From df4541b11cc73c271feb64045099812839a5beb9 Mon Sep 17 00:00:00 2001
From: zeeshan <zeeshan@stratawiz.com>
Date: Mon, 15 Jun 2026 17:44:00 +0530
Subject: [PATCH 1/2] Catch up changes

---
 ...b702-e048-4499-9b87-95f9ae2d94d5.blade.php | 69 ++++++++++---------
 ...eb14-e144-4667-84a8-32d939cf281a.blade.php | 11 ++-
 2 files changed, 47 insertions(+), 33 deletions(-)

diff --git a/resources/views/form/rapport-arise/1777029250-544db702-e048-4499-9b87-95f9ae2d94d5.blade.php b/resources/views/form/rapport-arise/1777029250-544db702-e048-4499-9b87-95f9ae2d94d5.blade.php
index 4722a140..1d2bf11d 100644
--- a/resources/views/form/rapport-arise/1777029250-544db702-e048-4499-9b87-95f9ae2d94d5.blade.php
+++ b/resources/views/form/rapport-arise/1777029250-544db702-e048-4499-9b87-95f9ae2d94d5.blade.php
@@ -73,14 +73,16 @@
                                                 <th>Reason For Not-Executing</th>
                                                 <th>Patient Screened</th>
                                                 <th>Patient Diagnosed</th>
-                                                {{-- <th>Foracort Rx</th> --}}
+                                               
                                                 <th>Seroflo Rx</th>
-                                               {{--  <th>Duolin Rx</th> --}}
-                                                <th>Aerocort Rx</th>
-                                                {{-- <th>Glycohale FB Rx</th> --}}
-                                                <th>E-Voltido Rx</th>
-                                                {{-- <th>E- Foracort G Rx</th> --}}
-                                                <th>E-Synchrobreathe range Rx</th>
+                                                <th>Maxiflo Rx</th>
+                                                <th>Voltido Rx</th>
+                                                <th>Voltido Trio Rx</th>
+                                                <th>Indaflo Rx</th>
+                                                <th>Budecort Rx</th>
+                                                <th>Levolin Rx</th>
+                                               
+                                                
 
                                             </tr>
                                         </thead>
@@ -124,14 +126,15 @@
                                                     <td>{{ isset($sub->formdata->reason) ? $sub->formdata->reason : '' }}</td>
                                                     <td>{{ isset($sub->formdata->patient_screened) ? $sub->formdata->patient_screened : '' }}</td>
                                                     <td>{{ isset($sub->formdata->patients_diagnosed) ? $sub->formdata->patients_diagnosed : '' }}</td>
-                                                    {{-- <td>{{ isset($sub->formdata->foracort_rx) ? $sub->formdata->foracort_rx : '' }}</td> --}}
+                                                    
                                                     <td>{{ isset($sub->formdata->seroflo_rx) ? $sub->formdata->seroflo_rx : '' }}</td>
-                                                    {{-- <td>{{ isset($sub->formdata->duolin_rx) ? $sub->formdata->duolin_rx : '' }}</td> --}}
-                                                    <td>{{ isset($sub->formdata->aerocort_rx) ? $sub->formdata->aerocort_rx : '' }}</td>
-                                                    {{-- <td>{{ isset($sub->formdata->glycohale_fb_rx) ? $sub->formdata->glycohale_fb_rx : '' }}</td> --}}
-                                                    <td>{{ isset($sub->formdata->e_voltido_rx) ? $sub->formdata->e_voltido_rx : '' }}</td>
-                                                    {{-- <td>{{ isset($sub->formdata->e_foracort_g_rx) ? $sub->formdata->e_foracort_g_rx : '' }}</td> --}}
-                                                    <td>{{ isset($sub->formdata->e_synchrobreathe_range_rx) ? $sub->formdata->e_synchrobreathe_range_rx : '' }}</td>
+                                                    <td>{{ isset($sub->formdata->maxiflo_rx) ? $sub->formdata->maxiflo_rx : '' }}</td>
+                                                    <td>{{ isset($sub->formdata->voltido_rx) ? $sub->formdata->voltido_rx : '' }}</td>
+                                                    <td>{{ isset($sub->formdata->voltido_trio_rx) ? $sub->formdata->voltido_trio_rx : '' }}</td>
+                                                    <td>{{ isset($sub->formdata->indaflo_rx) ? $sub->formdata->indaflo_rx : '' }}</td>
+                                                    <td>{{ isset($sub->formdata->budecort_rx) ? $sub->formdata->budecort_rx : '' }}</td>
+                                                    <td>{{ isset($sub->formdata->levolin_rx) ? $sub->formdata->levolin_rx : '' }}</td>
+                                                    
 
 
 
@@ -158,14 +161,13 @@
                                                 'reason',
                                                 'patient_screened',
                                                 'patients_diagnosed',
-                                                'foracort_rx',
                                                 'seroflo_rx',
-                                                'duolin_rx',
-                                                'aerocort_rx',
-                                                'glycohale_fb_rx',
-                                                'e_voltido_rx',
-                                                'e_foracort_g_rx',
-                                                'e_synchrobreathe_range_rx'
+                                                'maxiflo_rx',
+                                                'voltido_rx',
+                                                'voltido_trio_rx',
