@extends('layouts.app')

@section('header')
<div class="card borderless-card">
    <div class="card-block primary-breadcrumb">
        <div class="breadcrumb-header">
            <h5>Patient</h5>
        </div>
        <div class="page-header-breadcrumb">
            <ul class="breadcrumb-title">
                <li class="breadcrumb-item">
                    <a href="{{ \URL::to('/')}}">
                        <i class="fas fa-home"></i>
                    </a>
                </li>
                <li class="breadcrumb-item"><a href="{{ \URL::to('patient') }}">List Patient</a>
                </li>
                <li class="breadcrumb-item"><a href="#">Edit Patient</a>
                </li>
            </ul>
        </div>
    </div>
</div>

@endsection

@section('content')

<!-- Basic Form Inputs card start -->
<div class="card">
    <div class="card-header">
        <h5>Edit Patient</h5>
    </div>

    <div class="card-block">
        <form method="post" action="{{ \URL::to('patient/update') }}"  enctype="multipart/form-data" data-parsley-validate="">
            {{ csrf_field() }}
            <input type="hidden" name="patient_id" value="{{ $patient['id'] }}">
            <div class="form-group row">
                <label for="firstname" class="col-sm-2 col-form-label">First Name <i class="text-danger">*</i></label>
                <div class="col-sm-10">
                    <input type="text" id="firstname" name="firstname" class="form-control" value="{{ $patient['firstname'] }}" data-parsley-minlength="2" data-parsley-maxlength="50" data-parsley-required data-parsley-error-message="This field cannot be empty and value should be greater than 1 and less than 50">
                </div>
            </div>

            <div class="form-group row">
                <label for="lastname" class="col-sm-2 col-form-label">Last Name <i class="text-danger">*</i></label>
                <div class="col-sm-10">
                    <input type="text" id="lastname" name="lastname" class="form-control" maxlength="50" value="{{ $patient['lastname'] }}" data-parsley-minlength="1" data-parsley-maxlength="50" data-parsley-required data-parsley-error-message="This field cannot be empty and value should be greater than 0 and less than 50">
                </div>
            </div>

            <div class="form-group row">
                <label for="email" class="col-sm-2 col-form-label">Email</label>
                <div class="col-sm-10">
                    <input type="email" id="email"  name="email" class="form-control"  value="{{ $patient['email'] }}" data-parsley-error-message="Enter the valid Email id">
                </div>
            </div>

            <div class="form-group row">
                <label for="address" class="col-sm-2 col-form-label">Address</label>
                <div class="col-sm-10">
                    <textarea rows="5" cols="5" id="address" name="address" class="form-control" data-parsley-required data-parsley-error-message="This field cannot be empty and value should be greater than 10" data-parsley-minlength="10">{{ $patient['address'] }}</textarea>
                </div>
            </div>

            <div class="form-group row">
                 <label for="phnumber" class="col-sm-2 col-form-label">Phone Number</label>
                <div class="col-sm-10">
                    <input type="text" id="phnumber" name="phnumber" class="form-control" data-parsley-minlength="6" data-parsley-maxlength="20" data-parsley-error-message="Value should be greater than 5 and less than 20" value="{{ $patient['phnumber'] }}">
                </div>
            </div>

            <div class="form-group row">
                 <label for="mobilenumber" class="col-sm-2 col-form-label">Mobile Number <i class="text-danger">*</i></label>
                <div class="col-sm-10">
                    <input type="text" id="mobilenumber" name="mobilenumber" class="form-control" data-parsley-minlength="10" data-parsley-maxlength="20" data-parsley-error-message="This field cannot be empty and value should be greater than 9 and less than 20" value="{{ $patient['mobile'] }}" data-parsley-required>
                </div>
            </div>

            <div class="form-group row">
                <label class="col-sm-2 col-form-label">Profile Picture</label>
                <div class="col-sm-10">
                    <input type="file" id="profilepic" name="profilepic" class="form-control">
                    {!! $patient['profilepic'] !!}
                </div>
            </div>

            <div class="form-group row">
                 <label for="age" class="col-sm-2 col-form-label">Age <i class="text-danger">*</i></label>
                <div class="col-sm-10">
                    <input type="number" id="age" name="age" class="form-control" data-parsley-minlength="1" data-parsley-maxlength="3" data-parsley-error-message="This field cannot be empty and value should be greater than 1 and less than 3" data-parsley-required value="{{ $patient['age'] }}">
                </div>
            </div>

            {{-- <div class="form-group row">
                 <label for="dob" class="col-sm-2 col-form-label">Date of Birth <i class="text-danger">*</i></label>
                <div class="col-sm-10">
                    <div class="input-group">
                        <input type="text" name="dob" class="form-control" id='datetimepicker1'  data-parsley-required data-parsley-error-message="The Field cannot be empty" autocomplete="off" value="{{ date('d-m-Y',strtotime($patient['dob'])) }}">
                        <span class="input-group-addon"><i class="fas fa-calendar-alt"></i></span>
                    </div>
                </div>
            </div> --}}


            <div class="form-group row">
                <label class="col-sm-2">Sex <i class="text-danger">*</i></label>
                <div class="col-sm-10">
                    <div class="form-check">
                        <label class="radio-inline">
                            <input type="radio" name="sex" value="m" {{ $patient['sex_id'] == 'm' ? 'checked' : '' }}>Male                  
                        </label>
                        <label class="radio-inline">
                            <input type="radio" name="sex" value="f" {{ $patient['sex_id'] == 'f' ? 'checked' : '' }}>Female
                        </label> 
                    </div>
                </div>
            </div>

            <div class="form-group row">
                 <label for="bloodgroup" class="col-sm-2 col-form-label">Blood Group <i class="text-danger">*</i></label>
                <div class="col-sm-10">
                    <select id="bloodgroup" name="bloodgroup" class=" col-sm-10"></select>
                </div>
            </div>

            <div class="row">
                <label class="col-sm-2"></label>
                <div class="col-sm-10">
                    <button type="submit" class="btn btn-primary m-b-0">Update</button>
                </div>
            </div>

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

@endsection

@section('scripts')

<script type="text/javascript">
$(document).ready(function() {

    var bloodGroup_raw_data = '{!! $bloodGroup !!}';
    var bloodGroup_data = JSON.parse(bloodGroup_raw_data);

    var bloodgroup_id = '{!! $patient['bloodgroup_id'] !!}';

    $("#bloodgroup").select2({
        data: bloodGroup_data
    });

    $('#bloodgroup').val(bloodgroup_id);
    $('#bloodgroup').trigger('change'); 

    var FromEndDate = new Date();

    $('#datetimepicker1').datetimepicker({
        format: 'DD-MM-YYYY',
        ignoreReadonly: true,
        maxDate: 'now'
    });


});

</script>

@endsection