@extends('home')

@section('pagesection')
<div class="container">
    <div class="subheader">
        <h1 class="subheader-title">
            <i class='subheader-icon fal fa-table'></i> Create Customers
        </h1>
    </div>
    <div class="row">
        <div class="col-xl-12">
            <div id="panel-1" class="panel">
                <div class="panel-hdr">
                    <h2>
                        Add <span class="fw-300"><i>Customers</i></span>
                    </h2>
                    <div class="panel-toolbar">
                        <button class="btn btn-panel" data-action="panel-collapse" data-toggle="tooltip" data-offset="0,10" data-original-title="Collapse"></button>
                        <button class="btn btn-panel" data-action="panel-fullscreen" data-toggle="tooltip" data-offset="0,10" data-original-title="Fullscreen"></button>
                        <button class="btn btn-panel" data-action="panel-close" data-toggle="tooltip" data-offset="0,10" data-original-title="Close"></button>
                    </div>
                </div>
                <div class="panel-container show">
                    <div class="panel-content">
                        <div class="card-body">
                            <form method="POST" action="{{ route('customer.store') }}">
                                @csrf

                                <div class="form-group row">
                                    <label for="f_name" class="col-md-4 col-form-label text-md-right">First Name</label>

                                    <div class="col-md-6">
                                        <input id="f_name" type="text" class="form-control @error('name') is-invalid @enderror" name="f_name" value="{{ old('name') }}" required autocomplete="f_name" autofocus>
                                    </div>
                                </div>
                                <div class="form-group row">
                                    <label for="l_name" class="col-md-4 col-form-label text-md-right">Last Name</label>

                                    <div class="col-md-6">
                                        <input id="l_name" type="text" class="form-control @error('name') is-invalid @enderror" name="l_name" value="{{ old('name') }}" required autocomplete="l_name" autofocus>
                                    </div>
                                </div>
                                <div class="form-group row">
                                    <label for="email" class="col-md-4 col-form-label text-md-right">Email</label>

                                    <div class="col-md-6">
                                        <input id="email" type="email" class="form-control @error('name') is-invalid @enderror" name="email" value="{{ old('email') }}" required autocomplete="email" autofocus>
                                    </div>
                                </div>
                                <div class="form-group row">
                                    <label for="address" class="col-md-4 col-form-label text-md-right">Address</label>

                                    <div class="col-md-6">
                                        <input id="address" type="text" class="form-control @error('address') is-invalid @enderror" name="address" value="{{ old('address') }}" autocomplete="address" autofocus>
                                    </div>
                                </div>
                                <div class="form-group row">
                                    <label for="nic" class="col-md-4 col-form-label text-md-right">NIC</label>

                                    <div class="col-md-6">
                                        <input id="nic" type="number" class="form-control @error('name') is-invalid @enderror" name="nic" value="{{ old('name') }}" required autocomplete="nic" autofocus>
                                    </div>
                                </div>
                                <div class="form-group row">
                                    <label for="state" class="col-md-4 col-form-label text-md-right">State</label>

                                    <div class="col-md-6">
                                        <select class="form-control" name="state" id="state">
                                            @foreach (getStates() as $key => $item)
                                                <option value="{{ $key }}">{{ $key }}</option>
                                            @endforeach
                                          </select>

                                    </div>
                                </div>
                                <div class="form-group row">
                                    <label for="local" class="col-md-4 col-form-label text-md-right">Local Govt.</label>

                                    <div class="col-md-6">
                                        <select class="form-control" name="local" id="local">
                                            @foreach (array_values(getStates())[0] as $item)
                                                <option value="{{ $item }}">{{ $item }}</option>
                                            @endforeach
                                          </select>

                                    </div>
                                </div>
                                <div class="form-group row">
                                    <label for="dob" class="col-md-4 col-form-label text-md-right">Date of Birth</label>

                                    <div class="col-md-6">
                                        <input id="dob" type="date" class="form-control @error('name') is-invalid @enderror" name="dob" value="{{ old('name') }}" required autocomplete="dob" autofocus>
                                    </div>
                                </div>
                                <div class="form-group row">
                                    <label for="work_phone" class="col-md-4 col-form-label text-md-right">Work Phone</label>

                                    <div class="col-md-6">
                                        <input id="work_phone" type="text" class="form-control @error('name') is-invalid @enderror" name="work_phone" value="{{ old('name') }}" autocomplete="work_phone" autofocus>
                                    </div>
                                </div>
                                <div class="form-group row">
                                    <label for="mobile_phone" class="col-md-4 col-form-label text-md-right">Mobile Phone</label>

                                    <div class="col-md-6">
                                        <input id="mobile_phone" type="text" class="form-control @error('name') is-invalid @enderror" name="mobile_phone" value="{{ old('name') }}" autocomplete="mobile_phone" autofocus>
                                    </div>
                                </div>

                                <div class="form-group row">
                                    <label for="password" class="col-md-4 col-form-label text-md-right">Password</label>

                                    <div class="col-md-6">
                                        <input id="password" type="password" class="form-control @error('name') is-invalid @enderror" name="password" value="{{ old('password') }}" required autocomplete="password" autofocus>
                                    </div>
                                </div>

                                <div class="form-group row mb-0">
                                    <div class="col-md-6 offset-md-4">
                                        <button type="submit" class="btn btn-primary">
                                            Submit
                                        </button>
                                    </div>
                                </div>
                            </form>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
</div>
<script src="https://ajax.googleapis.com/ajax/libs/jquery/3.5.1/jquery.min.js"></script>
<script>

    $(document).ready(function(){
        $("#state").change(function(){
            var option = '';
            var data = {!! json_encode(array_values(getStates())) !!};
            $(data[$("#state")[0].selectedIndex]).each(function(index,v){
                    option +="<option value='"+v+"'>"+v+"</option>";
                });
                $("#local").empty().append(option);
        });
    });


</script>

@endsection