+                                                'indaflo_rx',
+                                                'budecort_rx',
+                                                'levolin_rx'
                                             ]))
                                             @continue
                                         @endif
@@ -486,28 +488,33 @@
                     }
                 }) */
 
-                $('#execution-execution_date,#execution-patient_screened,#execution-patients_diagnosed,#execution-foracort_rx,#execution-seroflo_rx,#execution-duolin_rx,#execution-aerocort_rx,#execution-glycohale_fb_rx,#execution-e_voltido_rx,#execution-e_foracort_g_rx,#execution-e_synchrobreathe_range_rx').parent().hide();
-                $('#execution-execution_date,#execution-patient_screened,#execution-patients_diagnosed,#execution-foracort_rx,#execution-seroflo_rx,#execution-duolin_rx,#execution-aerocort_rx,#execution-glycohale_fb_rx,#execution-e_voltido_rx,#execution-e_foracort_g_rx,#execution-e_synchrobreathe_range_rx').attr('required',false);
+                $('#execution-execution_date,#execution-patient_screened,#execution-patients_diagnosed,#execution-reason,#execution-seroflo_rx,#execution-maxiflo_rx,#execution-voltido_rx,#execution-voltido_trio_rx,#execution-indaflo_rx,#execution-budecort_rx,#execution-levolin_rx').parent().hide();
+                $('#execution-execution_date,#execution-patient_screened,#execution-patients_diagnosed,#execution-reason,#execution-seroflo_rx,#execution-maxiflo_rx,#execution-voltido_rx,#execution-voltido_trio_rx,#execution-indaflo_rx,#execution-budecort_rx,#execution-levolin_rx').attr('required',false);
 
                 $('#execution-execution').on('change',function(){
                     let value=$('#execution-execution').val();
                     if(value==='Yes'){
-                        $('#execution-execution_date,#execution-patient_screened,#execution-patients_diagnosed,#execution-foracort_rx,#execution-seroflo_rx,#execution-duolin_rx,#execution-aerocort_rx,#execution-glycohale_fb_rx,#execution-e_voltido_rx,#execution-e_foracort_g_rx,#execution-e_synchrobreathe_range_rx').parent().show();
-                        $('#execution-execution_date,#execution-patient_screened,#execution-patients_diagnosed,#execution-foracort_rx,#execution-seroflo_rx,#execution-duolin_rx,#execution-aerocort_rx,#execution-glycohale_fb_rx,#execution-e_voltido_rx,#execution-e_foracort_g_rx,#execution-e_synchrobreathe_range_rx').attr('required',true);
-                        $('#execution-reason').parent().hide();
-                        $('#execution-reason').prop('required',false);
+                        
+                        $('#execution-execution_date,#execution-patient_screened,#execution-patients_diagnosed,#execution-seroflo_rx,#execution-maxiflo_rx,#execution-voltido_rx,#execution-voltido_trio_rx,#execution-indaflo_rx,#execution-budecort_rx,#execution-levolin_rx').parent().show();
+                        $('#execution-execution_date,#execution-patient_screened,#execution-patients_diagnosed,#execution-seroflo_rx,#execution-maxiflo_rx,#execution-voltido_rx,#execution-voltido_trio_rx,#execution-indaflo_rx,#execution-budecort_rx,#execution-levolin_rx').attr('required',true);
+                        
                         $('#execution-form input.dynamic-hidden').remove();
                         $('#execution-form').append('<input type="hidden" class="dynamic-hidden" name="executed" value="1">');
                     
                     
                     }
-                    else{
-                        $('#execution-execution_date,#execution-patient_screened,#execution-patients_diagnosed,#execution-foracort_rx,#execution-seroflo_rx,#execution-duolin_rx,#execution-aerocort_rx,#execution-glycohale_fb_rx,#execution-e_voltido_rx,#execution-e_foracort_g_rx,#execution-e_synchrobreathe_range_rx').parent().hide();
-                        $('#execution-execution_date,#execution-patient_screened,#execution-patients_diagnosed,#execution-foracort_rx,#execution-seroflo_rx,#execution-duolin_rx,#execution-aerocort_rx,#execution-glycohale_fb_rx,#execution-e_voltido_rx,#execution-e_foracort_g_rx,#execution-e_synchrobreathe_range_rx').attr('required',false);
+                    else if(value==='No'){
+                        $('#execution-execution_date,#execution-patient_screened,#execution-patients_diagnosed,#execution-reason,#execution-seroflo_rx,#execution-maxiflo_rx,#execution-voltido_rx,#execution-voltido_trio_rx,#execution-indaflo_rx,#execution-budecort_rx,#execution-levolin_rx').parent().hide();
+                        $('#execution-execution_date,#execution-patient_screened,#execution-patients_diagnosed,#execution-reason,#execution-seroflo_rx,#execution-maxiflo_rx,#execution-voltido_rx,#execution-voltido_trio_rx,#execution-indaflo_rx,#execution-budecort_rx,#execution-levolin_rx').attr('required',false);
                         $('#execution-reason').parent().show();
-                        $('#execution-reason').prop('required',true);
+                        $('#execution-reason').attr('required',true);
                         $('#execution-form input.dynamic-hidden').remove();
                         $('#execution-form').append('<input type="hidden" class="dynamic-hidden" name="not_executed" value="0">');
+                    }
+                    else{
+                        $('#execution-execution_date,#execution-patient_screened,#execution-patients_diagnosed,#execution-reason,#execution-seroflo_rx,#execution-maxiflo_rx,#execution-voltido_rx,#execution-voltido_trio_rx,#execution-indaflo_rx,#execution-budecort_rx,#execution-levolin_rx').parent().hide();
+                        $('#execution-execution_date,#execution-patient_screened,#execution-patients_diagnosed,#execution-reason,#execution-seroflo_rx,#execution-maxiflo_rx,#execution-voltido_rx,#execution-voltido_trio_rx,#execution-indaflo_rx,#execution-budecort_rx,#execution-levolin_rx').attr('required',false);
