@extends('frontend.app')
<!-- Main Container  -->
@section('content')

<div class="position-relative">

    <div id="carouselExampleIndicators" class="carousel slide" data-pause="false" data-ride="carousel">
        <div class="carousel-inner">
            <div class="carousel-item active innerHeaderimg">
                <img src="/assets/frontend/images/inner-about.jpg" />
                <div class="carousel-caption innertopHEadcaption">
                    <div class="container">
                        <div class="row">
                            <div class="col-md-5">
                                <div class="capbg">
                                    <p>Home <i class="fa fa-angle-right mx-2"></i> Contact Us <i class="fa fa-angle-right mx-2"></i> </p>
                                    <div class="heading-seperator innerseperatorspace"><span></span></div>
                                    <h4>Feedback/Enquiry</h4>
                                </div>
                            </div>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
    {!! Form::model($enquiryMaster, ['method' => isset($enquiryMaster) && $enquiryMaster->id ? 'put' : 'post', 'enctype' => 'multipart/form-data']) !!}
    <section>
        <div class="container">
            <div class="row">
                <div class="col-md-8 py-sm-3 borderinner-right">
                    <div class="innerabout-content">
                        @if(isset($message) && $message)
                        <h6 style="color: green" class="mb-2 fw-bold">{{$message}}</h6>
                        @endif
                        <h2 class="f-20 font-weight-bold">Complaint/Suggestion/Feedback</h2>
                        <div class="row">
                            <div class="col-md-12">
                                <form class="myform">
                                    <div class="row">
                                        <div class="col-lg-6 login-form mt-3">
                                            <div class="form-label-group">
                                                <select class="form-control" id="title" name="title" placeholder="title" autofocus>
                                                    <option value="">Select Feedback type*</option>
                                                    @foreach ($feedback_type as $feedback)
                                                    <option value={{ $feedback }} @if(old('title') == $feedback) selected @endif>{{ $feedback }}</option>
                                                    @endforeach
                                                </select>
                                            </div>
                                            {!! $errors->first('title', '<label class="control-label" for="title">:message</label>')!!}
                                        </div>
                                        <div class="col-md-6 login-form mt-3">
                                            <div class="form-label-group">
                                                <input type="text" name='bp_number' id='bp_number' class="form-control pl-3" onkeypress="NumOnly(event)" maxlength="10" placeholder="BP Number (if you are registered customer)" value="{{ old('bp_number') }}">
                                            </div>
                                            {!! $errors->first('bp_number', '<label class="control-label" for="title">:message</label>')!!}
                                        </div>
                                        <div class="col-md-6  login-form mt-3">
                                            <div class="form-label-group">
                                                <input type="text" name='name' id='name' class="form-control pl-3" maxlength="180" placeholder="Full Name*" value="{{ old('name') }}">
                                            </div>
                                            {!! $errors->first('name', '<label class="control-label" for="title">:message</label>')!!}
                                        </div>
                                        <div class="col-md-6 login-form mt-3">
                                            <div class="form-label-group">
                                                <input type="text" name='mobile' id='mobile' class="form-control pl-3" maxlength="10" onkeypress="NumOnly(event)" placeholder="Mobile Number*" value="{{ old('mobile') }}">
                                            </div>
                                            {!! $errors->first('mobile', '<label class="control-label" for="title">:message</label>')!!}
                                        </div>
                                        <div class="col-md-6 login-form mt-3">
                                            <div class="form-label-group">
                                                <input type="text" name='email' id='email' class="form-control pl-3" maxlength="180" onkeypress="emailOnly(event)" placeholder="Email ID" value="{{ old('email') }}">
                                            </div>
                                            {!! $errors->first('email', '<label class="control-label" for="title">:message</label>')!!}
                                        </div>
                                        <div class="col-md-6 login-form mt-3">
                                            <div class="form-label-group">
                                                <input type="text" name='address' id='address' class="form-control pl-3" maxlength="199" placeholder="Area/Address*" value="{{ old('address') }}">
                                            </div>
                                            {!! $errors->first('address', '<label class="control-label" for="title">:message</label>')!!}
                                        </div>
                                        <div class="col-lg-6 login-form mt-3">
                                            <div class="form-label-group">
                                                <select class="form-control" id="type_of_connection" name="type_of_connection" placeholder="type_of_connection">
                                                    <option value="">Select Connection type*</option>
                                                    @foreach ($connection_type as $connection)
                                                    <option value={{ $connection }} @if(old('type_of_connection') == $connection) selected @endif>{{ $connection }}</option>
                                                    @endforeach
                                                </select>
                                            </div>
                                            {!! $errors->first('type_of_connection', '<label class="control-label" for="title">:message</label>')!!}
                                        </div>
                                        <div class="col-lg-6 login-form mt-3">
                                            <div class="form-label-group">
                                                <select class="form-control" id="reason" name="reason" placeholder="reason">
                                                    <option value="">Select Reason Type*</option>
                                                    @foreach ($reason as $reason)
                                                    <option value={{ $reason }} @if(old('reason') == $reason) selected @endif>{{ $reason }}</option>
                                                    @endforeach
                                                </select>
                                            </div>
                                            {!! $errors->first('reason', '<label class="control-label" for="title">:message</label>')!!}
                                        </div>
                                    </div>

