@extends('layouts.v2.frontend-user-backend')

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

@section('content')
@include('frontend.forms.v2.End-Of-Life-Plan.stepIndicator')
    <form action="{{route('EndoflifePlanFormStore')}}" method="POST" id="signUpForm">
      @csrf
      <input type="hidden" id="stepInput" name="step" value="5-g-4">
      @php
            $aid =  request()->input('aid') ?? 0;
            $typeStep =  request()->input('step') ?? $serviceb['type'][$aid];
      @endphp
      
      <input type="hidden" id="stepInput" name="aid" value="{{ $aid  }}">

      <div class="multiple-form dashboard-radio">


            <!-- step 1 -->
            @if((isset($serviceb['type']) && in_array('officiant', $serviceb['type']) ) && (isset($serviceb['type']) && $serviceb['type'][$aid] === 'officiant'))
               
               <h4>Officiant</h4>
               <p>Who will be your officiant?</p>
      
               <div class="form">
                  <div class="row">
                     <div class="col-12">
                           @php  
                              $graveside_officiant = json_decode($endoflifePlanForm->graveside_officiant, true);
                           @endphp
                           <div class="form-group mb-3">
                              <label for="name">Name:</label>
                              <input type="text"  value="{{isset($graveside_officiant['full_name']) ? $graveside_officiant['full_name'] : '' }}"  id="full_name" name="full_name" aria-describedby="nameHelp">
                           </div>
                           <div class="form-group mb-3">
                              <label for="email">Email :</label>
                              <input type="email"  value="{{isset($graveside_officiant['email']) ? $graveside_officiant['email'] : '' }}"  name="email" id="email_grave" aria-describedby="emailsHelp">
                           </div>
                           <div class="form-group mb-3">
                              <label for="phone">Phone :</label>
                              <input type="text"  value="{{isset($graveside_officiant['phone']) ? $graveside_officiant['phone'] : '' }}"  name="phone" id="phone_grave" aria-describedby="phoneHelp">
                           </div>
                     </div>
                  </div>
               </div>
               <div class="faq-box d-none">
                  <div class="title">Frequently Asked Questions</div>
                  <p>What is an officiant?</p>
                  <span class="tooltiptext">An officiant, sometimes known as a celebrant, functions as the master of ceremonies at a funeral or other service. For those who are religious, an officiant might be a religious leader; however, you can also hire an officiant or ask a friend or family member. An officiant's responsibilities can include greeting guests at the door, conducting the service, and directing guests to the graveside or reception.</span>
               </div>
            @endif
            {{-- Guests --}}
            @if(isset($serviceb['type']) && in_array('guests', $serviceb['type']) && isset($serviceb['type']) && $serviceb['type'][$aid] === 'guests')
               <h4>Guests</h4>
               <p>Who may attend your graveside service?</p>
      
               <div class="form">
                  <div class="row">
                     <div class="col-12">
                        @php
                           $graveside_service_guestsArray = json_decode($endoflifePlanForm->graveside_service_guests, true)
                        @endphp
                        <div class="dashboard-radio-form">
                           <div class="form-check">
                              <input id="attend_visitation_anyone" class="form-check-input" name="attend_guests" type="radio" value="anyone"  {{isset($graveside_service_guestsArray['attend_guests']) && $graveside_service_guestsArray['attend_guests'] == 'anyone' ? 'checked' : '' }}>
                              <label for="attend_visitation_anyone" class="marital-box"><p>Anyone</p></label>
                           </div>
                           <div class="form-check">
                              <input id="attend_visitation_family" class="form-check-input" name="attend_guests" type="radio" value="family"  {{isset($graveside_service_guestsArray['attend_guests']) && $graveside_service_guestsArray['attend_guests'] == 'family' ? 'checked' : '' }}>
                              <label for="attend_visitation_family" class="marital-box"><p>Family and friends only</p></label>
                           </div>
                        </div>
                        <p class="my-5">
                           Are there any specific individuals you wish to be contacted to attend?
                        </p>