+                        
                     
                     }
                 })
diff --git a/resources/views/form/rapport-arise/1780568628-677ceb14-e144-4667-84a8-32d939cf281a.blade.php b/resources/views/form/rapport-arise/1780568628-677ceb14-e144-4667-84a8-32d939cf281a.blade.php
index eb96f8b8..c923b625 100644
--- a/resources/views/form/rapport-arise/1780568628-677ceb14-e144-4667-84a8-32d939cf281a.blade.php
+++ b/resources/views/form/rapport-arise/1780568628-677ceb14-e144-4667-84a8-32d939cf281a.blade.php
@@ -28,7 +28,7 @@
                                 <br>
                             @endif
                             <div class="col-8">
-                                <h4 class="page-title">(RA-1)Catch Up Camp</h4>
+                                <h4 class="page-title">(RA-1) Catch Up Camp</h4>
                             </div>
                             @if (!isset($form->is_approval) || (isset($form->is_approval) && $form->is_approval != 'yes'))
                                 <div class="col-4">
@@ -491,13 +491,20 @@
                     
                     
                     }
-                    else{
+                    else if(value==='No'){
                         $('#execution-execution_date,#execution-patient_screened,#execution-patients_diagnosed,#execution-foracort_rx,#execution-seroflo_rx,#execution-duolin_rx,#execution-aerocort_rx,#execution-glycohale_fb_rx,#execution-e_voltido_rx,#execution-e_foracort_g_rx,#execution-e_synchrobreathe_range_rx,#execution-foracort_g_rx').parent().hide();
                         $('#execution-execution_date,#execution-patient_screened,#execution-patients_diagnosed,#execution-foracort_rx,#execution-seroflo_rx,#execution-duolin_rx,#execution-aerocort_rx,#execution-glycohale_fb_rx,#execution-e_voltido_rx,#execution-e_foracort_g_rx,#execution-e_synchrobreathe_range_rx,#execution-foracort_g_rx').attr('required',false);
                         $('#execution-reason').parent().show();
                         $('#execution-reason').prop('required',true);
                         $('#execution-form input.dynamic-hidden').remove();
                         $('#execution-form').append('<input type="hidden" class="dynamic-hidden" name="not_executed" value="0">');
+                    }
+
+
+                    else{
+                        $('#execution-execution_date,#execution-patient_screened,#execution-patients_diagnosed,#execution-foracort_rx,#execution-seroflo_rx,#execution-duolin_rx,#execution-aerocort_rx,#execution-glycohale_fb_rx,#execution-e_voltido_rx,#execution-e_foracort_g_rx,#execution-e_synchrobreathe_range_rx,#execution-foracort_g_rx').parent().hide();
+                        $('#execution-execution_date,#execution-patient_screened,#execution-patients_diagnosed,#execution-foracort_rx,#execution-seroflo_rx,#execution-duolin_rx,#execution-aerocort_rx,#execution-glycohale_fb_rx,#execution-e_voltido_rx,#execution-e_foracort_g_rx,#execution-e_synchrobreathe_range_rx,#execution-foracort_g_rx').attr('required',false);
+                        
                     
                     }
                 })

From f376096d1cbaa553854c0092dc00182fa7347715 Mon Sep 17 00:00:00 2001
From: Ravi Gulhane <>
Date: Tue, 16 Jun 2026 09:08:32 +0530
Subject: [PATCH 2/2] Team4 Molecule Identification Form

---
 ...f382-9fbb-45ac-896b-94de9104a11b.blade.php | 2280 ++++++-----------
 1 file changed, 749 insertions(+), 1531 deletions(-)

diff --git a/resources/views/form/rapport-team4/1781090899-2cedf382-9fbb-45ac-896b-94de9104a11b.blade.php b/resources/views/form/rapport-team4/1781090899-2cedf382-9fbb-45ac-896b-94de9104a11b.blade.php
index 97325b73..5c286e11 100644
--- a/resources/views/form/rapport-team4/1781090899-2cedf382-9fbb-45ac-896b-94de9104a11b.blade.php
+++ b/resources/views/form/rapport-team4/1781090899-2cedf382-9fbb-45ac-896b-94de9104a11b.blade.php
@@ -1,1532 +1,750 @@
-<!DOCTYPE html>
-
-
-<html lang="en">
-
-<head>
-    @include('layouts.shared/title-meta', ['title' => "Form"])
-    @include('layouts.shared/head-css', ["mode" => $mode ?? '', "demo" => $demo ?? ''])
-    <link href="{{asset('assets/libs/sweetalert2/sweetalert2.min.css')}}" rel="stylesheet" type="text/css" />
-    <link href="https://cdn.jsdelivr.net/npm/select2@4.1.0-rc.0/dist/css/select2.min.css" rel="stylesheet" />       
-</head>
-
-<div id="pageloader">
-   <img src="http://cdnjs.cloudflare.com/ajax/libs/semantic-ui/0.16.1/images/loader-large.gif" alt="processing..." />
-</div>
-<body class="loading">
-    <div class="account-pages">
-        <div class="container">
-            <div class="row justify-content-center">
-                <div class="col-md-8 col-lg-6 col-xl-5 p-0">
-                    <div class="card bg-pattern">
-                        <div class="card-body p-3 row">
-
-                            @if(Session::has('error'))<div class="alert alert-danger">{{Session::get('error')}}</div>
-                            <br>@endif
-                            @if(session('success'))<div class=" alert alert-success">{{ session('success') }}
-                            </div>
-                            <br>@endif
-                            <div class="col-8">
-                                <h4 class="page-title">{{$form->title}}</h4>
-                            </div>
-                            @if(!isset($form->is_approval) || (isset($form->is_approval) && $form->is_approval != 'yes' ) )
-                            <div class="col-4">
-                                @if($form->link_type == 'form')
-                                <!-- <a href="/form/history" class="float-end pt-1">View History</a> -->
-                                @else
