@extends('layouts.app')
@section('title', 'Exam From')
@push('styles')
<style type="text/css">
    .list-group-numbered {
        list-style-type: none;
        counter-reset: section;
    }
    .list-group-numbered>li::before {
        content: counters(section, ".") ". ";
        counter-increment: section;
    }
</style>
@endpush
@section('content')

<div class="pmd-card pmd-card-default py-5">
    <div class="pmd-card-title">
        <h3 class="pmd-card-title-text text-center mb-0"><b>Govt. Mankunwar Bai Arts & Commerce Autonomous College<br>For Women, Jabalpur (M.P.)</b></h3>
	        <div class="text-center">( NACC Accredited B+ )</div>
	        <div class="text-center">Affiliated to Rani Durgavati Vishwavidyalaya, Jabalpur</div>
	        <div class="text-center">(संबध्दता - रानी दुर्गावती विश्वविद्यालय, जबलपुर)</div>
	        <div class="text-center">Regular/ATKT/EX Examination April 2023</div>
	         <div class="text-center"><strong >Exam Form/परीक्षा फार्म</strong></div>
       
    </div>
     <div class="pmd-card-body">
        <div class="pmd-section">
            <div class="container"> 
                @if ($errors->any())
                    <div class="alert alert-danger">
                        <ul>
                            @foreach ($errors->all() as $error)
                                <li>{{ $error }}</li>
                            @endforeach
                        </ul>
                    </div>
                @endif
                {!! Form::open( ['route' => ['form'], 'class'=>'needs-validation', 'novalidate'=>'true', 'files'=>true ] ) !!}
                    <div class="row">
                        <div class="col-12">
                            <div class="form-group pmd-textfield">
                                <label class="control-label">MAIN/ATKT @if( $application->cat == "REG") ({{ 'मुख्य' }}) @else {{ 'पूरक' }} @endif</label>
                                <span class="form-control-static">{{ $application->cat }}</span>
                            </div> 
                        </div>
                    </div>

                    <div class="row">
                        <div class="col-md-6">
                            <div class="form-group pmd-textfield pmd-textfield-floating-label pmd-textfield-outline @if ($errors->has('exam_year')) has-error @endif">
                                <label class="control-label">Date/दिनांक</label>                        
                                {!! Form::text('exam_year', Carbon\Carbon::now()->format('d/m/Y'), [ 'required'=>true, 'class' => 'form-control datepicker', 'id'=>'exam_year']) !!}        
                                @if ($errors->has('exam_year')) <p class="help-block">{{ $errors->first('exam_year') }}</p> @endif                         
                            </div>
                        </div>
                        <div class="col-md-6">
                            <div class="form-group pmd-textfield pmd-textfield-floating-label pmd-textfield-outline">
                                <label class="control-label">Roll No/रोल नंबर</label>  
                                {!! Form::text('roll_no', Auth::user()->roll_number, ['class' => 'form-control', 'disabled'=>'true']) !!}
                            </div>
                        </div>
                    </div>

                    <div class="row">
                        <div class="col-md-6">              
                            <div class="form-group pmd-textfield pmd-textfield-floating-label pmd-textfield-outline">
                                <label class="control-label">Class/कक्षा का नाम</label>
                                {!! Form::text('class', $application->s_code, ['class' => 'form-control', 'disabled'=>'true']) !!}
                            </div>
                        </div>

                        <div class="col-md-6">              
                            <div class="form-group pmd-textfield pmd-textfield-floating-label pmd-textfield-outline">
                                <label class="control-label">Semester/Year</label>
                                {!! Form::text('sem', $application->sem, ['class' => 'form-control', 'disabled'=>'true']) !!}
                            </div>
                        </div>
                    </div>

                    <div class="row">
                        <div class="col-md-6">
                            <div class="form-group pmd-textfield pmd-textfield-floating-label pmd-textfield-outline">
                                <label class="control-label">Student Name/छात्र का नाम</label>
                                {!! Form::text('name', Auth::user()->name, ['class' => 'form-control', 'disabled'=>'true']) !!}
                            </div>
                        </div>

