@extends('layouts.frontend')

@section('title', '| FREE END-OF-LIFE PLAN')

@section('content')
@include('frontend.forms.End-Of-Life-Plan.stepIndicator')
 <!-- start -->
<div class="container">
    <form action="{{route('EndoflifePlanFormStore')}}" method="POST" id="signUpForm">
      @csrf
      <input type="hidden" id="stepInput" name="step" value="4-4-4-3">
      <div class="card">
         <div class="card-body">
            <!-- step 1 -->
            <div class="step" style="display: block">
               <div class="row">
                  <div class="col-md-8">
                     <div class="card-title">Additional Instructions</div>
                      <div class="card-sub-title">Do you wish to include any other instructions regarding your cremation?</div>
                        <div class="custom-button-yn">
                           <input id="ad_instructions-y" name="ad_instructions" value="yes" type="radio" {{ !empty($endoflifePlanForm->additional_instruction) ? 'checked': ''}}>
                           <label for="ad_instructions-y">Yes</label>
                           <input id="ad_instructions-n" name="ad_instructions" value="no" type="radio" {{ empty($endoflifePlanForm->additional_instruction) ? 'checked': ''}}>
                           <label for="ad_instructions-n">No</label>
                        </div>
                        <div id="instruction_sec_holder">
                           <div id="instruction_sec">
                              @php
                              $additional_instructionArray = json_decode($endoflifePlanForm->additional_instruction, true);
                              @endphp
                              @if(!empty($endoflifePlanForm->additional_instruction) && count($additional_instructionArray) > 0)                                 
                                 @foreach($additional_instructionArray as $index => $additional_instruction)
                                    <div class="card list mt-4" id="child">
                                       <div class="card-header d-flex justify-content-between">
                                          <div class="card-title m-0">Additional instruction</div>
                                          <a class="r-button" onclick="removetList(this)">
                                          <span class="fas fa-times"></span>
                                          <span class="remove">Remove</span>
                                          </a>
                                       </div>

                                       <div class="card-sub-title">Describe your wishes in complete sentences:</div>
                                       <input type="text" value="{{$additional_instruction['instruction']}}" class="form-control modified-input" id="additional_instructions" name="additional_instructions[]">
                                       <small id="cityHelp" class="form-text text-muted">e.g. I would like by husband and children, along with other family members, present at my cremation.</small>
                                    </div>
                                 @endforeach
                              @else
                                 <div class="card list mt-4" id="child">
                                    <div class="card-header d-flex justify-content-between">
                                       <div class="card-title m-0">Additional instruction</div>
                                       <a class="r-button" onclick="removetList(this)">
                                       <span class="fas fa-times"></span>
                                       <span class="remove">Remove</span>
                                       </a>
                                    </div>

                                    <div class="card-sub-title">Describe your wishes in complete sentences:</div>
                                    <input type="text" class="form-control modified-input" id="additional_instructions" name="additional_instructions[]">
                                    <small id="cityHelp" class="form-text text-muted">e.g. I would like by husband and children, along with other family members, present at my cremation.</small>
                                 </div>
                              @endif
                           </div>
                           <div class="add-child">
                              <a href="#" id="add-another-child" onclick="clone('instruction_sec')" class="add-button"><span class="fas fa-plus"></span>Add another instruction</a>
                           </div>
                        </div>
                  </div>
               </div>
            </div>
            <!-- start previous / next buttons -->
            <div id="buttonsection">
               <div class="form-footer d-flex justify-content-between">
                  <div>
                @if(isset($endoflifePlanForm->cremation) &&  $endoflifePlanForm->cremation == "loved")
                 <button type="button" onclick="window.location.href = '{{ route('endoflifePlan.create.step.four_4_4_2') }}'" class="btn btn-light btn-lg back-btn">Back</button>
                @else
                  <button type="button" onclick="window.location.href = '{{ route('endoflifePlan.create.step.four_4_2') }}'" class="btn btn-light btn-lg back-btn">Back</button>
                @endif
                  <button type="submit" class="btn btn-light btn-lg">Save and Continue</button>
               </div>
               <button type="submit" class="btn btn-light btn-lg" name="preview_submit" value="preview">{{env('PREVIEW_BUTTON_TEXT')}}</button>
                  <button type="button" class="btn btn-light btn-lg skip-btn d-none">Skip Step</button>
               </div>
            </div>
            <!-- end previous / next buttons -->
         </div>
      </div>
</div>

@endsection
@section('page-js')
<script src="{{ url('frontend/assets/js/forms/end-of-life-plan-multi-step.js?v=10.1.1') }}"></script>
<script src="{{ url('frontend/assets/js/forms/custom.js?v=10.3') }}"></script>

@endsection