@extends('admin.layouts.app')

@section('title','Add Doctor')

@section('header')
Add Doctor
@endsection

@section('content')

<form method="POST" action="{{ route('admin.doctors.store') }}">
@csrf

<div class="card shadow-sm mb-4">

    <div class="card-header">
        <h5 class="mb-0">Personal Information</h5>
    </div>

    <div class="card-body">

        <div class="row">

            <div class="col-md-4 mb-3">
                <label>First Name</label>
                <input
                    type="text"
                    name="first_name"
                    class="form-control"
                    value="{{ old('first_name') }}"
                    required>
            </div>

            <div class="col-md-4 mb-3">
                <label>Middle Name</label>
                <input
                    type="text"
                    name="middle_name"
                    class="form-control"
                    value="{{ old('middle_name') }}">
            </div>

            <div class="col-md-4 mb-3">
                <label>Last Name</label>
                <input
                    type="text"
                    name="last_name"
                    class="form-control"
                    value="{{ old('last_name') }}"
                    required>
            </div>

            <div class="col-md-3 mb-3">
                <label>Gender</label>
                <select
                    name="gender"
                    class="form-control"
                    required>
                    <option value="">Select</option>
                    <option value="Male">Male</option>
                    <option value="Female">Female</option>
                </select>
            </div>

            <div class="col-md-3 mb-3">
                <label>Date of Birth</label>
                <input
                    type="date"
                    name="date_of_birth"
                    class="form-control"
                    value="{{ old('date_of_birth') }}">
            </div>

            <div class="col-md-3 mb-3">
                <label>National ID</label>
                <input
                    type="text"
                    name="national_id"
                    class="form-control"
                    value="{{ old('national_id') }}">
            </div>

            <div class="col-md-3 mb-3">
                <label>Phone</label>
                <input
                    type="text"
                    name="phone"
                    class="form-control"
                    value="{{ old('phone') }}">
            </div>

            <div class="col-md-6 mb-3">
                <label>Email</label>
                <input
                    type="email"
                    name="email"
                    class="form-control"
                    value="{{ old('email') }}">
            </div>

            <div class="col-md-6 mb-3">
                <label>Address</label>
                <input
                    type="text"
                    name="address"
                    class="form-control"
                    value="{{ old('address') }}">
            </div>

        </div>

    </div>

</div>

<div class="card shadow-sm mb-4">

    <div class="card-header">
        <h5 class="mb-0">Professional Information</h5>
    </div>

    <div class="card-body">

        <div class="row">

            <div class="col-md-6 mb-3">

                <label>Department</label>

                <select
                    name="department_id"
                    class="form-control"
                    required>

                    <option value="">Select Department</option>

                    @foreach($departments as $department)

                        <option
                            value="{{ $department->id }}"
                            @selected(old('department_id') == $department->id)>

                            {{ $department->name }}

                        </option>

                    @endforeach

                </select>

            </div>

            <div class="col-md-6 mb-3">

                <label>Specialty</label>

                <select
                    name="specialty_id"
                    class="form-control"
                    required>

                    <option value="">Select Specialty</option>

                    @foreach($specialties as $specialty)

                        <option
                            value="{{ $specialty->id }}"
                            @selected(old('specialty_id') == $specialty->id)>

                            {{ $specialty->name }}

                        </option>

                    @endforeach

                </select>

            </div>

            <div class="col-md-4 mb-3">

                <label>License Number</label>

                <input
                    type="text"
                    name="license_number"
                    class="form-control"
                    value="{{ old('license_number') }}">

            </div>

            <div class="col-md-4 mb-3">

                <label>Qualification</label>

                <input
                    type="text"
                    name="qualification"
                    class="form-control"
                    value="{{ old('qualification') }}">

            </div>

            <div class="col-md-4 mb-3">

                <label>Experience (Years)</label>

                <input
                    type="number"
                    min="0"
                    name="experience_years"
                    class="form-control"
                    value="{{ old('experience_years',0) }}">

            </div>

            <div class="col-md-4 mb-3">

                <label>Consultation Fee</label>

                <input
                    type="number"
                    step="0.01"
                    min="0"
                    name="consultation_fee"
                    class="form-control"
                    value="{{ old('consultation_fee',0) }}">

            </div>

            <div class="col-md-4 mb-3">

                <label>Joining Date</label>

                <input
                    type="date"
                    name="joining_date"
                    class="form-control"
                    value="{{ old('joining_date') }}">

            </div>

            <div class="col-md-4 mb-3">

                <label>Status</label>

                <select
                    name="status"
                    class="form-control">

                    <option value="1" selected>Active</option>
                    <option value="0">Inactive</option>

                </select>

            </div>

            <div class="col-md-12 mb-3">

                <label>Notes</label>

                <textarea
                    name="notes"
                    class="form-control"
                    rows="4">{{ old('notes') }}</textarea>

            </div>

        </div>

    </div>

</div>

<button type="submit" class="btn btn-primary">
    Save Doctor
</button>

<a href="{{ route('admin.doctors.index') }}"
   class="btn btn-secondary">
    Cancel
</a>

</form>

@endsection