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

@section('title', '| Pour-Over Will Form')

@section('content')
@include('frontend.forms.v2.Pour-Over-Will.stepIndicator')
    <form action="{{route('pourOverWillFormcreate')}}" method="POST" id="signUpForm">
      @csrf
      <input type="hidden" id="stepInput" name="step" value="1">
      <div class="multiple-form dashboard-radio">

        @if (Session::has('message'))
            <div class="alert alert-info">{{ Session::get('message') }}</div>
        @endif

        <h4>Children</h4>
        <p>
            Do you have children?
            <a tabindex="0" class="info-icon" role="button" data-bs-toggle="popover" data-bs-html="true" data-bs-trigger="focus" title="Children Info" data-bs-content="<p>Only biological and legally adopted children should be listed.</p>">?</a>
        </p>

        <div class="form">
            <div class="row">
               <div class="col-12">
                    <div class="dashboard-radio-form">
                        <div class="form-check">
                            <input id="children-toggle-on" class="form-check-input" name="children" type="radio" value="on" {{ isset($pourOverWillForm->children_status) &&  $pourOverWillForm->children_status == "yes" ? 'checked' : ''}}>
                            <label for="children-toggle-on">
                                <p>Yes</p>
                            </label>
                        </div>
                        <div class="form-check">
                            <input id="children-toggle-off" class="form-check-input" name="children" type="radio" value="off" {{ isset($pourOverWillForm->children_status) &&  $pourOverWillForm->children_status == "no" ? 'checked' : ''}}>
                            <label for="children-toggle-off">
                                <p>No</p>
                            </label>
                        </div>
                    </div>
               </div>
            </div>
            <div class="row my-5">
              
                <div id="children-section-details" class="child-card-holder">
                    <p class="mb-4">
                        Who are your children? 
                        <a tabindex="0" class="info-icon" role="button" data-bs-toggle="popover" data-bs-html="true" data-bs-trigger="focus" title="Children Info" data-bs-content="<p>Minors and adult children residing in your household are classified as dependents.</p>">?</a>
                    </p>
                    <div id="children-container">
                       @php
                       $childrenarray = json_decode($pourOverWillForm->children, true);
                       @endphp

                       @if(!empty($pourOverWillForm->children) && count($childrenarray) > 0)
                           @foreach($childrenarray as $index => $child)
                           <!-- Existing child data -->
                           <div class="card list mb-3" id="child">
                               <div class="card-header">
                                   <div class="card-title">Child name</div>
                                   <a onclick="removetList(this)" class="r-button">
                                       <span class="fas fa-times"></span>
                                       <span class="remove">Remove</span>
                                   </a>
                               </div>
                               <div class="card-body">
                                   <div class="form-group mb-3">
                                       <label for="name">Name</label>
                                       <input type="text" name="child_name[]" id="child_name_{{$index}}" class="form-control modified-input" aria-describedby="nameHelp"  value="{{ $child['name'] }}">
                                       <small id="nameHelp" class="form-text text-muted">e.g. William Timothy Smith</small>
                                   </div>
                                   <div class="checkbox-item form-check-input-child">
                                       <input type="hidden" name="cdependent[{{$index}}]" value="no">
                                       <input class="custom-checkbox" name="cdependent[{{$index}}]" type="checkbox" value="yes"  id="flexCheckDefault" {{ $child['dependent'] == 'yes' ? 'checked' : '' }}>
                                       <label class="form-check-label">
                                        <p>Minor or dependent?</p>
                                       </label>
                                   </div>
                               </div>
                           </div>
                           @endforeach
                       @else
                           <!-- If no data, show an empty child form -->
                           <div class="card list mb-3" id="child">
                               <div class="card-header">
                                   <div class="card-title">Child name</div>
                                   <a onclick="removetList(this)" class="r-button">
                                       <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="child_name[]" id="child_name" aria-describedby="nameHelp" >
                                       <small id="nameHelp" class="form-text text-muted">e.g. William Timothy Smith</small>
                                   </div>
                                   <div class="checkbox-item form-check-input-child">
                                       <input  type="hidden" name="cdependent[0]" id="flexCheckDefault" value="no">
                                       <input class="custom-checkbox"  name="cdependent[0]" type="checkbox" value="yes" id="flexCheckDefault" checked>
                                       <label class="form-check-label">
                                           <p>Minor or dependent?</p>
                                       </label>
                                   </div>
                               </div>
                           </div>
                       @endif
                    </div>
                    <div class="add-child">
                       <a class="add-another" id="add-another-child" onclick="custom_clone('children-container')">Add Another Child</a>
                    </div>
                 </div>
            </div>

            <div id="buttonsection" class="submit-button-multiple">
                <button onclick="window.location.href = '{{ route('pourOverWillFormStart') }}'" type="button">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>

        </div>
      </div>
    </form>
@endsection
@section('page-js')
<script src="{{ url('frontend/assets/js/forms/pour-over-will-multi-stepform.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