@extends('layouts.panel.app', ['title' => 'Revisi Pengajuan'])

@section('content')
<script src="https://code.jquery.com/jquery-3.6.0.min.js"></script>
<section class="section">
    <div class="section-title">
        <h3>Pengajuan Keanggotaan</h3>
    </div>
    <p class="section-lead">
        Silahkan revisi data pengajuan di sini.
    </p>
    <div class="row">
        <div class="col-md-12">
            <div class="card border-0 shadow rounded">
                <div class="card-header">
                    <h4>Revisi Pengajuan</h4>
                    <div class="card-header-action">
                        <a href="{{ route('non-anggota.form') }}" class="btn btn-success">Kembali</a>
                    </div>
                </div>
                <div class="card-body">
                    <!-- FORM PENGISIAN -->
                    <div>
                        @php
                        $history = \App\Models\FormTrnHistory::where([
                        'form_status' => "R",
                        'form_id' => $application->id,
                        'user_id' => $application->user_id
                        ])->orderBy('ordering', 'desc')->first()
                        @endphp

                        @if($history != null)
                        <div class="alert alert-warning text-dark">
                            <i class="fa fa-exclamation-triangle"></i> Informasi perubahan data
                            <p class="text-white">{!!html_entity_decode($history->note)!!}</p>
                            </a>
                        </div>
                        @endif

                        Catatan : <span style="color: red;"> **</span>) Wajib diisi
                        <div class="text-center">
                                                        <!-- progressbar -->
                            <ul class="progressbar">
                                <li class="{{ $currentStep != 1 ? '' : 'active' }}"><a href="#step-1" type="button">Lembar Persetujuan</a></li>
                                <li class="{{ $currentStep != 2 ? '' : 'active' }}"><a href="#step-2" type="button">Data Pemohon</a></li>
                                <li class="{{ $currentStep != 3 ? '' : 'active' }}"><a href="#step-3" type="button">Unggah Dokumen</a></li>
                                <li class="{{ $currentStep != 4 ? '' : 'active' }}"><a href="#step-4" type="button" disabled="disabled">Data Verifikasi</a></li>
                            </ul>
                        </div>

                        <form class="form-keanggotaan-edit" method="POST">
                            @csrf
                            @method('POST')

                            <!-- LEMBAR PERSETUJUAN -->
                            <div class="row setup-content {{ $currentStep != 1 ? 'displayNone' : '' }}" id="step-1">
                                <div class="col-md-12">
                                    <hr>
                                    <h1 class="text-center">Persetujuan Anggota Ikatan Dokter Indonesia</h1>
                                    <hr>
                                    <h5>Lembar Persetujuan</h5>
                                    <p>Sebelum melakukan aktivitas dengan data anda, Kami sarankan anda membaca dan menyetujui ketentuan di bawah ini:</p>
                                    <ol>
                                        @php
                                        $label = \App\Models\Label::where(['code' => 'disclaimer-appl' ])->first()
                                        @endphp
                                        {!!html_entity_decode($label->desc)!!}
                                    </ol>
                                    <hr>
                                    <div>
                                        <label>
                                            <input type="radio" name="persetujuan" value="setuju" required>
                                            Saya telah membaca seluruh ketentuan di atas dan menyetujuinya.
                                        </label>
                                    </div>
                                    <div>
                                        <label>
                                            <input type="radio" name="persetujuan" value="tidak">
                                            Saya tidak setuju
                                        </label>
                                    </div>
                                    <div>
                                        <button type="button" class="btn btn-primary disclaimerBtn">Mulai Sekarang <i class="fa fa-arrow-right"></i></button>
                                    </div>
                                </div>
                            </div>