                        <div class="dashboard-radio-form">
                           <div class="form-check">
                              <input id="individuals_wish-y" class="form-check-input" name="individuals_wish" value="yes" type="radio" {{ !empty($graveside_service_guestsArray['multipleRecords'] ) ? 'checked' : '' }}>
                              <label for="individuals_wish-y"><p>Yes<p></label>
                           </div>
                           <div class="form-check">
                              <input id="individuals_wish-n" class="form-check-input" name="individuals_wish" value="no" type="radio" {{ empty($graveside_service_guestsArray['multipleRecords'] ) ? 'checked' : '' }}>
                              <label for="individuals_wish-n"><p>No</p></label>
                           </div>
                        </div>
                     </div>
                  </div>
                  <div class="row">
                     <div id="individual_holder" class="child-card-holder">
                        <div id="individual">
                           @if(!empty($graveside_service_guestsArray['multipleRecords']) && count($graveside_service_guestsArray['multipleRecords']) > 0)                                 
                              @foreach($graveside_service_guestsArray['multipleRecords'] as $index => $graveside_service_guests)
                              <div class="card list mb-3" id="child">
                                 <div class="card-header">
                                    <div class="card-title m-0">Individual</div>
                                    <a class="r-button" onclick="removetList(this)">
                                    <span class="fas fa-times"></span>
                                    <span class="remove">Remove</span>
                                    </a>
                                 </div>
                                 <div class="card-body">
                                    <div class="form-group mb-3">
                                       <label for="name">Name:</label>
                                       <input type="text"  name="full_name[]" id="full_name_{{$index}}" value="{{$graveside_service_guests['full_name']}}">
                                    </div>
                                    <div class="form-group mb-3">
                                       <label for="name">Relationship:</label>
                                       <input type="text"  name="relationship[]" id="relationship_{{$index}}"  value="{{$graveside_service_guests['relationship']}}">
                                    </div>
                                    <div class="form-group mb-3">
                                       <label for="city">Address :</label>
                                       <input type="text"  name="address[]" id="address_{{$index}}"   value="{{$graveside_service_guests['address']}}">
                                       <small id="cityHelp" class="form-text text-muted d-none">e.g. Street, City, State ZIP Code</small>
                                    </div>
                                    <div class="form-group mb-3">
                                       <label for="phone_number">Phone number :</label>
                                       <input type="text"  name="phone[]" id="phone_number_{{$index}}" value="{{$graveside_service_guests['phone']}}">
                                    </div>
                                    <div class="form-group mb-3">
                                       <label for="email">Email :</label>
                                       <input type="text"  name="email[]" id="email_{{$index}}" value="{{$graveside_service_guests['email']}}">
                                    </div>
                                 </div>
                              </div>
                              @endforeach
                           @else                          
                              <div class="card list mb-3" id="child">
                                 <div class="card-header">
                                    <div class="card-title m-0">Individual</div>
                                    <a class="r-button" onclick="removetList(this)">
                                    <span class="fas fa-times"></span>
                                    <span class="remove">Remove</span>
                                    </a>
                                 </div>
                                 <div class="card-body">
                                    <div class="form-group mb-3">
                                       <label for="name">Name:</label>
                                       <input type="text"  name="full_name[]" id="full_name" >
                                    </div>
                                    <div class="form-group mb-3">
                                       <label for="name">Relationship:</label>
                                       <input type="text"  name="relationship[]" id="relationship" >
                                    </div>
                                    <div class="form-group mb-3">
                                       <label for="city">Address :</label>
                                       <input type="text"  name="address[]" id="address"  >
                                       <small id="cityHelp" class="form-text text-muted d-none">e.g. Street, City, State ZIP Code</small>
                                    </div>
                                    <div class="form-group mb-3">
                                       <label for="phone_number">Phone number :</label>
                                       <input type="text"  name="phone[]" id="phone_number" >
                                    </div>
                                    <div class="form-group mb-3">
                                       <label for="email">Email :</label>
                                       <input type="text"  name="email[]" id="email" >
                                    </div>
                                 </div>
                              </div>
                           @endif
                        </div>
                        <div class="add-child">
                           <a href="#" id="add-another-child" onclick="clone('individual')" class="add-another">
                              
                              Add another individual
                           </a>
                        </div>
                     </div>
                  </div>
               </div>
            @endif
            {{-- Music/Readings --}}
            @if(isset($serviceb['type']) && in_array('music', $serviceb['type']) && isset($serviceb['type']) && $serviceb['type'][$aid] === 'music')
               @php
               $graveside_your_musicArray = json_decode($endoflifePlanForm->graveside_music, true)
               @endphp
               <h4>Graveside service details</h4>
               <p></p>

