@extends('layouts.contentLayoutMaster')
{{-- page title --}}
@section('title', 'Criar Convenio')
{{-- vendor styles --}}
@section('vendor-styles')
  <link rel="stylesheet" type="text/css" href="{{ asset('css/plugins/forms/validation/form-validation.css') }}">
  <link rel="stylesheet" type="text/css" href="{{ asset('vendors/css/forms/select/select2.min.css') }}">
  <link rel="stylesheet" type="text/css" href="{{ asset('vendors/css/pickers/pickadate/pickadate.css') }}">
@endsection

{{-- page styles --}}
@section('page-styles')
  <link rel="stylesheet" type="text/css" href="{{ asset('css/pages/page-users.css') }}">
@endsection

@section('content')
  <!-- users edit start -->
  <section class="users-edit">
    <div class="card">
      <div class="card-content">
        <div class="card-body">
          <ul class="nav nav-tabs mb-2" role="tablist">
            <li class="nav-item">
              <a class="nav-link d-flex align-items-center active" id="account-tab" data-toggle="tab" href="#account"
                aria-controls="account" role="tab" aria-selected="true">
                <i class="bx bx-user mr-25"></i><span class="d-none d-sm-block">Dados do Convenio</span>
              </a>
            </li>
          </ul>
          <div class="tab-content">
            @if ($message = Session::get('success'))
              <div class="alert alert-success alert-block">
                <button type="button" class="close" data-dismiss="alert">×</button>
                <strong>{{ $message }}</strong>
              </div>
            @endif

            @if (count($errors) > 0)
              <div class="alert alert-danger">
                <strong>Ops!</strong> Ouve algum problema com o Upload.
                <ul>
                  @foreach ($errors->all() as $error)
                    <li>{{ $error }}</li>
                  @endforeach
                </ul>
              </div>
            @endif
            <div class="tab-pane active fade show" id="account" aria-labelledby="account-tab" role="tabpanel">
              <form action="{{ route('insurance.store') }}" method="post">
                @csrf
                <div class="row">
                  <div class="col-12 col-sm-6">
                    <div class="form-group">
                      <div class="controls">
                        <label>Nome</label>
                        <input type="text" name="name" class="form-control" placeholder="Nome do Convenio" value="">
                      </div>
                    </div>
                    <div class="form-group">
                      <div class="controls">
                        <label>CGC</label>
                        <input type="text" name="cgc" class="form-control" placeholder="Digite p CGC" value="">
                      </div>
                    </div>
                    <div class="form-group">
                      <div class="controls">
                        <label>Endereço</label>
                        <input type="address" name="address" class="form-control" placeholder="Digite o Endereço"
                          value="">
                      </div>
                    </div>
                    <div class="form-group">
                      <div class="controls">
                        <label>Cidade</label>
                        <input type="text" name="city" class="form-control" placeholder="Digite a cidade" value="">
                      </div>
                    </div>
                  </div>
                  <div class="col-12 col-sm-6">
                    <div class="row">
                      <div class="col md-6">
                        <div class="form-group">
                          <div class="controls">
                            <label>Data de faturamento</label>
                            <input type="text" name="billing_date" class="form-control billing_date" placeholder="Digite apenas dia" value="">
                          </div>
                        </div>
                      </div>
                      <div class="col md-6">
                        <div class="form-group">
                          <div class="controls">
                            <label>Data de envio do protocolo</label>
                            <input type="text" name="protocol_date" class="form-control protocol_date" placeholder="Digite apenas dia" value="">
                          </div>
                        </div>
                      </div>
                    </div>
                    <div class="form-group">
                      <div class="controls">
                        <label>Telefone</label>
                        <input type="phone" name="phone" class="form-control phone" placeholder="Digite o telefone" value="">
                      </div>
                    </div>
                    <div class="form-group">
                      <div class="controls">
                        <label>Contato</label>
                        <input type="text" name="contact" class="form-control" placeholder="Nome nome do contato"
                          value="">
                      </div>
                    </div>
                    <div class="form-group">
                      <div class="controls">
                        <label>E-mail</label>
                        <input type="email" name="email" class="form-control" placeholder="digite o e-mail" value="">
                      </div>
                    </div>
                  </div>
                  <div class="col-12 d-flex flex-sm-row flex-column justify-content-end mt-1">
                    <button type="submit" class="btn btn-primary glow mb-1 mb-sm-0 mr-0 mr-sm-1">Salvar</button>
                  </div>
                </div>
              </form>
            </div>
          </div>
        </div>
      </div>
    </div>
  </section>
  <!-- users edit ends -->
@endsection

{{-- vendor scripts --}}
@section('vendor-scripts')
  <script src="{{ asset('vendors/js/forms/select/select2.full.min.js') }}"></script>
  <script src="{{ asset('vendors/js/forms/validation/jqBootstrapValidation.js') }}"></script>
  <script src="{{ asset('vendors/js/pickers/pickadate/picker.js') }}"></script>
  <script src="{{ asset('vendors/js/pickers/pickadate/picker.date.js') }}"></script>
  <link href="https://cdn.jsdelivr.net/npm/select2@4.1.0-rc.0/dist/css/select2.min.css" rel="stylesheet" />
  <script src="https://cdn.jsdelivr.net/npm/select2@4.1.0-rc.0/dist/js/select2.min.js"></script>
  <script type="text/javascript" src="https://cdnjs.cloudflare.com/ajax/libs/jquery.mask/1.14.0/jquery.mask.js"></script>
@endsection

{{-- page scripts --}}
@section('page-scripts')
  <script>
    $(document).ready(function() {
      $('.selectOk').select2();
      $('.zipcode').mask('00000-000');
      $('.cnpj').mask('00.000.000/0000-00');
      $('.number').mask('00000');
      $('.phone').mask("(99) 99999-9999");
      $('.billing_date').mask("99");
      $('.protocol_date').mask("99");
    });
  </script>
  <script src="{{ asset('js/scripts/pages/page-users.js') }}"></script>
  <script src="{{ asset('js/scripts/navs/navs.js') }}"></script>
@endsection