@extends('layouts.panel.app', ['title' => 'Ubah Surat'])

@section('content')


<section class="section">
    <div class="section-title">
        <h3>Pengantar Surat Izin Praktek (SIP) Anggota</h3>
    </div>
    <p class="section-lead">
        Silahkan ubah atau hapus data menu surat di sini.
    </p>
    <div class="row">
        <div class="col-md-12">
            <div class="card border-0 shadow rounded">
                <div class="card-header">
                    <h4>Ubah Surat</h4>
                    <div class="card-header-action">
                        <a href="{{ route('admin.letter-cover') }}" class="btn btn-success">Kembali</a>
                    </div>
                </div>
                <div class="card-body">
                    <form id="fmmstform-edit" action="{{ route('admin.letter-cover.update', $data->id) }}" method="POST" class="needs-validation" novalidate="">
                        @csrf
                        @method('PUT')
                        <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-12 form-group text-center">
                                <h3 class="font-weight-bold">{{$data->title}}</h3>
                                <h5 class="font-weight-bold">Nomor : {{$data->no}}</h5>
                            </div>

                            <div class="col-md-12 form-group">
                                <label class="font-weight-bold">NAMA LENGKAP <span style="color: red;"> **</span></label>
                                <input type="text" class="form-control" name="name" value="{{ old('name', $data->name) }}" placeholder="Masukkan nama" required="">
                                <!-- error message -->
                                <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">TEMPAT <span style="color: red;"> **</span></label>
                                <input type="text" class="form-control" name="place" value="{{ old('place', $data->place) }}" placeholder="Masukkan tempat" required="">
                                <!-- error message -->
                                <div class="invalid-feedback alert alert-danger mt-2">
                                    Masukan tempat
                                </div>
                            </div>

                            <div class="col-md-4 form-group">
                                <label class="font-weight-bold">TANGGAL LAHIR <span style="color: red;"> **</span></label>
                                <input type="date" class="form-control" name="birth_date" value="{{ old('birth_date', $data->birth_date) }}" placeholder="Masukkan tanggal" required="">
                                <!-- error message -->
                                <div class="invalid-feedback alert alert-danger mt-2">
                                    Masukan tanggal lahir
                                </div>
                            </div>

                            <div class="col-md-12 form-group">
                                <label class="font-weight-bold">ALAMAT RUMAH <span style="color: red;"> **</span></label>
                                <input type="text" class="form-control" name="address" value="{{ old('address', $data->address) }}" placeholder="Masukkan alamat" required="">
                                <!-- error message -->
                                <div class="invalid-feedback alert alert-danger mt-2">
                                    Masukan alamat
                                </div>
                            </div>


                            <div class="col-md-6 form-group">
                                <label class="font-weight-bold">IDI WILAYAH <span style="color: red;"> **</span></label>
                                <input type="text" class="form-control" name="area_idi" value="{{ old('area_idi', $data->area_idi) }}" placeholder="Masukkan wilayah" required="">
                                <!-- error message -->
                                <div class="invalid-feedback alert alert-danger mt-2">
                                    Masukan wilayah
                                </div>
                            </div>

                            <div class="col-md-6 form-group">
                                <label class="font-weight-bold">IDI CABANG <span style="color: red;"> **</span></label>
                                <input type="text" class="form-control" name="branch_idi" value="{{ old('branch_idi', $data->branch_idi) }}" placeholder="Masukkan cabang" required="">
                                <!-- error message -->
                                <div class="invalid-feedback alert alert-danger mt-2">
                                    Masukan cabang
                                </div>
                            </div>

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

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

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

                            <div class="col-md-12 form-group">
                                <label class="font-weight-bold">ALAMAT PRAKTEK <span style="color: red;"> **</span></label>
                                <input type="text" class="form-control" name="practice_address" value="{{ old('practice_address', $data->practice_address) }}" placeholder="Masukkan alamat" required="">
                                <!-- error message -->
                                <div class="invalid-feedback alert alert-danger mt-2">
                                    Masukan alamat
                                </div>
                            </div>

                            <div class="col-md-4 form-group">
                                <span class="font-weight-bold">SIP Ke- {{$data->sip_no}}</span>
                                <br>
                                <span class="font-weight-bold">Tanggal SIP {{ date('d-m-Y', strtotime($data->letter_date)) }}</span>
                                <br>
                                <span class="font-weight-bold">Masa Berlaku {{ date('d-m-Y', strtotime($data->letter_periode)) }}</span>
                            </div>

                            <div class="col-md-4 form-group">
                                <label class="font-weight-bold">TUJUAN</label>
                                <br>
                                @if ($data->letter_reason == "PEMBUATAN")
                                <div class="badge badge-info">Mengajukan</div>
                                @elseif ($data->letter_reason == "PERPANJANGAN")
                                <div class="badge badge-danger">Memperpanjang</div>
                                @elseif ($data->letter_reason == "PERUBAHAN")
                                <div class="badge badge-warning">Mengubah</div>
                                @endif
                            </div>

                            <div class="col-md-4 form-group">
                                <label class="font-weight-bold">STATUS <span style="color: red;"> **</span></label>
                                <select class="form-control" name="is_active" value="{{ old('is_active') }}" placeholder="Pilih status" required>
                                    <option value="">Pilih Status</option>
                                    <option value="Y" {{ 'Y' == old('is_active', $data->is_active) ? 'selected' : '' }}>Aktif</option>
                                    <option value="N" {{ 'N' == old('is_active', $data->is_active) ? 'selected' : '' }}>Tidak Aktif</option>
                                </select>
                                <!-- error message -->
                                <div class="invalid-feedback alert alert-danger mt-2">
                                    Pilih status
                                </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