{{-- HEADER --}}

Further Information

{{-- Added wire:model and changed keys to integers for reliable Livewire state --}}

{{-- Added wire:model bindings so data reaches Livewire --}}

{{-- Fixed Double ?? in label and added wire:model --}}

{{-- CARE BACKGROUND (Section 7a) --}}

Care Background

{{-- Address Prior to Care --}}

Address Prior to Care

{{-- Hospitals (multiple boxes) --}}

Hospitals @forelse($hospitals as $i => $hospital)

@empty

No hospitals added yet. Use "Add hospital" to record one or more.

@endforelse

@can('claims.edit')

@endcan