@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="3-2-3">
      <div class="multiple-form dashboard-radio">
         <h4>Death notice details</h4>
         <p>Would you like to include a photograph?</p>

         <div class="form">
            <div class="row">
               <div class="col-12">

                  <div class="dashboard-radio-form">
                     <div class="form-check">
                        <input id="photograph-y" class="form-check-input" name="photograph" value="yes" type="radio" {{isset($endoflifePlanForm->death_notice_photograph) && $endoflifePlanForm->death_notice_photograph == 'yes' ? 'checked' : ''}}>
                        <label for="photograph-y"><p>Yes</p></label>
                     </div>
                     <div class="form-check">
                        <input id="photograph-n" class="form-check-input" name="photograph" value="no" type="radio" {{isset($endoflifePlanForm->death_notice_photograph) && $endoflifePlanForm->death_notice_photograph == 'no' ? 'checked' : ''}}>
                        <label for="photograph-n"><p>No</p></label>
                     </div>
                  </div>
                  <div class="form-group mb-5 mt-5" id="photograph_details">
                     <label for="Name">Describe the photograph you wish to include and where it can be found:</label>
                     <input value="{{isset($endoflifePlanForm->photograph_details) ? $endoflifePlanForm->photograph_details : ''}}" type="text" class="form-control" id = "photograph_details_id_get" name="photograph_details">
                     <small id="nameHelp" class="form-text text-muted">e.g. I would like the photo of me wearing overalls in the garden to be used. It can be found in my photo album collection.</small>
                  </div>
                  <p>Would you like to include funeral or other service details?</p>
                  <div class="dashboard-radio-form">
                     <div class="form-check">
                        <input id="funeral_service-y" class="form-check-input" name="funeral_service" value="yes" type="radio" {{isset($endoflifePlanForm->funeral_service) && $endoflifePlanForm->funeral_service == 'yes' ? 'checked' : ''}}>
                        <label for="funeral_service-y"><p>Yes</p></label>
                     </div>
                     <div class="form-check">
                        <input id="funeral_service-n" class="form-check-input" name="funeral_service" value="no" type="radio" {{isset($endoflifePlanForm->funeral_service) && $endoflifePlanForm->funeral_service == 'no' ? 'checked' : ''}}>
                        <label for="funeral_service-n"><p>No</p></label>
                     </div>
                  </div>
                  <p class="mt-3">Would you like to request charitable donations instead of flowers?</p>
                  <div class="dashboard-radio-form">
                     <div class="form-check">
                        <input id="charitable-y" class="form-check-input" name="charitable" value="yes" type="radio" {{isset($endoflifePlanForm->charitable_donations) && $endoflifePlanForm->charitable_donations == 'yes' ? 'checked' : ''}}>
                        <label for="charitable-y"><p>Yes</p></label>
                     </div>
                     <div class="form-check">
                        <input id="charitable-n" class="form-check-input" name="charitable" value="no" type="radio" {{isset($endoflifePlanForm->charitable_donations) && $endoflifePlanForm->charitable_donations == 'no' ? 'checked' : ''}}>
                        <label for="charitable-n"><p>No</p></label>
                     </div>
                  </div>

                  <div id="charitable_main" class="child-card-holder">
                     <div id="charitable_holder">
                        @if(!empty($endoflifePlanForm->charitable_details))                                 
                        @foreach(json_decode($endoflifePlanForm->charitable_details, true) as $index => $charitable)
                           <div class="card list mb-3" id="child">
                              <div class="card-header">
                                 <div class="card-sub-title m-0">Charity</div>
                                 <a class="r-button" onclick="removetList(this)">
                                    <span class="fas fa-times"></span>
                                    <span class="remove">Remove</span>
                                 </a>
                              </div>
                              <div class="card-body">
                                 <div class="form-group mb-3">
                                    <label for="Name">Full Name of Charity:</label>
                                    <input value="{{$charitable['charity_name']}}" type="text" class="form-control" id = "charity_{{$index}}"  name="charity[]">
                                 </div>
                                 <div class="form-group mb-3">
                                    <label for="Name">Registration number:</label>
                                    <input value="{{$charitable['registration_number']}}" type="text" class="form-control" id = "registration_number_{{$index}}" name="registration_number[]" >
                                    <small id="nameHelp" class="form-text text-muted">e.g. 200583415</small>
                                 </div>
                              </div>
                           </div>
                        @endforeach
                        @else
                           <div class="card list mb-3" id="child">
                              <div class="card-header">
                                 <div class="card-sub-title m-0">Charity</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="card-body">
                                    <div class="form-group mb-3">
                                       <label for="Name">Full Name of Charity:</label>
                                       <input  type="text" class="form-control" name="charity[]" id = "charity">
                                    </div>
                                    <div class="form-group mb-3">
                                       <label for="Name">Registration number:</label>
                                       <input  type="text" class="form-control" name="registration_number[]"  id = "registration_number">
                                       <small id="nameHelp" class="form-text text-muted">e.g. 200583415</small>
                                    </div>
                                 </div>
                              </div>
                           </div>
                        @endif
                     </div>
                     <div class="add-child">
                        <a href="#" class="add-another" id="add-obituary-button" onclick="clone('charitable_holder')">
                        Add another charity</a>
                     </div>
                  </div>
               </div>
            </div>
         </div>
         <!-- start previous / next buttons -->
         <div id="buttonsection" class="submit-button-multiple">
            <button type="button" onclick="window.location.href = '{{ route('endoflifePlan.create.step.three_2_2') }}'">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