@extends('admin.layouts.app')

@section('content')
<div class="content-body">

    <div class="page-titles">
        <ol class="breadcrumb">
            <li class="breadcrumb-item"><a href="{{ route('admin.lab-users.index') }}">Lab Users</a></li>
            <li class="breadcrumb-item active"><a href="javascript:void(0)">Create</a></li>
        </ol>
    </div>

    <div class="container-fluid py-4">

        <h3 class="mb-3">Add Lab User</h3>

        @if ($errors->any())
            <div class="alert alert-danger">
                <ul class="mb-0">
                    @foreach ($errors->all() as $error)
                        <li>{{ $error }}</li>
                    @endforeach
                </ul>
            </div>
        @endif

        <form action="{{ route('admin.lab-users.store') }}" method="POST" id="ajax-submit" enctype="multipart/form-data">
            @csrf

            <div class="row g-3">

                <div class="col-md-6">
                    <label class="form-label">Name</label>
                    <div class="input-group">
                        <span class="input-group-text bg-light">
                            <i class="fa fa-user"></i>
                        </span>
                        <input type="text" name="name" value="{{ old('name') }}" class="form-control" required>
                    </div>

                </div>

                <div class="col-md-6">
                    <label class="form-label">Mobile Number</label>
                    {{-- <input type="text" name="mobile_number" value="{{ old('mobile_number') }}"
                        class="form-control"> --}}

                    <input type="tel" class="form-control" id="phone"  name="phone" required maxlength="10" >
                    <input type="hidden" id="patient_dial_code" name="dial_code">
                    <input type="hidden" id="patient_dial_code_iso" name="dial_code_iso">     
                </div>

                <div class="col-md-12">
                    <label class="form-label">Email</label>
                    <div class="input-group">
                        <span class="input-group-text bg-light">
                            <i class="fa fa-envelope"></i>
                        </span>
                        <input type="email" name="email" value="{{ old('email') }}"  class="form-control" required>
                    </div>
                </div>

 

                <div class="col-md-6">
                    <label class="form-label">Password</label>
                    <input type="password" name="password" class="form-control" value="{{ old('password') }}" required>
                </div>

                <div class="col-md-6">
                    <label class="form-label">Confirm Password</label>
                    <input type="password" name="password_confirmation" class="form-control" value="{{ old('password_confirmation') }}" required>
                </div>

                <div class="col-md-6">
                    
                    <label class="form-label">Profile Image</label>
                    <input type="file" name="image" class="form-control">
                    <img src="" class="img-thumbnail" alt="" srcset="">
                </div>

                <div class="col-md-6">
                    <label class="form-label">Status</label>
                    <select name="status" class="form-select select2" required>
                        <option value="1" selected>Active</option>
                        <option value="0">Inactive</option>
                    </select>
                </div>

               {{-- <div class="col-md-6">
                    <label class="form-label">Roles</label>
                    <select name="roles[]" class="form-select select2" multiple required>
                        @foreach ($roles as $role)
                            <option value="{{ $role }}"
                            {{ in_array($role, old('roles', [])) ? 'selected' : '' }}>
                            {{ $role }}
                        </option>
                        @endforeach
                    </select>
                </div> --}}

                {{-- <div class="col-md-6">
                    <label class="form-label">Extra Permissions (optional)</label>
                    <select name="permissions[]" class="form-select" multiple size="5">
                        @foreach ($permissions as $permission)
                            <option value="{{ $permission }}"
                                @selected(collect(old('permissions'))->contains($permission))>
                                {{ $permission }}
                            </option>
                        @endforeach
                    </select>
                </div> --}}

            </div>

            <div class="mt-4">
                <button type="submit" class="btn btn-primary">Create Lab User</button>
                <a href="{{ route('admin.lab-users.index') }}" class="btn btn-outline-secondary">Cancel</a>
            </div>

        </form>
    </div>

</div>
@endsection