@extends('master')
@section('content')
    <section class="section dashboard">
        <div class="row">
            <div class="col-12">
                <div class="d-flex justify-content-between align-items-center mb-4">
                    <h3 class="fw-bold fs-5">Doctors Information / Profile</h3>
                </div>
                <div class="card e-collect-form card-min-height">
                    <div class="card-body mt-5">
                        <form class="row g-3 needs-validation" action="{{ route('store.doctors') }}" method="post" novalidate>
                            @csrf
                            <div class="row">
                                <div class="col-md-6 mb-3">
                                    <label class="form-label fw-600" for="user_name">Name:</label>
                                    <input type="text"  value="{{ old('name') }}" class="form-control custom-input" name="name">
                                    @error('name')
                                    <span class="text-danger">{{ $message }}</span>
                                    @enderror
                                </div>
                                <div class="col-md-6 mb-3">
                                    <label class="form-label fw-600" for="user_email">Email:</label>
                                    <input type="email"  value="{{ old('email') }}" class="form-control custom-input"  name="email">
                                    @error('email')
                                    <span class="text-danger">{{ $message }}</span>
                                    @enderror
                                </div>
                            </div>


                            <div class="row">
                                <div class="col-md-6 mb-3">
                                    <label for="validationCustom02" class="form-label fw-600">Address</label>
                                    <input type="text" class="form-control custom-input"  value="{{ old('address') }}"  name="address" id="validationCustom02"
                                           required>
                                    @error('address')
                                    <span class="text-danger">{{ $message }}</span>
                                    @enderror

                                </div>
                                <div class="col-md-6 mb-3">
                                    <label for="validationCustom02" class="form-label fw-600">Gender</label>
                                    <select class="form-select" name="gender"    aria-label="Default select example">
                                        <option selected>Please Select</option>
                                        <option value="100">male</option>
                                        <option value="0">female</option>
                                    </select>
                                    @error('gender')
                                    <span class="text-danger">{{ $message }}</span>
                                    @enderror
                                </div>
                            </div>
                            <div class="row">
                                <div class="col-md-6 mb-3">
                                    <label class="form-label fw-600" for="contact_no">Contact No:</label>
                                    <input type="text"  value="{{ old('contact_no') }}" class="form-control custom-input" name="contact_no">
                                    @error('contact_no')
                                    <span class="text-danger">{{ $message }}</span>
                                    @enderror
                                </div>
                                    
                            </div>
                            <div class="row">
                                <div class="col-md-6 mb-3">
                                        <label class="form-label fw-600" for="s_cons_weekday">Standard Consultation (Mon-Fri after 5pm) :</label>
                                        <input type="text"  value="{{ old('s_cons_weekday') }}" class="form-control custom-input" name="s_cons_weekday">
                                        @error('s_cons_weekday')
                                        <span class="text-danger">{{ $message }}</span>
                                        @enderror
                                    </div>
                                 <div class="col-md-6 mb-3">
                                        <label class="form-label fw-600" for="s_cons_weekend">Standard Consultation (Sat- Sun and public holidays) :</label>
                                        <input type="text"  value="{{ old('s_cons_weekend') }}" class="form-control custom-input" name="s_cons_weekend">
                                        @error('s_cons_weekend')
                                        <span class="text-danger">{{ $message }}</span>
                                        @enderror
                                    </div>
                                    
                            </div>
                            
                            
                            <div class="row">
                                <div class="col-md-6 mb-3">
                                        <label class="form-label fw-600" for="l_cons_weekday">Long Consultation (Mon-Fri after 5pm) :</label>
                                        <input type="text"  value="{{ old('l_cons_weekday') }}" class="form-control custom-input" name="l_cons_weekday">
                                        @error('l_cons_weekday')
                                        <span class="text-danger">{{ $message }}</span>
                                        @enderror
                                    </div>
                                     <div class="col-md-6 mb-3">
                                        <label class="form-label fw-600" for="l_cons_weekend">Long Consultation (Sat- Sun and public holidays) :</label>
                                        <input type="text"  value="{{ old('l_cons_weekend') }}" class="form-control custom-input" name="l_cons_weekend">
                                        @error('l_cons_weekend')
                                        <span class="text-danger">{{ $message }}</span>
                                        @enderror
                                    </div>
                                       <div class="row">
                                <div class="col-md-6 mb-3">
                                    <label class="form-label fw-600" for="education">Education:</label>
                                    <input type="text"  value="{{ old('education') }}" class="form-control custom-input" name="education">
                                    @error('education')
                                    <span class="text-danger">{{ $message }}</span>
                                    @enderror
                                </div>
                                <div class="col-md-6 mb-3">
                                    <label class="form-label fw-600" for="experience">Experience:</label>
                                    <input type="text"  value="{{ old('experience') }}" class="form-control custom-input"  name="experience">
                                    @error('experience')
                                    <span class="text-danger">{{ $message }}</span>
                                    @enderror
                                </div>
                            </div>
                            <div class="row">
                                <div class="col-md-6 mb-3">
                                    <label class="form-label fw-600" for="designation">Designation:</label>
                                    <input type="text"  value="{{ old('designation') }}" class="form-control custom-input" name="designation">
                                    @error('designation')
                                    <span class="text-danger">{{ $message }}</span>
                                    @enderror
                                </div>
                                <div class="col-md-6 mb-3">
                                    <label class="form-label fw-600" for="speciality">Speciality:</label>
                                    <input type="text"  value="{{ old('speciality') }}" class="form-control custom-input"  name="speciality">
                                    @error('speciality')
                                    <span class="text-danger">{{ $message }}</span>
                                    @enderror
                                </div>
                            </div>



                            <div class="row">
                                <div class="col-md-6 mb-3">
                                    <label  class="form-label fw-600" for="user_password">Password:</label>
                                    <input type="password" value="{{ old('password') }}" class="form-control custom-input"  name="password">
                                    @error('password')
                                    <span class="text-danger">{{ $message }}</span>
                                    @enderror
                                </div>
                                <div class="col-md-6 mb-3 d-none">
                                    <label  class="form-label fw-600" for="roles">Roles:</label>
                                    <select class="form-control custom-input" name="roles" >
                                        <option value="" >Please Select</option>
                                        @foreach($roles as $role)
                                            <option value="{{ $role->id }}">{{ $role->title }}</option>
                                        @endforeach
                                    </select>
                                    @error('roles')
                                    <span class="text-danger">{{ $message }}</span>
                                    @enderror
                                </div>
                            </div>
                            </div>
                         

                            <div class="col-12">
                                <div class="form-action-button">
                                    <button type="submit" class="btn save-btn"> Save</button>
                                </div>
                            </div>

                        </form>
                    </div>
                </div>
            </div>
        </div>
    </section>
@endsection