@extends('layout.default')

@section('styles')@endsection
@section('subheaderRightToolbar')
    @PermissionsCan(groupPermissionName('consignee.index'))
    <a href="{{ route('consignee.index') }}" class="btn btn-light-primary font-weight-bolder mr-2">
        <i class="ki ki-long-arrow-back icon-sm"></i>Back(ESC)</a>
    @endPermissionsCan
    @PermissionsCan(groupPermissionName('consignee.store'))
    <div class="btn-group">
        <button type="submit" class="btn btn-primary font-weight-bolder" form="consignee_form">
            <i class="ki ki-check icon-sm"></i><u>S</u>ave & Continue
        </button>
    </div>
    @endPermissionsCan
@endsection
@section('content')
    <div class="card card-custom card-sticky" id="kt_page_sticky_card">
        <div class="card-body" id="load-section-js">
            <form class="form" id="consignee_form" data-method="post" data-url="{{ route('consignee.store') }}"
                  enctype="multipart/form-data">
                <div class="row">
                    <div class="col-xl-12">
                        <div class="my-5">
                            <div class="row">
                                <div class="col-md-4">
                                    <div class="form-group">
                                        <label>Name <b class="text-danger">*</b></label>
                                        <input class="form-control form-control-solid" type="text" name="name" id="name"
                                               placeholder="Enter Name"
                                               value="" autofocus/>
                                    </div>
                                </div>

                                <div class="col-md-4">
                                    <div class="form-group">
                                        <label>Code <b class="text-danger">*</b></label>
                                        <input id="code" class="form-control form-control-solid text-uppercase" type="text"
                                               maxlength="6" name="code" id="code"
                                               placeholder="Enter Code"
                                               value=""/>
                                    </div>
                                </div>

                                <div class="col-md-4">
                                    <div class="form-group">
                                        <label>Phone No <b class="text-danger">*</b></label>
                                        <input type="text" class="form-control form-control-solid" name="phone_no"
                                               placeholder="Phone number" data-inputmask='"mask": "9999999999"'
                                               data-mask pattern="^\[0-9]{5}\s[0-9]{5}$">
                                    </div>
                                </div>
                            </div>

                            <div class="row">
                                <div class="col-md-4">
                                    <div class="form-group">
                                        <label>Mobile no <b class="text-danger">*</b></label>
                                        <input type="number"
                                               class="form-control form-control-solid form-control-lg"
                                               name="mobile_no" id="mobile_no" value="" placeholder="Mobile No"/>
                                    </div>
                                </div>

                                <div class="col-md-4">
                                    <div class="form-group">
                                        <label>Email <b class="text-danger">*</b></label>
                                        <input type="email" class="form-control form-control-solid" name="email"
                                               placeholder="Enter Email Address">
                                    </div>
                                </div>

                                <div class="col-md-4">
                                    <div class="form-group">
                                        <label>Address </label>
                                        <textarea class="form-control form-control-solid" name="address" id="address" rows="1"
                                                  placeholder="Enter Address"></textarea>
                                    </div>
                                </div>
                            </div>

                            <div class="row">
                                <div class="col-md-4">
                                    <div class="form-group">
                                        <label>Country<b class="text-danger">*</b></label>
                                        <select class="form-control form-control-lg country-select2-js"
                                                name="country_id" id="country_id" data-action="{{ route('countries.autocomplete') }}">
                                        </select>
                                    </div>
                                </div>

                                <div class="col-md-4">
                                    <div class="form-group">
                                        <label>State<b class="text-danger">*</b></label>
                                        <select class="form-control form-control-lg state-select2-js"
                                                name="state_id" id="state_id" data-action="{{ route('states.autocomplete') }}" data-depended="country_id">
                                        </select>
                                    </div>
                                </div>

                                <div class="col-md-4">
                                    <div class="form-group">
                                        <label>Cities<b class="text-danger">*</b></label>
                                        <select class="form-control form-control-lg city-select2-js"
                                                name="city_id" id="city_id" data-action="{{ route('cities.autocomplete') }}" data-depended="state_id">
                                        </select>
                                    </div>
                                </div>
                            </div>

                            <div class="row">
                                <div class="col-md-4">
                                    <div class="form-group">
                                        <label>Pan Card No </label>
                                        <input class="form-control form-control-solid text-uppercase" type="text"
                                               name="pan_no" placeholder="Enter Pan Card No" maxlength="10"/>
                                    </div>
                                </div>