                         <div class="col-md-6">                
                            <div class="form-group pmd-textfield pmd-textfield-floating-label pmd-textfield-outline @if ($errors->has('d_of_b')) has-error @endif">
                                <label class="control-label">Date Of Birth</label>                        
                                {!! Form::text('d_of_b', Auth::user()->d_of_b->format('d/m/Y'), ['class' => 'form-control datepicker']) !!}        
                                @if ($errors->has('d_of_b')) <p class="help-block">{{ $errors->first('d_of_b') }}</p> @endif                         
                            </div>
                        </div>
                    </div>

                    <div class="row">
                        <div class="col-md-6">
                            <div class="form-group pmd-textfield pmd-textfield-floating-label pmd-textfield-outline">
                                <label class="control-label">Father's Name/पिता का नाम</label>
                                {!! Form::text('father_name', Auth::user()->f_name, ['class' => 'form-control', 'disabled'=>'true']) !!}
                            </div>
                        </div> 
                        
                        <div class="col-md-6">             
                            <div class="form-group pmd-textfield pmd-textfield-floating-label pmd-textfield-outline">
                                <label class="control-label">Mother's Name/माता का नाम</label>
                                {!! Form::text('mother_name', Auth::user()->m_name, ['class' => 'form-control', 'disabled'=>'true']) !!}                           
                            </div>
                        </div>
                    </div>

                    <div class="row">
                        <div class="col-md-6">                
                            <div class="form-group pmd-textfield pmd-textfield-floating-label pmd-textfield-outline @if ($errors->has('phone')) has-error @endif">
                                <label class="control-label">Mobile No/मोबाइल नंबर</label>
                                {!! Form::text('phone', Auth::user()->phone, ['class' => 'form-control']) !!}        
                                @if ($errors->has('phone')) <p class="help-block">{{ $errors->first('phone') }}</p> @endif
                            </div>
                        </div>
                        
                        
                        
                        
                         <div class="row">
                        <div class="col-md-6">                
                            <div class="form-group pmd-textfield pmd-textfield-floating-label pmd-textfield-outline @if ($errors->has('cast')) has-error @endif">
                                  <label class="control-label">Category(Gen/SC/ST/OBC)</label>
                                {!! Form::text('cast', Auth::user()->cast, ['class' => 'form-control']) !!}        
                                @if ($errors->has('cast')) <p class="help-block">{{ $errors->first('cast') }}</p> @endif
                            </div>
                        </div>
                        </div>
                        </div>
                        
                        <div class="row">
                        
                        <div class="col-md-6">                
                            <div class="form-group pmd-textfield pmd-textfield-floating-label pmd-textfield-outline @if ($errors->has('mother_name')) has-error @endif">
                                <label class="control-label">Email</label>
                                {!! Form::text('email', Auth::user()->email, ['class' => 'form-control']) !!}        
                                @if ($errors->has('email')) <p class="help-block">{{ $errors->first('email') }}</p> @endif
                            </div>
                        </div>
                 
                       
                        <div class="col-md-8">  
                             <div class="form-group pmd-textfield pmd-textfield-floating-label pmd-textfield-outline @if ($errors->has('address')) has-error @endif">
                                 <label class="control-label">Full Address/पता</label>
                                 {!! Form::textarea('address', Auth::user()->address, ['class' => 'form-control', 'size' => '30x5']) !!} 
                                 @if ($errors->has('address')) <p class="help-block">{{ $errors->first('address') }}</p> @endif
                             </div>
                         </div> 
                 
                  </div> 
                  </div>
                  </div>
                  

                       @if ($application->sem === 'III' || $application->sem === 'III')
                    <!--old code 1st slot -->
             <!--       <div class="row">
                        <div class="col-6">
                            <div class="form-group">
                                <label class="control-label"><strong >Subjects</strong ></label>
                                  <label class="control-label">{{ $application->s_code }}</label>
                                <ol class="list-group list-group-numbered">
                                   
                                
                                 
                                 <label class="control-label">MAJOR</label>
                                  <li class="list-group-item ">{{ $application->sub5 }}</li>
                                 <li class="list-group-item ">{{ $application->sub6 }}</li>
                                 <label class="control-label">MINOR</label>
                                  <li class="list-group-item ">{{ $application->sub7 }}</li>
                                  <label class="control-label">OPEN ELECTIVE</label>
                                   <li class="list-group-item ">{{ $application->sub8 }}</li>
                                   <label class="control-label">VOCATIONAL</label>
                                    <li class="list-group-item ">{{ $application->sub9 }}</li>
                                     <label class="control-label">PROJECT INTERNSHIP</label>
                                     <li class="list-group-item ">{{ $application->sub10 }}</li>
                                   
