@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="4-4-4-3">
      <div class="multiple-form dashboard-radio">
         <h4>Additional instructions</h4>
         <p>Do you wish to include any other instructions regarding your cremation?</p>

         <div class="form">
            <div class="row">
               <div class="col-12">
                  <div class="dashboard-radio-form">
                     <div class="form-check">
                        <input id="ad_instructions-y" class="form-check-input" name="ad_instructions" value="yes" type="radio"  {{ isset($endoflifePlanForm->additional_instruction_status) &&  $endoflifePlanForm->additional_instruction_status == "yes" ? 'checked' : ''}}>
                        <label for="ad_instructions-y"><p>Yes</p></label>
                     </div>
                     <div class="form-check">
                        <input id="ad_instructions-n" class="form-check-input" name="ad_instructions" value="no" type="radio"  {{ isset($endoflifePlanForm->additional_instruction_status) &&  $endoflifePlanForm->additional_instruction_status == "yes" ? 'checked' : ''}}>
                        <label for="ad_instructions-n"><p>No</p></label>
                     </div>
                  </div>
                  <div id="instruction_sec_holder" class="child-card-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">
                                    <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="form-group my-5">
                                    <label>Describe your wishes in complete sentences:</label>
                                    <input type="text" value="{{$additional_instruction['instruction']}}"  id="additional_instructions__{{$index}}" 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>
                              </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="form-group my-5">
                                 <label>Describe your wishes in complete sentences:</label>
                                 <input type="text"  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>
                           </div>
                        @endif
                     </div>
                     <div class="add-child">
                        <a href="#" id="add-another-child" class="add-another" onclick="clone('instruction_sec')" class="add-button">Add another instruction</a>
                     </div>
                  </div>
               </div>
            </div>
         </div>
         <!-- start previous / next buttons -->
         <div id="buttonsection" class="submit-button-multiple">
            @if(isset($endoflifePlanForm->cremation) &&  $endoflifePlanForm->cremation == "loved")
            <button type="button" onclick="window.location.href = '{{ route('endoflifePlan.create.step.four_4_4_2') }}'">Back</button>
            @else
            <button type="button" onclick="window.location.href = '{{ route('endoflifePlan.create.step.four_4_2') }}'">Back</button>
            @endif
            <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