210 lines
13 KiB
PHP
210 lines
13 KiB
PHP
<!DOCTYPE html>
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<html lang="en">
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<head>
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@include('layouts.shared/title-meta', ['title' => "Form"])
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@include('layouts.shared/head-css', ["mode" => $mode ?? '', "demo" => $demo ?? ''])
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<link href="{{asset('assets/libs/sweetalert2/sweetalert2.min.css')}}" rel="stylesheet" type="text/css" />
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</head>
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<div id="pageloader">
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<img src="http://cdnjs.cloudflare.com/ajax/libs/semantic-ui/0.16.1/images/loader-large.gif" alt="processing..." />
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</div>
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<body class="loading authentication-bg authentication-bg-pattern">
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<div class="account-pages mt-5 mb-5">
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<div class="container">
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<div class="row justify-content-center">
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<div class="col-md-8">
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<div class="card bg-pattern">
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<div class="card-body p-3 row">
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<div class="text-center w-75 m-auto">
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<div class="auth-logo">
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<a href="/road/register" class="logo logo-dark text-center">
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<span class="logo-lg">
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<img src="{{asset($logo)}}" alt="" height="100">
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</span>
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</a>
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<a href="/road/register" class="logo logo-light text-center">
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<span class="logo-lg">
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<img src="{{asset($logo)}}" alt="" height="100">
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</span>
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</a>
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</div>
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<h4>{{$title}}</h4>
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<h5>{{$session->number}}</h5>
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@foreach($session->dates->date as $i => $date)
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<h5>{{date("d M, Y", strtotime($date) )}} <small>{{date("h:iA", strtotime($session->dates->start[$i]) )}}-{{date("h:iA", strtotime($session->dates->end[$i]) )}}</small></h5>
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@endforeach
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</div>
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@if(Session::has('error'))<div class="alert alert-danger">{{Session::get('error')}}</div>
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<br>@endif
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@if(session('success'))<div class=" alert alert-success">{{ session('success') }}
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</div>
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<br>@endif
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<div class="col-8">
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<h4 class="page-title">{{$form->title}}</h4>
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</div>
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<form method="POST" id="report-form" enctype="multipart/form-data">
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<input type="hidden" name="form_id" value="{{$form_id}}">
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<input type="hidden" name="session_code" value="{{$session->code}}">
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<input type="hidden" name="recipient" value="{{$recipient}}">
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@csrf
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@foreach($questions as $question)
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<div class="col-md-12 mb-2">
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@if($question->code == 'cases_on_could_it_be_asthma_bronchiolitis')
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<p>Kindly spare a few minutes and give us your feedback. It will be invaluable to us and will help us improve our programme</p>
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<p class="text-danger">On a scale of 1 to 10 (where 1 is the lowest and 10 is the highest) how satisfied were you with the following:-<br />
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SCIENTIFIC CONTENT:<p>
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<p><strong>Cases on Could it be Asthma?</strong></p>
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@endif
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@if($question->code == 'uncontrolled_asthma_with_allergic_rhinitis')
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<p><strong>Cases on The Broad Spectrum of Asthma</strong></p>
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@endif
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@if($question->code == 'lung_oscillometry_recorded_talk_by_dr_sundeep_salvi_on_lung_oscillometry')
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<p><strong>Lung Oscillometry</strong></p>
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@endif
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@if($question->code == 'suggestions')
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<p class="text-danger"><strong>Most important take away and </strong>any suggestions for improvement of the programme are welcome. Please take a few minutes to pen down the same</p>
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@endif
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@if($question->type != 'label')
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<label for="field-{{$question->code}}" class="form-label">{{$question->question}} {!!$question->required == 'yes' ? '<span class="text-danger">*</span>':''!!} </label>
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@endif
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@switch($question->type)
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@case('label')
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<h5>{{$question->question}}</h5>
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@break
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@case('hidden')
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<input type="{{$question->type}}" id="field-{{$question->code}}" name="{{$question->code}}" value="{{isset($question->value)?$question->value:''}}">
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@break
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@case('text')
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@case('email')
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@case('tel')
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@case('date')
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<input type="{{$question->type}}" id="field-{{$question->code}}" name="{{$question->code}}" class="form-control" {{$question->required == 'yes'?'required':'' }} value="{{isset($question->value)?$question->value:''}}">
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@break
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@case('number')
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<input type="{{$question->type}}" min="0" max="9999999999" step="1" id="field-{{$question->code}}" name="{{$question->code}}" class="form-control" {{$question->required == 'yes'?'required':'' }} value="{{isset($question->value)?$question->value:0}}">
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@break
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@case('textarea')
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<textarea id="field-{{$question->code}}" name="{{$question->code}}" class="form-control" {{$question->required == 'yes'?'required':'' }}>{{isset($question->value)?$question->value:''}}</textarea>
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@break
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@case('dropdown')
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<select class="form-control" id="field-{{$question->code}}" name="{{$question->code}}" {{$question->required == 'yes'?'required':'' }}>
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<option value=""> -- Select -- </option>