               <div class="form">
                  <div class="row">
                     <div class="col-12">
                        <div class="form-group mb-3">
                           <label for="song">Describe the music that you want played during your graveside service:</label>
                           <span class="tooltiptext d-none">Name the song(s), genre, or artist if playing recorded music. Name the song(s), genre, or singer/musician if live music will be played.</span>
                           <input value="{{isset($graveside_your_musicArray['played']) ? $graveside_your_musicArray['played'] : ''}}" type="text"  name="played" aria-describedby="playedHelp">
                           <small id="playedHelp" class="form-text text-muted">e.g. I would like classical music by Beethoven to be playing during the visitation.</small>
                        </div>
                        <div class="form-group mb-3">
                           <label for="name">List the reading(s) and who will perform them:</label>
                           <input value="{{isset($graveside_your_musicArray['perform']) ? $graveside_your_musicArray['perform'] : ''}}" type="text"  name="perform" aria-describedby="performHelp">
                           <small id="performHelp" class="form-text text-muted">e.g. I would like my sister to read "The Dash" by Linda Ellis.</small>
                        </div>
                     </div>
                  </div>
               </div>
      
            @endif
            {{-- Speaker --}}
            @if(isset($serviceb['type']) && in_array('speakers', $serviceb['type']) && isset($serviceb['type']) && $serviceb['type'][$aid] === 'speakers')
              
               <h4>Speaker</h4>
               <p>Who would you like to speak at your graveside service?</p>
      
               <div class="form">
                  <div class="row">
                     <div class="col-12">
                        @php
                           $speakerArray = json_decode($endoflifePlanForm->graveside_speaker, true)
                        @endphp
                        <div id="graveside_service_holder" class="child-card-holder">
                           <div id="graveside_service_ten">
                              @if(!empty($endoflifePlanForm->graveside_speaker) && count($speakerArray) > 0)                                 
                                 @foreach($speakerArray as $index => $speaker)
                                 <div class="card list mb-3" id="child">
                                    <div class="card-header">
                                       <div class="card-title m-0">Speaker</div>
                                       <a class="r-button" onclick="removetList(this)">
                                       <span class="fas fa-times"></span>
                                       <span class="remove">Remove</span>
                                       </a>
                                    </div>
                                    <div class="card-body">
                                       <div class="form-group mb-3">
                                          <label for="name">Name:</label>
                                          <input type="text"  name="full_name[]" id="full_name_{{$index}}" value="{{$speaker['full_name']}}">
                                       </div>
                                       <div class="form-group mb-3">
                                          <label for="name">Relationship:</label>
                                          <input type="text"  name="relationship[]" id="relationship_{{$index}}"  value="{{$speaker['relationship']}}">
                                       </div>
                                       <div class="form-group mb-3">
                                          <label for="phone_number">Phone Number :</label>
                                          <input type="text"  name="phone[]" id="phone_number_{{$index}}"  value="{{$speaker['phone']}}">
                                       </div>
                                       <div class="form-group mb-3">
                                          <label for="email">Email :</label>
                                          <input type="text"  name="email[]" id="email_{{$index}}"  value="{{$speaker['email']}}">
                                       </div>
                                    </div>
                                 </div>
                                 @endforeach
                              @else                          
                                 <div class="card list mb-3" id="child">
                                    <div class="card-header">
                                       <div class="card-title m-0">Speaker</div>
                                       <a class="r-button" onclick="removetList(this)">
                                       <span class="fas fa-times"></span>
                                       <span class="remove">Remove</span>
                                       </a>
                                    </div>
                                    <div class="card-body">
                                       <div class="form-group mb-3">
                                          <label for="name">Name:</label>
                                          <input type="text"  name="full_name[]" id="full_name">
                                       </div>
                                       <div class="form-group mb-3">
                                          <label for="name">Relationship:</label>
                                          <input type="text"  name="relationship[]" id="relationship">
                                       </div>
                                       <div class="form-group mb-3">
                                          <label for="phone_number">Phone Number :</label>
                                          <input type="text"  name="phone[]" id="phone_number">
                                       </div>
                                       <div class="form-group mb-3">
                                          <label for="email">Email :</label>
                                          <input type="text"  name="email[]" id="email">
                                       </div>
                                    </div>
                                 </div>
                              @endif
                           </div>
                           <div class="add-child">
                              <a href="#" id="add-another-child" onclick="clone('graveside_service_ten')" class="add-another">
                                 
                                 Add another speaker
                              </a>
                           </div>
                        </div>
                     </div>
                  </div>
               </div>
            @endif
            {{-- other --}}
            @if(isset($serviceb['type']) && in_array('other', $serviceb['type']) && isset($serviceb['type']) && $serviceb['type'][$aid] === 'other')
               
               <h4>Additional instructions</h4>
               <p>Do you wish to include any other instructions regarding your graveside service?</p>
      