                            <!-- DATA PEMOHON -->
                            <div class="row setup-content {{ $currentStep != 2 ? 'displayNone' : '' }}" id="step-2">
                                <div id="loading" style="display: none;">
                                    <img src="{{ asset('assets-panel/img/loading-submit.gif') }}" alt="Loading...">
                                </div>
                                <div class="col-md-12">
                                    <div class="text-center">
                                        <h3> FORMULIR KEANGGOTAAN</h3>
                                        <div class="col-md-12 form-group">
                                            <label class="font-weight-bold" for="application_type">TIPE PERMOHONAN <span style="color: red;"> **</span></label>
                                            <select id="application_type" class="form-control" name="application_type" required>
                                                <!-- <option value="">Pilih Permohonan</option> -->
                                                @foreach($form as $item)
                                                <option {{ $application->application_type == $item->code ? "selected" : "" }} value="{{ $item->code }}"><b>{{ $item->code }}</b> ( {{ $item->desc }} ) </option>
                                                @endforeach
                                            </select>
                                            @error('application_type') <span class="error text-danger">{{ $message }}</span> @enderror
                                        </div>
                                    </div>
                                    <hr>
                                    <!-- DATA DIRI -->
                                    <div>
                                        <div class="row justify-content-md-left">
                                            <div class="col-4">
                                                <h3> Identitas Diri</h3>
                                            </div>
                                        </div>
                                        <hr>
                                        <div class="alert alert-info alert-has-icon">
                                            @php
                                            $label = \App\Models\Label::where(['code' => 'info-degree' ])->first()
                                            @endphp
                                            <div class="alert-icon"><i class="far fa-lightbulb"></i></div>
                                            <div class="alert-body">
                                                <div class="alert-title"><strong> {!!html_entity_decode($label->title)!!}</strong></div>
                                                {!!html_entity_decode($label->desc)!!}
                                            </div>
                                        </div>
                                        <div class="row">
                                            <div class="col-md-2 form-group">
                                                <label class="font-weight-bold">GELAR DEPAN</label>
                                                <input type="text" name="front_degree" class="form-control" value="{{$application->front_degree}}">
                                                @error('front_degree') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-8 form-group">
                                                <label class="font-weight-bold">NAMA LENGKAP PEMOHON <span style="color: red;"> **</span></label>
                                                <input type="text" name="name" class="form-control" value="{{$application->name}}" required>
                                                @error('name') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-2 form-group">
                                                <label class="font-weight-bold">GELAR BELAKANG</label>
                                                <input type="text" name="back_degree" class="form-control" value="{{$application->back_degree}}">
                                                @error('back_degree') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                        </div>
                                        <div class="row">
                                            <div class="col-md-4 form-group">
                                                <label class="font-weight-bold">WARGA NEGARA <span style="color: red;"> **</span></label>
                                                <select class="form-control" name="citizen" placeholder="Pilih Warga Negara" required>
                                                    <option value="">Pilih Warga Negara</option>
                                                    <option value="WNI" {{{ $data->citizen == 'WNI' ? "selected" : "" }}}>Indonesia</option>
                                                    <option value="WNA" {{{ $data->citizen == 'WNA' ? "selected" : "" }}}>Asing</option>
                                                </select> @error('citizen') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-4 form-group">
                                                <label class="font-weight-bold" for="gender">JENIS KELAMIN <span style="color: red;"> **</span></label><br />
                                                <label class="radio-inline"><input type="radio" name="gender" value="L" {{{ $application->gender == 'L' ? "checked" : "" }}} required> LAKI-LAKI</label>
                                                <label class="radio-inline"><input type="radio" name="gender" value="P" {{{ $application->gender == 'P' ? "checked" : "" }}}> PEREMPUAN</label>
                                                @error('gender') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-4 form-group">
                                                <label class="font-weight-bold">AGAMA <span style="color: red;"> **</span></label>
                                                <select class="form-control" name="religion" placeholder="Pilih Agama" required>
                                                    <option value="">Pilih Agama</option>
                                                    <option value="ISLAM" {{{ $data->religion == 'ISLAM' ? "selected" : "" }}}>Islam</option>
                                                    <option value="KRISTEN" {{{ $data->religion == 'KRISTEN' ? "selected" : "" }}}>Kristen</option>
                                                    <option value="KATOLIK" {{{ $data->religion == 'KATOLIK' ? "selected" : "" }}}>Katolik</option>
                                                    <option value="HINDU" {{{ $data->religion == 'HINDU' ? "selected" : "" }}}>Hindu</option>
                                                    <option value="BUDHA" {{{ $data->religion == 'BUDHA' ? "selected" : "" }}}>Budha</option>
                                                    <option value="KONGHUCU" {{{ $data->religion == 'KONGHUCU' ? "selected" : "" }}}>Konghucu</option>
                                                    <option value="LAINNYA" {{{ $data->religion == 'LAINNYA' ? "selected" : "" }}}>Lainnya</option>
                                                </select> @error('religion') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                        </div>
                                        <div class="row">
                                            <div class="col-md-8 form-group">
                                                <label class="font-weight-bold">TEMPAT LAHIR <span style="color: red;"> **</span></label>
                                                <input type="text" name="place" class="form-control" value="{{$application->place}}" required>
                                                @error('place') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-4 form-group">
                                                <label class="font-weight-bold">TANGGAL LAHIR <span style="color: red;"> **</span></label>
                                                <input type="date" name="birth_date" class="form-control" value="{{$application->birth_date}}" required>
                                                @error('birth_date') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                        </div>
                                        <div class="row">
                                            <div class="col-md-12 form-group">
                                                <label class="font-weight-bold">ALAMAT RUMAH (KTP) <span style="color: red;"> **</span></label>
                                                <input type="text" name="home_address" class="form-control" value="{{$application->home_address}}" required>
                                                @error('home_address') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-6 form-group">
                                                <label class="font-weight-bold">PROVINSI <span style="color: red;"> **</span></label>
                                                <select class="form-control" id="home_province" name="home_province" placeholder="Pilih provinsi">
                                                    <option value=""> Pilih Provinsi</option>
                                                    @foreach($provinces as $item)
                                                    <option {{ $data->home_province == $item->id ? "selected" : "" }} value="{{ $item->id }}">{{ $item->name }}</option>
                                                    @endforeach
                                                    <!-- @php
                                                    $province = \App\Models\Provinces::where('id', $application->home_province)->first();
                                                    @endphp
                                                    @if($province)
                                                    <option {{ $application->home_province == $province->id ? "selected" : "" }} value="{{ $province->id }}">{{ $province->name }}</option>
                                                    @endif -->
                                                </select>
                                                @error('home_province') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-6 form-group">
                                                <label class="font-weight-bold">KABUPATEN / KOTA <span style="color: red;"> **</span></label>
                                                <select class="form-control" id="home_regency" name="home_regency" placeholder="Pilih kabupaten /kota">
                                                    <option value="">Pilih Kabupaten / Kota</option>
                                                    @php
                                                    $regency = \App\Models\Regencies::where('id', $application->home_regency)->first();
                                                    @endphp
                                                    @if ($regency)
                                                    <option {{ $application->home_regency == $regency->id ? "selected" : "" }} value="{{ $regency->id }}">{{ $regency->name }}</option>
                                                    @endif
                                                </select>
                                                @error('home_regency') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-6 form-group">
                                                <label class="font-weight-bold">KECAMATAN <span style="color: red;"> **</span></label>
                                                <select class="form-control" id="home_district" name="home_district" placeholder="Pilih kecamatan">
                                                    <option value="">Pilih Kecamatan</option>
                                                    @php
                                                    $district = \App\Models\Districts::where('id', $application->home_district)->first();
                                                    @endphp
                                                    @if ($district)
                                                    <option {{ $application->home_district == $district->id ? "selected" : "" }} value="{{ $district->id }}">{{ $district->name }}</option>
                                                    @endif
                                                </select>
                                                @error('home_district') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-6 form-group">
                                                <label class="font-weight-bold">DESA / KELURAHAN <span style="color: red;"> **</span></label>
                                                <select class="form-control" id="home_village" name="home_village" placeholder="Pilih desa / kelurahan">
                                                    <option value="">Pilih Desa / Kelurahan</option>
                                                    @php
                                                    $village = \App\Models\Villages::where('id', $application->home_village)->first();
                                                    @endphp
                                                    @if ($village)
                                                    <option {{ $application->home_village == $village->id ? "selected" : "" }} value="{{ $village->id }}">{{ $village->name }}</option>
                                                    @endif
                                                </select>
                                                @error('home_village') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                        </div>
                                        <div class="row">
                                            <div class="col-md-12 form-group">
                                                <label class="font-weight-bold">ALAMAT DOMISILI <span style="color: red;"> **</span>
                                                </label>
                                                <input type="text" name="residence_address" class="form-control" value="{{$application->residence_address}}" required>
                                                @error('residence_address') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-6 form-group">
                                                <label class="font-weight-bold">PROVINSI <span style="color: red;"> **</span></label>
                                                <select class="form-control" id="residence_province" name="residence_province" placeholder="Pilih provinsi">
                                                    <option value="">Pilih Provinsi</option>
                                                    @foreach($provinces as $item)
                                                    <option {{ $data->home_province == $item->id ? "selected" : "" }} value="{{ $item->id }}">{{ $item->name }}</option>
                                                    @endforeach
                                                    <!-- @php
                                                    $residence_province = \App\Models\Provinces::where('id', $application->residence_province)->first();
                                                    @endphp
                                                    @if($residence_province)
                                                    <option {{ $application->residence_province == $residence_province->id ? "selected" : "" }} value="{{ $residence_province->id }}">{{ $residence_province->name }}</option>
                                                    @endif -->
                                                </select>
                                                @error('residence_province') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-6 form-group">
                                                <label class="font-weight-bold">KABUPATEN / KOTA <span style="color: red;"> **</span></label>
                                                <select class="form-control" id="residence_regency" name="residence_regency" placeholder="Pilih kabupaten /kota">
                                                    <option value="">Pilih Kabupaten / Kota</option>
                                                    @php
                                                    $residence_regency = \App\Models\Regencies::where('id', $application->residence_regency)->first();
                                                    @endphp
                                                    @if ($residence_regency)
                                                    <option {{ $application->residence_regency == $residence_regency->id ? "selected" : "" }} value="{{ $residence_regency->id }}">{{ $residence_regency->name }}</option>
                                                    @endif
                                                </select>
                                                @error('residence_regency') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-6 form-group">
                                                <label class="font-weight-bold">KECAMATAN <span style="color: red;"> **</span></label>
                                                <select class="form-control" id="residence_district" name="residence_district" placeholder="Pilih kecamatan">
                                                    <option value="">Pilih Kecamatan</option>
                                                    @php
                                                    $residence_district = \App\Models\Districts::where('id', $application->residence_district)->first();
                                                    @endphp
                                                    @if ($residence_district)
                                                    <option {{ $application->residence_district == $residence_district->id ? "selected" : "" }} value="{{ $residence_district->id }}">{{ $residence_district->name }}</option>
                                                    @endif
                                                </select>
                                                @error('residence_district') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-6 form-group">
                                                <label class="font-weight-bold">DESA / KELURAHAN <span style="color: red;"> **</span></label>
                                                <select class="form-control" id="residence_village" name="residence_village" placeholder="Pilih desa / kelurahan">
                                                    <option value="">Pilih Desa / Kelurahan</option>
                                                    @php
                                                    $residence_village = \App\Models\Villages::where('id', $application->residence_village)->first();
                                                    @endphp
                                                    @if ($residence_village)
                                                    <option {{ $application->residence_village == $residence_village->id ? "selected" : "" }} value="{{ $residence_village->id }}">{{ $residence_village->name }}</option>
                                                    @endif
                                                </select>
                                                @error('residence_village') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                        </div>
                                        <div class="row">
                                            <div class="col-md-3 form-group">
                                                <label class="font-weight-bold">EMAIL <span style="color: red;"> **</span></label>
                                                <input type="email" name="email" class="form-control" value="{{$application->email}}" required>
                                                @error('email') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-3 form-group">
                                                <label class="font-weight-bold">TELEPON <span style="color: red;"> **</span></label>
                                                <input type="number" name="phone" class="form-control" value="{{$application->phone}}" required>
                                                @error('phone') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-3 form-group">
                                                <label class="font-weight-bold" for="description">STATUS PERKAWINAN </label><br />
                                                <label class="radio-inline"><input type="radio" name="marital_status" value="true" {{{ $application->marital_status == 'true' ? "checked" : "" }}}> Kawin</label>
                                                <label class="radio-inline"><input type="radio" name="marital_status" value="false" {{{ $application->marital_status == 'false' ? "checked" : "" }}}> Belum Kawin</label>
                                                @error('marital_status') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-3 form-group">
                                                <label class="font-weight-bold">NAMA SUAMI / ISTRI</label>
                                                <input type="text" name="husband_wife_name" class="form-control" value="{{$application->husband_wife_name}}">
                                                @error('husband_wife_name') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                        </div>
                                    </div>
                                    <hr>
                                    <!-- DATA PENDIDIKAN -->
                                    <div>
                                        <div class="row justify-content-md-left">
                                            <div class="col-4">
                                                <h3> Pendidikan</h3>
                                            </div>
                                        </div>
                                        <hr>
                                        @if ($application->academic_degree_a == null || $application->institution_a == null)
                                        <div class="alert alert-danger alert-dismissible fade show" role="alert">
                                            <strong>Perhatian!</strong> Data Pendidikan Terakhir belum dilengkapi klik Ubah Data untuk merubah.
                                            <button type="button" class="close" data-dismiss="alert" aria-label="Close">
                                                <span aria-hidden="true">&times;</span>
                                            </button>
                                        </div>
                                        @endif
                                        <div class="card">
                                            <div class="card-header">
                                                <h4>Pendidikan Terakhir</h4>
                                                <div class="card-header-action">
                                                    <a data-collapse="#mycard-collapse1" class="btn btn-icon btn-info" href="#"><i class="fas fa-minus"></i></a>
                                                </div>
                                            </div>
                                            <div class=" collapse show" id="mycard-collapse1" style="">
                                                <div class="card-body">
                                                    <div class="row">
                                                        <div class="col-md-4 form-group">
                                                            <label class="font-weight-bold">JENIS PENDIDIKAN <span style="color: red;"> **</span></label>
                                                            <select class="form-control" id="academic_degree_a" name="academic_degree_a">
                                                                <option value="">Pilih Jenis Pendidikan</option>
                                                                @foreach($education as $item)
                                                                <option {{ $data->academic_degree_a == $item->id ? "selected" : "" }} value="{{ $item->id }}">{{ $item->name }}</option>
                                                                @endforeach
                                                                <!-- @php
                                                                $academic_degree_a = \App\Models\Academic::where('id', $application->academic_degree_a)->first();
                                                                @endphp
                                                                @if ($academic_degree_a)
                                                                <option {{ $application->academic_degree_a == $academic_degree_a->id ? "selected" : "" }} value="{{ $academic_degree_a->id }}">{{ $academic_degree_a->name }}</option>
                                                                @endif -->
                                                            </select>
                                                            @error('academic_degree_a') <span class="error text-danger">{{ $message }}</span> @enderror
                                                        </div>
                                                        <div class="col-md-8 form-group">
                                                            <label class="font-weight-bold">NAMA INSTITUSI PENDIDIKAN <span style="color: red;"> **</span></label>
                                                            <select class="form-control select2" id="institution_a" name="institution_a" placeholder="Pilih Institusi Pendidikan">
                                                                <option value="">Pilih Institusi Pendidikan</option>
                                                                @foreach($university as $item)
                                                                <option {{ $data->institution_a == $item->id ? "selected" : "" }} value="{{ $item->id }}">{{ $item->name }}</option>
                                                                @endforeach
                                                                <!-- @php
                                                                $institution_a = \App\Models\Education::where('id', $application->institution_a)->first();
                                                                @endphp
                                                                @if ($institution_a)
                                                                <option {{ $application->institution_a == $institution_a->id ? "selected" : "" }} value="{{ $institution_a->id }}">{{ $institution_a->name }}</option>
                                                                @endif -->
                                                            </select>
                                                            @error('institution_a') <span class="error text-danger">{{ $message }}</span> @enderror
                                                        </div>
                                                    </div>
                                                    <div class="row">
                                                        <div class="col-md-4 form-group">
                                                            <label class="font-weight-bold">TANGGAL IJAZAH <span style="color: red;"> **</span></label>
                                                            <input type="date" name="graduation_year_a" class="form-control" value="{{$application->graduation_year_a}}" required>
                                                            @error('graduation_year_a') <span class="error text-danger">{{ $message }}</span> @enderror
                                                        </div>
                                                        <div class="col-md-8 form-group">
                                                            <label class="font-weight-bold">NOMOR IJAZAH <span style="color: red;"> **</span></label>
                                                            <input type="text" name="ijazah_no_a" class="form-control" value="{{$application->ijazah_no_a}}" required>
                                                            @error('ijazah_no_a') <span class="error text-danger">{{ $message }}</span> @enderror
                                                        </div>
                                                    </div>
                                                </div>
                                            </div>
                                        </div>
                                        <div class="card">
                                            <div class="card-header">
                                                <h4>Pendidikan Lainnya</h4>
                                                <div class="card-header-action">
                                                    <a data-collapse="#mycard-collapse2" class="btn btn-icon btn-info" href="#"><i class="fas fa-plus"></i></a>
                                                </div>
                                            </div>
                                            <div class="collapse show" id="mycard-collapse2" style="">
                                                <div class="card-body">
                                                    <div class="row">
                                                        <div class="col-md-4 form-group">
                                                            <label class="font-weight-bold">JENIS PENDIDIKAN </label>
                                                            <select class="form-control" id="academic_degree_b" name="academic_degree_b">
                                                                <option value="">Pilih Jenis Pendidikan</option>
                                                                @foreach($education as $item)
                                                                <option {{ $application->academic_degree_b == $item->id ? "selected" : "" }} value="{{ $item->id }}">{{ $item->name }}</option>
                                                                @endforeach
                                                            </select>
                                                            @error('academic_degree_b') <span class="error text-danger">{{ $message }}</span> @enderror
                                                        </div>
                                                        <div class="col-md-8 form-group">
                                                            <label class="font-weight-bold">NAMA INSTITUSI PENDIDIKAN </label>
                                                            <select class="form-control select2" id="institution_b" name="institution_b" placeholder="Pilih Institusi Pendidikan">
                                                                <option value="">Pilih Institusi Pendidikan</option>
                                                                @foreach($university as $item)
                                                                <option {{ $application->institution_b == $item->id ? "selected" : "" }} value="{{ $item->id }}">{{ $item->name }}</option>
                                                                @endforeach
                                                            </select>
                                                            @error('institution_b') <span class="error text-danger">{{ $message }}</span> @enderror
                                                        </div>
                                                    </div>
                                                    <div class="row">
                                                        <div class="col-md-4 form-group">
                                                            <label class="font-weight-bold">TANGGAL IJAZAH </label>
                                                            <input type="date" name="graduation_year_b" value="{{$application->graduation_year_b}}" class="form-control">
                                                            @error('graduation_year_b') <span class="error text-danger">{{ $message }}</span> @enderror
                                                        </div>
                                                        <div class="col-md-8 form-group">
                                                            <label class="font-weight-bold">NOMOR IJAZAH </label>
                                                            <input type="text" name="ijazah_no_b" value="{{$application->ijazah_no_b}}" class="form-control">
                                                            @error('ijazah_no_b') <span class="error text-danger">{{ $message }}</span> @enderror
                                                        </div>
                                                    </div>
                                                </div>
                                            </div>
                                        </div>
                                        <div class="card">
                                            <div class="card-header">
                                                <h4>Pendidikan Lainnya</h4>
                                                <div class="card-header-action">
                                                    <a data-collapse="#mycard-collapse3" class="btn btn-icon btn-info" href="#"><i class="fas fa-plus"></i></a>
                                                </div>
                                            </div>
                                            <div class="collapse show" id="mycard-collapse3" style="">
                                                <div class="card-body">
                                                    <div class="row">
                                                        <div class="col-md-4 form-group">
                                                            <label class="font-weight-bold">JENIS PENDIDIKAN </label>
                                                            <select class="form-control" id="academic_degree_c" name="academic_degree_c">
                                                                <option value="">Pilih Jenis Pendidikan</option>
                                                                @foreach($education as $item)
                                                                <option {{ $application->academic_degree_c == $item->id ? "selected" : "" }} value="{{ $item->id }}">{{ $item->name }}</option>
                                                                @endforeach
                                                            </select>
                                                            @error('academic_degree_c') <span class="error text-danger">{{ $message }}</span> @enderror
                                                        </div>
                                                        <div class="col-md-8 form-group">
                                                            <label class="font-weight-bold">NAMA INSTITUSI PENDIDIKAN </label>
                                                            <select class="form-control select2" id="institution_c" name="institution_c" placeholder="Pilih Institusi Pendidikan">
                                                                <option value="">Pilih Institusi Pendidikan</option>
                                                                @foreach($university as $item)
                                                                <option {{ $application->institution_c == $item->id ? "selected" : "" }} value="{{ $item->id }}">{{ $item->name }}</option>
                                                                @endforeach
                                                            </select>
                                                            @error('institution_c') <span class="error text-danger">{{ $message }}</span> @enderror
                                                        </div>
                                                    </div>
                                                    <div class="row">
                                                        <div class="col-md-4 form-group">
                                                            <label class="font-weight-bold">TANGGAL IJAZAH </label>
                                                            <input type="date" name="graduation_year_c" value="{{$application->graduation_year_c}}" class="form-control">
                                                            @error('graduation_year_c') <span class="error text-danger">{{ $message }}</span> @enderror
                                                        </div>
                                                        <div class="col-md-8 form-group">
                                                            <label class="font-weight-bold">NOMOR IJAZAH </label>
                                                            <input type="text" name="ijazah_no_c" value="{{$application->ijazah_no_c}}" class="form-control">
                                                            @error('ijazah_no_c') <span class="error text-danger">{{ $message }}</span> @enderror
                                                        </div>
                                                    </div>
                                                </div>
                                            </div>
                                        </div>
                                        <hr>
                                        <div class="row">
                                            <div class="col-md-4 form-group">
                                                <label class="font-weight-bold">NO IJAZAH DU <span style="color: red;"> **</span></label>
                                                <input type="text" name="ijazah_du" class="form-control" value="{{$application->ijazah_du}}" required>
                                                @error('ijazah_du') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-2 form-group">
                                                <label class="font-weight-bold">TGL IJAZAH DU <span style="color: red;"> **</span></label>
                                                <input type="date" name="ijazah_du_year" class="form-control" value="{{$application->ijazah_du_year}}" required>
                                                @error('ijazah_du_year') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-4 form-group">
                                                <label class="font-weight-bold">NO IJAZAH SP</label>
                                                <input type="text" name="ijazah_sp" class="form-control" value="{{$application->ijazah_sp}}">
                                                @error('ijazah_sp') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-2 form-group">
                                                <label class="font-weight-bold">TGL IJAZAH SP</label>
                                                <input type="date" name="ijazah_sp_year" class="form-control" value="{{$application->ijazah_sp_year}}">
                                                @error('ijazah_sp_year') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                        </div>
                                        <div class="row">
                                            <div class="col-md-4 form-group">
                                                <label class="font-weight-bold">SPESIALIS</label>
                                                <!-- <input type="text" name="specialist" class="form-control" value="{{$application->specialist}}"> -->
                                                <select class="form-control select2" id="specialist" name="specialist">
                                                    <option value="">Pilih Spesialis</option>
                                                    @foreach($specialist as $item)
                                                    <option {{ $application->specialist == $item->specialist ? "selected" : "" }} value="{{ $item->specialist }}">{{ $item->specialist }}</option>
                                                    @endforeach
                                                </select>
                                                @error('specialist') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-2 form-group">
                                                <label class="font-weight-bold" for="description">SPESIALIS KONSULTAN</label><br />
                                                <label class="radio-inline"><input type="radio" name="consultant_specialist" value="true" {{{ $application->consultant_specialist == 'true' ? "checked" : "" }}} disabled> YA</label>
                                                <label class="radio-inline"><input type="radio" name="consultant_specialist" value="false" {{{ $application->consultant_specialist == 'false' ? "checked" : "" }}} disabled> TIDAK</label>
                                                @error('consultant_specialist') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-4 form-group">
                                                <label class="font-weight-bold">NO IJAZAH DOKTOR</label>
                                                <input type="text" name="ijazah_doktor" class="form-control" value="{{$application->ijazah_doktor}}">
                                                @error('ijazah_doktor') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-2 form-group">
                                                <label class="font-weight-bold">TGL IJAZAH DOKTOR</label>
                                                <input type="date" name="ijazah_doktor_year" class="form-control" value="{{$application->ijazah_doktor_year}}">
                                                @error('ijazah_doktor_year') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                        </div>

