@extends('layouts.app')

@section('content')
    <h3 class="page-title">@lang('quickadmin.member-personal-details.title')</h3>
    
    {!! Form::model($member_personal_detail, ['method' => 'PUT', 'route' => ['admin.member_personal_details.update', $member_personal_detail->id], 'files' => true,]) !!}

    <div class="panel panel-default">
        <div class="panel-heading">
            @lang('quickadmin.qa_edit')
        </div>

        <div class="panel-body">
            <div class="row">
                <div class="col-xs-12 form-group">
                    {!! Form::label('membership_number_id', trans('quickadmin.member-personal-details.fields.membership-number').'*', ['class' => 'control-label']) !!}
                    {!! Form::select('membership_number_id', $membership_numbers, old('membership_number_id'), ['class' => 'form-control select2', 'required' => '']) !!}
                    <p class="help-block">Membership Number</p>
                    @if($errors->has('membership_number_id'))
                        <p class="help-block">
                            {{ $errors->first('membership_number_id') }}
                        </p>
                    @endif
                </div>
            </div>
            <div class="row">
                <div class="col-xs-12 form-group">
                    @if ($member_personal_detail->member_photo)
                        <a href="{{ asset(env('UPLOAD_PATH').'/'.$member_personal_detail->member_photo) }}" target="_blank"><img src="{{ asset(env('UPLOAD_PATH').'/thumb/'.$member_personal_detail->member_photo) }}"></a>
                    @endif
                    {!! Form::label('member_photo', trans('quickadmin.member-personal-details.fields.member-photo').'*', ['class' => 'control-label']) !!}
                    {!! Form::file('member_photo', ['class' => 'form-control', 'style' => 'margin-top: 4px;']) !!}
                    {!! Form::hidden('member_photo_max_size', 3) !!}
                    {!! Form::hidden('member_photo_max_width', 4096) !!}
                    {!! Form::hidden('member_photo_max_height', 4096) !!}
                    <p class="help-block">Member profile picture</p>
                    @if($errors->has('member_photo'))
                        <p class="help-block">
                            {{ $errors->first('member_photo') }}
                        </p>
                    @endif
                </div>
            </div>
            <div class="row">
                <div class="col-xs-12 form-group">
                    {!! Form::label('firstname', trans('quickadmin.member-personal-details.fields.firstname').'*', ['class' => 'control-label']) !!}
                    {!! Form::text('firstname', old('firstname'), ['class' => 'form-control', 'placeholder' => 'First Name', 'required' => '']) !!}
                    <p class="help-block">First Name</p>
                    @if($errors->has('firstname'))
                        <p class="help-block">
                            {{ $errors->first('firstname') }}
                        </p>
                    @endif
                </div>
            </div>
            <div class="row">
                <div class="col-xs-12 form-group">
                    {!! Form::label('middle_name', trans('quickadmin.member-personal-details.fields.middle-name').'', ['class' => 'control-label']) !!}
                    {!! Form::text('middle_name', old('middle_name'), ['class' => 'form-control', 'placeholder' => 'Middle Name']) !!}
                    <p class="help-block">Middle Name</p>
                    @if($errors->has('middle_name'))
                        <p class="help-block">
                            {{ $errors->first('middle_name') }}
                        </p>
                    @endif
                </div>
            </div>
            <div class="row">
                <div class="col-xs-12 form-group">
                    {!! Form::label('last_name', trans('quickadmin.member-personal-details.fields.last-name').'*', ['class' => 'control-label']) !!}
                    {!! Form::text('last_name', old('last_name'), ['class' => 'form-control', 'placeholder' => 'Last Name', 'required' => '']) !!}
                    <p class="help-block">Last Name</p>
                    @if($errors->has('last_name'))
                        <p class="help-block">
                            {{ $errors->first('last_name') }}
                        </p>
                    @endif
                </div>
            </div>
            <div class="row">
                <div class="col-xs-12 form-group">
                    {!! Form::label('member_email', trans('quickadmin.member-personal-details.fields.member-email').'', ['class' => 'control-label']) !!}
                    {!! Form::email('member_email', old('member_email'), ['class' => 'form-control', 'placeholder' => 'Member Email']) !!}
                    <p class="help-block">Member Email</p>
                    @if($errors->has('member_email'))
                        <p class="help-block">
                            {{ $errors->first('member_email') }}
                        </p>
                    @endif
                </div>
            </div>
            <div class="row">
                <div class="col-xs-12 form-group">
                    {!! Form::label('blood_group', trans('quickadmin.member-personal-details.fields.blood-group').'*', ['class' => 'control-label']) !!}
                    <p class="help-block">Blood Group</p>
                    @if($errors->has('blood_group'))
                        <p class="help-block">
                            {{ $errors->first('blood_group') }}
                        </p>
                    @endif
                    <div>
                        <label>
                            {!! Form::radio('blood_group', 'A Positive', false, ['required' => '']) !!}
                            A+
                        </label>
                    </div>
                    <div>
                        <label>
                            {!! Form::radio('blood_group', 'A Negative', false, ['required' => '']) !!}
                            A-
                        </label>
                    </div>
                    <div>
                        <label>
                            {!! Form::radio('blood_group', 'B Positive', false, ['required' => '']) !!}
                            B+
                        </label>
                    </div>
                    <div>
                        <label>
                            {!! Form::radio('blood_group', 'B Negative', false, ['required' => '']) !!}
                            B-
                        </label>
                    </div>
                    <div>
                        <label>
                            {!! Form::radio('blood_group', 'O Positive', false, ['required' => '']) !!}
                            O +
                        </label>
                    </div>
                    <div>
                        <label>
                            {!! Form::radio('blood_group', 'O Negative', false, ['required' => '']) !!}
                            O -
                        </label>
                    </div>
                    <div>
                        <label>
                            {!! Form::radio('blood_group', 'AB Positive', false, ['required' => '']) !!}
                            AB +
                        </label>
                    </div>
                    <div>
                        <label>
                            {!! Form::radio('blood_group', 'AB Negative', false, ['required' => '']) !!}
                            AB -
                        </label>
                    </div>
                    <div>
                        <label>
                            {!! Form::radio('blood_group', 'None', false, ['required' => '']) !!}
                            None (Sijui)
                        </label>
                    </div>
                    
