@extends('website.layouts.app')

@section('content')
    <div class="container">
        <div class="pb-5">
            <div class="back_page">
                <i class="fa-solid fa-arrow-left"></i>
                <a href="{{ route('form16.abstract') }}">Back to account overview</a>
            </div>

            <div class="mandatory-form-container">
                <div class="card">
                    <div class="card-header">
                        <div class="h5 mb-0">Personal Details</div>
                    </div>
                    <div class="card-body">
                        <form action="{{ route('form16.savePersonalDetails') }}" class="form-horizontal" method="POST">
                            @csrf
                            <div class="form-group">
                                <div class="row">
                                    <div class="col-md-4">
                                        <label for="sex"
                                            class="form-label @error('sex') is-invalid @enderror">Sex</label>
                                    </div>
                                    <div class="col-md-4">
                                        <select name="sex" id="sex" class="form-select">
                                            <option value="none">Select</option>
                                            <option value="male"
                                                {{ old('sex', $custPersonalDtls['sex']) == 'male' ? 'selected' : '' }}>Male
                                            </option>
                                            <option value="female"
                                                {{ old('sex', $custPersonalDtls['sex']) == 'female' ? 'selected' : '' }}>
                                                Female</option>
                                            <option value="others"
                                                {{ old('sex', $custPersonalDtls['sex']) == 'others' ? 'selected' : '' }}>
                                                Other</option>
                                        </select>
                                        @error('sex')
                                            <div class="invalid-feedback">{{ $message }}</div>
                                        @enderror
                                    </div>
                                </div>
                            </div>
                            <div class="form-group">
                                <div class="row">
                                    <div class="col-md-4">
                                        <label for="father_name" class="form-label">Father
                                            Name <span class="text-danger">*</span></label>
                                    </div>
                                    <div class="col-md-4">
                                        <input type="text" name="father_name" id="father_name"
                                            class="form-control @error('father_name') is-invalid @enderror"
                                            placeholder="Enter father name"
                                            value="{{ old('father_name', $custPersonalDtls['father_name']) }}" required>
                                        @error('father_name')
                                            <div class="invalid-feedback">{{ $message }}</div>
                                        @enderror
                                    </div>
                                </div>
                            </div>
                            <div class="form-group" id="husband_name_input">
                                <div class="row">
                                    <div class="col-md-4">
                                        <label for="husband_name" class="form-label">Husband
                                            Name</label>
                                    </div>
                                    <div class="col-md-4">
                                        <input type="text" name="husband_name" id="husband_name"
                                            class="form-control  @error('husband_name') is-invalid @enderror"
                                            placeholder="Enter husband name"
                                            value="{{ old('husband_name', $custPersonalDtls['husband_name']) }}">
                                        @error('husband_name')
                                            <div class="invalid-feedback">{{ $message }}</div>
                                        @enderror
                                    </div>
                                </div>
                            </div>
                            <div class="form-group">
                                <div class="row">
                                    <div class="col-md-4">
                                        <label for="date_of_birth" class="form-label">Date of
                                            Birth</label>
                                    </div>
                                    <div class="col-md-4">
                                        <input type="date" name="date_of_birth" id="date_of_birth"
                                            class="form-control @error('date_of_birth') is-invalid @enderror"
                                            placeholder="dd-mm-yyyy"
                                            value="{{ old('date_of_birth', $custPersonalDtls['date_of_birth']) }}">
                                        @error('date_of_birth')
                                            <div class="invalid-feedback">{{ $message }}</div>
                                        @enderror
                                    </div>
                                </div>
                            </div>
                            <div class="form-group">
                                <div class="row">
                                    <div class="col-md-4">
                                        <label for="caste_tribe" class="form-label">Whether the
                                            applicant belongs to Scheduled caste/tribe</label>
                                    </div>
                                    <div class="col-md-4">
                                        <div class="form-check form-check-inline">
                                            <input class="form-check-input @error('caste_tribe') is-invalid @enderror"
                                                type="radio" name="caste_tribe" id="casteTribe1" value="1"
                                                {{ old('caste_tribe', $custPersonalDtls['caste_tribe']) == 1 ? 'checked' : '' }}>
                                            <label class="form-check-label" for="casteTribe1">Yes</label>
                                        </div>
                                        <div class="form-check form-check-inline">
                                            <input class="form-check-input @error('caste_tribe') is-invalid @enderror"
                                                type="radio" name="caste_tribe" id="casteTribe2" value="0"