                                    </div>
                                    <hr>
                                    <!-- DATA PEKERJAAN -->
                                    <div>
                                        <div class="row justify-content-md-left">
                                            <div class="col-4">
                                                <h3> Pekerjaan</h3>
                                            </div>
                                        </div>
                                        <hr>
                                        <h5 class="text-primary"> Tempat Bekerja</h5>
                                        <div class="row">
                                            <div class="col-md-4 form-group">
                                                <label class="font-weight-bold">STATUS KEPEGAWAIAN</label>
                                                <select class="form-control" name="employment_status">
                                                    <option value="">Pilih Status Kepegawaian</option>
                                                    <option {{ $application->employment_status == "DOKTER PNS" ? "selected" : "" }} value="DOKTER PNS">Dokter PNS</option>
                                                    <option {{ $application->employment_status == "TKK" ? "selected" : "" }} value="TKK">TKK</option>
                                                    <option {{ $application->employment_status == "THL" ? "selected" : "" }} value="THL">THL</option>
                                                    <option {{ $application->employment_status == "HONOR" ? "selected" : "" }} value="HONOR">Honor</option>
                                                    <option {{ $application->employment_status == "BUMN" ? "selected" : "" }} value="BUMN">BUMN</option>
                                                    <option {{ $application->employment_status == "TNI" ? "selected" : "" }} value="TNI">TNI</option>
                                                    <option {{ $application->employment_status == "POLRI" ? "selected" : "" }} value="POLRI">POLRI</option>
                                                    <option {{ $application->employment_status == "SWASTA" ? "selected" : "" }} value="SWASTA">Swasta</option>
                                                    <option {{ $application->employment_status == "NON PEGAWAI" ? "selected" : "" }} value="NON PEGAWAI">Non Pegawai</option>
                                                </select>
                                                @error('employment_status') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-4 form-group">
                                                <label class="font-weight-bold">WAKTU BEKERJA</label>
                                                <select class="form-control" name="time_type">
                                                    <option value="">Pilih Waktu Pekerja</option>
                                                    <option {{ $application->time_type == "PURNA WAKTU" ? "selected" : "" }} value="PURNA WAKTU">Purna Waktu</option>
                                                    <option {{ $application->time_type == "FULL TIMER" ? "selected" : "" }} value="FULL TIMER">Full Timer</option>
                                                </select>
                                                @error('time_type') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-4 form-group">
                                                <label class="font-weight-bold">TEMPAT PRAKTEK</label>
                                                <input type="text" name="hospital" class="form-control" value="{{$application->hospital}}">
                                                @error('hospital') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                        </div>
                                        <div class="row">
                                            <div class="col-md-12 form-group">
                                                <label class="font-weight-bold">ALAMAT PRAKTEK</label>
                                                <input type="text" name="practice_address" class="form-control" value="{{$application->practice_address}}">
                                                @error('practice_address') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-6 form-group">
                                                <label class="font-weight-bold">PROVINSI </label>
                                                <select class="form-control" id="practice_province" name="practice_province" placeholder="Pilih provinsi">
                                                    <option value="">Pilih Provinsi</option>
                                                    @foreach($provinces as $item)
                                                    <option {{ $data->practice_province == $item->id ? "selected" : "" }} value="{{ $item->id }}">{{ $item->name }}</option>
                                                    @endforeach
                                                    <!-- @php
                                                $practice_province = \App\Models\Provinces::where('id', $data->practice_province)->first();
                                                @endphp
                                                @if($practice_province)
                                                <option {{ $data->practice_province == $practice_province->id ? "selected" : "" }} value="{{ $practice_province->id }}">{{ $practice_province->name }}</option>
                                                @endif -->
                                                </select>
                                                @error('practice_province') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-6 form-group">
                                                <label class="font-weight-bold">KABUPATEN / KOTA </label>
                                                <select class="form-control" id="practice_regency" name="practice_regency" placeholder="Pilih kabupaten /kota">
                                                    <option value="">Pilih Kabupaten / Kota</option>
                                                    @php
                                                    $practice_regency = \App\Models\Regencies::where('id', $application->practice_regency)->first();
                                                    @endphp
                                                    @if($practice_regency)
                                                    <option {{ $application->practice_regency == $practice_regency->id ? "selected" : "" }} value="{{ $practice_regency->id }}">{{ $practice_regency->name }}</option>
                                                    @endif
                                                </select>
                                                @error('practice_regency') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-6 form-group">
                                                <label class="font-weight-bold">KECAMATAN</label>
                                                <select class="form-control" id="practice_subdistrict" name="practice_subdistrict" placeholder="Pilih kecamatan">
                                                    <option value="">Pilih Kecamatan</option>
                                                    @php
                                                    $practice_subdistricts = \App\Models\Districts::where('id', $application->practice_subdistrict)->first();
                                                    @endphp
                                                    @if($practice_subdistricts)
                                                    <option {{ $application->practice_subdistrict == $practice_subdistricts->id ? "selected" : "" }} value="{{ $practice_subdistricts->id }}">{{ $practice_subdistricts->name }}</option>
                                                    @endif
                                                </select>
                                                @error('practice_subdistrict') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-6 form-group">
                                                <label class="font-weight-bold">DESA / KELURAHAN </label>
                                                <select class="form-control" id="practice_village" name="practice_village" placeholder="Pilih desa / kelurahan">
                                                    <option value="">Pilih Desa / Kelurahan</option>
                                                    @php
                                                    $practice_village = \App\Models\Villages::where('id', $application->practice_village)->first();
                                                    @endphp
                                                    @if($practice_village)
                                                    <option {{ $application->practice_village == $practice_village->id ? "selected" : "" }} value="{{ $practice_village->id }}">{{ $practice_village->name }}</option>
                                                    @endif
                                                </select>
                                                @error('practice_village') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-6 form-group">
                                                <label class="font-weight-bold">JABATAN</label>
                                                <!-- <input type="text" name="position" class="form-control" value="{{$application->position}}"> -->
                                                <select class="form-control" name="position">
                                                    <option value="">Pilih Jabatan</option>
                                                    <option value="DOKTER UMUM" {{{ $application->position == 'DOKTER UMUM' ? "selected" : "" }}}>DOKTER UMUM</option>
                                                    <option value="DOKTER SPESIALIS" {{{ $application->position == 'DOKTER SPESIALIS' ? "selected" : "" }}}>DOKTER SPESIALIS</option>
                                                </select>
                                                @error('position') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-6 form-group">
                                                <label class="font-weight-bold" for="description">GURU BESAR / PROFESSOR </label><br />
                                                <label class="radio-inline"><input type="radio" name="professor" value="true" {{{ $application->professor == 'true' ? "checked" : "" }}}> YA</label>
                                                <label class="radio-inline"><input type="radio" name="professor" value="false" {{{ $application->professor == 'false' ? "checked" : "" }}}> TIDAK</label>
                                                @error('professor') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                        </div>
                                        <h5 class="text-primary"> Praktek Pribadi</h5>
                                        <div class="row">
                                            <div class="col-md-12 form-group">
                                                <label class="font-weight-bold">TEMPAT PRAKTEK</label>
                                                <input type="text" name="private_practice" class="form-control" value="{{$application->private_practice}}">
                                                @error('private_practice') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-12 form-group">
                                                <label class="font-weight-bold">ALAMAT PRAKTEK</label>
                                                <input type="text" name="private_practice_address" class="form-control" value="{{$application->private_practice_address}}">
                                                @error('private_practice_address') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-6 form-group">
                                                <label class="font-weight-bold">PROVINSI </label>
                                                <select class="form-control" id="private_practice_province" name="private_practice_province" placeholder="Pilih provinsi">
                                                    <option value="">Pilih Provinsi</option>
                                                    @foreach($provinces as $item)
                                                    <option {{ $data->private_practice_province == $item->id ? "selected" : "" }} value="{{ $item->id }}">{{ $item->name }}</option>
                                                    @endforeach
                                                    <!-- @php
                                                $private_practice_province = \App\Models\Provinces::where('id', $data->private_practice_province)->first();
                                                @endphp
                                                @if($private_practice_province)
                                                <option {{ $data->private_practice_province == $private_practice_province->id ? "selected" : "" }} value="{{ $private_practice_province->id }}">{{ $private_practice_province->name }}</option>
                                                @endif -->
                                                </select>
                                                @error('private_practice_province') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-6 form-group">
                                                <label class="font-weight-bold">KABUPATEN / KOTA </label>
                                                <select class="form-control" id="private_practice_regency" name="private_practice_regency" placeholder="Pilih kabupaten /kota">
                                                    <option value="">Pilih Kabupaten / Kota</option>
                                                    @php
                                                    $private_practice_regency = \App\Models\Regencies::where('id', $application->private_practice_regency)->first();
                                                    @endphp
                                                    @if($private_practice_regency)
                                                    <option {{ $application->private_practice_regency == $private_practice_regency->id ? "selected" : "" }} value="{{ $private_practice_regency->id }}">{{ $private_practice_regency->name }}</option>
                                                    @endif
                                                </select>
                                                @error('private_practice_regency') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-6 form-group">
                                                <label class="font-weight-bold">KECAMATAN</label>
                                                <select class="form-control" id="private_practice_district" name="private_practice_district" placeholder="Pilih kecamatan">
                                                    <option value="">Pilih Kecamatan</option>
                                                    @php
                                                    $private_practice_district = \App\Models\Districts::where('id', $application->private_practice_subdistrict)->first();
                                                    @endphp
                                                    @if($private_practice_district)
                                                    <option {{ $application->private_practice_subdistrict == $private_practice_district->id ? "selected" : "" }} value="{{ $private_practice_district->id }}">{{ $private_practice_district->name }}</option>
                                                    @endif
                                                </select>
                                                @error('private_practice_district') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-6 form-group">
                                                <label class="font-weight-bold">DESA / KELURAHAN </label>
                                                <select class="form-control" id="private_practice_village" name="private_practice_village" placeholder="Pilih desa / kelurahan">
                                                    <option value="">Pilih Desa / Kelurahan</option>
                                                    @php
                                                    $private_practice_village = \App\Models\Villages::where('id', $application->private_practice_village)->first();
                                                    @endphp
                                                    @if($private_practice_village)
                                                    <option {{ $application->private_practice_village == $private_practice_village->id ? "selected" : "" }} value="{{ $private_practice_village->id }}">{{ $private_practice_village->name }}</option>
                                                    @endif
                                                </select>
                                                @error('private_practice_village') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                        </div>
                                    </div>
                                    <hr>
                                    <!-- DATA TAMBAHAN -->
                                    <div>
                                        <div class="row justify-content-md-left">
                                            <div class="col-4">
                                                <h3> Informasi Tambahan</h3>
                                            </div>
                                        </div>
                                        <hr>
                                        @if ($application->central_idi_npa == null)
                                        <div class="alert alert-danger alert-dismissible fade show" role="alert">
                                            <strong>Perhatian!</strong> Data Keanggotaan belum dilengkapi klik Ubah Data untuk merubah.
                                            <button type="button" class="close" data-dismiss="alert" aria-label="Close">
                                                <span aria-hidden="true">&times;</span>
                                            </button>
                                        </div>
                                        @endif
                                        <div class="row">
                                            <div class="col-md-3 form-group">
                                                <label class="font-weight-bold">ANGGOTA IDI WILAYAH</label>
                                                <!-- <input type="text" name="area_members" class="form-control" value="{{$application->area_members}}"> -->
                                                <select class="form-control select2" id="area_members" name="area_members" placeholder="Pilih IDI Wilayah">
                                                    <option value="">Pilih IDI Wilayah</option>
                                                    @foreach($area as $item)
                                                    <option {{ old('area_members', $application->area_members) == $item->area ? "selected" : "" }} value="{{ $item->area }}">{{ $item->area }}</option>
                                                    @endforeach
                                                </select>
                                                @error('area_members') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-3 form-group">
                                                <label class="font-weight-bold">ANGGOTA IDI CABANG</label>
                                                <!-- <input type="text" name="branch_members" class="form-control" value="{{$application->branch_members}}"> -->
                                                <select class="form-control select2" id="branch_members" name="branch_members" placeholder="Pilih IDI Cabang">
                                                    <option value="">Pilih IDI Cabang</option>
                                                    @foreach($branch as $item)
                                                    <option {{ old('branch_members', $application->branch_members) == $item->branch ? "selected" : "" }} value="{{ $item->branch }}">{{ $item->branch }}</option>
                                                    @endforeach
                                                </select>
                                                @error('branch_members') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-6 form-group">
                                                <label class="font-weight-bold">NPAC</label>
                                                <input type="text" name="npac_npa" class="form-control" value="{{$application->npac_npa}}">
                                                @error('npac_npa') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                        </div>
                                        <div class="row">
                                            <div class="col-md-6 form-group">
                                                <label class="font-weight-bold">NO. STR DOKTER UMUM</label>
                                                <input type="text" id="str_no" name="str_no" class="form-control" value="{{$application->str_no}}" required>
                                                <span id="error-str" class="error text-danger"></span>
                                                @error('str_no') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-6 form-group">
                                                <label class="font-weight-bold">MASA BERLAKU STR DOKTER UMUM</label>
                                                <input type="date" name="validity_period_str" class="form-control" value="{{$application->validity_period_str}}" required>
                                                @error('validity_period_str') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                        </div>
                                        <div class="row">
                                            <div class="col-md-6 form-group">
                                                <label class="font-weight-bold">NO. STR SPESIALIS </label>
                                                <input type="text" name="str_no_sp" class="form-control" value="{{$application->str_no_sp}}">
                                                @error('str_no_sp') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-6 form-group">
                                                <label class="font-weight-bold">MASA BERLAKU STR SPESIALIS </label>
                                                <input type="date" name="validity_period_str_sp" class="form-control" value="{{$application->validity_period_str_sp}}">
                                                @error('validity_period_str_sp') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                        </div>
                                        <div class="row">
                                            <div class="col-md-6 form-group">
                                                <label class="font-weight-bold">NO. STR KOMPETENSI TAMBAHAN </label>
                                                <input type="text" name="str_no_kt" class="form-control" value="{{$application->str_no_kt}}">
                                                @error('str_no_kt') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-6 form-group">
                                                <label class="font-weight-bold">MASA BERLAKU STR KOMPETENSI TAMBAHAN </label>
                                                <input type="date" name="validity_period_str_kt" class="form-control" value="{{$application->validity_period_str_kt}}">
                                                @error('validity_period_str_kt') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                        </div>
                                        <div class="row">
                                            <div class="col-md-3 form-group">
                                                <label class="font-weight-bold">IDI WILAYAH SEBELUMNYA</label>
                                                <!-- <input type="text" name="area_of_idi" class="form-control" value="{{$application->area_of_idi}}"> -->
                                                <select class="form-control select2" id="area_of_idi" name="area_of_idi" placeholder="Pilih IDI Wilayah">
                                                    <option value="">Pilih IDI Wilayah</option>
                                                    @foreach($area as $item)
                                                    <option {{ old('area_of_idi', $application->area_of_idi) == $item->area ? "selected" : "" }} value="{{ $item->area }}">{{ $item->area }}</option>
                                                    @endforeach
                                                </select>
                                                @error('area_of_idi') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-3 form-group">
                                                <label class="font-weight-bold">IDI CABANG SEBELUMNYA</label>
                                                <!-- <input type="text" name="branch_of_idi" class="form-control" value="{{$application->branch_of_idi}}"> -->
                                                <select class="form-control select2" id="branch_of_idi" name="branch_of_idi" placeholder="Pilih IDI Wilayah">
                                                    <option value="">Pilih IDI Cabang</option>
                                                    @foreach($branch as $item)
                                                    <option {{ old('branch_of_idi', $application->branch_of_idi) == $item->branch ? "selected" : "" }} value="{{ $item->branch }}">{{ $item->branch }}</option>
                                                    @endforeach
                                                </select>
                                                @error('branch_of_idi') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-3 form-group">
                                                <label class="font-weight-bold">TAHUN MUTASI</label>
                                                <input type="number" name="mutation_year" class="form-control" value="{{$application->mutation_year}}">
                                                @error('mutation_year') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                            <div class="col-md-3 form-group">
                                                <label class="font-weight-bold">NPA IDI PUSAT<span style="color: red;"> **</span></label>
                                                <input type="text" name="central_idi_npa" class="form-control" value="{{$application->central_idi_npa}}">
                                                @error('central_idi_npa') <span class="error text-danger">{{ $message }}</span> @enderror
                                            </div>
                                        </div>
                                    </div>

