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

@section('content')


<section class="section">
    <div class="section-title">
        <h3>Surat Rekomendasi Izin Praktek (SRIP) Non Anggota</h3>
    </div>
    <p class="section-lead">
        Silahkan tambah, 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-sip-b') }}" class="btn btn-success">Kembali</a>
                    </div>
                </div>
                <div class="card-body">
                    <form id="fmmstform-edit" action="{{ route('admin.letter-sip-b.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 BESERTA GELAR<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-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-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">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">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-4 form-group">
                                <label class="font-weight-bold">NOMOR STR <span style="color: red;"> **</span></label>
                                <input type="text" class="form-control" name="str_no" value="{{ old('str_no', $data->str_no) }}" placeholder="Masukkan nomor" required="">
                                <!-- error message -->
                                <div class="invalid-feedback alert alert-danger mt-2">
                                    Masukan nomor
                                </div>
                            </div>

                            <div class="col-md-4 form-group">
                                <label class="font-weight-bold">MASA BERLAKU STR <span style="color: red;"> **</span></label>
                                <input type="date" class="form-control" name="str_periode" value="{{ old('str_periode', $data->str_periode) }}" placeholder="Masukkan masa berlaku" required="">
                                <!-- error message -->
                                <div class="invalid-feedback alert alert-danger mt-2">
                                    Masukan masa berlaku
                                </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">
                                <label class="font-weight-bold">SURAT PENGANTAR IDI CABANG <span style="color: red;"> **</span></label>
                                <input type="text" class="form-control" name="sp_branch" value="{{ old('sp_branch', $data->sp_branch) }}" placeholder="Masukkan sp cabang" required="">
                                <!-- error message -->
                                <div class="invalid-feedback alert alert-danger mt-2">
                                    Masukan sp cabang
                                </div>
                            </div>

                            <div class="col-md-8 form-group">
                                <label class="font-weight-bold">NOMOR SURAT PENGANTAR <span style="color: red;"> **</span></label>
                                <input type="text" class="form-control" name="sp_no" value="{{ old('sp_no', $data->sp_no) }}" placeholder="Masukkan nomor sp" required="">
                                <!-- error message -->
                                <div class="invalid-feedback alert alert-danger mt-2">
                                    Masukan nomor sp
                                </div>
                            </div>

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

                            <div class="col-md-8 form-group">
                                <label class="font-weight-bold">NOMOR SURAT REKOMENDASI PERHIMPUNAN <span style="color: red;"> **)</span></label>
                                <input type="text" class="form-control" name="sk_no" value="{{ old('sk_no', $data->sk_no) }}" placeholder="Masukkan nomor sk" {{ $data->sip_doctor == 'DSp' ? 'required' : '' }}>
                                <!-- error message -->
                                <div class="invalid-feedback alert alert-danger mt-2">
                                    Masukan nomor sk
                                </div>
                            </div>

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

                            <div class="col-md-4 form-group">
                                <span class="font-weight-bold">SIP Ke-{{$data->sip_no}}</span>
                                <div class="badge {{ $data->sip_doctor == 'DU' ? 'badge-dark' : 'badge-secondary' }}">
                                    {{ $data->sip_doctor == 'DU' ? 'Dokter Umum' : 'Dokter Spesialis' }}
                                </div>
                                <br>
                                <span class="font-weight-bold">Tanggal SIP {{ date('d-m-Y', strtotime($data->letter_date)) }}</span>
                                <br>
                                <span class="font-weight-bold">Masa Berlaku {{ date('d-m-Y', strtotime($data->sip_periode)) }}</span>
                            </div>

                            <div class="col-md-4 form-group">
                                <label class="font-weight-bold">TUJUAN</label>
                                <br>
                                @if ($data->letter_reason == "mendapatkan")
                                <div class="badge badge-info">Mengajukan</div>
                                @elseif ($data->letter_reason == "memperpanjang")
                                <div class="badge badge-danger">Memperpanjang</div>
                                @elseif ($data->letter_reason == "memperbaharui")
                                <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