-                                <a href="{{url()->previous()}}" class="float-end pt-1">Back</a>
-                                @endif
-                            </div>
-                            @endif
-                            @if(isset($form->user_info))
-                            <div class="col-12">
-                                <h6>Submitted By: {{$form->user_info->name}}</h6>
-                            </div>
-                            @endif
-                            <form method="POST" action="/form/submit" id="report-form" enctype="multipart/form-data">
-                                <input type="hidden" name="form_id" value="{{$form_id}}">
-                                @csrf
-                                @if($id)
-                                <input type="hidden" name="id" value="{{$id}}">
-                                @endif
-                                @if(isset($form->manager_can_submit) && $form->manager_can_submit == true)
-                                <div class="col-md-12 mb-2">
-                                <label for="field-user_id" class="form-label"> Select User / Territory <span class="text-danger">*</span> </label>
-                                    <select class="form-control" id="field-user_id" name="user_id" required>
-                                        <option value=""> -- Select -- </option>
-                                        @foreach($form->users as $option)
-                                        <option value="{{$option->value}}" hierarchy="{{$option->hierarchy_id}}" {{isset($question->value) && $question->value == $option->value ? 'selected':''}}>{{$option->display}}</option>
-                                        @endforeach
-                                    </select>
-                                    <input type="hidden" id="field-hierarchy_id" name="hierarchy_id" value="">
-                                </div>
-                                @endif
-
-                                @foreach($questions as $question)
-                                    @php
-
-                                    $hideFields = [
-                                        
-                                        'contact_id',
-                                        'month_1',
-                                        'month_2',
-                                        'month_3',
-                                        'converted',
-                                        'rx_support',
-                                        'other_molecule_use'
-                                    ];
-
-                                    @endphp
-
-                                    @if(in_array($question->code, $hideFields))
-                                        @continue
-                                    @endif
-                                    <div class="{{ in_array($question->code, ['upload-supporting-doc1', 'upload-supporting-doc2']) ? 'upload-doc-fields' : '' }} col-md-12 mb-2">
-                                    <label for="field-{{$question->code}}" class="form-label">{{$question->question}} {!!$question->required == 'yes' ? '<span class="text-danger">*</span>':''!!} </label>
-                                    @switch($question->type)
-                                        @case('hidden')
-                                            <input type="{{$question->type}}" id="field-{{$question->code}}" name="{{$question->code}}" value="{{isset($question->value)?$question->value:''}}">
-                                            @break
-                                        @case('text')
-                                        @case('email')
-                                        @case('tel')
-                                        @case('date')
-                                            <input type="{{$question->type}}" id="field-{{$question->code}}" name="{{$question->code}}" class="form-control" {{$question->required == 'yes'?'required':'' }} value="{{isset($question->value)?$question->value:''}}">
-                                            @break
-                                        @case('number')
-                                            <input type="{{$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)?$question->value:0}}">
-                                            @break
-                                        @case('textarea')
-                                            <textarea id="field-{{$question->code}}" name="{{$question->code}}" class="form-control" {{$question->required == 'yes'?'required':'' }}>{{isset($question->value)?$question->value:''}}</textarea>
-                                            @break
-                                        @case('dropdown')
-                                            <select class="form-control" id="field-{{$question->code}}" name="{{$question->code}}" {{$question->required == 'yes'?'required':'' }}>
-                                                <option value=""> -- Select -- </option>
-                                                @foreach($question->options as $option)
-                                                <option value="{{$option->value}}" {{isset($question->value) && $question->value == $option->value ? 'selected':''}}>{{$option->display}}</option>
-                                                @endforeach
-                                            </select>
-                                            @break
-                                        @case('radio')
-                                            @foreach($question->options as $option)
-                                            <div class="form-check mb-2 form-check-success">
-                                                <input class="form-check-input" type="radio" name="{{$question->code}}" id="field-{{$question->code}}_{{$option->value}}" value="{{$option->value}}">
