@php
use Request as Input; 
@endphp

<div class="row">
    <div class="col-8">
        <div class="mb-3">
            <div class="form-group">
                <label for="label_id">Label</label>
                <span class="error">*</span>
                <select class="form-select select2 label" id="label_id" name="label_id">
                    <option value="">Select Label</option>
                    @foreach ($labels as $key => $label)
                        <option value="{{ $label->id }}"
                            {{ isset($contact) && $contact->label_id == $label->id ? 'selected' : '' }}>
                            {{ $label->label_name }}</option>
                    @endforeach
                </select>
            </div>
        </div>
    </div>
</div>
<div class="row">
    <div class="col-4">
        <div class="mb-3">
            {!! Form::label('first_name', 'First Name', ['class' => 'form-label', 'for' => 'first_name']) !!}
            <span class="error">*</span>
            {!! Form::text(
                'first_name',
                Input::old('first_name', isset($contact) ? $contact->getRawOriginal('first_name') : ''),
                [
                    'id' => 'first_name',
                    'class' => 'form-control',
                    'placeholder' => 'Enter First Name',
                ],
            ) !!}
        </div>
    </div>
    <div class="col-4">
        <div class="mb-3">
            {!! Form::label('last_name', 'Last Name', ['class' => 'form-label', 'for' => 'last_name']) !!}
            <span class="error">*</span>
            {!! Form::text(
                'last_name',
                Input::old('last_name', isset($contact) ? $contact->getRawOriginal('last_name') : ''),
                [
                    'id' => 'last_name',
                    'class' => 'form-control',
                    'placeholder' => 'Enter Last Name',
                ],
            ) !!}
        </div>
    </div>
</div>

<div class="row">
    <div class="col-4">
        <div class="mb-3">
            {!! Form::label('phone_number', 'Contact Number', ['class' => 'form-label ', 'for' => 'phone_number']) !!}
            <span class="error">*</span>
            {!! Form::text('phone_number',Input::old('phone_number', isset($contact) ? $contact->getRawOriginal('phone_number') : ''), ['class' => 'form-control phone_number','placeholder'=>'Enter Contact Number']) !!}
            
        </div>
    </div>
    <div class="col-4">
        <div class="mb-3">
            {!! Form::label('secondary_contact_no', 'Secondary Contact (Optional)', ['class' => 'form-label', 'for' => 'secondary_contact_no']) !!}

            {!! Form::text(
                'secondary_contact_no',
                Input::old('secondary_contact_no', isset($contact) ? $contact->getRawOriginal('secondary_contact_no') : ''),
                [
                    'id' => 'secondary_contact_no',
                    'class' => 'form-control secondary_contact_no phone_number',
                    'placeholder' => 'Enter Secondary Contact',
                ],
            ) !!}
        </div>
    </div>
</div>
<div class="row">
    <div class="col-4">
        <div class="mb-3">
            {!! Form::label('email', 'Email', ['class' => 'form-label', 'for' => 'email']) !!}
            {{-- <span class="error">*</span> --}}
            {!! Form::text('email', Input::old('email', isset($contact) ? $contact->getRawOriginal('email') : ''), [
                'id' => 'email',
                'class' => 'form-control',
                'placeholder' => 'Enter Email',
            ]) !!}
        </div>
    </div>
    <div class="col-4">
        <div class="mb-3">
            {!! Form::label('date_of_birth', 'Date of Birth', ['class' => 'form-label', 'for' => 'flatpicker']) !!}
            {!! Form::text(
                'date_of_birth',
                Input::old(
                    'date_of_birth',
                    isset($contact) && $contact->getRawOriginal('date_of_birth')
                        ? Carbon\Carbon::createFromFormat('Y-m-d', $contact->getRawOriginal('date_of_birth'))->format(
                            config('const.datepickerDateFromat1'),
                        )
                        : '',
                ),
                [
                    'id' => 'flatpicker',
                    'class' => 'form-control flatpickr-validation',
                    'placeholder' => 'Select Date of Birth',
                ],
            ) !!}
        </div>
    </div>
</div>
<hr class="hr-lines">
<h5>Address</h5>
<div class="row">
    <div class="col-4">
        <div class="mb-3">
            {!! Form::label('address', 'Address', ['class' => 'form-label', 'for' => 'address']) !!}
            {!! Form::textarea(
                'address',
                Input::old('address', isset($contact) ? $contact->getRawOriginal('address') : ''),
                [
                    'id' => 'address',
                    'class' => 'form-control',
                    'placeholder' => 'Enter Address',
                    'rows' => '1',
                ],
            ) !!}
        </div>
    </div>

    <div class="col-4">
        <div class="mb-3">
            {!! Form::label('city', 'City', ['class' => 'form-label', 'for' => 'city']) !!}
            {!! Form::text('city', Input::old('city', isset($contact) ? $contact->getRawOriginal('city') : ''), [
                'id' => 'city',
                'class' => 'form-control',
                'placeholder' => 'Enter City',
            ]) !!}
        </div>
    </div>
</div>

<div class="row">
    <div class="col-4">
        <div class="mb-3">
            <div class="form-group">
                <label for="state_id">State</label>
                <select class="form-select  select2 state" id="state_id" name="state_id" data-allow-clear="true">
                    <option value="">Select State</option>
                    @foreach ($states as $key => $state)
                        <option value="{{ $state->id }}"
                            {{ isset($contact) && $contact->state_id == $state->id ? 'selected' : '' }}>
                            {{ $state->name }}</option>
                    @endforeach
                </select>
            </div>
        </div>
    </div>

    <div class="col-4">
        <div class="mb-3">
            <div class="form-group">
                <label for="county_id">County</label>
                {!! Form::text('county', Input::old('city', isset($contact) ? $contact->getRawOriginal('county') : ''), [
                'id' => 'county',
                'class' => 'form-control',
                'placeholder' => 'Enter County',
            ]) !!}
            </div>
        </div>
    </div>
</div>

<div class="row">
    <div class="col-4">
        <div class="mb-3">
            {!! Form::label('zip_code', 'Zip Code', ['class' => 'form-label', 'for' => 'zip_code']) !!}
            {!! Form::text('zip_code', Input::old('zip_code', isset($contact) ? $contact->getRawOriginal('zip_code') : ''), [
                'id' => 'zip_code',
                'class' => 'form-control',
                'placeholder' => 'Enter Zip Code',
            ]) !!}
        </div>
    </div>

    <div class="col-4">
        <div class="mb-3">
            <div class="form-group">
                <label for="status">Status</label>
                <span class="error">*</span>
                <select class="form-select" id="status" name="status">
                    @foreach ($statuses as $key => $status)
                        <option value="{{ $key }}"
                            {{ isset($contact) && $contact->status == $key ? 'selected' : ($status == config('const.statusActive') ? 'selected' : '') }}>
                            {{ $status }}</option>
                    @endforeach
                </select>
            </div>
        </div>
    </div>
</div>


<div class="row">

</div>

@if (isset($contact->id))
    <button type="submit" class="btn btn-primary submitbutton">
        <span class="spinner-border me-1 loader-btn d-none" role="button" aria-hidden="true"></span>
        Update
    </button>
@else
    <button type="submit" class="btn btn-primary submitbutton"><span class="spinner-border me-1 loader-btn d-none"
            role="status" aria-hidden="true"> </span> Create</button>
@endif
<a href="{{ route('admin.contact.index') }}" class="btn btn-secondary">Cancel</a>