                                    <!-- Tombol -->
                                    <button class="btn btn-warning nextBtn btn-lg pull-right" type="button">
                                        Lanjut <i class="fa fa-arrow-right"></i>
                                    </button>
                                </div>
                            </div>

                            <!-- UNGGAH DOKUMEN -->
                            <div class="row setup-content {{ $currentStep != 3 ? 'displayNone' : '' }}" id="step-3">
                                <div class="col-md-12">
                                    <hr>
                                    <h3 class="text-center"> Upload Dokumen Pendukung</h3>
                                    <small id="form_name" class="badge badge-success"></small>
                                    <hr>
                                    <div class="col-md-12">
                                        <input type="hidden" name="appl_id" value="{{$application->id}}">
                                        <div class="form-loading row"></div>
                                        <div class="form-document row"></div>
                                    </div>

                                    <!-- Tombol -->
                                    <button class="btn btn-danger backBtn btn-lg pull-right" type="button">
                                        <i class="fa fa-arrow-left"></i> Kembali
                                    </button>
                                    <button class="btn btn-warning nextBtn btn-lg pull-right" type="button">
                                        Lanjut <i class="fa fa-arrow-right"></i>
                                    </button>
                                </div>
                            </div>

                            <!-- DATA VERIFIKASI -->
                            <div class="row setup-content {{ $currentStep != 4 ? 'displayNone' : '' }}" id="step-4">
                                <div class="col-md-12">

                                    <h3 class="text-center mb-2"> Cek Kembali Data Anda</h3>
                                    <hr>
                                    <h5>IDENTITAS DIRI</h5>
                                    <hr>
                                    <div class="table-responsive">
                                        <table class="table table-striped mb-0">
                                            <tr>
                                                <td>Pengajuan</td>
                                                <td>:</td>
                                                <td>
                                                    <div id="application_name" class="badge badge-success"></div>
                                                </td>
                                                <td>Foto</td>
                                                <td>:</td>
                                                <td>
                                                    <div class="gallery">
                                                        @if($data->gender == 'L')
                                                        @php
                                                        $foto = 'avatar-1.png';
                                                        @endphp
                                                        @else
                                                        @php
                                                        $foto = 'avatar-5.png';
                                                        @endphp
                                                        @endif
                                                        <div class="gallery-item" data-image="{{ file_exists('storage/image/' . $data->foto) && $data->foto != null && $data->foto != 'default-foto.png' ? asset('storage/image/' . $data->foto) : asset('assets-panel/img/avatar/'.$foto) }}" data-title="Klik Gambar"></div>
                                                    </div>
                                                </td>
                                            </tr>
                                            <tr>
                                                <td>Nama Lengkap</td>
                                                <td>:</td>
                                                <td><strong id="memberName"></strong></td>
                                                <td>Tempat, Tanggal Lahir</td>
                                                <td>:</td>
                                                <td><strong id="memberBirthPlace"></strong></td>
                                            </tr>
                                            <tr>
                                                <td>Alamat KTP</td>
                                                <td>:</td>
                                                <td colspan="4"><strong id="memberAddress"></strong></td>
                                            </tr>
                                            <tr>
                                                <td>No Telp/HP</td>
                                                <td>:</td>
                                                <td><strong id="memberPhone"></strong></td>
                                                <td>Email</td>
                                                <td>:</td>
                                                <td><strong id="memberEmail"></strong></td>
                                            </tr>
                                        </table>
                                    </div>
                                    <hr>
                                    <h5>INFORMASI PENDIDIKAN</h5>
                                    <hr>
                                    <div class="table-responsive">
                                        <table class="table table-striped mb-0">
                                            <tr>
                                                <td colspan="6"><strong>PENDIDIKAN TERAKHIR</strong></td>
                                            </tr>
                                            <tr>
                                                <td>Institusi Pendidikan</td>
                                                <td>:</td>
                                                <td><strong id="memberInstitutionA"></strong></td>
                                                <td>Jenjang Pendidikan</td>
                                                <td>:</td>
                                                <td><strong id="memberAcademicDegreeA"></strong></td>
                                            </tr>
                                            <tr>
                                                <td>Nomor Ijazah</td>
                                                <td>:</td>
                                                <td><strong id="memberIjazahNoA"></strong></td>
                                                <td>Tahun Lulus</td>
                                                <td>:</td>
                                                <td><strong id="memberGraduationYearA"></strong></td>
                                            </tr>
                                            <tr>
                                                <td colspan="6"><strong>PENDIDIKAN LAINNYA</strong></td>
                                            </tr>
                                            <tr>
                                                <td>Institusi Pendidikan</td>
                                                <td>:</td>
                                                <td><strong id="memberInstitutionB"></strong></td>
                                                <td>Jenjang Pendidikan</td>
                                                <td>:</td>
                                                <td><strong id="memberAcademicDegreeB"></strong></td>
                                            </tr>
                                            <tr>
                                                <td>Nomor Ijazah</td>
                                                <td>:</td>
                                                <td><strong id="memberIjazahNoB"></strong></td>
                                                <td>Tahun Lulus</td>
                                                <td>:</td>
                                                <td><strong id="memberGraduationYearB"></strong></td>
                                            </tr>
                                            <tr>
                                                <td colspan="6"><strong>PENDIDIKAN LAINNYA</strong></td>
                                            </tr>
                                            <tr>
                                                <td>Institusi Pendidikan</td>
                                                <td>:</td>
                                                <td><strong id="memberInstitutionC"></strong></td>
                                                <td>Jenjang Pendidikan</td>
                                                <td>:</td>
                                                <td><strong id="memberAcademicDegreeC"></strong></td>
                                            </tr>
                                            <tr>
                                                <td>Nomor Ijazah</td>
                                                <td>:</td>
                                                <td><strong id="memberIjazahNoC"></strong></td>
                                                <td>Tahun Lulus</td>
                                                <td>:</td>
                                                <td><strong id="memberGraduationYearC"></strong></td>
                                            </tr>
                                        </table>
                                    </div>
                                    <hr>
                                    <h5>INFORMASI PEKERJAAN</h5>
                                    <hr>
                                    <div class="table-responsive">
                                        <table class="table table-striped mb-0">
                                            <tr>
                                                <td colspan="6"><strong>PEKERJAAN</strong></td>
                                            </tr>
                                            <tr>
                                                <td>Status Kepegawaian / Waktu</td>
                                                <td>:</td>
                                                <td><strong id="memberEmploymentStatus"></strong></td>
                                                <td>Jabatan</td>
                                                <td>:</td>
                                                <td><strong id="memberPosition"></strong></td>
                                            </tr>
                                            <tr>
                                                <td>Tempat Praktek</td>
                                                <td>:</td>
                                                <td><strong id="memberPractice"></strong></td>
                                                <td>Alamat Praktek</td>
                                                <td>:</td>
                                                <td><strong id="memberPracticeAddress"></strong></td>
                                            </tr>
                                            <tr>
                                                <td colspan="6"><strong>PRAKTEK PRIBADI</strong></td>
                                            </tr>
                                            <tr>
                                                <td>Tempat Praktek</td>
                                                <td>:</td>
                                                <td><strong id="memberPrivatePractice"></strong></td>
                                                <td>Alamat Praktek</td>
                                                <td>:</td>
                                                <td><strong id="memberPrivatePracticeAddress"></strong></td>
                                            </tr>
                                        </table>
                                    </div>
                                    <hr>
                                    <h5>INFORMASI TAMBAHAN</h5>
                                    <hr>
                                    <div class="table-responsive">
                                        <table class="table table-striped mb-0">
                                            <tr>
                                                <td>No STR Dokter Umum</td>
                                                <td>:</td>
                                                <td><strong id="memberStr"></strong></td>
                                                <td>Masa Berlaku STR</td>
                                                <td>:</td>
                                                <td><strong id="memberStrPeriode"></strong></td>
                                            </tr>
                                            <tr>
                                                <td>No STR Dokter Spesialis</td>
                                                <td>:</td>
                                                <td><strong id="memberStrSP"></strong></td>
                                                <td>Masa Berlaku STR</td>
                                                <td>:</td>
                                                <td><strong id="memberStrSPPeriode"></strong></td>
                                            </tr>
                                            <tr>
                                                <td>No STR Kompetensi Tambahan</td>
                                                <td>:</td>
                                                <td><strong id="memberStrKT"></strong></td>
                                                <td>Masa Berlaku STR</td>
                                                <td>:</td>
                                                <td><strong id="memberStrKTPeriode"></strong></td>
                                            </tr>
                                            <tr>
                                                <td>Anggota IDI</td>
                                                <td>:</td>
                                                <td><strong id="memberArea"></strong></td>
                                                <td>NPAC / NPA IDI</td>
                                                <td>:</td>
                                                <td><strong id="memberNomor"></strong></td>
                                            </tr>
                                        </table>
                                    </div>
                                    <hr>
                                    <h5>DOKUMEN REVISI</h5>
                                    <hr>
                                    <div class="table-responsive">
                                        <table id="upload-table" class="table table-striped mb-0">
                                            <thead>
                                                <tr style="text-align:left">
                                                    <th>Kode</th>
                                                    <th>Dokumen</th>
                                                    <th>File</th>
                                                    <th style="text-align:center">Lihat</th>
                                                </tr>
                                            </thead>
                                            <tbody>
                                                <!--  Populate table with data from upload array -->
                                            </tbody>
                                        </table>
                                    </div>
                                    <br>
                                    <br>
                                    <div class="row mt-5">
                                        <div class="col-lg-6 col-md-12 col-12 col-sm-12">
                                            <div class="alert alert-warning">
                                                @php
                                                $label = \App\Models\Label::where(['code' => 'note-revision' ])->first()
                                                @endphp

