@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-m-5">
      @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 -->
            {{-- Location --}}
            @if(isset($serviceb['type']) && in_array('location', $serviceb['type']) && isset($serviceb['type']) && $serviceb['type'][$aid] === 'location')
               <h4>Memorial service location</h4>
               <p>Where will your memorial service be held?</p>
      
               <div class="form">
                  <div class="row">
                     <div class="col-12">
                           @php
                              $memorial_location = json_decode($endoflifePlanForm->memorial_service_held, true);
                           @endphp
                           <div class="form-group mb-3">
                              <label for="name">Name:</label>
                              <input type="text"  name="full_name" id="full_name" value="{{isset($memorial_location['full_name']) ? $memorial_location['full_name'] : '' }}" aria-describedby="nameHelp">
                              <small id="nameHelp" class="form-text text-muted">e.g. Kendrick Funeral Home, my family's cabin</small>
                           </div>
                           <div class="form-group mb-3">
                              <label for="city">Address:</label>
                              <input type="text"  name="address" id="address" value="{{isset($memorial_location['address']) ? $memorial_location['address'] : '' }}" aria-describedby="addressHelp">
                              <small id="addressHelp" class="form-text text-muted">e.g. Street, City, State ZIP Code</small>
                           </div>
                           <div class="faq-box d-none">
                              <div class="title">Frequently Asked Questions</div>
                              <div class="tooltip">
                                 <p>Where should I hold my memorial service?</p>
                                 <span class="tooltiptext">A memorial service can be held anywhere, and the location depends on whether you want a formal service or a more intimate affair. The service can be held at an event space like a banquet hall or restaurant, or somewhere of personal significance such as a house of worship, a family home or a park.</span>
                              </div>
                           </div>
                     </div>
                  </div>
               </div>  
         
            @endif
            {{-- Guests --}}
            @if(isset($serviceb['type']) && in_array('guests', $serviceb['type']) && isset($serviceb['type']) && $serviceb['type'][$aid] === 'guests')
               @php
                  $memorial_gestArray = json_decode($endoflifePlanForm->memorial_guests, true)
               @endphp

