@extends('layouts.administrator.master')

@section('title')
    Form Keanggotaan Perseorangan
@endsection
@section('content')
    <div class="nk-content-body">
        <div class="nk-block-head nk-block-head-sm">
            <div class="nk-block-between">
                <div class="nk-block-head-content">
                    <h3 class="nk-block-title page-title">{{ __('Formulir Keanggotaan Perseorangan Pertapindo') }}</h3>
                    <p>{{ __('Kelola data keanggotaan perseorangan') }}</p>
                </div>
            </div>
        </div>
        <div class="nk-block nk-block-lg">
            <div class="card card-preview">
                <div class="card-inner">
                    @include('pages.registration.personal._navbar', ['model' => $registration])
                    <div class="tab-content">
                        <div class="tab-pane active" id="tabItem5" role="tabpanel">
                            <form
                                action="{{ route('services.membership.registration.personal.store', ['no_reg' => $registration->no_reg]) }}"
                                method="POST" enctype="multipart/form-data">
                                @csrf
                                <div class="form-group">
                                    <label class="form-label" for="customFileLabel">Foto Profil <span
                                            class="text-danger">(Format
                                            png.jpg dan Max
                                            512KB)</span></label>
                                    <div class="form-control-wrap text-center">
                                        @if (isset($registration->photo))
                                            <img id="logoOutputLogoC"
                                                src="{{ asset('uploads/membership/photo/' . $registration->photo) }}"
                                                alt="" height="200" width="200"
                                                class="rounded rounded-full shadow" style="object-fit: cover;">
                                        @else
                                            <img id="logoOutputLogoC" src="{{ asset('landing/img/noimage.png') }}"
                                                alt="" height="200" width="200"
                                                class="rounded rounded-full shadow" style="object-fit: cover;">
                                        @endif
                                        <div class="form-file pt-2">
                                            <input type="file" accept="image/png, image/gif, image/jpeg, image/svg+xml"
                                                id="customFile"
                                                onchange="document.getElementById('logoOutputLogoC').src = window.URL.createObjectURL(this.files[0])"
                                                name="photo">
                                        </div>
                                    </div>
                                </div>

