<!DOCTYPE html>
<html lang="en">

<head>
    <meta charset="UTF-8">
    <meta name="viewport" content="width=device-width, initial-scale=1.0">
    <title>Sign Up - TGP Hospital</title>
    <link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/6.4.0/css/all.min.css">
    <link rel="stylesheet" href="<?php echo e(asset('home')); ?>/css/signup.css">

</head>

<body>
    <div class="signup-container">
        <div class="signup-left">
            <a href="<?php echo e(route('home')); ?>" style="text-decoration: none; color: white;  cursor:pointer;">
                <div class="hospital-logo">

                    <i class="fas fa-hospital"></i>
                    <h1>TGP Hospital</h1>
                </div>
            </a>

            <div class="welcome-text">
                <h2>Join Our Healthcare Community</h2>
                <p>Create your TGP Hospital patient portal account to manage your healthcare needs in one convenient
                    place.</p>
            </div>

            <ul class="features-list">
                <li><i class="fas fa-calendar-check"></i> Schedule appointments online</li>
                <li><i class="fas fa-file-medical"></i> Access your medical records</li>
                <li><i class="fas fa-comments"></i> Secure messaging with your doctors</li>
                <li><i class="fas fa-prescription"></i> Request prescription refills</li>
                <li><i class="fas fa-bell"></i> Receive health reminders</li>
            </ul>
        </div>

        <div class="signup-right">
            <div class="signup-header">
                <h2>Create Your Account</h2>
                <p>Join thousands of patients managing their health with TGP Hospital</p>
            </div>

            <form class="signup-form" id="signupForm">
                <div class="form-row">
                    <div class="input-group">
                        <i class="fas fa-user"></i>
                        <input type="text" placeholder="First Name" required>
                    </div>

                    <div class="input-group">
                        <i class="fas fa-user"></i>
                        <input type="text" placeholder="Last Name" required>
                    </div>
                </div>

                <div class="input-group">
                    <i class="fas fa-envelope"></i>
                    <input type="email" placeholder="Email Address" required>
                </div>

                <div class="input-group">
                    <i class="fas fa-phone"></i>
                    <input type="tel" placeholder="Phone Number" required>
                </div>

                <div class="form-row">
                    <div class="input-group">
                        <i class="fas fa-lock"></i>
                        <input type="password" id="password" placeholder="Password" required>
                        <div class="password-strength">
                            <div class="password-strength-bar" id="passwordStrengthBar"></div>
                        </div>
                    </div>

                    <div class="input-group">
                        <i class="fas fa-lock"></i>
                        <input type="password" placeholder="Confirm Password" required>
                    </div>
                </div>

                <div class="form-row">
                    <div class="input-group">
                        <i class="fas fa-birthday-cake"></i>
                        <input type="date" placeholder="Date of Birth">
                    </div>

                    <div class="input-group">
                        <i class="fas fa-venus-mars"></i>
                        <select>
                            <option value="" disabled selected>Gender</option>
                            <option value="male">Male</option>
                            <option value="female">Female</option>
                            <option value="other">Other</option>
                        </select>
                    </div>
                </div>

                <div class="terms">
                    <input type="checkbox" id="terms" required>
                    <label for="terms">I agree to the <a href="#">Terms of Service</a> and <a
                            href="#">Privacy Policy</a>. I consent to receiving communications from TGP
                        Hospital.</label>
                </div>

                <button type="submit" class="signup-button">Create Account</button>
            </form>

            <div class="login-link">
                Already have an account? <a href="<?php echo e(route('login.index')); ?>">Log in here</a>
            </div>
        </div>
    </div>

    <script src="<?php echo e(asset('home')); ?>/js/signup.js"></script>
</body>

</html>
<?php /**PATH /home/techgian/hospital2.techgiantpro.com/resources/views/home/register.blade.php ENDPATH**/ ?>