                </div>
            </div>
            <div class="row">
                <div class="col-xs-12 form-group">
                    {!! Form::label('gender', trans('quickadmin.member-personal-details.fields.gender').'*', ['class' => 'control-label']) !!}
                    <p class="help-block">Gender</p>
                    @if($errors->has('gender'))
                        <p class="help-block">
                            {{ $errors->first('gender') }}
                        </p>
                    @endif
                    <div>
                        <label>
                            {!! Form::radio('gender', 'male', false, ['required' => '']) !!}
                            Male (Mme)
                        </label>
                    </div>
                    <div>
                        <label>
                            {!! Form::radio('gender', 'female', false, ['required' => '']) !!}
                            Female (Mke)
                        </label>
                    </div>
                    
                </div>
            </div>
            <div class="row">
                <div class="col-xs-12 form-group">
                    {!! Form::label('phone_number', trans('quickadmin.member-personal-details.fields.phone-number').'*', ['class' => 'control-label']) !!}
                    {!! Form::text('phone_number', old('phone_number'), ['class' => 'form-control', 'placeholder' => 'Phone Number( Mfano : 0744025960)', 'required' => '']) !!}
                    <p class="help-block">Phone Number( Mfano : 0744025960)</p>
                    @if($errors->has('phone_number'))
                        <p class="help-block">
                            {{ $errors->first('phone_number') }}
                        </p>
                    @endif
                </div>
            </div>
            <div class="row">
                <div class="col-xs-12 form-group">
                    {!! Form::label('nationality', trans('quickadmin.member-personal-details.fields.nationality').'*', ['class' => 'control-label']) !!}
                    <p class="help-block">Utaifa wako</p>
                    @if($errors->has('nationality'))
                        <p class="help-block">
                            {{ $errors->first('nationality') }}
                        </p>
                    @endif
                    <div>
                        <label>
                            {!! Form::radio('nationality', 'Tanzanian', false, ['required' => '']) !!}
                            Tanzanian
                        </label>
                    </div>
                    <div>
                        <label>
                            {!! Form::radio('nationality', 'Not Tanzanian', false, ['required' => '']) !!}
                            Non Tanzanian
                        </label>
                    </div>
                    
                </div>
            </div>
            
        </div>
    </div>

    {!! Form::submit(trans('quickadmin.qa_update'), ['class' => 'btn btn-danger']) !!}
    {!! Form::close() !!}
@stop