                                <div class="form-group mb-3">
                                    <label class="mb-1">{{ __('Nama Lengkap') }}</label>
                                    <input type="text" name="full_name" class="form-control"
                                        value="{{ optional($registration)->full_name ?? old('full_name') }}"
                                        placeholder="{{ __('Nama Lengkap') }}" required>
                                </div>
                                <div class="row">
                                    <div class="col-12 col-lg-6">
                                        <div class="form-group mb-3">
                                            <label class="mb-1">{{ __('Tempat lahir') }}</label>
                                            <select name="place_birth" class="form-control form-control-sm" required>
                                                <option value="">{{ __('Pilih Tempat Lahir') }}</option>
                                                @foreach ($province as $item)
                                                    <option value="{{ $item->kode }}"
                                                        {{ $item->kode == $registration->place_birth ? 'selected' : '' }}>
                                                        {{ $item->nama }}</option>
                                                @endforeach
                                            </select>
                                        </div>
                                    </div>
                                    <div class="col-12 col-lg-6">
                                        <div class="form-group mb-3">
                                            <label class="mb-1">{{ __('Tanggal Lahir') }}</label>
                                            <input type="date" name="date_birth" class="form-control form-control-sm"
                                                value="{{ optional($registration)->date_birth ?? old('date_birth') }}"
                                                required>
                                        </div>
                                    </div>
                                    <div class="col-12 col-lg-4">
                                        <div class="form-group mb-3">
                                            <label class="mb-1">{{ __('No KTP/KK') }}</label>
                                            <input type="number" name="nik" class="form-control"
                                                value="{{ optional($registration)->nik ?? old('nik') }}"
                                                placeholder="{{ __('No KTP/KK') }}" required>
                                        </div>
                                    </div>
                                    <div class="col-12 col-lg-4">
                                        <div class="form-group mb-3">
                                            <label class="mb-1">{{ __('Email') }}</label>
                                            <input type="text" name="email" class="form-control"
                                                value="{{ optional($registration)->email ?? old('email') }}"
                                                placeholder="{{ __('Email') }}" required>
                                        </div>
                                    </div>
                                    <div class="col-12 col-lg-4">
                                        <div class="form-group mb-3">
                                            <label class="mb-1">{{ __('No Kontak (WA)') }}</label>
                                            <div class="input-group">
                                                <input type="tel" name="contact" class="form-control" id="contact"
                                                    value="{{ optional($registration)->contact ?? old('contact') }}"
                                                    placeholder="{{ __('No Kontak (WA)') }}" required>
                                            </div>
                                        </div>
                                    </div>
                                    <div class="col-12">
                                        <div class="form-group mb-3">
                                            <label class="mb-1">{{ __('Alamat') }}</label>
                                            <textarea type="text" name="address" class="form-control" placeholder="Jalan, Kota, Provinsi, Negara" required>{{ optional($registration)->address ?? old('address') }}</textarea>
                                        </div>
                                    </div>
                                    <div class="col-12 col-lg-4">
                                        <div class="form-group mb-3">
                                            <label class="mb-1">{{ __('Status Personil/Profesi') }}</label>
                                            <select name="status_personnel" class="form-control" required>
                                                <option value="">{{ __('Pilih Status Personal/Profesi') }}</option>
                                                @foreach ($status as $item)
                                                    <option value="{{ $item->id }}"
                                                        {{ $item->id == old('status_personnel') || $item->id == $registration->status_personnel ? 'selected' : '' }}>
                                                        {{ $item->name }}</option>
                                                @endforeach
                                            </select>
                                        </div>
                                    </div>
                                    <div class="col-12 col-lg-4">
                                        <label class="mb-1">{{ __('Lama Bekerja') }}</label>
                                        <div class="input-group mb-3">
                                            <input type="number" name="length_work" class="form-control"
                                                value="{{ optional($registration)->length_work ?? old('length_work') }}"
                                                placeholder="{{ __('Lama Bekerja') }}" required>
                                            <div class="input-group-append">
                                                <span class="input-group-text" id="basic-addon2">Tahun</span>
                                            </div>
                                        </div>
                                    </div>
                                    <div class="col-12 col-lg-4">
                                        <div class="form-group mb-3">
                                            <label class="mb-1">{{ __('Jejak Minat yang diinginkan') }}</label>
                                            <input type="text" name="interested" class="form-control"
                                                value="{{ optional($registration)->interested ?? old('interested') }}"
                                                placeholder="{{ __('Jejak Minat yang diinginkan') }}">
                                        </div>
                                    </div>
                                    <div class="col-12 col-lg-4">
                                        <div class="form-group mb-3">
                                            <label class="mb-1">{{ __('Instagram') }}</label>
                                            <input type="text" name="instagram" class="form-control"
                                                value="{{ optional(json_decode($registration->social_media))->instagram ?? old('instagram') }}"
                                                placeholder="{{ __('Instagram') }}">
                                        </div>
                                    </div>
                                    <div class="col-12 col-lg-4">
                                        <div class="form-group mb-3">
                                            <label class="mb-1">{{ __('Facebook') }}</label>
                                            <input type="text" name="facebook" class="form-control"
                                                value="{{ optional(json_decode($registration->social_media))->facebook ?? old('facebook') }}"
                                                placeholder="{{ __('Facebook') }}">
                                        </div>
                                    </div>
                                    <div class="col-12 col-lg-4">
                                        <div class="form-group mb-3">
                                            <label class="mb-1">{{ __('LinkedIn') }}</label>
                                            <input type="text" name="linkedin" class="form-control"
                                                value="{{ optional(json_decode($registration->social_media))->linkedin ?? old('linkedin') }}"
                                                placeholder="{{ __('LinkedIn') }}">
                                        </div>
                                    </div>
                                </div>
                                <div class="mx-auto mt-4 text-end">
                                    <button class="btn btn-primary me-2">{{ __('Selanjutnya') }}</button>
                                </div>
                            </form>
                        </div>


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