               <div class="form">
                  <div class="row">
                     <div class="col-12">
                        <div class="dashboard-radio-form">
                           <div class="form-check">
                              <input id="graveside_service-y" class="form-check-input" name="in_graveside_service" value="yes" type="radio" {{ isset($endoflifePlanForm->graveside_other_instructions) ? 'checked' : '' }}>
                              <label for="graveside_service-y"><p>Yes</p></label>
                           </div>
                           <div class="form-check">
                              <input id="graveside_service-n" class="form-check-input" name="in_graveside_service" value="no" type="radio" {{ !isset($endoflifePlanForm->graveside_other_instructions) ? 'checked' : '' }}>
                              <label for="graveside_service-n"><p>No</p></label>
                           </div>
                        </div>
                        <div id="graveside_service_holder" class="child-card-holder">
                           <div id="graveside_service_12">
                              @php
                              $graveside_instructionsArray = json_decode($endoflifePlanForm->graveside_other_instructions, true)
                              @endphp
                              @if(!empty($endoflifePlanForm->graveside_other_instructions) && count($graveside_instructionsArray) > 0)                                 
                              @foreach($graveside_instructionsArray as $index => $details)
                                 <div class="card list mt-4" id="child">
                                    <div class="card-header">
                                       <div class="card-sub-title m-0">Describe your wishes in complete sentences:</div>
                                       <a class="r-button" onclick="removetList(this)">
                                          <span class="fas fa-times"></span>
                                          <span class="remove">Remove</span>
                                       </a>
                                    </div> 
                                    <div class="card-body">
                                       <div class="form-group my-3">
                                          <input type="text"  value="{{$details['detail']}}" name="graveside_reception_describe[]"id="graveside_reception_describe_{{$index}}" aria-describedby="visitationDescribe" placeholder="">
                                          <small id="visitationDescribe" class="form-text text-muted">e.g. I would like my husband and two daughters to each throw a spadeful of dirt on my coffin.</small>
                                       </div>
                                    </div>
                                 </div>
                              @endforeach
                              @else
                              <div class="card list mt-4" id="child">
                                 <div class="card-header">
                                    <div class="card-sub-title m-0">Describe your wishes in complete sentences:</div>
                                    <a class="r-button" onclick="removetList(this)">
                                       <span class="fas fa-times"></span>
                                       <span class="remove">Remove</span>
                                    </a>
                                 </div> 
                                 <div class="card-body">
                                    <div class="form-group my-3">
                                       <input type="text"  name="graveside_reception_describe[]" aria-describedby="visitationDescribe" placeholder="">
                                       <small id="visitationDescribe" class="form-text text-muted">e.g. I would like my husband and two daughters to each throw a spadeful of dirt on my coffin.</small>
                                    </div>
                                 </div>
                              </div>
                              @endif
                           </div>
                           <div class="add-child">
                              <a href="#" id="add-another-child" onclick="clone('graveside_service_12')" class="add-another">
                                 
                                 Add another instruction
                              </a>
                           </div>
                        </div>
                     </div>
                  </div>
               </div>
            @endif





         <!-- start previous / next buttons -->
         <div id="buttonsection" class="submit-button-multiple">
            @foreach ($serviceb['type'] as $service)
               @if ($service === $typeStep)
                  @if ($aid == 0)
                     <button type="button" onclick="window.location.href = '{{ route('endoflifePlan.create.step.five_graveside-3') }}'">Back</button> 
                  @else
                     <button type="button" onclick="window.location.href = '{{ route('endoflifePlan.create.step.five_graveside-4', ['step' => $serviceb['type'][$aid - 1], 'aid' => $aid - 1]) }}'">Back</button> 
                  @endif
               @endif
            @endforeach
            {{-- <button type="button" onclick="window.location.href = '{{ route('endoflifePlan.create.step.five_graveside-3') }}'" class="btn btn-light btn-lg back-btn">Back</button> --}}
            <button type="submit" class="submit-btn">Save and Continue</button>
            <button type="submit" class="d-none" name="preview_submit" value="preview">{{env('PREVIEW_BUTTON_TEXT')}}</button>
            <button type="button" class="skip-btn d-none">Skip Step</button>
         </div>
         <!-- end previous / next buttons -->
      </div>
    </form>	




      <div class="card">
         <div class="card-body">
        


         </div>
      </div>
</div>

@endsection
@section('page-js')
<script src="{{ url('frontend/assets/js/forms/end-of-life-plan-multi-step.js') }}?v={{ time() }}"></script>
<script src="{{ url('frontend/assets/js/forms/custom.js?v=10.3') }}"></script>
<script src="{{ url('v2/js/form-validation.js') }}?v={{ time() }}"></script>
@endsection