-                                                <label class="form-check-label" for="field-{{$question->code}}_{{$option->value}}">{{$option->display}}</label>
-                                            </div>
-                                            @endforeach
-                                            @break
-                                        @case('radiometrix')
-                                            @php
-                                                // Decode the first option's value to use as heading labels
-                                                $headings =
-                                                    count($question->options) > 0
-                                                        ? json_decode($question->options[0]->value, true)
-                                                        : [];
-
-                                                if(!is_array($headings)){
-                                                    $headings = [];
-                                                }
-                                            @endphp
-
-                                            {{-- Matrix Wrapper with Horizontal Scroll on Small Screens --}}
-                                            <div class="table-responsive">
-                                                <div class="d-table w-100">
-                                                    {{-- Table Headers --}}
-                                                    <div class="d-table-row font-weight-bold">
-                                                        <div class="d-table-cell p-2" style="width: 150px;"></div>
-                                                        {{-- Placeholder for row labels --}}
-                                                        @foreach ($headings as $head)
-                                                            <div class="d-table-cell text-center p-2">{{ $head }}
-                                                            </div>
-                                                        @endforeach
-                                                    </div>
-
-                                                    {{-- Table Rows --}}
-                                                    @foreach ($question->options as $option)
-                                                        @php
-                                                            $nn = json_decode($option->value, true);
-
-                                                            // fallback if invalid json
-                                                            if(!is_array($nn)){
-                                                                $nn = [];
-                                                            }
-                                                        @endphp
-                                                        <div class="d-table-row align-middle">
-                                                            <div class="d-table-cell font-weight-bold p-2"
-                                                                style="width: 150px;">
-                                                                {{ $option->display }}
-                                                            </div>
-
-                                                            @foreach ($nn as $value)
-                                                                <div class="d-table-cell text-center p-2">
-                                                                    <input type="radio"
-                                                                id="field-{{ $option->display }}-{{ $value }}"
-                                                                name="{{ $question->code }}[{{$option->display}}]" value="{{$value}}" class="form-check-input"
-                                                                {{ isset($question->display) && $option->display != $option->display ? 'checked' : '' }}>
-
-                                                                </div>
-                                                            @endforeach
-                                                        </div>
-                                                    @endforeach
-                                                </div>
-                                            </div>
-                                        @break    
-                                        @case('checkbox')
-                                            @foreach($question->options as $option)
-                                            <div class="form-check mb-2 form-check-primary ms-2">
-                                                <input class="form-check-input" type="checkbox" id="field-{{$question->code}}-{{$option->value}}" name="{{$question->code}}[]" value="{{$option->value}}" {{isset($question->value) && $question->value != '' && in_array($option->value, $question->value) ? 'checked':''}}>
-                                                <label class="form-check-label" for="field-{{$question->code}}-{{$option->value}}">{{$option->display}}</label>
-                                            </div>
-                                            @endforeach
-                                            @break
-
-                                            @case('file')
-
-                                            @if(!isset($form->is_approval) || (isset($form->is_approval) && $form->is_approval != 'yes' ) )
-
-                                            <input
-                                                type="file"
-                                                id="field-{{$question->code}}"
-                                                name="{{$question->code}}"
