@extends('Admin/layout')
@section('title','Visit Add')
@section('content')
<div class="container-fluid">
    <div class="row">
        <div class="col-xxl-12">
            <div class="card">
            <div class="card-header align-items-center d-flex">
                <h4 class="card-title mb-0 flex-grow-1">Visit Add</h4>
            </div>
            <!-- end card header -->
            <div class="card-body">
                <div class="live-preview">
                <form action="{{route('visitportal.visit-store')}}" method="POST" class="needs-validation" enctype="multipart/form-data"  novalidate>
                {{ csrf_field() }}
                    <div class="row">
                    <h5 class="text-primary mb-2 flex-grow-1">Basic Info</h5>
                    <br/>
                    <div class="col-md-4">
                        <div class="mb-3">
                        <label for="firstNameinput" class="form-label">Full Name <span class="text-danger">*</span></label>
                        <input type="text" class="form-control" placeholder="Enter your fullname" id="firstNameinput" name="name" value="{{old('name')}}" required>
                        @if ($errors->has('name'))<div class="invalid-feedback">{{ $errors->first('name') }}</div>@endif
                        </div>
                    </div>
                    <!--end col-->
                    <div class="col-md-4">
                        <div class="mb-3">
                        <label for="lastNameinput" class="form-label">Father Name/Spouse Name</label>
                        <input type="text" class="form-control" placeholder="Enter Father Name/Spouse Name" name="father_name" id="father_name" value="{{old('father_name')}}">
                        @if ($errors->has('father_name'))<div class="invalid-feedback">{{ $errors->first('father_name') }}</div>@endif
                        </div>
                    </div>
                  
                    <div class="col-md-4">
                        <div class="mb-3">
                        <label for="phonenumberInput" class="form-label">Phone Number </label>
                        <input type="tel" class="form-control" placeholder="Phone Number" id="phone" name="phone" oninput="digitValidate(this)" value="{{old('phone')}}" maxlength="10"  >
                        @if ($errors->has('phone'))<div class="invalid-feedback">{{ $errors->first('phone') }}</div>@endif
                        </div>
                    </div>
                    <!--end col-->
                    <div class="col-md-4">
                        <div class="mb-3">
                        <label for="emailidInput" class="form-label">Email Address </label>
                        <input type="email" class="form-control" placeholder="Email Address" id="email" name="email" value="{{old('email')}}" >
                        @if ($errors->has('email'))<div class="invalid-feedback">{{ $errors->first('email') }}</div>@endif
                        </div>
                    </div>
                   
                    <!--end col-->
                    <div class="col-md-4">
                        <div class="mb-3">
                        <label for="address1ControlTextarea" class="form-label">Date<span class="text-danger">*</span></label>
                        <input type="date" class="form-control flatpickr-input active" name="submit_date" placeholder="Date" data-provider="flatpickr" data-date-format="F j, Y" id="date" readonly="readonly" value="{{old('date')}}" required> 
                        </div>
                    </div>
                    <!--end col-->
                    <div class="col-md-4">
                        <div class="mb-3">
                        <label for="address1ControlTextarea" class="form-label">Time (24 Hour Format)<span class="text-danger">*</span></label>
                        <input type="text" class="form-control flatpickr-input active" name="submit_time" placeholder="Time" value="{{old('time')}}" data-provider="timepickr" data-time-hrs="true" id="timepicker-24hrs" readonly="readonly" required>
                        </div>
                    </div>
                   
                   
                  
                    
                    <h5 class="text-primary mb-2 flex-grow-1">Details About Upliner,Scheme Name</h5>
                    <br/>
                    <div class="col-md-6">
                        <div class="mb-3">
                        <label for="citynameInput" class="form-label">Scheme Name <span class="text-danger">*</span></label>
                        <select class="form-select" data-choices id="scheme_name" name="scheme_name"  required>
                            <option value="" >Select Scheme Name</option>
                            @if(!empty($tbl_schemes))
                                @foreach($tbl_schemes as $key => $value)
                                    <option value="{{$value->id}}" >{{$value->name}}</option>
                                @endforeach
                            @endif
                        </select>
                        @if ($errors->has('scheme_name')) <p class="custom_err">{{ $errors->first('scheme_name') }}</p> @endif
                        </div>
                    </div>
                    <!--end col-->
                    <div class="col-md-6">
                        <div class="mb-3">
                        <label for="citynameInput" class="form-label">Associate Name <span class="text-danger">*</span></label>
                        <select class="form-select" data-choices id="associate_name" name="associate_name"  required>
                        <option value="" >Select Associate Name</option>
                            @if(!empty($tblassociates))
                                @foreach($tblassociates as $key => $value)
                                    <option value="{{$value->id}}" >{{$value->name}}, {{$value->rera_no}}, {{$value->phone}}</option>
                                @endforeach
                            @endif
                        </select>
                        @if ($errors->has('associate_name')) <p class="custom_err">{{ $errors->first('associate_name') }}</p> @endif
                        </div>
                    </div>
                    <!--end col-->
                    <div class="col-md-12">
                        <div class="mb-3">
                        <label for="emailidInput" class="form-label">Upload Image </label>
                        <input type="file" class="form-control" required name="file">
                                @if ($errors->has('file')) <p class="custom_err">{{ $errors->first('file') }}</p> @endif
                        </div>
                    </div>
                     <!--end col-->
                    <div class="col-md-12">
                        <div class="mb-3">
                        <label for="emailidInput" class="form-label">Short Note </label>
                        <textarea class="form-control" placeholder="Short Note" id="short_note" name="short_note" > {{old('short_note')}}</textarea>
                        @if ($errors->has('short_note'))<div class="invalid-feedback">{{ $errors->first('short_note') }}</div>@endif
                        </div>
                    </div>
                   
                    <!--end col-->
                    <div class="col-lg-12">
                        <div class="text-end">
                        <button type="submit" class="btn btn-primary">Submit</button>
                        </div>
                    </div>
                    <!--end col-->
                    </div>
                    <!--end row-->
                </form>
                </div>
            
            </div>
            </div>
        </div>
        <!-- end col -->
    </div>

</div>
<script src="{{ URL::asset('assets/js/jquery.min.js') }}"></script>
<script>
    $(document).ready(function(){
        setDobValidation();
    });
    digitValidate = function(ele){
    ele.value = ele.value.replace(/[^0-9]/g,'');
 }
</script>
@endsection