@extends('adminlte::page')

@section('title', config('adminlte.title') . ' | Emergency Contacts')

@section('content_header')
    <div class="container-fluid">
        <div class="row mb-2">
            <div class="col-sm-6 m-0 text-dark">
                <h1>Add Emergency Contact</h1>
            </div>
            <div class="col-sm-6">
                <ol class="breadcrumb float-sm-right">
                    <li class="breadcrumb-item"><a href="/">Home</a></li>
                    <li class="breadcrumb-item"><a href="{{ route('emergency_contacts.index') }}">Emergency Contacts</a></li>
                    <li class="breadcrumb-item active">Create</li>
                </ol>
            </div>
        </div>
    </div>
@stop

@section('content')
    <div class="row">
        <div class="col-12">
            <div class="card">
                <div class="card-body">
                    <div class="container">

                        <div class="row mb-2">
                            <div class="col-12 p-4">
                                <a href={{ route('emergency_contacts.index') }} class="btn btn-secondary"><i
                                        class="fas fa-arrow-left"></i> Back</a>
                            </div>
                        </div>
                        <hr class="bg-secondary">
                        @if ($errors->any())
                            <div class="alert alert-danger">
                                <ul>
                                    @foreach ($errors->all() as $error)
                                        <li>{{ $error }}</li>
                                    @endforeach
                                </ul>
                            </div>
                        @endif
                        <form action="{{ route('emergency_contacts.store') }}" method="POST">
                            @csrf

                            <div class="card border-light m-4">
                                <div class="card-header bg-light text-xl">Add emergency contact details</div>
                                <div class="card-body text-lg">
                                    <div class="card-text">
                                        <label id="namelab" for="name">Full Name<span
                                                class="text-danger">*</span></label>
                                        <input type="text" id="name" name="name" class="form-control"
                                            placeholder="Full Name" value="{{ old('name') }}" required>
                                        <label id="realtionshiplab" for="relationship">Relationship</label>
                                        <select class="custom-select" name="relationship" id="relationship">
                                            <option value="">Choose Relationship</option>
                                            <option value="Spouse/Partner"
                                                {{ old('relationship') === 'Spouse/Partner' ? 'selected' : '' }}>
                                                Spouse/Partner</option>
                                            <option value="Father" {{ old('relationship') === 'Father' ? 'selected' : '' }}>
                                                Father</option>
                                            <option value="Mother" {{ old('relationship') === 'Mother' ? 'selected' : '' }}>
                                                Mother</option>
                                            <option value="Son" {{ old('relationship') === 'Son' ? 'selected' : '' }}>Son
                                            </option>
                                            <option value="Daughter"
                                                {{ old('relationship') === 'Daughter' ? 'selected' : '' }}>Daughter</option>
                                            <option value="Brother"
                                                {{ old('relationship') === 'Brother' ? 'selected' : '' }}>Brother</option>
                                            <option value="Sister"
                                                {{ old('relationship') === 'Sister' ? 'selected' : '' }}>Sister</option>
                                            <option value="Grandson"
                                                {{ old('relationship') === 'Grandson' ? 'selected' : '' }}>Grandson
                                            </option>
                                            <option value="Granddaughter"
                                                {{ old('relationship') === 'Granddaughter' ? 'selected' : '' }}>
                                                Granddaughter</option>
                                            <option value="Grandfather"
                                                {{ old('relationship') === 'Grandfather' ? 'selected' : '' }}>Grandfather
                                            </option>
                                            <option value="Grandmother"
                                                {{ old('relationship') === 'Grandmother' ? 'selected' : '' }}>Grandmother
                                            </option>
                                            <option value="Family member"
                                                {{ old('relationship') === 'Family member' ? 'selected' : '' }}>Family
                                                member</option>
                                            <option value="Friend"
                                                {{ old('relationship') === 'Friend' ? 'selected' : '' }}>Friend</option>
                                            <option value="Other" {{ old('relationship') === 'Other' ? 'selected' : '' }}>
                                                Other</option>
                                        </select>

