{{ Form::open(['route' => 'admin.medecinconseil.accepterententePhaSubs', 'method' => 'POST', 'onsubmit'=>'showOverlay()', 'id' => 'form_entente']) }}
@php
$codeMedicament = $ententeprealablePhaSubs->first()->codeMedicamentPrescrit;
@endphp
{{ Form::text('numeroDemandeSubstitution', $ententeprealablePhaSubs->first()->numeroDemandeSubstitution, ['readonly' => 'true', 'class' => 'input-chic', 'id'=>'id']) }}
{{ Form::text('nomPrescrit_view', $ententeprealablePhaSubs->first()->nomPrescrit, ['readonly' => 'true', 'class' => 'input-chic input-highlight', 'style'=>'color:#e74c3c !important; border-color:rgba(231,76,60,0.3) !important;']) }}
{{ Form::text('libellePolice', $ententeprealablePhaSubs->first()->libellePolice, ['readonly' => 'true', 'class' => 'input-chic']) }}
{{ Form::text('libelleSubstitut_view', $ententeprealablePhaSubs->first()->libelleSubstitut, ['readonly' => 'true', 'class' => 'input-chic input-highlight']) }}
{{ Form::text('dateSysteme', $ententeprealablePhaSubs->first()->dateSysteme, ['readonly' => 'true', 'class' => 'input-chic']) }}
{{ Form::text('prestataire_view', $ententeprealablePhaSubs->first()->prestataire, ['readonly' => 'true', 'class' => 'input-chic']) }}
{{ Form::text('beneficiaire_view', $ententeprealablePhaSubs->first()->beneficiaire.' / '.$ententeprealablePhaSubs->first()->numeroBeneficiaire, ['readonly' => 'true', 'class' => 'input-chic']) }}
{{ Form::text('motifReel', "BON POUR ACCORD", ['class' => 'input-chic', 'style' => 'border-color: rgba(255,255,255,0.3) !important; color: #fff !important;', 'id' => 'motifReel']) }}
@if ($codeMedicament != "MEDIC")
{{ Form::text('prixPrescription', $ententeprealablePhaSubs->first()->prixPrescription, ['readonly' => 'true', 'class' => 'input-chic']) }}
{{ Form::text('prixSubstitution', $ententeprealablePhaSubs->first()->prixSubstitution, ['readonly' => 'true', 'class' => 'input-chic']) }}
{{ Form::text('gap', $ententeprealablePhaSubs->first()->gap, ['readonly' => 'true', 'class' => 'input-chic']) }}
@endif