                                                @if($label != null)
                                                <i class="fa fa-info-circle text-center"><strong> {!!html_entity_decode($label->title)!!}</strong></i>
                                                <p>{!!html_entity_decode($label->desc)!!}</p>
                                                @else
                                                <i class="fa fa-info-circle text-center"><strong> Catatan</strong></i>
                                                <p>Belum tersedia</p>
                                                @endif
                                            </div>
                                            <div class="form-group">
                                                <label class="font-weight-bold">STATUS REVISI <span style="color: red;"> **</span></label>
                                                <select class="form-control select2" id="application_status" name="application_status" placeholder="Pilih Status" required>
                                                    <option value="">Pilih Status</option>
                                                    @foreach($status as $sts)
                                                    <option value="{{$sts->type}}">( {{$sts->code}} ) {{$sts->status_user}}</option>
                                                    @endforeach
                                                </select>
                                                <!-- error message -->
                                                <div class="invalid-feedback alert alert-danger mt-2">
                                                    Pilih status
                                                </div>
                                            </div>
                                        </div>

                                        <div class="col-lg-6 col-md-12 col-12 col-sm-12">
                                            <div class="form-group">
                                                <label class="font-weight-bold">KETERANGAN <span style="color: red;"> **</span></label> <i class="fas fa-question" title="contoh : 1. Dokumen buram silakan unggah ulang 2. Berkas sudah sesuai lanjut ke proses berikutnya" style="float: right;"></i>
                                                <textarea class="form-control summernote-simple" id="note" name="note" rows="10" placeholder="contoh :  Saya sudah mengubah nomor STR dan mengunggah dokumen yang baru" required style="max-width:100%;min-height:50px;height:100%;width:100%;">Perbaikan data pengajuan sudah diperbaiki dengan benar</textarea>
                                                <!-- error message untuk title -->
                                                <div class="invalid-feedback alert alert-danger mt-2">
                                                    Masukan keterangan
                                                </div>
                                            </div>
                                        </div>
                                    </div>
                                    <hr>

                                    <div class="col-md-12">
                                        <div class="alert alert-info alert-has-icon">
                                            @php
                                            $label = \App\Models\Label::where(['code' => 'disclaimer-str' ])->first()
                                            @endphp
                                            <div class="alert-icon"><i class="far fa-lightbulb"></i></div>
                                            <div class="alert-body">
                                                <div class="alert-title"><strong> {!!html_entity_decode($label->title)!!}</strong></div>
                                                {!!html_entity_decode($label->desc)!!}
                                            </div>
                                        </div>
                                        <input type="checkbox" id="agree" name="agree" value="1" checked required>
                                        <label for="agree"> Setujui Disclaimer</label>
                                    </div>
                                    <div class="col-md-8">
                                        <button class="btn btn-danger backBtn btn-lg pull-right" type="button">
                                            <i class="fa fa-arrow-left"></i> Kembali
                                        </button>
                                        <button class="btn btn-success submitBtn btn-lg pull-right" data-id="{{ $application->id }}" type="button">
                                            Kirim <i class="fa fa-paper-plane"></i>
                                        </button>
                                    </div>
                                </div>
                            </div>

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

<script src="https://code.jquery.com/jquery-3.6.0.min.js"></script>

<!-- DROPDOWN -->
<script>
    // get select value wilayah
    $(document).ready(function() {
        // home
        $("select[name='home_province']").on('change', function() {
            var provinsi_id = $(this).val();
            if (provinsi_id) {
                $.ajax({
                    url: '/non-anggota/get-kabupaten-kota/' + provinsi_id,
                    type: "GET",
                    dataType: "json",
                    success: function(data) {
                        $('#home_regency').empty();
                        $('#home_regency').append('<option value="">-- Pilih Kabupaten / Kota --</option>');
                        $.each(data, function(key, value) {
                            $('#home_regency').append('<option value="' + value.id + '">' + value.name + '</option>');
                        });
                    },
                    error: function(xhr, status, error) {
                        console.log(xhr.responseText);
                    }
                });
            } else {
                $('#home_regency').empty();
                $('#home_district').empty();
                $('#home_village').empty();
            }
        });

        $('#home_regency').on('change', function() {
            var id = $(this).val();
            if (id) {
                $.ajax({
                    url: '/non-anggota/get-kecamatan/' + id,
                    type: "GET",
                    dataType: "json",
                    success: function(data) {
                        $('#home_district').empty();
                        $('#home_district').append('<option value="">-- Pilih Kecamatan --</option>');
                        $.each(data, function(key, value) {
                            $('#home_district').append('<option value="' + value.id + '">' + value.name + '</option>');
                        });
                    },
                    error: function(xhr, status, error) {
                        console.log(xhr.responseText);
                    }
                });
            } else {
                $('#home_district').empty();
                $('#home_village').empty();
            }
        });

        $('#home_district').on('change', function() {
            var id = $(this).val();
            if (id) {
                $.ajax({
                    url: '/non-anggota/get-desa-kelurahan/' + id,
                    type: "GET",
                    dataType: "json",
                    success: function(data) {
                        $('#home_village').empty();
                        $('#home_village').append('<option value="">-- Pilih Desa / Kelurahan --</option>');
                        $.each(data, function(key, value) {
                            $('#home_village').append('<option value="' + value.id + '">' + value.name + '</option>');
                        });
                    },
                    error: function(xhr, status, error) {
                        console.log(xhr.responseText);
                    }
                });
            } else {
                $('#home_village').empty();
            }
        });

        // domisili
        $('#residence_province').on('change', function() {
            var provinsi_id = $(this).val();
            if (provinsi_id) {
                $.ajax({
                    url: '/non-anggota/get-kabupaten-kota/' + provinsi_id,
                    type: "GET",
                    dataType: "json",
                    success: function(data) {
                        $('#residence_regency').empty();
                        $('#residence_regency').append('<option value="">-- Pilih Kabupaten / Kota --</option>');
                        $.each(data, function(key, value) {
                            $('#residence_regency').append('<option value="' + value.id + '">' + value.name + '</option>');
                        });
                    },
                    error: function(xhr, status, error) {
                        console.log(xhr.responseText);
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                });
            } else {
                $('#residence_regency').empty();
                $('#residence_district').empty();
                $('#residence_village').empty();
            }
        });

        $('#residence_regency').on('change', function() {
            var id = $(this).val();
            if (id) {
                $.ajax({
                    url: '/non-anggota/get-kecamatan/' + id,
                    type: "GET",
                    dataType: "json",
                    success: function(data) {
                        $('#residence_district').empty();
                        $('#residence_district').append('<option value="">-- Pilih Kecamatan --</option>');
                        $.each(data, function(key, value) {
                            $('#residence_district').append('<option value="' + value.id + '">' + value.name + '</option>');
                        });
                    },
                    error: function(xhr, status, error) {
                        console.log(xhr.responseText);
                    }
                });
            } else {
                $('#residence_district').empty();
                $('#residence_village').empty();
            }
        });

        $('#residence_district').on('change', function() {
            var id = $(this).val();
            if (id) {
                $.ajax({
                    url: '/non-anggota/get-desa-kelurahan/' + id,
                    type: "GET",
                    dataType: "json",
                    success: function(data) {
                        $('#residence_village').empty();
                        $('#residence_village').append('<option value="">-- Pilih Desa / Kelurahan --</option>');
                        $.each(data, function(key, value) {
                            $('#residence_village').append('<option value="' + value.id + '">' + value.name + '</option>');
                        });
                    },
                    error: function(xhr, status, error) {
                        console.log(xhr.responseText);
                    }
                });
            } else {
                $('#residence_village').empty();
            }
        });

        // practice
        $('#practice_province').on('change', function() {
            var provinsi_id = $(this).val();
            if (provinsi_id) {
                $.ajax({
                    url: '/non-anggota/get-kabupaten-kota/' + provinsi_id,
                    type: "GET",
                    dataType: "json",
                    success: function(data) {
                        $('#practice_regency').empty();
                        $('#practice_regency').append('<option value="">-- Pilih Kabupaten / Kota --</option>');
                        $.each(data, function(key, value) {
                            $('#practice_regency').append('<option value="' + value.id + '">' + value.name + '</option>');
                        });
                    },
                    error: function(xhr, status, error) {
                        console.log(xhr.responseText);
                    }
                });
            } else {
                $('#practice_regency').empty();
                $('#practice_subdistrict').empty();
                $('#practice_village').empty();
            }
        });

        $('#practice_regency').on('change', function() {
            var id = $(this).val();
            if (id) {
                $.ajax({
                    url: '/non-anggota/get-kecamatan/' + id,
                    type: "GET",
                    dataType: "json",
                    success: function(data) {
                        $('#practice_subdistrict').empty();
                        $('#practice_subdistrict').append('<option value="">-- Pilih Kecamatan --</option>');
                        $.each(data, function(key, value) {
                            $('#practice_subdistrict').append('<option value="' + value.id + '">' + value.name + '</option>');
                        });
                    },
                    error: function(xhr, status, error) {
                        console.log(xhr.responseText);
                    }
                });
            } else {
                $('#practice_subdistrict').empty();
                $('#practice_village').empty();
            }
        });

        $('#practice_subdistrict').on('change', function() {
            var id = $(this).val();
            if (id) {
                $.ajax({
                    url: '/non-anggota/get-desa-kelurahan/' + id,
                    type: "GET",
                    dataType: "json",
                    success: function(data) {
                        $('#practice_village').empty();
                        $('#practice_village').append('<option value="">-- Pilih Desa / Kelurahan --</option>');
                        $.each(data, function(key, value) {
                            $('#practice_village').append('<option value="' + value.id + '">' + value.name + '</option>');
                        });
                    },
                    error: function(xhr, status, error) {
                        console.log(xhr.responseText);
                    }
                });
            } else {
                $('#practice_village').empty();
            }
        });

        // private
        $('#private_practice_province').on('change', function() {
            var provinsi_id = $(this).val();
            if (provinsi_id) {
                $.ajax({
                    url: '/non-anggota/get-kabupaten-kota/' + provinsi_id,
                    type: "GET",
                    dataType: "json",
                    success: function(data) {
                        $('#private_practice_regency').empty();
                        $('#private_practice_regency').append('<option value="">-- Pilih Kabupaten / Kota --</option>');
                        $.each(data, function(key, value) {
                            $('#private_practice_regency').append('<option value="' + value.id + '">' + value.name + '</option>');
                        });
                    },
                    error: function(xhr, status, error) {
                        console.log(xhr.responseText);
                    }
                });
            } else {
                $('#private_practice_regency').empty();
                $('#private_practice_district').empty();
                $('#private_practice_village').empty();
            }
        });

        $('#private_practice_regency').on('change', function() {
            var id = $(this).val();
            if (id) {
                $.ajax({
                    url: '/non-anggota/get-kecamatan/' + id,
                    type: "GET",
                    dataType: "json",
                    success: function(data) {
                        $('#private_practice_district').empty();
                        $('#private_practice_district').append('<option value="">-- Pilih Kecamatan --</option>');
                        $.each(data, function(key, value) {
                            $('#private_practice_district').append('<option value="' + value.id + '">' + value.name + '</option>');
                        });
                    },
                    error: function(xhr, status, error) {
                        console.log(xhr.responseText);
                    }
                });
            } else {
                $('#private_practice_district').empty();
                $('#private_practice_village').empty();
            }
        });

        $('#private_practice_district').on('change', function() {
            var id = $(this).val();
            if (id) {
                $.ajax({
                    url: '/non-anggota/get-desa-kelurahan/' + id,
                    type: "GET",
                    dataType: "json",
                    success: function(data) {
                        $('#private_practice_village').empty();
                        $('#private_practice_village').append('<option value="">-- Pilih Desa / Kelurahan --</option>');
                        $.each(data, function(key, value) {
                            $('#private_practice_village').append('<option value="' + value.id + '">' + value.name + '</option>');
                        });
                    },
                    error: function(xhr, status, error) {
                        console.log(xhr.responseText);
                    }
                });
            } else {
                $('#private_practice_village').empty();
            }
        });


        // sip
        $(".sip-detail").each(function() {
            var sipNo = $(this).data("sip-no");
            var sipProvince = $(this).find(".sip-province");
            var sipRegency = $(this).find(".sip-regency");
            var sipSubdistrict = $(this).find(".sip-subdistrict");
            var sipVillage = $(this).find(".sip-village");

            sipProvince.on('change', function() {
                var provinsi_id = sipProvince.val();

                if (provinsi_id) {
                    // Select data
                    $.ajax({
                        url: '/non-anggota/select-provinsi/' + provinsi_id,
                        type: "GET",
                        dataType: "json",
                        success: function(data) {

                        },
                        error: function(xhr) {
                            alert('Error: ' + xhr.statusText);
                        }
                    });

                    // All data 
                    $.ajax({
                        url: '/non-anggota/get-kabupaten-kota/' + provinsi_id,
                        type: "GET",
                        dataType: "json",
                        success: function(data) {
                            sipRegency.empty(); // Hapus opsi sebelum menambahkan yang baru
                            sipRegency.append('<option value="">-- Pilih Kabupaten / Kota --</option>');

                            // Loop melalui data dan tambahkan opsi ke dropdown
                            $.each(data, function(key, value) {
                                sipRegency.append('<option value="' + value.id + '">' + value.name + '</option>');
                            });
                        },
                        error: function(xhr, status, error) {
                            console.log(xhr.responseText);
                        }
                    });
                } else {
                    sipRegency.empty();
                }
            });

            sipRegency.on('change', function() {
                var id = sipRegency.val();

                if (id) {
                    // select data
                    $.ajax({
                        url: '/non-anggota/select-kabupaten-kota/' + id,
                        type: "GET",
                        dataType: "json",
                        success: function(data) {

                        },
                        error: function(xhr) {
                            alert('Error: ' + xhr.statusText);
                        }
                    });
                    // get all
                    $.ajax({
                        url: '/non-anggota/get-kecamatan/' + id,
                        type: "GET",
                        dataType: "json",
                        success: function(data) {
                            sipSubdistrict.empty();
                            sipSubdistrict.append('<option value="">-- Pilih Kecamatan --</option>');
                            $.each(data, function(key, value) {
                                sipSubdistrict.append('<option value="' + value.id + '">' + value.name + '</option>');
                            });
                        },
                        error: function(xhr, status, error) {
                            console.log(xhr.responseText);
                        }
                    });
                } else {
                    sipSubdistrict.empty();
                }
            });

            sipSubdistrict.on('change', function() {
                var id = sipSubdistrict.val();

                if (id) {
                    $.ajax({
                        url: '/non-anggota/select-kecamatan/' + id,
                        type: "GET",
                        dataType: "json",
                        success: function(data) {

