FORMULIR REKOMENDASI
TIPE PERMOHONAN **
Pilih Permohonan
@foreach($form as $item)
{{ $item->code }} ( {{ $item->desc }} )
@endforeach
@error('application_type') {{ $message }} @enderror
ALAMAT RUMAH (KTP) **
@error('home_address') {{ $message }} @enderror
PROVINSI **
Pilih Provinsi
@php
$province = \App\Models\Provinces::where('id', $data->home_province)->first();
@endphp
@if($province)
home_province == $province->id ? "selected" : "" }} value="{{ $province->id }}">{{ $province->name }}
@endif
@error('home_province') {{ $message }} @enderror
KABUPATEN / KOTA **
Pilih Kabupaten / Kota
@php
$regency = \App\Models\Regencies::where('id', $data->home_regency)->first();
@endphp
@if ($regency)
home_regency == $regency->id ? "selected" : "" }} value="{{ $regency->id }}">{{ $regency->name }}
@endif
@error('home_regency') {{ $message }} @enderror
KECAMATAN **
Pilih Kecamatan
@php
$district = \App\Models\Districts::where('id', $data->home_subdistrict)->first();
@endphp
@if ($district)
home_subdistrict == $district->id ? "selected" : "" }} value="{{ $district->id }}">{{ $district->name }}
@endif
@error('home_district') {{ $message }} @enderror
DESA / KELURAHAN **
Pilih Desa / Kelurahan
@php
$village = \App\Models\Villages::where('id', $data->home_village)->first();
@endphp
@if ($village)
home_village == $village->id ? "selected" : "" }} value="{{ $village->id }}">{{ $village->name }}
@endif
@error('home_village') {{ $message }} @enderror
ALAMAT DOMISILI **
@error('residence_address') {{ $message }} @enderror
PROVINSI **
Pilih Provinsi
@php
$residence_province = \App\Models\Provinces::where('id', $data->residence_province)->first();
@endphp
@if($residence_province)
residence_province == $residence_province->id ? "selected" : "" }} value="{{ $residence_province->id }}">{{ $residence_province->name }}
@endif
@error('residence_province') {{ $message }} @enderror
KABUPATEN / KOTA **
Pilih Kabupaten / Kota
@php
$residence_regency = \App\Models\Regencies::where('id', $data->residence_regency)->first();
@endphp
@if ($residence_regency)
residence_regency == $residence_regency->id ? "selected" : "" }} value="{{ $residence_regency->id }}">{{ $residence_regency->name }}
@endif
@error('residence_regency') {{ $message }} @enderror
KECAMATAN **
Pilih Kecamatan
@php
$residence_district = \App\Models\Districts::where('id', $data->residence_subdistrict)->first();
@endphp
@if ($residence_district)
residence_subdistrict == $residence_district->id ? "selected" : "" }} value="{{ $residence_district->id }}">{{ $residence_district->name }}
@endif
@error('residence_district') {{ $message }} @enderror
DESA / KELURAHAN **
Pilih Desa / Kelurahan
@php
$residence_village = \App\Models\Villages::where('id', $data->residence_village)->first();
@endphp
@if ($residence_village)
residence_village == $residence_village->id ? "selected" : "" }} value="{{ $residence_village->id }}">{{ $residence_village->name }}
@endif
@error('residence_village') {{ $message }} @enderror
@if ($data->academic_degree_a == null || $data->institution_a == null)
Perhatian! Data Pendidikan Terakhir belum dilengkapi klik Ubah Data untuk merubah.