                                </ol>
                                
                            </div> 
                         
                        </div>
                    </div>-->
                    
                    
                    <div class="row">
                        <div class="col-6">
                            <div class="form-group">
                                <label class="control-label"><strong >Subjects</strong ></label>
                                  <label class="control-label">{{ $application->s_code }}</label>
                                 <ol class="list-group list-group-numbered">
                                
                                <li class="list-group-item ">{{ $application->sub1 }}</li>
                                <li class="list-group-item ">{{ $application->sub2 }}</li>
                                <li class="list-group-item ">{{ $application->sub3 }}</li>
                                <li class="list-group-item ">{{ $application->sub4 }}</li>
                                 
                       
                                  <li class="list-group-item ">{{ $application->sub5 }}</li>
                                 <li class="list-group-item ">{{ $application->sub6 }}</li>
                            
                                  <li class="list-group-item ">{{ $application->sub7 }}</li>
                   
                                   <li class="list-group-item ">{{ $application->sub8 }}</li>
                                   <li class="list-group-item ">{{ $application->sub9 }}</li>
                                   <li class="list-group-item ">{{ $application->sub10 }}</li>
                                   <li class="list-group-item ">{{ $application->sub11 }}</li>
                                   <li class="list-group-item ">{{ $application->sub12 }}</li>
                                  
                                   
                                   
                                </ol>
                                
                            </div> 
                         
                        </div>
                    </div>
                    
                     @endif  
                    
                   
                   
                    @if ($application->code === 'NEP')
                    <!--NEP SUBJECT -->
                  <div class="row">
                        <div class="col-6">
                            <div class="form-group">
                                <label class="control-label"><strong >Subjects</strong ></label>
                                  <label class="control-label">{{ $application->s_code }}</label><br>
                                  @if(isset($application->sub1))
                                   <label class="control-label"><strong >{{ $application->sub1 }}</strong ></label>
                                    @endif
                                   @if(isset($application->sub2))
                                  <li class="list-group-item ">{{ $application->sub2 }}</li>
                                   @endif
                                  @if(isset($application->sub3))
                                   <li class="list-group-item ">{{ $application->sub3 }}</li>
                                    @endif
                                  
                                   <label class="control-label"><strong ></strong ></label>
                             
                                  @if(isset($application->sub4))
                                <li class="list-group-item ">{{ $application->sub4 }}</li>
                                @endif
                                @if(isset($application->sub5)) 
                                <li class="list-group-item ">{{ $application->sub5 }}</li>
                             @endif
                             
                                @if(isset($application->sub6))
                                 <li class="list-group-item ">{{ $application->sub6 }}</li>
                                 @endif
                                 @if(isset($application->sub7))
                                 <li class="list-group-item ">{{ $application->sub7 }}</li>
                                 @endif
                                 @if(isset($application->sub8))
                                 <li class="list-group-item ">{{ $application->sub8 }}</li>
                                 @endif
                                 @if(isset($application->sub9))
                                  <li class="list-group-item ">{{ $application->sub9 }}</li>
                                  @endif
                                  @if(isset($application->sub10))
                                 <li class="list-group-item ">{{ $application->sub10 }}</li>
                                 @endif
                                 @if(isset($application->sub11))
                                   <li class="list-group-item ">{{ $application->sub11 }}</li>
                                   @endif
                                   @if(isset($application->sub12))
                                   <li class="list-group-item ">{{ $application->sub12 }}</li>
                                   @endif
                                   
                                   @if(isset($application->sub13))
                                   <li class="list-group-item ">{{ $application->sub13 }}</li>
                                   @endif
                                   
                                   @if(isset($application->sub14))
                                   <li class="list-group-item ">{{ $application->sub14 }}</li>
                                   @endif
                     <!--            <label class="control-label"><strong >MAJOR</strong ></label> -->
                                  
                     <!--            <label class="control-label"><strong >MINOR</strong ></label>  -->
                                 
                      <!--            <label class="control-label"><strong >OPEN ELECTIVE</strong ></label> -->
                                   