-                                                class="form-control"
-                                                accept=".jpg,.jpeg,.pdf,image/*"
-                                                capture="environment"
-                                                {{$question->required == 'yes'?'required':'' }}>
-
-                                            @elseif(isset($question->value))
-
-                                            <img src="{{$question->value}}" class="img-fluid">
-
-                                            @endif
-
-                                            @break
-                                        @case('multitextbox')
-                                            <div class="row">
-                                                @foreach($question->options as $option)
-                                                <div class="col-6">{{$option->display}}</div>
-                                                <div class="col-6 mb-1">
-                                                    <input type="number" id="field-{{$option->value}}" name="{{$option->value}}" class="form-control" required value="{{isset($option->val)?$option->val:0}}">
-                                                </div>
-                                                @endforeach
-                                            </div>
-                                            @break
-                                    @endswitch
-                                    </div>
-                                @endforeach
-                                @if(!isset($form->is_approval) || (isset($form->is_approval) && $form->is_approval != 'yes' ) )
-                                <div class="text-center d-gri mt-3">
-                                    <div class="col-md-12 mt-3">
-                                    <div class="card">
-                                        {{-- <div class="card-header">
-                                            <h5 class="mb-0">Tagged Doctors</h5>
-                                        </div> --}}
-                                        <div class="card-body p-0">
-                                            <div class="table-responsive">
-                                            @php
-$doctors = [];
-
-foreach($questions as $question){
-    if($question->code == 'contact_id'){
-        $doctors = $question->options ?? [];
-        break;
-    }
-}
-@endphp
-                                       <table class="table table-bordered  mb-0">
-                                                    <thead>
-                                                        <tr>
-                                                            <th>Doctor Name</th>
-                                                            
-                                                            <th>Rxn/Week Support</th>
-                                                            
-                                                            <th>Other Molecule Use</th>
-                                                        </tr>
-                                                    </thead>
-                                                    <tbody id="doctor-table-body">
-
-@for($i=1; $i<=5; $i++)
-
-<tr>
-
-    <td>
-     <input
-    type="hidden"
-    name="id[temp]"
-    class="submission-id"
-/>
-        <select
-            name="contact_id[]"
-            class="form-control doctor-select"
-            required
-        >
-            <option value="">-- Select Doctor --</option>
-
-            @foreach($questions as $question)
-
-                @if($question->code == 'contact_id')
-
-                    @foreach($question->options as $doctor)
-
-                        <option value="{{$doctor->value}}">
-                            {{$doctor->display}}
-                        </option>
-
-                    @endforeach
-
-                @endif
-
-            @endforeach
-
-        </select>
-    </td>
-
-    <td>
-    
-        <select
-            name="rx_support[]"
-            class="form-control"
-            required
-        >
-            <option value="">-- Select --</option>
-            <option value="1-3 Rxn/Week">1-3 Rxn/Week</option>
-            <option value="4-7 Rxn/Week">4-7 Rxn/Week</option>
-            <option value="8-11 Rxn/Week">8-11 Rxn/Week</option>
-            <option value=">11 Rxn/Week">&gt;11 Rxn/Week</option>
-        </select>
-    </td>
-
-    <td>
-    
-        <select
-            name="other_molecule_use[]"
-            class="form-control"
-            required
-        >
-            <option value="">-- Select --</option>
-            <option value="Erdosteine Prescriber">
-                Erdosteine Prescriber
-            </option>
-            <option value="Erdosteine + Acebrophylline">
-                Erdosteine + Acebrophylline
-            </option>
-            <option value="NAC + Acebrophylline">
-                NAC + Acebrophylline
-            </option>
-            <option value="No">
-                No
-            </option>
-        </select>
-    </td>
-
-</tr>
-
-@endfor
-
-</tbody>
-                                                </table>
-                                            </div>
-                                        </div>
-                                    </div>
-                                 </div>
-                                 
-                                    <button class="btn btn-primary" type="submit" id="submit-btn"> Submit </button>
-                                </div> 
-                                @endif
-                            </form>
-                            <!-- SAMPLE FORM MODAL -->
-                        </div> <!-- end card-body -->
-                    </div>
-                    <!-- end card -->
-                    <!-- end row -->
