@extends('layouts.panel.app', ['title' => 'Tambah Form'])

@section('content')

<section class="section">
    <div class="section-title">
        <h3>Form</h3>
    </div>
    <p class="section-lead">
        Silahkan tambah data menu form di sini.
    </p>
    <div class="row">
        <div class="col-md-12">
            <div class="card border-0 shadow rounded">
                <div class="card-header">
                    <h4>Tambah Form</h4>
                    <div class="card-header-action">
                        <a href="{{ route('admin.mstform') }}" class="btn btn-success">Kembali</a>
                    </div>
                </div>
                <div class="card-body">

                    <form id="fmmstform" action="{{ route('admin.mstform.store') }}" method="POST" class="needs-validation" novalidate="">
                        @csrf

                        <div class="alert alert-info alert-has-icon">
                            @php
                            $label = \App\Models\Label::where(['code' => 'info-master' ])->first()
                            @endphp
                            <div class="alert-icon"><i class="far fa-lightbulb"></i></div>
                            <div class="alert-body">
                                <div class="alert-title"><strong> {!!html_entity_decode($label->title)!!}</strong></div>
                                {!!html_entity_decode($label->desc)!!}
                            </div>
                        </div>
                        <label class="font-weight-bold">Note : <span style="color: red;"> **</span> ) wajib diisi </label>
                        <hr>

                        <div class="row">
                            <div class="col-md-4 form-group">
                                <label class="font-weight-bold">NAMA <span style="color: red;"> **</span></label>
                                <input type="text" class="form-control" name="name" value="{{ old('name') }}" placeholder="Masukkan nama" required="">
                                <!-- error message untuk name -->
                                <div class="invalid-feedback alert alert-danger mt-2">
                                    Masukan nama
                                </div>
                            </div>

                            <div class="col-md-8 form-group">
                                <label class="font-weight-bold">DESKRIPSI <span style="color: red;"> **</span></label>
                                <input type="text" class="form-control" name="desc" value="{{ old('desc') }}" placeholder="Masukkan deskripsi" required="">
                                <!-- error message untuk name -->
                                <div class="invalid-feedback alert alert-danger mt-2">
                                    Masukan deskripsi
                                </div>
                            </div>
                        </div>

                        <div class="row">
                            <div class="col-md-4 form-group">
                                <label class="font-weight-bold">TIPE <span style="color: red;"> **</span></label>
                                <select class="form-control" name="type" value="{{ old('type') }}" placeholder="Pilih tipe" required="">
                                    <option value="">Pilih Tipe</option>
                                    <option value="FPI" {{ 'FPI' == old('type') ? 'selected' : '' }}>Pembayaran</option>
                                    <option value="FPA" {{ 'FPA' == old('type') ? 'selected' : '' }}>Pendaftaran</option>
                                    <option value="FRS" {{ 'FRS' == old('type') ? 'selected' : '' }}>SIP</option>
                                    <option value="FRS-P" {{ 'FRS-P' == old('type') ? 'selected' : '' }}>Pengantar SIP</option>
                                    <option value="FRS-KP" {{ 'FRS-KP' == old('type') ? 'selected' : '' }}>SIP Khusus PPDS</option>
                                    <option value="FRP" {{ 'FRP' == old('type') ? 'selected' : '' }}>Rekomendasi PPDS</option>
                                    <option value="FRP-P" {{ 'FRP-PP' == old('type') ? 'selected' : '' }}>Pengantar PPDS</option>
                                    <option value="FRT" {{ 'FRT' == old('type') ? 'selected' : '' }}>Pengantar STR</option>
                                    <option value="FRF" {{ 'FRF' == old('type') ? 'selected' : '' }}>Rekomendasi Fellowship</option>
                                    <option value="FRL" {{ 'FRL' == old('type') ? 'selected' : '' }}>Pengantar LOG</option>
                                    <option value="FRK" {{ 'FRK' == old('type') ? 'selected' : '' }}>SK Pindah Anggota</option>
                                </select>
                                <!-- error message untuk route -->
                                <div class="invalid-feedback alert alert-danger mt-2">
                                    Pilih tipe
                                </div>
                            </div>

                            <div class="col-md-4 form-group">
                                <label class="font-weight-bold">DOKTER</label>
                                <select class="form-control" name="doctor" value="{{ old('doctor') }}" placeholder="Pilih tipe dokter">
                                    <option value="">Pilih Tipe Dokter</option>
                                    <option value="Drb" {{ 'Drb' == old('doctor') ? 'selected' : '' }}>Dokter Baru</option>
                                    <option value="Drm" {{ 'Drm' == old('doctor') ? 'selected' : '' }}>Dokter Baru - Mutasi</option>
                                    <option value="Dri" {{ 'Dri' == old('doctor') ? 'selected' : '' }}>Dokter Baru - Internship</option>
                                    <option value="DU" {{ 'DU' == old('doctor') ? 'selected' : '' }}>Dokter Umum</option>
                                    <option value="DSp" {{ 'DSp' == old('doctor') ? 'selected' : '' }}>Dokter Spesialis</option>
                                    <option value="DIn" {{ 'DIn' == old('doctor') ? 'selected' : '' }}>Dokter Internship</option>
                                    <option value="DPs" {{ 'DPs' == old('doctor') ? 'selected' : '' }}>Dokter PPDS</option>
                                    <option value="Dup" {{ 'Dup' == old('doctor') ? 'selected' : '' }}>Dokter Duplikat STR</option>
                                    <option value="Ext" {{ 'Ext' == old('doctor') ? 'selected' : '' }}>Dokter Perpanjangan STR</option>
                                    <option value="DIa" {{ 'DIa' == old('doctor') ? 'selected' : '' }}>Dokter Perpanjangan Iuran</option>
                                </select>
                                <!-- error message untuk route -->
                                <div class="invalid-feedback alert alert-danger mt-2">
                                    Pilih tipe dokter
                                </div>
                            </div>

                            <div class="col-md-4 form-group">
                                <label class="font-weight-bold">AKSES <span style="color: red;"> **</span></label>
                                <select class="form-control" name="role_id" value="{{ old('role_id') }}" placeholder="Pilih akses" required="">
                                    <option value="">Pilih Akses</option>
                                    @foreach($role as $item)
                                    <option value="{{ $item->id }}" {{ $item->id == old('role_id') ? 'selected' : '' }}>{{ $item->name }}</option>
                                    @endforeach
                                </select>
                                <!-- error message untuk route -->
                                <div class="invalid-feedback alert alert-danger mt-2">
                                    Pilih akses
                                </div>
                            </div>

                            <div class="col-md-4 form-group">
                                <label class="font-weight-bold">BIAYA <span style="color: red;"> **</span></label>
                                <select class="form-control" name="is_cost" value="{{ old('is_cost') }}" placeholder="Pilih biaya" required>
                                    <option value="">Pilih Biaya</option>
                                    <option value="FREE">Tanpa Biaya</option>
                                    <option value="PAID">Perlu Biaya</option>
                                </select>
                                <!-- error message untuk route -->
                                <div class="invalid-feedback alert alert-danger mt-2">
                                    Pilih biaya
                                </div>
                            </div>

                        </div>

                        <div class="form-group">
                            <button type="submit" style="width:100px" class="btn btn-primary btn-action" data-toggle="tooltip" title="Simpan"><i class="fas fa-save"></i></button>
                            <button type="reset" onclick="myReset()" class="btn btn-warning btn-action" data-toggle="tooltip" title="Batal"><i class="fas fa-redo-alt"></i></button>
                        </div>

                    </form>
                </div>
            </div>
        </div>
    </div>
</section>

@endsection