@extends('layouts.main')

@section('main-content')
    <!-- Zero configuration table -->
    <section class="main-content-section thin-section-border p-3">
        <div class="row">
            <div class="col-md-6 thin-section-border p-2 m-auto">
                <form action="{{ route('complaint.save') }}" method="POST" id="createComplaintForm" enctype="multipart/form-data">
                    @csrf
                    <input type="hidden" name="request_type" value="create_complaint">
                    <div class="form-group">
                        <label class="form-label" for="complainant_name">Complainant's Name</label>
                        <input type="text" class="form-control" id="complainant_name" name="complainant_name" required value="{{ old('complainant_name') }}">
                    </div>
                    <div class="form-group">
                        <label class="form-label" for="complainant_email">Complainant's Email</label>
                        <input type="email" class="form-control" id="complainant_email" name="complainant_email" required value="{{ old('complainant_email') }}">
                    </div>
                    <div class="form-group">
                        <label class="form-label" for="complainant_phone">Complainant's Phone</label>
                        <input type="text" class="form-control" id="complainant_phone" name="complainant_phone" onkeypress="return BaseHelper.allowOnlyPhoneCharacters(event)" required value="{{ old('complainant_phone') }}">
                    </div>
                    <div class="form-group">
                        <label class="form-label" for="category">Category</label>
                        <select class="form-control" id="category" required name="category" data-preselected="{{ old('category') }}">
                            <option value="">Select Category</option>
                            @foreach($categories as $category)
                                <option value="{{ $category->id }}" @if(old('category') == $category->id) selected @endif>{{ $category->display_name }}</option>
                            @endforeach
                        </select>
                    </div>
                    <div class="form-group">
                        <label class="form-label" for="source">Complaint source</label>
                        <select class="form-control" id="source" required name="source" data-preselected="{{ old('source') }}">
                            <option value="">Select Source</option>
                            @foreach($sources as $source)
                                <option value="{{ $source->id }}" @if(old('source') == $source->id) selected @endif>{{ $source->name }}</option>
                            @endforeach
                        </select>
                    </div>
                    <div class="form-group">
                        <label class="form-label" for="description">Complaint</label>
                        <textarea class="form-control" required id="description" name="description">{{ old('description') }}</textarea>
                    </div>
                    <div class="form-group">
                        <label class="form-label" for="category">Assign To department</label>
                        <select class="form-control" id="department" name="department" data-preselected="{{ old('department') }}">
                            <option value="">Select Department</option>
                            @foreach($departments as $department)
                                <option value="{{ $department->id }}" @if(old('department') == $department->id) selected @endif>{{ $department->display_name }}</option>
                            @endforeach
                        </select>
                    </div>

                    <div class="form-group">
                        <label class="form-label" for="description">Supporting Documents</label>
                        {{--<input type="file" multiple class="form-control" id="supporting_documents" name="supporting_documents[]">{{ old('description') }}</input>--}}
                        <div class="form-group" id="uploadDocumentSection" data-latest-id="5">
                            {{--<label class="form-label">Upload documents</label>--}}
                            <div class="row p-2">
                                <input type="file" class="form-control col-md-4 mr-2" name="supporting_documents[0][document]">
                                <textarea type="text" class="form-control col-md-6" name="supporting_documents[][description]" placeholder="Description"></textarea>
                            </div>
                            <div class="row p-2">
                                <input type="file" class="form-control col-md-4 mr-2" name="supporting_documents[1][document]">
                                <textarea type="text" class="form-control col-md-6" name="supporting_documents[1][description]" placeholder="Description"></textarea>
                            </div>
                            <div class="row p-2">
                                <input type="file" class="form-control col-md-4 mr-2" name="supporting_documents[2][document]">
                                <textarea type="file" class="form-control col-md-6" name="supporting_documents[2][description]" placeholder="Description"></textarea>
                            </div>
                            <div class="row p-2">
                                <input type="file" class="form-control col-md-4 mr-2" name="supporting_documents[3][document]" placeholder="Document Title">
                                <textarea type="file" class="form-control col-md-6" name="supporting_documents[3][description]" placeholder="Description"></textarea>
                            </div>
                            <div class="row p-2">
                                <input type="file" class="form-control col-md-4 mr-2" name="supporting_documents[4][document]">
                                <textarea type="file" class="form-control col-md-6" name="supporting_documents[4][description]" placeholder="Description"></textarea>
                            </div>
                            <div class="row p-2">
                                <input type="file" class="form-control col-md-4 mr-2" name="supporting_documents[5][document]" placeholder="Document Title">
                                <textarea type="file" class="form-control col-md-6" name="supporting_documents[5][description]" placeholder="Description"></textarea>
                            </div>
                        </div>
                    </div>
                    <div class="form-row">
                        <div class="col-md-6 m-auto">
                            <button class="btn btn-success w-100" type="submit">Submit</button>
                        </div>
                    </div>
                </form>
            </div>
        </div>
    </section>
@endsection