Full Name {{ $errors->first('name')}}

Gender

Male Female Other

Contact No (optional) {{ $errors->first('phone')}}

Doctor Category (Multiple selection allowed) {{ $errors->first('categories')}}

Email Address (optional) {{ $errors->first('email')}}

Registration No (optional) {{ $errors->first('reg')}}

Education {{ $errors->first('education')}}

Other details/View(optional) {{ $errors->first('other_details')}}

File upload

Upload