×
@endif
JENIS PENDIDIKAN **
Pilih Jenis Pendidikan
@php
$academic_degree_a = \App\Models\Academic::where('id', $data->academic_degree_a)->first();
@endphp
@if ($academic_degree_a)
academic_degree_a == $academic_degree_a->id ? "selected" : "" }} value="{{ $academic_degree_a->id }}">{{ $academic_degree_a->name }}
@endif
@error('academic_degree_a') {{ $message }} @enderror
NAMA INSTITUSI PENDIDIKAN **
Pilih Institusi Pendidikan
@php
$institution_a = \App\Models\Education::where('id', $data->institution_a)->first();
@endphp
@if ($institution_a)
institution_a == $institution_a->id ? "selected" : "" }} value="{{ $institution_a->id }}">{{ $institution_a->name }}
@endif
@error('institution_a') {{ $message }} @enderror
JENIS PENDIDIKAN
Pilih Jenis Pendidikan
@php
$academic_degree_b = \App\Models\Academic::where('id', $data->academic_degree_b)->first();
@endphp
@if ($academic_degree_b)
academic_degree_b == $academic_degree_b->id ? "selected" : "" }} value="{{ $academic_degree_b->id }}">{{ $academic_degree_b->name }}
@endif
@error('academic_degree_b') {{ $message }} @enderror
NAMA INSTITUSI PENDIDIKAN
Pilih Institusi Pendidikan
@php
$institution_b = \App\Models\Education::where('id', $data->institution_b)->first();
@endphp
@if ($institution_b)
institution_b == $institution_b->id ? "selected" : "" }} value="{{ $institution_b->id }}">{{ $institution_b->name }}
@endif
@error('institution_b') {{ $message }} @enderror
JENIS PENDIDIKAN
Pilih Jenis Pendidikan
@php
$academic_degree_c = \App\Models\Academic::where('id', $data->academic_degree_c)->first();
@endphp
@if ($academic_degree_c)
academic_degree_c == $academic_degree_c->id ? "selected" : "" }} value="{{ $academic_degree_c->id }}">{{ $academic_degree_c->name }}
@endif
@error('academic_degree_c') {{ $message }} @enderror
NAMA INSTITUSI PENDIDIKAN
Pilih Institusi Pendidikan
@php
$institution_c = \App\Models\Education::where('id', $data->institution_c)->first();
@endphp
@if ($institution_c)
institution_c == $institution_c->id ? "selected" : "" }} value="{{ $institution_c->id }}">{{ $institution_c->name }}
@endif
@error('institution_c') {{ $message }} @enderror
Tempat Bekerja
STATUS KEPEGAWAIAN
Pilih Status Kepegawaian
employment_status == "DOKTER PNS" ? "selected" : "" }} value="DOKTER PNS">Dokter PNS
employment_status == "TKK" ? "selected" : "" }} value="TKK">TKK
employment_status == "THL" ? "selected" : "" }} value="THL">THL
employment_status == "HONOR" ? "selected" : "" }} value="HONOR">Honor
employment_status == "BUMN" ? "selected" : "" }} value="BUMN">BUMN
employment_status == "TNI" ? "selected" : "" }} value="TNI">TNI
employment_status == "POLRI" ? "selected" : "" }} value="POLRI">POLRI
employment_status == "SWASTA" ? "selected" : "" }} value="SWASTA">Swasta
employment_status == "NON PEGAWAI" ? "selected" : "" }} value="NON PEGAWAI">Non Pegawai
@error('employment_status') {{ $message }} @enderror
WAKTU BEKERJA
Pilih Waktu Pekerja
time_type == "PURNA WAKTU" ? "selected" : "" }} value="PURNA WAKTU">Purna Waktu
time_type == "FULL TIMER" ? "selected" : "" }} value="FULL TIMER">Full Timer
@error('time_type') {{ $message }} @enderror
TEMPAT PRAKTEK
@error('hospital') {{ $message }} @enderror
Praktek Pribadi
TEMPAT PRAKTEK
@error('private_practice') {{ $message }} @enderror
ALAMAT PRAKTEK
@error('private_practice_address') {{ $message }} @enderror
PROVINSI
Pilih Provinsi
@php
$private_practice_province = \App\Models\Provinces::where('id', $data->private_practice_province)->first();
@endphp
@if($private_practice_province)
private_practice_province == $private_practice_province->id ? "selected" : "" }} value="{{ $private_practice_province->id }}">{{ $private_practice_province->name }}
@endif
@error('private_practice_province') {{ $message }} @enderror
KABUPATEN / KOTA
Pilih Kabupaten / Kota
@php
$private_practice_regency = \App\Models\Regencies::where('id', $data->private_practice_regency)->first();
@endphp
@if($private_practice_regency)
private_practice_regency == $private_practice_regency->id ? "selected" : "" }} value="{{ $private_practice_regency->id }}">{{ $private_practice_regency->name }}
@endif
@error('private_practice_regency') {{ $message }} @enderror
KECAMATAN
Pilih Kecamatan
@php
$private_practice_district = \App\Models\Districts::where('id', $data->private_practice_subdistrict)->first();
@endphp
@if($private_practice_district)
private_practice_subdistrict == $private_practice_district->id ? "selected" : "" }} value="{{ $private_practice_district->id }}">{{ $private_practice_district->name }}
@endif
@error('private_practice_district') {{ $message }} @enderror
DESA / KELURAHAN
Pilih Desa / Kelurahan
@php
$private_practice_village = \App\Models\Villages::where('id', $data->private_practice_village)->first();
@endphp
@if($private_practice_village)
private_practice_village == $private_practice_village->id ? "selected" : "" }} value="{{ $private_practice_village->id }}">{{ $private_practice_village->name }}
@endif
@error('private_practice_village') {{ $message }} @enderror
@if ($data->central_idi_npa == null)
Perhatian! Data Keanggotaan belum dilengkapi klik Ubah Data untuk merubah.
×
@endif
Lanjut