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@foreach($question->options as $option)
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<option value="{{$option->value}}" {{isset($question->value) && $question->value == $option->value ? 'selected':''}}>{{$option->display}}</option>
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@endforeach
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</select>
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@break
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@case('checkbox')
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@foreach($question->options as $option)
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<div class="form-check mb-2 form-check-primary">
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<input class="form-check-input" type="checkbox" id="field-{{$question->code}}-{{$option->value}}" name="{{$question->code}}[]" value="{{$option->value}}" {{isset($question->value) && $question->value != '' && in_array($option->value, $question->value) ? 'checked':''}}>
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<label class="form-check-label" for="field-{{$question->code}}-{{$option->value}}">{{$option->display}}</label>
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</div>
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@endforeach
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@break
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@case('radio')
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<div class="row ps-2">
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@foreach($question->options as $i => $option)
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<div class="form-check col-auto form-check-blue mb-2">
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<input class="form-check-input" type="radio" name="{{$question->code}}" value="{{$option->value}}" id="field-{{$question->code}}-{{$option->value}}" {{($question->required == 'yes' && $i == 0 )?'required':'' }}>
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<label class="form-check-label" for="field-{{$question->code}}-{{$option->value}}">{{$option->display}}</label>
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</div>
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@endforeach
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</div>
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@break
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@case('file')
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<input type="file" id="field-{{$question->code}}" name="{{$question->code}}" class="form-control" value="" accept="image/jpg, image/jpeg, image/png" required>
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@break
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@case('multitextbox')
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<div class="row">
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@foreach($question->options as $option)
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<div class="col-6">{{$option->display}}</div>
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<div class="col-6 mb-1">
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<input type="number" id="field-{{$option->value}}" name="{{$option->value}}" class="form-control" required value="{{isset($option->val)?$option->val:0}}">
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</div>
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@endforeach
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</div>
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@break
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@endswitch
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</div>
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@endforeach
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@if(!isset($form->is_approval) || (isset($form->is_approval) && $form->is_approval != 'yes' ) )
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<div class="text-center d-grid mt-3">
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<button class="btn btn-primary" type="submit" id="submit-btn"> Submit </button>
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</div>
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@endif
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</form>
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</div> <!-- end card-body -->
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</div>
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<!-- end card -->
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<!-- end row -->
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</div> <!-- end col -->
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</div>
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<!-- end row -->
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</div>
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<!-- end container -->
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</div>
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<!-- end page -->
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<style type="text/css">
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#pageloader {
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background: rgba( 255, 255, 255, 0.8 );
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display: none;
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height: 100%;
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position: fixed;
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width: 100%;
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z-index: 9999;
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}
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#pageloader img {
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left: 50%;
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margin-left: -32px;
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margin-top: -32px;
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position: absolute;
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top: 50%;
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}
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</style>
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@include('layouts.shared/footer-script')
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<script src="{{asset('assets/libs/sweetalert2/sweetalert2.min.js')}}"></script>
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<script type="text/javascript">
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jQuery(document).ready(function($){
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// $('#report-form').on('submit', function(event){
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// event.preventDefault();
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// $("#pageloader").fadeIn();
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// $.ajax({
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// type: "POST",
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// url: '/srvey/ajaxsubmit',
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// data: new FormData($('#report-form')[0]),
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// processData: false,
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// contentType: false,
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// success: function( data ) {
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// $("#pageloader").fadeOut();
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// if(data.status == 'success') {
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// Swal.fire({
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// title: 'Great!',
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// text: 'Your data is successfully submitted!',
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// icon: 'success'
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// })
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// $('#report-form').trigger("reset");
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// } else {
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// Swal.fire({
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// icon: 'error',
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// title: 'Data not submitted',
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// text: 'Something went wrong, please try again after some time!'
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// })
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// }
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// },
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// });
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// });
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});
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</script>
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</body>
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</html> |