                        },
                        error: function(xhr) {
                            alert('Error: ' + xhr.statusText);
                        }
                    });

                    $.ajax({
                        url: '/non-anggota/get-desa-kelurahan/' + id,
                        type: "GET",
                        dataType: "json",
                        success: function(data) {
                            sipVillage.empty();
                            sipVillage.append('<option value="">-- Pilih Desa / Kelurahan --</option>');
                            $.each(data, function(key, value) {
                                sipVillage.append('<option value="' + value.id + '">' + value.name + '</option>');
                            });
                        },
                        error: function(xhr, status, error) {
                            console.log(xhr.responseText);
                        }
                    });
                } else {
                    sipVillage.empty();
                }
            });

            sipVillage.on('change', function() {
                var id = sipVillage.val();

                if (id) {
                    $.ajax({
                        url: '/non-anggota/select-desa-kelurahan/' + id,
                        type: "GET",
                        dataType: "json",
                        success: function(data) {

                        },
                        error: function(xhr) {
                            alert('Error: ' + xhr.statusText);
                        }
                    });
                } else {
                    sipVillage.empty();
                }
            });
        });


    });

    // select value edit wilayah
    $(document).ready(function() {

        // alamat rumah
        var selectElement = document.querySelector("input[name='home_province_id']");
        if (selectElement === null || selectElement === undefined) {
            regencies_id = 0;
        } else {
            regencies_id = selectElement.value;
        }

        // alert(regencies_id);
        $.ajax({
            url: '/non-anggota/select-provinsi/' + regencies_id,
            type: "GET",
            dataType: "json",
            success: function(data) {
                // $('#edit_regencies').empty();
                // $('#edit_regencies').append('<option value="">-- Pilih Kabupaten / Kota --</option>');
                $.each(data, function(key, value) {
                    $("select[name='home_province']").append('<option value="' + value.id + '">' + value.name + '</option>');
                });

                //select 2
                $("select[name='home_province']").select2();
            },
            error: function(xhr) {
                alert('Error: ' + xhr.statusText);
            }
        });

        // alamat rumah
        var selectElement = document.querySelector("input[name='home_regency_id']");
        if (selectElement === null || selectElement === undefined) {
            regencies_id = 0;
        } else {
            regencies_id = selectElement.value;
        }

        // alert(regencies_id);
        $.ajax({
            url: '/non-anggota/select-kabupaten-kota/' + regencies_id,
            type: "GET",
            dataType: "json",
            success: function(data) {
                // $('#edit_regencies').empty();
                // $('#edit_regencies').append('<option value="">-- Pilih Kabupaten / Kota --</option>');
                $.each(data, function(key, value) {
                    $("select[name='home_regency']").append('<option value="' + value.id + '">' + value.name + '</option>');
                });
                $("select[name='home_regency']").select2();
            },
            error: function(xhr) {
                alert('Error: ' + xhr.statusText);
            }
        });

        var selectElement2 = document.querySelector('#home_districts_id');
        if (selectElement2 === null || selectElement2 === undefined) {
            districts_id = 0;
        } else {
            districts_id = selectElement2.value;
        }

        $.ajax({
            url: '/non-anggota/select-kecamatan/' + districts_id,
            type: "GET",
            dataType: "json",
            success: function(data) {
                $.each(data, function(key, value) {
                    $('#home_district').append('<option value="' + value.id + '">' + value.name + '</option>');
                });
                $("select[name='home_district']").select2();
            },
            error: function(xhr) {
                alert('Error: ' + xhr.statusText);
            }
        });

        var selectElement3 = document.querySelector('#home_villages_id');
        if (selectElement3 === null || selectElement3 === undefined) {
            villages_id = 0;
        } else {
            villages_id = selectElement3.value;
        }

        $.ajax({
            url: '/non-anggota/select-desa-kelurahan/' + villages_id,
            type: "GET",
            dataType: "json",
            success: function(data) {
                $.each(data, function(key, value) {
                    $('#home_village').append('<option value="' + value.id + '">' + value.name + '</option>');
                });
                $("select[name='home_village']").select2();
            },
            error: function(xhr) {
                alert('Error: ' + xhr.statusText);
            }
        });

        // domisili

        var selectElement = document.querySelector("input[name='residence_province_id']");
        if (selectElement === null || selectElement === undefined) {
            regencies_id = 0;
        } else {
            regencies_id = selectElement.value;
        }

        // alert(regencies_id);
        $.ajax({
            url: '/non-anggota/select-provinsi/' + regencies_id,
            type: "GET",
            dataType: "json",
            success: function(data) {
                // $('#edit_regencies').empty();
                // $('#edit_regencies').append('<option value="">-- Pilih Kabupaten / Kota --</option>');
                $.each(data, function(key, value) {
                    $("select[name='residence_province']").append('<option value="' + value.id + '">' + value.name + '</option>');
                });

                //select 2
                $("select[name='residence_province']").select2();
            },
            error: function(xhr) {
                alert('Error: ' + xhr.statusText);
            }
        });

        var selectElement = document.querySelector('#residence_regency_id');
        if (selectElement === null || selectElement === undefined) {
            regencies_id = 0;
        } else {
            regencies_id = selectElement.value;
        }

        // alert(regencies_id);
        $.ajax({
            url: '/non-anggota/select-kabupaten-kota/' + regencies_id,
            type: "GET",
            dataType: "json",
            success: function(data) {
                // $('#edit_regencies').empty();
                // $('#edit_regencies').append('<option value="">-- Pilih Kabupaten / Kota --</option>');
                $.each(data, function(key, value) {
                    $('#residence_regency').append('<option value="' + value.id + '">' + value.name + '</option>');
                });
                $("select[name='residence_regency']").select2();
            },
            error: function(xhr) {
                alert('Error: ' + xhr.statusText);
            }
        });

        var selectElement2 = document.querySelector('#residence_districts_id');
        if (selectElement2 === null || selectElement2 === undefined) {
            districts_id = 0;
        } else {
            districts_id = selectElement2.value;
        }

        $.ajax({
            url: '/non-anggota/select-kecamatan/' + districts_id,
            type: "GET",
            dataType: "json",
            success: function(data) {
                $.each(data, function(key, value) {
                    $('#residence_district').append('<option value="' + value.id + '">' + value.name + '</option>');
                });
                $("select[name='residence_district']").select2();
            },
            error: function(xhr) {
                alert('Error: ' + xhr.statusText);
            }
        });

        var selectElement3 = document.querySelector('#prof_residence_villages_id');
        if (selectElement3 === null || selectElement3 === undefined) {
            villages_id = 0;
        } else {
            villages_id = selectElement3.value;
        }

        $.ajax({
            url: '/non-anggota/select-desa-kelurahan/' + villages_id,
            type: "GET",
            dataType: "json",
            success: function(data) {
                $.each(data, function(key, value) {
                    $('#residence_village').append('<option value="' + value.id + '">' + value.name + '</option>');
                });
                $("select[name='residence_village']").select2();
            },
            error: function(xhr) {
                alert('Error: ' + xhr.statusText);
            }
        });

        // pekerjaan
        var selectElement4 = document.querySelector('#practice_regency_id');
        if (selectElement4 === null || selectElement4 === undefined) {
            regencies_id = 0;
        } else {
            regencies_id = selectElement4.value;
        }

        $.ajax({
            url: '/non-anggota/select-kabupaten-kota/' + regencies_id,
            type: "GET",
            dataType: "json",
            success: function(data) {
                // $('#edit_regencies').empty();
                // $('#edit_regencies').append('<option value="">-- Pilih Kabupaten / Kota --</option>');
                $.each(data, function(key, value) {
                    $('#practice_regency').append('<option value="' + value.id + '">' + value.name + '</option>');
                });
                $("select[name='practice_province']").select2();
                $("select[name='practice_regency']").select2();

            },
            error: function(xhr) {
                // alert('Error: ' + xhr.statusText);
                $('#practice_regency').append('<option value=0>-- Pilih Kabupaten / Kota --</option>');
            }
        });

        var selectElement5 = document.querySelector('#practice_subdistrict_id');
        if (selectElement5 === null || selectElement5 === undefined) {
            districts_id = 0;
        } else {
            districts_id = selectElement5.value;
        }

        $.ajax({
            url: '/non-anggota/select-kecamatan/' + districts_id,
            type: "GET",
            dataType: "json",
            success: function(data) {
                $.each(data, function(key, value) {
                    $('#practice_subdistrict').append('<option value="' + value.id + '">' + value.name + '</option>');
                });
                $("select[name='practice_subdistrict']").select2();
            },
            error: function(xhr) {
                // alert('Error: ' + xhr.statusText);
                $('#practice_subdistrict').append('<option value=0>-- Pilih Kecamatan --</option>');
            }
        });

        var selectElement6 = document.querySelector('#practice_village_id');
        if (selectElement6 === null || selectElement6 === undefined) {
            villages_id = 0;
        } else {
            villages_id = selectElement6.value;
        }

        $.ajax({
            url: '/non-anggota/select-desa-kelurahan/' + villages_id,
            type: "GET",
            dataType: "json",
            success: function(data) {
                $.each(data, function(key, value) {
                    $('#practice_village').append('<option value="' + value.id + '">' + value.name + '</option>');
                });
                $("select[name='practice_village']").select2();
            },
            error: function(xhr) {
                // alert('Error: ' + xhr.statusText);
                $('#practice_village').append('<option value=0>-- Pilih Desa / Kelurahan --</option>');
            }
        });

        // praktik
        var selectElement7 = document.querySelector('#private_practice_regency_id');
        if (selectElement7 === null || selectElement7 === undefined) {
            regencies_id = 0;
        } else {
            regencies_id = selectElement7.value;
        }

        $.ajax({
            url: '/non-anggota/select-kabupaten-kota/' + regencies_id,
            type: "GET",
            dataType: "json",
            success: function(data) {
                $.each(data, function(key, value) {
                    $('#private_practice_regency').append('<option value="' + value.id + '">' + value.name + '</option>');
                });
                $("select[name='private_practice_province']").select2();
                $("select[name='private_practice_regency']").select2();

            },
            error: function(xhr) {
                // alert('Error: ' + xhr.statusText);
                $('#private_practice_regency').append('<option value=0>-- Pilih Kabupaten / Kota --</option>');
            }
        });

        var selectElement8 = document.querySelector('#prof_private_practice_subdistrict_id');
        if (selectElement8 === null || selectElement8 === undefined) {
            districts_id = 0;
        } else {
            districts_id = selectElement8.value;
        }

        $.ajax({
            url: '/non-anggota/select-kecamatan/' + districts_id,
            type: "GET",
            dataType: "json",
            success: function(data) {
                $.each(data, function(key, value) {
                    $('#private_practice_district').append('<option value="' + value.id + '">' + value.name + '</option>');
                });
                $("select[name='private_practice_district']").select2();
            },
            error: function(xhr) {
                // alert('Error: ' + xhr.statusText);
                $('#private_practice_district').append('<option value=0>-- Pilih Kecamatan --</option>');
            }
        });

        var selectElement9 = document.querySelector('#private_practice_village_id');
        if (selectElement9 === null || selectElement9 === undefined) {
            villages_id = 0;
        } else {
            villages_id = selectElement9.value;
        }

        $.ajax({
            url: '/non-anggota/select-desa-kelurahan/' + villages_id,
            type: "GET",
            dataType: "json",
            success: function(data) {
                $.each(data, function(key, value) {
                    $('#private_practice_village').append('<option value="' + value.id + '">' + value.name + '</option>');
                });
                $("select[name='private_practice_village']").select2();
            },
            error: function(xhr) {
                // alert('Error: ' + xhr.statusText);
                $('#private_practice_village').append('<option value=0>-- Pilih Desa / Kelurahan --</option>');
            }
        });

    });
</script>

<!-- NEXT STEP VALIDATION -->
<script>
    $(document).ready(function() {
        var currentStep = 1;
        // console.log("Langkah : " + currentStep);

        $(".progressbar li").click(function() {
            var targetStep = $(this).index() + 1;

            // console.log("Step : " + targetStep);

            if (targetStep > currentStep) {
                // pengguna mencoba melompat ke depan, periksa jika data di langkah sebelumnya sudah lengkap
                if (checkData(currentStep)) {
                    // pindah ke langkah berikutnya
                    goToNextStep();
                } else {
                    // data belum lengkap, berikan pesan kesalahan
                    swal("Informasi", "Silahkan lengkapi data pada langkah sebelumnya terlebih dahulu", "error");
                }
            } else {
                // pengguna mencoba melompat ke belakang, langsung pindah ke langkah tersebut
                goToStep(targetStep);
            }
        });

        function checkData(step) {
            // fungsi ini akan memeriksa jika data di langkah sebelumnya sudah lengkap
            if (step == 1) {
                // periksa persetujuan
                return true;
            } else if (step == 2) {
                // periksa data pemohon
                return true;
            } else if (step == 3) {
                // periksa dokumen yang diunggah
                // jika dokumen sudah lengkap, kembalikan nilai true, jika tidak, kembalikan nilai false
                return true;
            } else if (step == 4) {
                // periksa data ulang dan submit
                return true;
            }
        }

        function goToNextStep() {
            // lakukan validasi data pada langkah saat ini
            var isValid = validateStep(currentStep);
            if (isValid) {
                document.getElementById('loading').style.display = 'none';
                goToStep(currentStep + 1);
            } else {
                // tampilkan pesan error jika data belum valid
                swal("Informasi", "Harap lengkapi data pada langkah " + currentStep + " terlebih dahulu.", 'warning');
            }
        }