                                        <div class="form-check form-check-inline">
                                            <input type="checkbox" class="form-check-input" id="primary" name="primary"
                                                value="1" {{ old('primary') ? 'checked' : '' }}>
                                            <label class="form-check-label" id="primarylab" for="primary">Primary emergency
                                                contact for <b>{{ $user->name }}</b></label>
                                        </div>
                                        <div>
                                            <label id="tellab" for="telephone">Telephone Number<span
                                                    class="text-danger">*</span></label>
                                            <input type="text" id="telephone" name="telephone" class="form-control"
                                                placeholder="Telephone Number" value="{{ old('telephone') }}">
                                            <label id="moblab" for="mobile">Mobile Number<span
                                                    class="text-danger">*</span></label>
                                            <input type="text" id="mobile" name="mobile" class="form-control"
                                                placeholder="Mobile Number" value="{{ old('mobile') }}">
                                            <label id="emaillab" for="email">Email</label>
                                            <input type="text" id="email" name="email" class="form-control"
                                                placeholder="Email" value="{{ old('email') }}">
                                        </div>
                                        <hr class="bg-secondary">
                                        <div class="text-center">
                                            <a class="btn btn-secondary" id="ProfileAddress">Use address from profile</a>
                                        </div>
                                        <div>
                                            <label id="address1lab" for="address1">Address 1</label>
                                            <input type="text" id="address1" name="address1" class="form-control"
                                                placeholder="Address 1" value="{{ old('address1') }}">
                                            <label id="address2lab" for="address2">Address 2</label>
                                            <input type="text" id="address2" name="address2" class="form-control"
                                                placeholder="Address 2" value="{{ old('address2') }}">
                                            <label id="address3lab" for="address2">Address 3</label>
                                            <input type="text" id="address3" name="address3" class="form-control"
                                                placeholder="Address 3" value="{{ old('address3') }}">
                                            <label id="townlab" for="town">Town</label>
                                            <input type="text" id="town" name="town" class="form-control"
                                                placeholder="town" value="{{ old('town') }}">
                                            <label id="postcodelab" class="w-100 mt-2">Postcode
                                                <div class="input-group mb-3">
                                                    <input type="text" id="postcode" class="form-control"
                                                        name="postcode" placeholder="Postcode"
                                                        value="{{ old('postcode') }}">
                                                    <div class="input-group-append">
                                                        <button class="btn btn-outline-secondary" type="button"
                                                            id="postcodebutton">Find Address</button>
                                                    </div>

                                                </div>
                                            </label>
                                            <script src="{{ asset('js/postcode-lookup.js') }}"></script>
                                            <script>
                                                $('#ProfileAddress').click(function() {
                                                    $("#address1").val("{{ $user->address1 }}");
                                                    $("#address2").val("{{ $user->address2 }}");
                                                    $("#address3").val("{{ $user->address3 }}");
                                                    $("#town").val("{{ $user->town }}");
                                                    $("#postcode").val("{{ $user->postcode }}");
                                                    $("#country").val("{{ $user->country }}");
                                                });

                                                new PostcodeLookup({
                                                    routeUrl: "{{ route('postcode.process') }}"
                                                });
                                            </script>
                                            <div id="postcodemsg" class="alert alert-danger alert-dismissible fade show"
                                                role="alert" style="display:none;">
                                                <strong>Error!</strong> Please enter the postcode.
                                                    <button type="button" class="close" data-dismiss="alert"
                                                        aria-label="Close">
                                                        <span aria-hidden="true">&times;</span>
                                                    </button>
                                            </div>
                                            <div id="populateaddress" class="input-group mb-3" style="display:none;">
                                                <div class="input-group-prepend">
                                                    <span class="input-group-text" id="foundaddressspan">Found
                                                        Address</span>
                                                </div>
                                                <select name="foundaddress" id="foundaddress" class="custom-select">

                                                </select>
                                            </div>
                                            <label id="countrylab" class="w-100">Country:<span
                                                    class="text-danger">*</span>
                                                <input type="text" id="country" list="countryList"
                                                    class="form-control" name="country"
                                                    placeholder="Type in for your country" value="{{ old('country') }}">
                                                <datalist id="countryList">
                                                    @foreach ($countryNames as $countryName)
                                                        <option value="{{ $countryName->country }}"></option>
                                                    @endforeach
                                                </datalist>
                                            </label>
                                            <hr class="bg-secondary">
                                            <div>
                                                <label id="notelab" for="note">Notes</label>
                                                <textarea id="note" name="note" placeholder="Make a note" class="form-control">{{ old('note') }}</textarea>
                                            </div>
                                            <hr class="bg-secondary">
                                            <div class="m-2">
                                                <a href="{{ route('emergency_contacts.index') }}"
                                                    class="btn btn-secondary">cancel</a> <button type="submit"
                                                    class="btn btn-primary">Add emergency contact details</button>
                                            </div>
                                        </div>
                                    </div>
                        </form>

                    </div>
                </div>

            </div>

        </div>
    </div>
    </div>
    </div>
@stop

@section('footer')
    &nbsp;
@stop