@extends('layouts.master_home')

@section('dashboard_content')
    <div class="page-content">
        <!-- BEGIN PAGE HEAD -->
        <div class="page-head">
            <!-- BEGIN PAGE TITLE -->
            <div class="page-title">
                <h1>Doctor
                    <small>manage</small>
                </h1>
            </div>
            <!-- END PAGE TITLE -->
            <!-- BEGIN PAGE TOOLBAR -->
            <div class="page-toolbar">
                <!-- BEGIN THEME PANEL -->
                <a href="{{ url('/') }}/{{$slug}}/"
                   class="btn green"><i
                            class="fa fa-backward"></i> Back</a>
                <!-- END THEME PANEL -->
            </div>
            <!-- END PAGE TOOLBAR -->
        </div>
        <!-- END PAGE HEAD -->
        <div class="row">
            <div class="col-md-12">
                <div class="portlet light">
                    <div class="portlet-title">
                        <div class="caption">
                            <i class="icon-credit-card font-green-sharp"></i>
                            <span class="caption-subject font-green-sharp bold uppercase">Doctor Details</span>
                            <span class="caption-helper"></span>
                        </div>
                        <div class="actions">

                        </div>
                    </div>
                    <div class="portlet-body form">
                        <form class="form-horizontal" method="post"
                              action="{{!isset($specialization->id) ? route($slug.'/store') : route($slug.'/update',['id' => encrypt($specialization->id)])}}"
                              enctype="multipart/form-data">
                            <div class="form-body">
                                {{ csrf_field() }}
                                <div class="row">
                                    <div class="col-md-4"></div>
                                    <div class="form-group col-md-4">
                                        <label for="prefix">Prefix:</label>
                                        <select name="prefix" class="form-control">
                                            @foreach (Config::get('constants.DOCTOR_PREFIX') as $key => $value)
                                                <option value="{{ $key }}"
                                                        @if ($key == old('prefix', !isset($specialization->prefix) ?"": $specialization->prefix)))
                                                        selected="selected"
                                                        @endif
                                                >{{ $value }}</option>
                                            @endforeach
                                        </select>
                                        @if ($errors->has('prefix'))
                                            <span class="help-block validation-advice">
                                                <strong>{{ $errors->first('prefix') }}</strong>
                                            </span>
                                        @endif
                                    </div>
                                </div>
                                <div class="row">
                                    <div class="col-md-4"></div>
                                    <div class="form-group col-md-4">
                                        <label for="first_name">First Name:</label>
                                        <input type="text" class="form-control" name="first_name"
                                               value="{{ !isset($specialization->first_name) ? "": $specialization->first_name}}">
                                        @if ($errors->has('first_name'))
                                            <span class="help-block validation-advice">
                                                <strong>{{ $errors->first('first_name') }}</strong>
                                            </span>
                                        @endif
                                    </div>
                                </div>
                                <div class="row">
                                    <div class="col-md-4"></div>
                                    <div class="form-group col-md-4">
                                        <label for="last_name">Last Name:</label>
                                        <input type="text" class="form-control" name="last_name"
                                               value="{{ !isset($specialization->last_name) ? "": $specialization->last_name}}">
                                        @if ($errors->has('last_name'))
                                            <span class="help-block validation-advice">
                                                <strong>{{ $errors->first('last_name') }}</strong>
                                            </span>
                                        @endif
                                    </div>
                                </div>
                                <div class="row">
                                    <div class="col-md-4"></div>
                                    <div class="form-group col-md-4">
                                        <label for="specialization">Specializations:</label>
                                        <select name="specialization[]" class="form-control" multiple>
                                            @foreach ($specializationsList as $value)
                                                <option value="{{ $value->id }}"
                                                        @if(isset($selectedSpecializations))
                                                        @foreach($selectedSpecializations as $SelectedValue => $selectVal)
                                                        @if ($value->id == old('specialization', !isset($selectVal->specialization_id) ? "": $selectVal->specialization_id))
                                                        selected="selected"
                                                        @endif
                                                        @endforeach
                                                        @endif
                                                >{{ $value->title }}</option>
                                            @endforeach
                                        </select>
                                        @if ($errors->has('specialization'))
                                            <span class="help-block validation-advice">
                                                <strong>{{ $errors->first('specialization') }}</strong>
                                            </span>
                                        @endif
                                    </div>
                                </div>