-                </div> <!-- end col -->
-            </div>
-            <!-- end row -->
-        </div>
-        <!-- end container -->
-    </div>
-    <!-- end page -->
-    
-<style type="text/css">
-select option:disabled {
-    color: #999;
-    font-style: italic;
-}
-select option:disabled {
-    color: #999;
-    font-style: italic;
-}
-#pageloader {
-  background: rgba( 255, 255, 255, 0.8 );
-  display: none;
-  height: 100%;
-  position: fixed;
-  width: 100%;
-  z-index: 9999;
-}
-
-#pageloader img {
-  left: 50%;
-  margin-left: -32px;
-  margin-top: -32px;
-  position: absolute;
-  top: 50%;
-}
-.form-label {
-    font-weight:bold;
-    font-size:16px;
-}
-.upload-doc-fields {
-    display: none;
-}
-
-.rx_count{
-    width: 70px;
-}
-
-
-
-</style>
-@include('layouts.shared/footer-script')
-<script src="https://cdn.jsdelivr.net/npm/select2@4.1.0-rc.0/dist/js/select2.min.js"></script>
-<script src="{{asset('assets/libs/sweetalert2/sweetalert2.min.js')}}"></script>
-<script type="text/javascript">
-    jQuery(document).ready(function($){
-        function updateDoctorDropdowns() {
-
-    let selectedDoctors = [];
-
-    $('.doctor-select').each(function(){
-
-        let value = $(this).val();
-
-        if(value){
-            selectedDoctors.push(value);
-        }
-
-    });
-
-    $('.doctor-select').each(function(){
-
-        let currentDropdown = $(this);
-        let currentValue = currentDropdown.val();
-
-        currentDropdown.find('option').each(function(){
-
-            let option = $(this);
-
-            let originalText =
-                option.data('original-text') || option.text();
-
-            option.data('original-text', originalText);
-
-            option.text(originalText);
-
-            option.prop('disabled', false);
-
-            let optionValue = option.val();
-
-            if(
-                optionValue &&
-                optionValue !== currentValue &&
-                selectedDoctors.includes(optionValue)
-            ){
-                option.prop('disabled', true);
-
-                option.text(
-                    originalText +
-                    ' (Already Added)'
-                );
-            }
-
-        });
-
-    });
-
-}
-$(document).on(
-    'change',
-    '.doctor-select',
-    updateDoctorDropdowns
-);
-
-updateDoctorDropdowns();
-    
-function updateOtherMoleculeDropdowns() {
-
-    let selectedMolecule = $('#field-molecule_use').val();
-
-    $('select[name="other_molecule_use[]"]').each(function(){
-
-        let ddl = $(this);
-
-        ddl.find('option').each(function(){
-
-            let option = $(this);
-
-            // restore original text
-            let originalText =
-                option.data('original-text') || option.text();
-
-            option.data('original-text', originalText);
-
-            option.text(originalText);
-
-            option.prop('disabled', false);
-
-            if(
-                selectedMolecule &&
-                option.val() === selectedMolecule
-            ){
-                option.prop('disabled', true);
-                option.text(
-                    originalText + ' (Already Added)'
-                );
-            }
-
-        });
-
-    });
-
-}
-
-$('#field-molecule_use').on(
-    'change',
-    updateOtherMoleculeDropdowns
-);
-
-updateOtherMoleculeDropdowns();
-
-$('#field-molecule_use').on(
-    'change',
-    updateOtherMoleculeDropdowns
-);
-
-updateOtherMoleculeDropdowns();
-$('#field-molecule_use').on(
-    'change',
-    updateOtherMoleculeDropdowns
-);
-
-updateOtherMoleculeDropdowns();
-        $('.doctor-select').select2({
-    width: '100%',
-    placeholder: 'Search Doctor',
-    allowClear: true
-});
-setTimeout(function(){
-
-    $('.doctor-select').each(function(index){
-        $(this)
-    .closest('tr')
-    .find('.submission-id')
-    .val(historySubmissionIds[index] || '');
-
-        let doctorName =
-            historyDoctors[index];
-
-        if(!doctorName){
-            return;
-        }
-
-
-        let ddl = $(this);
-
-        ddl.find('option').each(function(){
-
-            if(
-                $(this).text().trim()
-                === doctorName
-            )
-            {
-                if(historyMoleculeUse.length > 0){
-
-    $('#field-molecule_use')
-        .val(historyMoleculeUse[0])
-        .trigger('change');
-
-}
-
-if(historyRecordDate.length > 0){
-
-    $('#field-record_date')
-        .val(historyRecordDate[0]);
-
-}
-
-                let rxValue =
-    historyRxSupport[index];
-
-if(rxValue){
-
-    ddl.closest('tr')
-       .find('select[name="rx_support[]"]')
-       .val(rxValue);
-
-}
-
-let moleculeValue =
-    historyOtherMolecule[index];
-
-if(moleculeValue){
-
-    ddl.closest('tr')
-       .find('select[name="other_molecule_use[]"]')
-       .val(moleculeValue);
-
-}
-                ddl.val($(this).val());
-
-                ddl.trigger('change');
-let doctorId = $(this).val();
-
-ddl.closest('tr')
-   .find('.submission-id')
-   .attr(
-       'name',
-       'id[]'
-   )
-   .val(
-       historySubmissionIds[index] || ''
-   );
-                console.log(
-                    'SELECTED',
-                    doctorName
-                );
-
-                return false;
-            }
-
-        });
-
-    });
-
-},1000);
-
-
-    @php
-        // KEEP ORIGINAL DOCTOR LOGIC
-        $doctors = [];
-        foreach($questions as $question){
-            if($question->code == 'contact_id'){
-                $doctors = is_iterable($question->options ?? null) ? $question->options : [];
-            }
-        }
-        // RX HISTORY DATA ONLY
-        $history = Formhelper::getMultiformData( $form->partition, $form_id, $form->user_id );
-        $categorySubmissions = [];
-        $categoryDoctorSubmissions = [];
-        $doctorRxCounts = [];
-        $doctorMonthData = [];
-