                     <!--              <label class="control-label"><strong >VOCATIONAL</strong ></label> -->
                                  
                      <!--               <label class="control-label"><strong >PROJECT INTERNSHIP</strong ></label> -->
                                     
                                   
                                
                                
                            </div> 
                         
                        </div>
                    </div>
                    
                    
                    
                     @endif  
                   
                   
                   
                   
                   
                   
                 
                    
                    
                    <div class="row">
                        <div class="col-6">
                            <div class="form-check">
                                <input class="form-check-input" type="checkbox" value="" id="flexChecksubject" required>
                                <label class="form-check-label" for="flexChecksubject">
                                    My Subjects are as per my choice as entered in Admission Record.
                                </label>
                            </div>
                        </div>
                    </div>

                    <div class="row pt-4">
                        <div class="col-12">
                            <div class="form-group">
                                <label class="control-label">Upload Photo</label>
                                <div data-provides="fileinput" class="fileinput file-upload-140 mb-0">
                                    <div data-trigger="fileinput" class="fileinput-preview thumbnail img-fluid mb-0">
                                        @if(Auth::user()->image)
                                            <img src='{{ Auth::user()->profile_picture }}' width="140" alt="profile avatar">
                                        @else
                                            <img src="{{ asset('images/image-placeholder.jpg') }}" width="140" alt="profile avatar">
                                        @endif
                                        
                                    </div>
                                    <div class="action-button">
                                        <span
                                            class="btn btn-secondary pmd-btn-fab btn-xs pmd-btn-raised btn-file pmd-ripple-effect">
                                            <span class="fileinput-new"><i class="material-icons pmd-xs">add</i></span>
                                            <span class="fileinput-exists"><i
                                                    class="material-icons pmd-xs">mode_edit</i></span>
                                            <input type="file" name="profile_photo" >
                                        </span>
                                        <a data-dismiss="fileinput"
                                            class="btn btn-danger btn-xs pmd-btn-fab pmd-ripple-effect pmd-btn-raised btn-file fileinput-exists"
                                            href="javascript:void(0);"><i class="material-icons pmd-xs">close</i></a>
                                    </div>
                                </div>

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

                    <div class="row">
                        <div class="col-md-12">
                            <h3 class="text-center"><b>Declaration/घोषणा</b></h3>
                            <div class="form-check">
                                <input class="form-check-input" type="checkbox" value="" id="flexCheckDefault" required>
                                <label class="form-check-label" for="flexCheckDefault">
                                THE INFORMATION GIVEN BY ME ABOVE IS CORRECT AND IF IT IS FOUND INCORRECT MY FORM IS LIABLE TO BE REJECTED BY THE PRINCIPAL. I GIVE AN UNDERTAKING THAT I WILL ABIDE BY ALL THE RULES OF THE EXAM AND WILL NOT RESORT TO INDICIPLINE AND UFM.DURING COLLEGE TIMING I AM NOT IN EMPLOYMENT.
                                    <br> मेरे द्वारा ऊपर दी गई जानकारी सही है और यदि यह सही नहीं पाई जाती है तो प्रचार्य द्वारा मेरे फार्म को निरस्त किया जा सकता है | मैं वचन देती हूँ  कि मैं परीक्षा के सभी नियमों का पालन करूँगी और अनुशासनहीनता और यूएफएम का सहारा नहीं लूँगी | महविद्यालय के समय में किसी रोजगार में नहीं हूँ | )
                                </label>
                            </div>
                        </div>
                    </div>

                    <div class="form-group btns">
                        <div class="text-center">
                            <input type="hidden" name="application_id" value="{{ $application->id }}">
                            <input type="hidden" name="amount" value="{{ $application->fee }}">
                            <button type="submit" class="btn btn-lg pmd-btn-raised pmd-ripple-effect btn-primary">Pay Examination Fee ₹ {{ $application->fee }}</button>
                        </div>
                    </div>
                {!! Form::close() !!}
            </div>
        </div>
    </div>
</div>
@endsection

@push('scripts')
<!-- Propeller date time picker css-->
<script>
    $(document).ready(function () {

        // Date picker
        $(".datepicker").datetimepicker({
            format: 'DD/MM/YYYY'
        });

        // Custom file uplaod
        bsCustomFileInput.init();

    });

</script>
@endpush