        // Dapatkan elemen-elemen yang diperlukan
        var persetujuanRadios = document.querySelectorAll('input[name="persetujuan"]');
        var lanjutkanButton = document.querySelector('.disclaimerBtn');

        // Tambahkan event listener pada tombol Lanjutkan
        lanjutkanButton.onclick = function(e) {
            var persetujuanTerpilih = '';

            // Periksa apakah salah satu opsi persetujuan telah dipilih
            for (var i = 0; i < persetujuanRadios.length; i++) {
                if (persetujuanRadios[i].checked) {
                    persetujuanTerpilih = persetujuanRadios[i].value;
                    break;
                }
            }

            // Jika persetujuan tidak terpilih, tampilkan swal alert
            if (!persetujuanTerpilih) {
                e.preventDefault(); // Mencegah pengiriman form
                swal("Maaf",
                    "Silakan pilih salah satu opsi persetujuan!",
                    "error");
            } else {
                // Jika persetujuan terpilih, tampilkan loading spinner pada tombol Lanjutkan
                if (persetujuanTerpilih == 'setuju') {
                    swal("Informasi",
                        "Anda telah menyetujui disclaimer, silahkan lanjutkan ke langkah berikutnya",
                        "success");
                    goToNextStep();
                } else {
                    swal("Informasi",
                        "Anda tidak menyetujui disclaimer, silahkan hubungi admin untuk informasi lebih lanjut",
                        "warning");
                }
            }
        };

        $(".nextBtn").click(function() {
            // tampilkan tampilan loading
            document.getElementById('loading').style.display = 'block';

            // pindah ke langkah berikutnya jika data sudah valid setelah waktu delay 1 detik
            setTimeout(function() {
                // pindah ke langkah berikutnya
                goToNextStep();
                // sembunyikan tampilan loading setelah proses selesai
                document.getElementById('loading').style.display = 'none';
            }, 1000);
        });

        $(".backBtn").click(function() {
            // pindah ke langkah sebelumnya
            goToStep(currentStep - 1);
        });

        function validateStep(step) {
            // validasi data pada langkah tertentu
            var isValid = true;
            // implementasikan validasi data pada masing-masing langkah
            switch (step) {
                case 1:

                    // Dapatkan elemen-elemen yang diperlukan
                    var persetujuanRadios = document.querySelectorAll('input[name="persetujuan"]');
                    var persetujuanTerpilih = '';

                    // Periksa apakah salah satu opsi persetujuan telah dipilih
                    for (var i = 0; i < persetujuanRadios.length; i++) {
                        if (persetujuanRadios[i].checked) {
                            persetujuanTerpilih = persetujuanRadios[i].value;
                            break;
                        }
                    }

                    // Jika persetujuan tidak terpilih, tampilkan swal alert
                    if (!persetujuanTerpilih) {
                        swal("Maaf",
                            "Silakan pilih salah satu opsi persetujuan!",
                            "error");
                        isValid = false;
                    }

                    break;
                case 2:
                    // validasi data pada langkah 1

                    var isForm = false;

                    function dateToMDY(dateStr) {
                        const date = new Date(dateStr);
                        const day = String(date.getDate()).padStart(2, '0');
                        const month = String(date.getMonth() + 1).padStart(2, '0');
                        const year = date.getFullYear();
                        return `${day}-${month}-${year}`;
                    }

                    var application_type = $("select[name='application_type']").val();
                    if (!application_type) {
                        $("select[name='application_type']").addClass("is-invalid");
                        isValid = false;
                    } else {
                        $("select[name='application_type']").removeClass("is-invalid");

                        let input = document.getElementById('form_code');
                        if (input) {
                            input.value = application_type;
                        }

                        var appl_id = $("input[name='appl_id']").val();

                        isForm = true;
                    }

                    var front_degree = $("input[name='front_degree']").val();
                    var name = $("input[name='name']").val();
                    var back_degree = $("input[name='back_degree']").val();
                    var fullName = front_degree + ' ' + name.toUpperCase() + ' ' + back_degree;
                    document.getElementById('memberName').innerHTML = fullName;

                    var place = $("input[name='place']").val();
                    var birth_date = $("input[name='birth_date']").val();

                    var birthPlaceInfo = place ? place.toUpperCase() : '';
                    if (birth_date) {
                        var formattedDate = dateToMDY(birth_date);
                        birthPlaceInfo += birthPlaceInfo ? ', ' + formattedDate : formattedDate;
                    }

                    document.getElementById('memberBirthPlace').innerHTML = birthPlaceInfo;

                    var home_address = $("input[name='home_address']").val();
                    document.getElementById('memberAddress').innerHTML = home_address ? home_address.toUpperCase() : '';

                    var email = $("input[name='email']").val();
                    document.getElementById('memberEmail').innerHTML = email;

                    var phone = $("input[name='phone']").val();
                    document.getElementById('memberPhone').innerHTML = phone;

                    var academic_degree_a = $("select[name='academic_degree_a']").val();
                    if (!academic_degree_a) {
                        $("select[name='academic_degree_a']").addClass("is-invalid");
                        isValid = false;
                    } else {
                        $("select[name='academic_degree_a']").removeClass("is-invalid");
                        fetchAcademic('a', academic_degree_a);
                    }

                    var academic_degree_b = $("select[name='academic_degree_b']").val();
                    var academic_degree_c = $("select[name='academic_degree_c']").val();
                    if (academic_degree_b) {
                        fetchAcademic('b', academic_degree_b);
                    }
                    if (academic_degree_c) {
                        fetchAcademic('c', academic_degree_c);
                    }


                    function fetchAcademic(label, id) {
                        $.ajax({
                            url: '/non-anggota/get-academic/' + id,
                            type: "GET",
                            dataType: "json",
                            success: function(data) {
                                console.log("ACADEMIC " + JSON.stringify(data));
                                if (label === 'a' && id != null) {
                                    document.getElementById('memberAcademicDegreeA').innerHTML = data.name ? data.name.toUpperCase() : '';
                                } else if (label === 'b' && id != null) {
                                    document.getElementById('memberAcademicDegreeB').innerHTML = data.name ? data.name.toUpperCase() : '';
                                } else if (label === 'c' && id != null) {
                                    document.getElementById('memberAcademicDegreeC').innerHTML = data.name ? data.name.toUpperCase() : '';
                                }
                            },
                            error: function(xhr) {
                                alert('Error: ' + xhr.statusText);
                            }
                        });
                    }

                    var institution_a = $("select[name='institution_a']").val();
                    if (!institution_a) {
                        $("select[name='institution_a']").addClass("is-invalid");
                        isValid = false;
                    } else {
                        $("select[name='institution_a']").removeClass("is-invalid");
                        fetchInstitution("a", institution_a);
                    }

                    var institution_b = $("select[name='institution_b']").val();
                    var institution_c = $("select[name='institution_c']").val();
                    if (institution_b) {
                        fetchInstitution("b", institution_b);
                    }
                    if (institution_c) {
                        fetchInstitution("c", institution_c);
                    }

                    function fetchInstitution(label, id) {
                        $.ajax({
                            url: '/non-anggota/get-institution/' + id,
                            type: "GET",
                            dataType: "json",
                            success: function(data) {
                                console.log("INSTITUSION " + JSON.stringify(data));
                                if (label === 'a' && id != null) {
                                    document.getElementById('memberInstitutionA').innerHTML = data.name ? data.name.toUpperCase() : '';
                                } else if (label === 'b' && id != null) {
                                    document.getElementById('memberInstitutionB').innerHTML = data.name ? data.name.toUpperCase() : '';
                                } else if (label === 'c' && id != null) {
                                    document.getElementById('memberInstitutionC').innerHTML = data.name ? data.name.toUpperCase() : '';
                                }
                            },
                            error: function(xhr) {
                                alert('Error: ' + xhr.statusText);
                            }
                        });
                    }

                    var graduation_year_a = $("input[name='graduation_year_a']").val();
                    document.getElementById('memberGraduationYearA').innerHTML = graduation_year_a ? dateToMDY(graduation_year_a) : '';

                    var graduation_year_b = $("input[name='graduation_year_b']").val();
                    document.getElementById('memberGraduationYearB').innerHTML = graduation_year_b ? dateToMDY(graduation_year_b) : '';

                    var graduation_year_c = $("input[name='graduation_year_c']").val();
                    document.getElementById('memberGraduationYearC').innerHTML = graduation_year_c ? dateToMDY(graduation_year_c) : '';


                    var ijazah_no_a = $("input[name='ijazah_no_a']").val();
                    document.getElementById('memberIjazahNoA').innerHTML = ijazah_no_a;

                    var ijazah_no_b = $("input[name='ijazah_no_b']").val();
                    document.getElementById('memberIjazahNoB').innerHTML = ijazah_no_b;

                    var ijazah_no_c = $("input[name='ijazah_no_c']").val();
                    document.getElementById('memberIjazahNoC').innerHTML = ijazah_no_c;


                    var ijazah_du = $("input[name='ijazah_du']").val();
                    if (!ijazah_du) {
                        $("input[name='ijazah_du']").addClass("is-invalid");
                        isValid = false;
                    } else {
                        $("input[name='ijazah_du']").removeClass("is-invalid");
                    }

                    var ijazah_du_year = $("input[name='ijazah_du_year']").val();
                    if (!ijazah_du_year) {
                        $("input[name='ijazah_du_year']").addClass("is-invalid");
                        isValid = false;
                    } else {
                        $("input[name='ijazah_du_year']").removeClass("is-invalid");
                    }

                    var employment_status = $("select[name='employment_status']").val();
                    var time_type = $("select[name='time_type']").val();
                    var position = $("select[name='position']").val();
                    document.getElementById('memberEmploymentStatus').innerHTML = employment_status + '/' + time_type;
                    document.getElementById('memberPosition').innerHTML = position;

                    var hospital = $("input[name='hospital']").val();
                    var practice_address = $("input[name='practice_address']").val();
                    document.getElementById('memberPractice').innerHTML = hospital ? hospital.toUpperCase() : '';
                    document.getElementById('memberPracticeAddress').innerHTML = practice_address;

                    var private_practice = $("input[name='private_practice']").val();
                    var private_practice_address = $("input[name='private_practice_address']").val();
                    document.getElementById('memberPrivatePractice').innerHTML = private_practice ? private_practice.toUpperCase() : '';
                    document.getElementById('memberPrivatePracticeAddress').innerHTML = private_practice_address;

                    var str_no = $("input[name='str_no']").val();
                    document.getElementById('memberStr').innerHTML = str_no;
                    var validity_period_str = $("input[name='validity_period_str']").val();
                    document.getElementById('memberStrPeriode').innerHTML = validity_period_str ? dateToMDY(validity_period_str) : '';

                    var str_no_sp = $("input[name='str_no_sp']").val();
                    var validity_period_str_sp = $("input[name='validity_period_str_sp']").val();
                    document.getElementById('memberStrSP').innerHTML = str_no_sp;
                    document.getElementById('memberStrSPPeriode').innerHTML = validity_period_str_sp ? dateToMDY(validity_period_str_sp) : '';

                    var str_no_kt = $("input[name='str_no_kt']").val();
                    var validity_period_str_kt = $("input[name='validity_period_str_kt']").val();
                    document.getElementById('memberStrKT').innerHTML = str_no_kt;
                    document.getElementById('memberStrKTPeriode').innerHTML = validity_period_str_kt ? dateToMDY(validity_period_str_kt) : '';

                    var area_of_idi = $("select[name='area_of_idi']").val();
                    var branch_of_idi = $("select[name='branch_of_idi']").val();
                    document.getElementById('memberArea').innerHTML = area_of_idi + '-' + branch_of_idi;

                    var npac_npa = $("input[name='npac_npa']").val();
                    var central_idi_npa = $("input[name='central_idi_npa']").val();
                    if (!central_idi_npa) {
                        $("input[name='central_idi_npa']").addClass("is-invalid");
                        isValid = false;
                    } else {
                        $("input[name='central_idi_npa']").removeClass("is-invalid");
                        document.getElementById('memberNomor').innerHTML = npac_npa + '/' + central_idi_npa;
                    }

                    if (isValid) {
                        // loading setup form
                        var formDocumentContainer = $('.form-document');
                        let loading = `<div class="col-md-12">
                                                    <div class="alert alert-warning alert-has-icon">
                                                        <div class="alert-icon"><i class="far fa-lightbulb"></i></div>
                                                        <div class="alert-body">
                                                            <div class="alert-title">Harap Bersabar</div>
                                                            <span class="spinner-border spinner-border-sm" role="status" aria-hidden="true"></span> Menyiapkan Dokumen ...
                                                        </div>
                                                    </div>
                                                </div>
                                                <div class="col-md-12 text-center">
                                                    <img id="imgPreview" src="/assets-panel/img/empty-data.gif" alt="Gambar" style="width: 272px; height: 272px" />
                                                    <br>
                                                    <span class="spinner-border spinner-border-sm" role="status" aria-hidden="true"></span> Tunggu Sebentar Saja ...
                                                </div>
                                                <br>`;
                        formDocumentContainer.html(loading);

                        $.get('/non-anggota/get-setup-form-edit/' + application_type, function(result) {
                            const resultString = JSON.stringify(result);
                            // console.log("SETUP FORM : " + resultString);
                            setupform = result;

                            if (setupform !== undefined && setupform !== null) {
                                document.getElementById('form_name').innerHTML = setupform.name;
                                document.getElementById('application_name').innerHTML = setupform.name;

                                fetch(`/non-anggota/get-setup-document-edit/${setupform.id}`)
                                    .then(response => response.json())
                                    .then(setupdocument => {
                                        const sipsetupdocumentString = JSON.stringify(setupdocument);
                                        // console.log("SETUP DOCUMENT : " + sipsetupdocumentString);
                                        if (Array.isArray(setupdocument) || setupdocument.length > 0) {
                                            let html = `<div class="row">`;