                                <div class="row">
                                    <div class="col-md-4"></div>
                                    <div class="form-group col-md-4">
                                        <label for="hospitals">Hospitals:</label>
                                        <select name="hospitals[]" class="form-control" multiple>
                                            @foreach ($hospitalList as $value)
                                                <option value="{{ $value->id }}"
                                                        @if(isset($selectedHospitals))
                                                        @foreach($selectedHospitals as $SelectedValue => $selectVal)
                                                        @if ($value->id == old('hospitals', !isset($selectVal->hospital_id) ? "": $selectVal->hospital_id))
                                                        selected="selected"
                                                        @endif
                                                        @endforeach
                                                        @endif
                                                >{{ $value->name }}</option>
                                            @endforeach
                                        </select>
                                        @if ($errors->has('hospitals'))
                                            <span class="help-block validation-advice">
                                                <strong>{{ $errors->first('hospitals') }}</strong>
                                            </span>
                                        @endif
                                    </div>
                                </div>
                                <div class="row">
                                    <div class="col-md-4"></div>
                                    <div class="form-group col-md-4">
                                        <label for="Name">Gender:</label>
                                        <select name="gender" class="form-control">
                                            @foreach (Config::get('constants.GENDER') as $key => $value)
                                                <option value="{{ $key }}"
                                                        @if ($key == old('gender', !isset($specialization->gender) ?"": $specialization->gender)))
                                                        selected="selected"
                                                        @endif
                                                >{{ $value }}</option>
                                            @endforeach
                                        </select>
                                        @if ($errors->has('gender'))
                                            <span class="help-block validation-advice">
                                                <strong>{{ $errors->first('gender') }}</strong>
                                            </span>
                                        @endif
                                    </div>
                                </div>
                                <div class="row">
                                    <div class="col-md-4"></div>
                                    <div class="form-group col-md-4">
                                        <label for="Nic">NIC:</label>
                                        <input type="text" class="form-control" name="nic"
                                               value="{{ !isset($specialization->nic) ? "": $specialization->nic}}">
                                        @if ($errors->has('nic'))
                                            <span class="help-block validation-advice">
                                                <strong>{{ $errors->first('nic') }}</strong>
                                            </span>
                                        @endif
                                    </div>
                                </div>
                                <div class="row">
                                    <div class="col-md-4"></div>
                                    <div class="form-group col-md-4">
                                        <label for="Mobile">Mobile:</label>
                                        <input type="text" class="form-control" name="mobile"
                                               value="{{ !isset($specialization->mobile) ?"": $specialization->mobile}}">
                                        @if ($errors->has('mobile'))
                                            <span class="help-block validation-advice">
                                                <strong>{{ $errors->first('mobile') }}</strong>
                                            </span>
                                        @endif
                                    </div>
                                </div>
                                <div class="row">
                                    <div class="col-md-4"></div>
                                    <div class="form-group col-md-4">
                                        <label for="Email">Email:</label>
                                        <input type="text" class="form-control" name="email"
                                               value="{{ !isset($specialization->email) ?"": $specialization->email}}">
                                        @if ($errors->has('email'))
                                            <span class="help-block validation-advice">
                                                <strong>{{ $errors->first('email') }}</strong>
                                            </span>
                                        @endif
                                    </div>
                                </div>
                                <div class="row">
                                    <div class="col-md-4"></div>
                                    <div class="form-group col-md-4">
                                        <label for="image">Image:</label>
                                        <input class="form-control" type="file" name="image">
                                    </div>
                                </div>
                            </div>
                            <div class="form-actions">
                                <div class="row">
                                    <div class="col-md-4"></div>
                                    <div class="form-group col-md-4" style="margin-top:60px">
                                        <button type="submit" class="btn btn-success">Submit</button>
                                    </div>
                                </div>
                            </div>
                        </form>
                    </div>
                </div>
            </div>
        </div>

    </div>
@endsection