               <h4>Guests</h4>
               <p>Who may attend your memorial service?</p>

               <div class="form">
                  <div class="row">
                     <div class="col-12">
                        <div class="dashboard-radio-form">
                           <div class="form-check">
                              <input id="attend_visitation_anyone" class="form-check-input" name="attend_memorial" type="radio" value="anyone" {{!isset($memorial_gestArray['attend_guests']) || $memorial_gestArray['attend_guests'] == 'anyone' ? 'checked' : '' }}>
                              <label for="attend_visitation_anyone" class="marital-box">
                                 <p>Anyone</p>
                              </label>
                           </div>
                           <div class="form-check">
                              <input id="attend_visitation_family" class="form-check-input" name="attend_memorial" type="radio" value="family"  {{isset($memorial_gestArray['attend_guests']) && $memorial_gestArray['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?
                           <div class="tooltip d-none">
                              <div class="iccon">?</div>
                              <span class="tooltiptext">Specify any individuals your family may not know or think to contact upon your passing.</span>
                           </div>
                        </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($memorial_gestArray['multipleRecords'] ) ? 'checked' : '' }}>
                              <label for="individuals_wish-y"><p>Yes</p></label>
                           </div>
                           <div class="form-check">
                              <input id="individuals_wish-n" class="form-check-input" name="individuals_wish" value="no" type="radio" {{ empty($memorial_gestArray['multipleRecords'] ) ? 'checked' : '' }}>
                              <label for="individuals_wish-n"><p>No</p></label>
                           </div>
                        </div>
                        <div id="individual_holder" class="child-card-holder">
                           <div id="individual">
                              @if(!empty($memorial_gestArray['multipleRecords']) && count($memorial_gestArray['multipleRecords']) > 0)                                 
                                 @foreach($memorial_gestArray['multipleRecords'] as $index => $memorial_gest)
                                    <div class="card list mb-3" id="child">
                                       <div class="card-header">
                                          <div class="card-title m-0">Individual</div>
                                          <a class="r-button" onclick="removetList(this)">
                                          <span class="fas fa-times"></span>
                                          <span class="remove">Remove</span>
                                          </a>
                                       </div>
                                       <div class="card-body">
                                          <div class="form-group mb-3">
                                             <label for="name">Name:</label>
                                             <input type="text"  name="full_name[]" id="full_name_{{$index}}"  value="{{$memorial_gest['full_name']}}">
                                          </div>
                                          <div class="form-group mb-3">
                                             <label for="name">Relationship:</label>
                                             <input type="text"  name="relationship[]" id="relationship_{{$index}}"  value="{{$memorial_gest['relationship']}}">
                                          </div>
                                          <div class="form-group mb-3">
                                             <label for="phone_number">Phone Number :</label>
                                             <input type="text"  name="phone[]" id="phone_number_{{$index}}"  value="{{$memorial_gest['phone']}}">
                                          </div>
                                          <div class="form-group mb-3">
                                             <label for="email">Email :</label>
                                             <input type="text"  name="email[]" id="email_{{$index}}"  value="{{$memorial_gest['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="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>
               </div>
            @endif
            {{-- Music/Readings --}}
            @if(isset($serviceb['type']) && in_array('music', $serviceb['type']) && isset($serviceb['type']) && $serviceb['type'][$aid] === 'music')
               @php
                  $memorial_your_serviceArray = json_decode($endoflifePlanForm->memorial_service_music, true)
               @endphp
               <h4>Memorial service details</h4>
               <p></p>
               <div class="form">
                  <div class="row">
                     <div class="col-12">
                        <div class="form-group mb-3">
                           <label for="name">
                              Describe the music that you want played during your memorial service:
                              <div class="tooltip d-none">
                                 <span>
                                    <ion-icon name="help-circle"></ion-icon>
                                 </span>
                                 <span class="tooltiptext">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>
                              </div>
                           </label>
                           <input value="{{isset($memorial_your_serviceArray['played']) ? $memorial_your_serviceArray['played'] : ''}}" type="text"  name="played" aria-describedby="nameHelp" class="remove_space">
                           <small id="addressHelp" class="form-text text-muted">e.g. I would like classical music by Beethoven to be playing during the visitation.</small>
                        </div>
                        <div class="form-group mb-3">
                           <label for="name">List the reading(s) and who will perform them:</label>
                           <input value="{{isset($memorial_your_serviceArray['perform']) ? $memorial_your_serviceArray['perform'] : ''}}" type="text"  name="perform" aria-describedby="nameHelp" class="remove_space">
                           <small id="addressHelp" class="form-text text-muted">e.g. I would like my sister to read "The Dash" by Linda Ellis.</small>
                        </div>
                     </div>
                  </div>
               </div>
            @endif
            {{-- Speakers --}}
            @if(isset($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 memorial service?</p>
      
               <div class="form">
                  <div class="row">
                     <div class="col-12">
                        @php
                        $speakerArray = json_decode($endoflifePlanForm->memorial_service_speaker, true)
                        @endphp
                        <div id="graveside_service_holder" class="child-card-holder">
                           <div id="graveside_service_ten">
                              @if(!empty($endoflifePlanForm->memorial_service_speaker) && count($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 memorial 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_memorial_service" value="yes" type="radio" {{ !empty($endoflifePlanForm->memorial_service_instructions) ? 'checked' : '' }}>
                              <label for="graveside_service-y"><p>Yes</p></label>
                           </div>
                           <div class="form-check">
                              <input id="graveside_service-n" class="form-check-input" name="in_memorial_service" value="no" type="radio" {{ empty($endoflifePlanForm->memorial_service_instructions) ? 'checked' : '' }}>
                              <label for="graveside_service-n"><p>No</p></label>
                           </div>
                        </div>
                     </div>
                  </div>
                  <div class="row">
                     <div id="graveside_service_holder" class="child-card-holder">
                        <div id="graveside_service_12">
                           @php
                           $memorial_minstructionsArray = json_decode($endoflifePlanForm->memorial_service_instructions, true)
                           @endphp
                           @if(!empty($endoflifePlanForm->memorial_service_instructions) && count($memorial_minstructionsArray) > 0)                                 
                           @foreach($memorial_minstructionsArray 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="memorial_describe[]" id="memorial_describe_{{$index}}"aria-describedby="memorialDescribe" placeholder="">
                                       <small id="memorialDescribe" class="form-text text-muted">e.g. I would like balloons to be released into the air at the end of the service.</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="memorial_describe[]" aria-describedby="memorialDescribe" placeholder="">
                                    <small id="memorialDescribe" class="form-text text-muted">e.g. I would like balloons to be released into the air at the end of the service.</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>        
            @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_memorial-4') }}'">Back</button> 
                        @else                 
                           <button type="button" onclick="window.location.href = '{{ route('endoflifePlan.create.step.five_memorial-5', ['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_memorial-4') }}'" >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>	  
@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