@extends('layouts.admin')

@section('ext_css')
    <link rel="stylesheet" href="{{ asset('NepaliDatepicker/nepali.datepicker.v2.2.min.css') }}" />
@endsection

@section('content')
    <div class="row">
        <div class="panel panel-default">
            <div class="panel-heading">
                <h3 class="panel-title"> Add Black List
                    <span class="pull-right"><strong class="text-danger">*</strong> Required Fields</span>
                </h3>
            </div>

            <div class="panel-body">
                <form action="{{ route('admin.blacklist.store') }}" method="POST" class="form-horizontal form-padding" enctype="multipart/form-data">
                    <div class="col-xs-12 col-sm-12 col-md-6 col-lg-12">
                        <div class="form-group">
                            <label class="col-md-3 control-label" for="black_list_no">Blacklist No. <span class="text-danger">*</span></label>
                            <div class="col-md-9">
                                <input type="text" id="black_list_no" name="black_list_no" class="form-control" value="{{ old('black_list_no') }}" placeholder="Blacklist No." >
                                <small class="help-block text-danger">{{$errors->first('black_list_no')}}</small>
                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-md-3 control-label" for="nature_of_relation">Nature Of relation <span class="text-danger">*</span></label>
                            <div class="col-md-9">
                                <input type="text" id="nature_of_relation" name="nature_of_relation" class="form-control" value="{{ old('nature_of_relation') }}" placeholder="Nature Of relation" >
                                <small class="help-block text-danger">{{$errors->first('nature_of_relation')}}</small>
                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-md-3 control-label" for="name_of_entity">Name of Entity (Individual and Institution blacklist list till date) <span class="text-danger">*</span></label>
                            <div class="col-md-9">
                                <input type="text" id="name_of_entity" name="name_of_entity" class="form-control" value="{{ old('name_of_entity') }}" placeholder="Name of Entity (Individual and Institution blacklist list till date)" >
                                <small class="help-block text-danger">{{$errors->first('name_of_entity')}}</small>
                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-md-3 control-label" for="ctz_reg_pan_no">Ctz No./Registration and Pan no. <span class="text-danger">*</span></label>
                            <div class="col-md-9">
                                <input type="text" id="ctz_reg_pan_no" name="ctz_reg_pan_no" class="form-control" value="{{ old('ctz_reg_pan_no') }}" placeholder="Ctz No./Registration and Pan no." >
                                <small class="help-block text-danger">{{$errors->first('ctz_reg_pan_no')}}</small>
                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-md-3 control-label" for="ctz_reg_pan_no_issued_date">Ctz No./Registration and Pan no. issue date <span class="text-danger">*</span></label>
                            <div class="col-md-9">
                                <input type="text" id="ctz_reg_pan_no_issued_date" name="ctz_reg_pan_no_issued_date" class="form-control nepali-calendar nep-date" value="{{ old('ctz_reg_pan_no_issued_date') }}" placeholder="Ctz No./Registration and Pan no. issue date" autocomplete="off" >
                                <small class="help-block text-danger">{{$errors->first('ctz_reg_pan_no_issued_date')}}</small>
                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-md-3 control-label" for="ctz_reg_pan_no_issued_district_org">Ctz No./ Registration and Pan no issue district/ Registered Organization <span class="text-danger">*</span></label>
                            <div class="col-md-9">
                                <input type="text" id="ctz_reg_pan_no_issued_district_org" name="ctz_reg_pan_no_issued_district_org" class="form-control" value="{{ old('ctz_reg_pan_no_issued_district_org') }}" placeholder="Ctz No./ Registration and Pan no issue district/ Registered Organization" >
                                <small class="help-block text-danger">{{$errors->first('ctz_reg_pan_no_issued_district_org')}}</small>
                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-md-3 control-label" for="fathers_name">Father's Name </label>
                            <div class="col-md-9">
                                <input type="text" id="fathers_name" name="fathers_name" class="form-control" value="{{ old('fathers_name') }}" placeholder="Father's Name" >
                                <small class="help-block text-danger">{{$errors->first('fathers_name')}}</small>
                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-md-3 control-label" for="grand_fathers_name">Grand Father's Name </label>
                            <div class="col-md-9">
                                <input type="text" id="grand_fathers_name" name="grand_fathers_name" class="form-control" value="{{ old('grand_fathers_name') }}" placeholder="Grand Father's Name" >
                                <small class="help-block text-danger">{{$errors->first('grand_fathers_name')}}</small>
                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-md-3 control-label" for="blacklist_date">Blacklist Date <span class="text-danger">*</span></label>
                            <div class="col-md-9">
                                <input type="text" id="blacklist_date" name="blacklist_date" class="form-control nepali-calendar nep-date" value="{{ old('blacklist_date') }}" placeholder="Blacklist Date" autocomplete="off" >
                                <small class="help-block text-danger">{{$errors->first('blacklist_date')}}</small>
                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-md-3 control-label" for="release_date">Release Date </label>
                            <div class="col-md-9">
                                <input type="text" id="release_date" name="release_date" class="form-control nepali-calendar" value="{{ old('release_date') }}" placeholder="Release Date" autocomplete="off" >
                                <small class="help-block text-danger">{{$errors->first('release_date')}}</small>
                            </div>
                        </div>

                        @csrf
                        <div class="form-group">
                            <label class="col-md-3 control-label"></label>
                            <div class="col-md-4">
                                <input type="submit" class="btn btn-block btn-success" name="submit" value="CREATE">
                            </div>
                        </div>
                    </div>
                </form>
            </div>
        </div>
    </div>
@endsection

@section('ext_js')
    <script src="{{ asset('NepaliDatepicker/nepali.datepicker.v2.2.min.js') }}"></script>

    <script>
        $(document).ready(function() {
            $('.nep-date').nepaliDatePicker({
                'dateFormat': 'yy-mm-dd',
                changeMonth: true,
                changeYear: true,
                maxDate: "+0d",
                disableDaysAfter: 1
            });

            $('#release_date').nepaliDatePicker({
                'dateFormat': 'yy-mm-dd',
                changeMonth: true,
                changeYear: true,
                minDate: "+0d",
                disableDaysBefore: 1
            });
        });
    </script>

@endsection