start_time_period) }}
                </div>
            </div>
            <div class="row large-text-center">
                <div class="large-3 large-text-right columns">
                    <label class="required">End Time</label>
                </div>
                <div class="large-3 columns">
                    {{ form_widget(form.end_time_hour) }}
                </div>
                <div class="large-3 columns">
                    {{ form_widget(form.end_time_minute) }}
                </div>
                <div class="large-3 columns">
                    {{ form_widget(form.end_time_period) }}
                </div>
            </div>
            <div class="row">
                <div class="large-3 large-text-right columns">
                    {{ form_label(form.note_type) }}
                </div>
                <div class="large-9 columns">
                    {{ form_widget(form.note_type) }}
                    {{ form_widget(form.note_template_description) }}
                    {{ form_widget(form.noteTemplate) }}
                </div>
            </div>
            <div class="row large-text-center">
                <div class="large-3 large-text-right columns">
                    {{ form_label(form.note) }}
                </div>
                <div class="large-9 columns">
                    {{ form_widget(form.note) }}
                </div>
            </div>
        </div>
    </div>
    {{ form_widget(form.patient_city_id) }}
    {{ form_widget(form.health_facility_city_id) }}
    {{ form_widget(form.health_facility_geoLat) }}
    {{ form_widget(form.health_facility_geoLong) }}
    {{ form_widget(form.referringHealthFacility_geoLat) }}
    {{ form_widget(form.referringHealthFacility_geoLong) }}
    {{ form_widget(form.referringProvider_geoLat) }}
    {{ form_widget(form.referringProvider_geoLong) }}
    {{ form_widget(form.action) }}
    {{ form_widget(form.id) }}
    {{ form_widget(form.health_facility) }}
    {{ form_widget(form.start_time) }}
    {#{{ form_widget(form.start_time_period) }}
    {{ form_widget(form.start_time_hour) }}
    {{ form_widget(form.start_time_minute) }}#}
    {{ form_widget(form._token) }}
</form>