                                    <div class="form-group login-form mt-3">
                                        <div class="form-label-group">
                                            <input type="text" name='subject' class="form-control pl-3" placeholder="Subject*" maxlength="180" value="{{old('subject')}}">
                                        </div>
                                        {!! $errors->first('subject', '<label class="control-label" for="title">:message</label>')!!}
                                    </div>

                                    <div class="form-group login-form mt-3">
                                        <div class="form-label-group">
                                            <textarea name='comments' class="form-control pl-3 h-100" id="exampleFormControlTextarea1" rows="8" placeholder="Comments*" maxlength="2000">{{old('comments')}}</textarea>
                                        </div>
                                        {!! $errors->first('comments', '<label class="control-label" for="title">:message</label>')!!}
                                    </div>
                                    <label><input type="checkbox" name="declaration" {{ old('declaration') == 'on' ? 'checked' : '' }} required> I do hereby declare that I have read all the details mentioned above before submitting.</label>
                                    {!! $errors->first('declaration', '<label class="control-label" for="title">:message</label>')!!}
                                    <p><button type="submit" class="btn btn-primary px-4 px-sm-5 mt-4">Submit</button></p>
                                </form>

                            </div>
                        </div>
                    </div>

                </div>

                <div class="col-md-4 py-3 py-sm-5">
                    @include('frontend.layouts.partials.right-menu')
                    @include('frontend.layouts.partials.our_services')
                </div>

            </div>

        </div>

    </section>

    @endsection

    @section('scripts')
    @parent
    <script src="/assets/frontend/js/validation.js"></script>
    <script>
        $('#bp_number').blur(function(e) {
            e.preventDefault();
            console.log('hi');
            var bp_number = $('#bp_number').val();
            var data = {
                bp_number: bp_number
                , '_token': '{{{csrf_token()}}}'
            }
            $.ajax({
                url: '/ajax/get-bpnumber-details'
                , type: 'POST'
                , data: data
                , success: function(data) {
                    var data = JSON.parse(data);
                    console.log(data);
                    console.log(data.status);
                    if (data.status == 200) {
                        console.log('hi');
                        $('#name').val(data.response.full_name);
                        $('#email').val(data.response.email_id);
                        $('#mobile').val(data.response.mobile_number);
                        $('#address').val(data.response.full_address);
                        $('#bp_number_error_message').html('');
                    } else {
                        console.log('wrong');
                        $('#name').val('');
                        $('#email').val('');
                        $('#mobile').val('');
                        $('#address').val('');
                        $('#bp_number_error_message').html(data.message);
                    }
                }
            });
        });

    </script>
    @endsection