                                            const promises = setupdocument.map(value =>
                                                fetch(`/non-anggota/get-setup-document-detail-edit/${value.document_detail_id}/${appl_id}/NO`)
                                                .then(response => response.json())
                                            );

                                            Promise.all(promises)
                                                .then(setupdocumentdetails => {
                                                    let html = `<div class="row">`;

                                                    for (let setupdocumentdetail of setupdocumentdetails.flat()) {
                                                        const filesString = JSON.stringify(setupdocumentdetail);
                                                        // console.log("SETUP DETAIL : " + filesString);

                                                        let bintang = (setupdocumentdetail.is_mandatory == 'required') ? '**' : '';
                                                        let required = (setupdocumentdetail.is_mandatory == 'required') ? 'required' : '';

                                                        // required="${setupdocumentdetail.is_mandatory}"
                                                        html += `<div class="col-md-4 form-group">
                                                                            <label class="font-weight-bold text-dark">Dokumen Unggahan : <strong class="font-weight-bold text-success">${ setupdocumentdetail.file_name && setupdocumentdetail.file_name.file_name ? setupdocumentdetail.file_name.file_name : '' }</strong></label>
                                                                            <br>
                                                                            <label class="font-weight-bold" title="${setupdocumentdetail.is_submission !== 'NO' ? 'KHUSUS '+ setupdocumentdetail.is_submission : ''}">${setupdocumentdetail.name} <span class="text-danger">${setupdocumentdetail.allowed_file_types} ${bintang}</span></label>
                                                                            <input type="file" name="files.${setupdocumentdetail.code}" data-name="${setupdocumentdetail.name}" class="form-control" max="${setupdocumentdetail.max_size}" accept="${setupdocumentdetail.allowed_file_types}" />
                                                                            <span class="error text-danger">${setupdocumentdetail.code}</span>
                                                                        </div>`;
                                                    }

                                                    html += `</div>`;
                                                    formDocumentContainer.html(html);
                                                    // console.log(html);

                                                    var validBtn = $('.validBtn');
                                                    validBtn.show();
                                                })
                                                .catch(error => console.log(error));
                                        } else {
                                            let html = `<div class="col-md-12 form-group">
                                                                <div class="alert alert-warning alert-has-icon">
                                                                    <div class="alert-icon"><i class="far fa-lightbulb"></i></div>
                                                                    <div class="alert-body">
                                                                        <div class="alert-title">Maaf</div>
                                                                        Belum ada form yang di setup, silahkan menghubungi Admin IDI Cabang Tangerang.
                                                                    </div>
                                                                </div>
                                                                </div>
                                                                <div class="md-12 text-center">
                                                                    <img id="imgPreview" src="/assets-panel/img/empty-data.gif" alt="Gambar" style="width: 272px; height: 272px" />
                                                                </div>
                                                                <br>`;
                                            formDocumentContainer.html(html);
                                            // console.log(html);
                                        }
                                    });
                            } else {
                                let html = `<div class="col-md-12 form-group">
                                                    <div class="alert alert-warning alert-has-icon">
                                                        <div class="alert-icon"><i class="far fa-lightbulb"></i></div>
                                                        <div class="alert-body">
                                                            <div class="alert-title">Maaf</div>
                                                            Belum ada dokumen yang di setup, silahkan menghubungi Admin IDI Cabang Tangerang.
                                                        </div>
                                                    </div>
                                                </div>
                                                <div class="md-12 text-center">
                                                    <img id="imgPreview" src="/assets-panel/img/empty-data.gif" alt="Gambar" style="width: 272px; height: 272px" />
                                                </div>`;
                                formDocumentContainer.html(html);
                                // console.log(html);
                            }
                        });
                    } else {
                        var formDocumentContainer = $('.form-document');
                        let loading = `<div class="col-md-12">
                                                    <div class="alert alert-warning alert-has-icon">
                                                        <div class="alert-icon"><i class="far fa-lightbulb"></i></div>
                                                        <div class="alert-body">
                                                            <div class="alert-title">Silakan Kembali</div>
                                                            <span class="spinner-border spinner-border-sm" role="status" aria-hidden="true"></span> Ada Yang Tidak Beres ...
                                                        </div>
                                                    </div>
                                                </div>
                                                <div class="col-md-12 text-center">
                                                    <img id="imgPreview" src="/assets-panel/img/empty-data.gif" alt="Gambar" style="width: 272px; height: 272px" />
                                                    <br>
                                                    <span class="spinner-border spinner-border-sm" role="status" aria-hidden="true"></span> Lengkapi Data Sebelumnya ...
                                                </div>
                                                <br>`;
                        formDocumentContainer.html(loading);

                        var validBtn = $('.validBtn');
                        validBtn.hide();

                    }

                    break;
                case 3:
                    // Mendapatkan semua input file pada form
                    var inputFiles = $('input[type=file]');
                    var isValid = true;

                    let upload = [];

                    // Melakukan validasi pada setiap input file
                    inputFiles.each(function() {
                        var inputFile = $(this);
                        var inputName = inputFile.attr('name');
                        var inputValue = inputFile.val();
                        var inputDocName = inputFile.data('name');

                        if (inputFile.prop('required') && !inputValue) {
                            isValid = false;
                            inputFile.addClass('is-invalid');
                            inputFile.after('<span class="error text-danger">File harus diunggah</span>');
                        } else if (inputValue) {
                            var allowedTypes = inputFile.attr('accept').split(',');
                            var fileType = inputValue.substring(inputValue.lastIndexOf('.') + 1).toLowerCase();
                            var fileSize = inputFile.prop('files')[0].size;
                            var maxSize = inputFile.data('max-size');

                            if ($.inArray('.' + fileType, allowedTypes) == -1) {
                                isValid = false;
                                inputFile.addClass('is-invalid');
                                inputFile.after('<span class="error text-danger">Tipe file tidak didukung</span>');
                            } else if (fileSize > maxSize) {
                                isValid = false;
                                inputFile.addClass('is-invalid');
                                inputFile.after('<span class="error text-danger">Ukuran file terlalu besar (maks. ' + maxSize / 1024 / 1024 + ' MB)</span>');
                            } else {
                                inputFile.removeClass('is-invalid');
                                inputFile.next('.error').remove();

                                // var fileNameTag = document.querySelector('#file_name');
                                // var fileLink = document.querySelector('#file_link');
                                var fileName = inputValue.split('\\').pop();
                                // fileNameTag.innerText = fileName;
                                // fileLink.href = URL.createObjectURL(this.files[0]);

                                var stringDoc = inputName.replace('files.', '');

                                // Membuat objek sip dari nilai yang diambil
                                var document = {
                                    'file_data': inputDocName,
                                    'file_doc': stringDoc,
                                    'file_name': fileName,
                                    'file_link': URL.createObjectURL(this.files[0])
                                };

                                // Menambahkan objek sip ke dalam array allSips
                                upload.push(document);

                                const uploadString = JSON.stringify(upload);
                                // console.log("Document : " + uploadString);

                            }
                        }
                    });

                    const uploadString = JSON.stringify(upload);
                    // console.log("Proses File : " + uploadString);

                    // Kosongkan isi dari tbody di dalam tabel
                    $('#upload-table tbody').empty();

                    // Looping untuk setiap objek di dalam array upload
                    for (let i = 0; i < upload.length; i++) {
                        // Membuat baris baru di dalam tabel
                        $('#upload-table tbody').append('<tr></tr>');

                        // Memasukkan data ke dalam baris yang baru saja dibuat
                        $('#upload-table tbody tr:last-child').append('<td>' + upload[i].file_doc + '</td>');
                        $('#upload-table tbody tr:last-child').append('<td>' + upload[i].file_data + '</td>');
                        $('#upload-table tbody tr:last-child').append('<td>' + upload[i].file_name + '</td>');
                        $('#upload-table tbody tr:last-child').append('<td><div class="row justify-content-md-center"><a href="' + upload[i].file_link + '" target="_blank" class="btn btn-primary btn-action" data-toggle="tooltip" title="Lihat"><i class="fas fa-eye"></i></a></div></td>');

                        // Debugging, untuk menampilkan isi objek
                        const uploadString = JSON.stringify(upload[i]);
                        // console.log("Data : " + uploadString);
                    }

                    // Mengembalikan hasil validasi
                    return isValid;

                    // Menghapus pesan error saat input file diubah
                    $('input[type=file]').change(function() {
                        $(this).removeClass('is-invalid');
                        $(this).next('.error').remove();
                    });

                    break;

                case 4:
                    // tambahkan case untuk langkah-langkah berikutnya

                    var application_status = $("select[name='application_status']").val();
                    if (!application_status) {
                        $("select[name='application_status']").addClass("is-invalid");
                        isValid = false;
                    } else {
                        $("select[name='application_status']").removeClass("is-invalid");
                    }

                    var note = $("textarea[name='note']").val();
                    if (!note) {
                        $("textarea[name='note']").addClass("is-invalid");
                        isValid = false;
                    } else {
                        $("textarea[name='note']").removeClass("is-invalid");
                    }

                    break;

                default:
                    isValid = false;
            }
            return isValid;
        }

        function goToStep(step) {
            // sembunyikan konten langkah saat ini
            $(".setup-content").hide();

            // tampilkan konten langkah yang sesuai
            $("#step-" + step).show();

            // ubah tampilan progress bar
            $(".progressbar li").removeClass("active");
            $(".progressbar li:nth-child(" + step + ")").addClass("active");

            // perbarui nilai currentStep
            currentStep = step;

            // sembunyikan tombol Kembali (Back) jika sedang berada di langkah pertama
            if (currentStep === 2) {
                $(".backBtn").hide();
            } else {
                $(".backBtn").show();
            }

            // ganti teks tombol Lanjut (Next) menjadi Selesai (Finish) jika sudah mencapai langkah terakhir
            if (currentStep === $(".progressbar li").length) {
                $(".nextBtn").text("Kirim");
            } else {
                $(".nextBtn").innerHTML = 'Lanjut <i class="fa fa-arrow-right"></i>';
            }
        }
    });
</script>

<!-- SUBMIT DATA -->
<script>
    document.addEventListener('DOMContentLoaded', function() {
        // Cari elemen form dan tombol submit
        const form = document.querySelector('.form-keanggotaan-edit');
        const submitBtn = document.querySelector('.submitBtn');
        const agree = document.querySelector('#agree');

        // Tambahkan event listener pada tombol submit
        submitBtn.addEventListener('click', function() {
            // id
            var id = $(this).data('id');

            // Validasi form
            var application_status = $("select[name='application_status']").val();
            if (!application_status) {
                $("select[name='application_status']").addClass("is-invalid");
                return;
            } else {
                $("select[name='application_status']").removeClass("is-invalid");
            }

            var note = $("textarea[name='note']").val();
            if (!note) {
                $("textarea[name='note']").addClass("is-invalid");
                return;
            } else {
                $("textarea[name='note']").removeClass("is-invalid");
            }

            if (!agree.checked) {
                // Jika form tidak valid, munculkan pesan peringatan
                swal('Peringatan', 'Anda sudah membaca tapi belum menyetujui persyaratan', 'warning');
                return;
            }


            // Jika form valid, tampilkan loading spinner pada tombol submit
            showLoading();
            disableButton();

            var CSRF_TOKEN = $('meta[name="csrf-token"]').attr('content');

            // Buat objek FormData dari form
            const formData = new FormData(form);

            // Show confirmation dialog using SweetAlert
            swal({
                title: "Yakin Melakukan Revisi Pengajuan ?",
                text: "Cek Data dan konfirmasi Jika sudah sesuai !",
                type: "warning",
                showCancelButton: !0,
                confirmButtonText: "Kirim",
                cancelButtonText: "Batal",
                cancelButtonColor: "#FA2A21",
                confirmButtonColor: "#1AA13E",
                reverseButtons: !0
            }).then(function(e) {
                if (e.value === true) {
                    // Send form data to server using fetch
                    fetch('/non-anggota/form/revisi', {
                            method: 'POST',
                            body: formData
                        })
                        .then(response => {
                            if (!response.ok) {
                                throw new Error('Respon jaringan tidak baik');
                            }
                            return response.json();
                        })
                        .then(data => {
                            // Handle response from server
                            if (data.success === true) {
                                swal("Berhasil", data.message, "success");
                                window.location.replace("{{ url('non-anggota/form') }}");
                                // console.log(data);
                            } else {
                                swal("Gagal", data.message, "error");
                                // Hilangkan loading spinner pada tombol submit
                                hideLoading();
                                enableButton();
                            }
                        })
                        .catch(error => {
                            // Handle error
                            console.error(error);
                            swal("Gagal", error.message, "error");
                            // Hilangkan loading spinner pada tombol submit
                            hideLoading();
                            enableButton();
                        });
                } else {
                    e.dismiss;
                    // Hilangkan loading spinner pada tombol submit
                    hideLoading();
                    enableButton();
                }
            }, function(dismiss) {
                return false;
                // Hilangkan loading spinner pada tombol submit
                hideLoading();
                enableButton();
            });

        });

        // Fungsi untuk menampilkan loading spinner pada tombol submit
        function showLoading() {
            submitBtn.innerHTML = '<span class="spinner-border spinner-border-sm" role="status" aria-hidden="true"></span> Loading...';
            submitBtn.disabled = true;
        }

        // Fungsi untuk menghilangkan loading spinner pada tombol submit
        function hideLoading() {
            submitBtn.innerHTML = 'Kirim';
        }

        // Fungsi untuk menonaktifkan tombol submit
        function disableButton() {
            submitBtn.disabled = true;
        }

        // Fungsi untuk mengaktifkan tombol submit
        function enableButton() {
            submitBtn.disabled = false;
        }
    });
</script>

@endsection