                                                {{ old('caste_tribe', $custPersonalDtls['caste_tribe']) == 0 ? 'checked' : '' }}>
                                            <label class="form-check-label" for="casteTribe2">No</label>
                                        </div>
                                        @error('caste_tribe')
                                            <div class="invalid-feedback">{{ $message }}</div>
                                        @enderror
                                    </div>
                                </div>
                            </div>
                            <div class="form-group">
                                <div class="row">
                                    <div class="col-md-4">
                                        <label for="occupation" class="form-label">Occupation</label>
                                    </div>
                                    <div class="col-md-4">
                                        <input type="text" name="occupation" id="occupation"
                                            class="form-control @error('occupation') is-invalid @enderror"
                                            placeholder="Enter occupation"
                                            value="{{ old('occupation', $custPersonalDtls['occupation']) }}">
                                        @error('occupation')
                                            <div class="invalid-feedback">{{ $message }}</div>
                                        @enderror
                                    </div>
                                </div>
                            </div>
                            <div class="form-group">
                                <div class="row">
                                    <div class="col-md-4">
                                        <label for="annual_income" class="form-label">Annual Income
                                            Rs.</label>
                                    </div>
                                    <div class="col-md-4">
                                        <input type="text" name="annual_income" id="annual_income"
                                            class="form-control @error('annual_income') is-invalid @enderror"
                                            placeholder="Enter annual income"
                                            value="{{ old('annual_income', $custPersonalDtls['annual_income']) }}">
                                        @error('annual_income')
                                            <div class="invalid-feedback">{{ $message }}</div>
                                        @enderror
                                    </div>
                                </div>
                            </div>
                            <div class="form-group">
                                <div class="row">
                                    <div class="col-md-4">
                                        <label for="residental_address" class="form-label">Residental
                                            Address (Full Postal Address with the name of main Village, Taluk &amp;
                                            District) <span class="text-danger">*</span></label>
                                    </div>
                                    <div class="col-md-4">
                                        <textarea type="text" name="residental_address" id="residental_address"
                                            class="form-control @error('residental_address') is-invalid @enderror" placeholder="Enter residental address"
                                            required>{{ old('residental_address', $custPersonalDtls['residental_address']) }}</textarea>
                                        @error('residental_address')
                                            <div class="invalid-feedback">{{ $message }}</div>
                                        @enderror
                                    </div>
                                </div>
                            </div>
                            <div class="form-group">
                                <div class="row">
                                    <div class="col-md-4">
                                        <label for="residental_address" class="form-label">Particular of Properties held
                                            if any</label>
                                    </div>
                                    <div class="col-md-4">
                                        @foreach ($propertyTypes as $propertyType)
                                            <label class="form-label text-start">{{ $propertyType->name }}</label>
                                            <div class="row mb-3">
                                                @foreach ($propertyAttributes as $propertyAttribute)
                                                    <div class="col-md-6">
                                                        {{-- {{ dd($propertyDetails) }} --}}
                                                        @php
                                                            $propertyDetailKey = "property_{$propertyType->id}_{$propertyAttribute->id}";
                                                            $existingValue = isset($propertyDetails[$propertyDetailKey])
                                                                ? $propertyDetails[$propertyDetailKey]
                                                                : null;
                                                        @endphp
                                                        <input type="text"
                                                            name="{{ $propertyDetailKey }}"
                                                            id="" class="form-control"
                                                            placeholder="{{ $propertyAttribute->name }}"
                                                            value="{{ old($propertyDetailKey, $existingValue) }}">
                                                    </div>
                                                @endforeach
                                            </div>
                                        @endforeach
                                    </div>
                                </div>
                            </div>
                            <div class="form-group">
                                <div class="row">
                                    <div class="col-md-4">&nbsp;</div>
                                    <div class="col-md-4">
                                        <div class="text-center">
                                            <button type="submit" class="btn btn-primary">Submit</button>
                                            <a href="{{ route('form16.abstract') }}"
                                                class="btn btn-danger ms-2">Cancel</a>
                                        </div>
                                    </div>
                                </div>

                            </div>
                        </form>
                    </div>
                </div>
            </div>
        </div>
    </div>
@endsection