                                <div class="col-md-4">
                                    <div class="form-group">
                                        <label>GST No</label>
                                        <input class="form-control form-control-solid text-uppercase" type="text"
                                               name="gst_no" placeholder="Enter GST No" maxlength="15"/>
                                    </div>
                                </div>

                                <div class="col-md-4">
                                    <div class="form-group">
                                        <label>Contact Person </label>
                                        <input class="form-control form-control-solid" type="text" name="contact_person"
                                               placeholder="Enter Contact Person" value=""/>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>

                    <hr>
                    <h2>Bank Details</h2>
                    <div class="col-xl-12">
                        <div class="my-5">
                            <div class="form-group row">
                                <div class="col-md-4">
                                    <div class="form-group">
                                        <label>Bank A/C No</label>
                                        <input class="form-control form-control-solid" type="text" name="bank_ac_no" id="bank_ac_no"
                                               placeholder="Enter Bank A/C No"
                                               value="" autofocus/>
                                    </div>
                                </div>

                                <div class="col-md-4">
                                    <div class="form-group">
                                        <label>Bank A/C Name</label>
                                        <input class="form-control form-control-solid text-uppercase" type="text"
                                               name="bank_ac_name" id="bank_ac_name"
                                               placeholder="Enter Bank A/C Name"
                                               value=""/>
                                    </div>
                                </div>

                                <div class="col-md-4">
                                    <div class="form-group">
                                        <label>Bank Name</label>
                                        <input type="text" class="form-control form-control-solid" name="bank_name"
                                               placeholder="Enter Bank Name" id="bank_name" value="">
                                    </div>
                                </div>
                            </div>

                            <div class="form-group row">
                                <div class="col-md-4">
                                    <div class="form-group">
                                        <label>Branch Name</label>
                                        <input class="form-control form-control-solid" type="text" name="branch_name" id="branch_name"
                                               placeholder="Enter Branch Name"
                                               value="" autofocus/>
                                    </div>
                                </div>

                                <div class="col-md-4">
                                    <div class="form-group">
                                        <label>IFSC Code</label>
                                        <input id="code" class="form-control form-control-solid text-uppercase" type="text"
                                               name="ifsc_code" id="ifsc_code"
                                               placeholder="Enter IFSC Code"
                                               value=""/>
                                    </div>
                                </div>

                                <div class="col-md-4">
                                    <div class="form-group">
                                        <label>MICR Code</label>
                                        <input type="text" class="form-control form-control-solid"
                                               name="micr_code" id="micr_code"
                                               placeholder="Enter MICR Code"
                                               value=""/>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>


                    <hr>
                    <h2>Attachments</h2>
                    <div class="col-xl-12">
                        <div class="my-5">
                            <div class="form-group row">
                                <div class="col-md-4">
                                    <div class="form-group">
                                        <label>Aadhaar Card</label>
                                        <div class="input-group">
                                            <div class="custom-file">
                                                <input type="file" class="custom-file-input" id="aadhaar_card_file"
                                                       name="aadhaar_card_file">
                                                <label class="custom-file-label" for="documents">Choose File</label>
                                            </div>
                                        </div>
                                    </div>
                                </div>

                                <div class="col-md-4">
                                    <div class="form-group">
                                        <label>PAN Card</label>
                                        <div class="input-group">
                                            <div class="custom-file">
                                                <input type="file" class="custom-file-input" id="pan_card_file"
                                                       name="pan_card_file">
                                                <label class="custom-file-label" for="documents">Choose File</label>
                                            </div>
                                        </div>
                                    </div>
                                </div>

                                <div class="col-md-4">
                                    <div class="form-group">
                                        <label>GST Certificate</label>
                                        <div class="input-group">
                                            <div class="custom-file">
                                                <input type="file" class="custom-file-input" id="gst_certificate"
                                                       name="gst_certificate">
                                                <label class="custom-file-label" for="documents">Choose File</label>
                                            </div>
                                        </div>
                                    </div>
                                </div>
                            </div>

                            <div class="form-group row">
                                <div class="col-md-4">
                                    <div class="form-group">
                                        <label>Cancelled cheque</label>
                                        <div class="input-group">
                                            <div class="custom-file">
                                                <input type="file" class="custom-file-input" id="cancelled_cheque_file"
                                                       name="cancelled_cheque_file">
                                                <label class="custom-file-label" for="documents">Choose File</label>
                                            </div>
                                        </div>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                </div>
            </form>
        </div>
    </div>
@endsection

@section('scripts')
    <script type="text/javascript" src="{{ asset('js/modules/consignee/create.js?v='.time()) }}"></script>
@endsection