-        $categoryAttributes = [
-            'foracort-ciphaler' => 'foracort_ciphaler',
-            'duolin-synchrobreathe' => 'duolin_synchrobreathe',
-            'foracort-g' => 'foracort_g',
-            'pedia' => 'pedia',
-            'triple-combination-voltido-trio-indaflo-g' => 'triple_combination_voltido_trio_indaflo_g',
-            'ics-laba-seroflo-maxiflo-voltido' => 'ics_laba_seroflo_maxiflo_voltido',
-            'competition-dr' => 'competition_dr',
-        ];
-
-        $doctorNameById = [];
-        $doctorIdByName = [];
-        foreach ($doctors as $doc) {
-            $doctorNameById[$doc->value] = $doc->display;
-            $doctorIdByName[trim($doc->display)] = $doc->value;
-        }
-
-        if (isset($history->data->submissions) && is_iterable($history->data->submissions)) {
-            foreach ($history->data->submissions as $sub) {
-                $formdata = $sub->formdata ?? null;
-                if (!$formdata) {
-                    continue;
-                }
-                $category = strtolower(trim($formdata->{'select-category'} ?? ''));
-                if (!$category) {
-                    continue;
-                }
-                if (!isset($categorySubmissions[$category])) {
-                    $categorySubmissions[$category] = [];
-                }
-                if (isset($formdata->sample_count)) {
-                    $doctorId = trim($formdata->contact_id ?? '');
-                    $doctorName = $doctorNameById[$doctorId] ?? trim($formdata->contact_id ?? '');
-                    $rxValue = intval($formdata->sample_count ?? 0);
-                    if (!$doctorId) {
-                        continue;
-                    }
-                    $categorySubmissions[$category][] = [
-                        'type' => 'rx',
-                        'doctor_id' => $doctorId,
-                        'doctor_name' => $doctorName,
-                        'sample_count' => $rxValue,
-                        'date' => $formdata->date ?? '',
-                    ];
-                    if (!isset($doctorRxCounts[$category])) {
-                        $doctorRxCounts[$category] = [];
-                    }
-                    if (!isset($doctorRxCounts[$category][$doctorName])) {
-                        $doctorRxCounts[$category][$doctorName] = 0;
-                    }
-                    $doctorRxCounts[$category][$doctorName] += $rxValue;
-                    continue;
-                }
-
-                $rawDoctorId = '';
-                if (!empty($formdata->contact_id)) {
-                    $contactId = $formdata->contact_id;
-                    if (is_array($contactId) || $contactId instanceof \Traversable) {
-                        $contactValues = array_values((array) $contactId);
-                        $rawDoctorId = trim((string) ($contactValues[0] ?? ''));
-                    } else {
-                        $rawDoctorId = trim((string) $contactId);
-                    }
-                }
-
-                $doctorId = $rawDoctorId;
-                if (
-                    $doctorId !== '' &&
-                    !isset($doctorNameById[$doctorId]) &&
-                    isset($doctorIdByName[$doctorId])
-                ) {
-                    $doctorId = $doctorIdByName[$doctorId];
-                }
-
-                $categoryPrefix = $categoryAttributes[$category] ?? null;
-                $month1Val = $formdata->month_1 ?? '';
-                $month2Val = $formdata->month_2 ?? '';
-                $month3Val = $formdata->month_3 ?? '';
-
-                if ($categoryPrefix) {
-                    if (isset($formdata->{$categoryPrefix . '_month_1'}) && $formdata->{$categoryPrefix . '_month_1'} !== '') {
-                        $month1Val = $formdata->{$categoryPrefix . '_month_1'};
-                    }
-                    if (isset($formdata->{$categoryPrefix . '_month_2'}) && $formdata->{$categoryPrefix . '_month_2'} !== '') {
-                        $month2Val = $formdata->{$categoryPrefix . '_month_2'};
-                    }
-                    if (isset($formdata->{$categoryPrefix . '_month_3'}) && $formdata->{$categoryPrefix . '_month_3'} !== '') {
-                        $month3Val = $formdata->{$categoryPrefix . '_month_3'};
-                    }
-                }
-
-                $convertedVal = $formdata->converted ?? '';
-                if ($categoryPrefix && isset($formdata->{$categoryPrefix . '_converted'}) && $formdata->{$categoryPrefix . '_converted'} !== '') {
-                    $convertedVal = $formdata->{$categoryPrefix . '_converted'};
-                }
-
-                $submissionRow = [
-                    'submission_id' => $sub->id,
-                    'converted' => $convertedVal,
-                    'doctor_id' => $doctorId,
-                    'doctor_name' => $doctorNameById[$doctorId] ?? $rawDoctorId,
-                    'month_1' => $month1Val,
-                    'month_2' => $month2Val,
-                    'month_3' => $month3Val,
-                ];
-
-                if ($categoryPrefix) {
-                    $submissionRow[$categoryPrefix . '_month_1'] = $month1Val;
-                    $submissionRow[$categoryPrefix . '_month_2'] = $month2Val;
-                    $submissionRow[$categoryPrefix . '_month_3'] = $month3Val;
-                    $submissionRow[$categoryPrefix . '_converted'] = $convertedVal;
-                }
-
-                $categorySubmissions[$category][] = $submissionRow;
-
-                if (!isset($doctorMonthData[$category])) {
-                    $doctorMonthData[$category] = [];
-                }
-
-                if (!isset($categoryDoctorSubmissions[$category])) {
-                    $categoryDoctorSubmissions[$category] = [];
-                }
-
-                if ($doctorId !== '') {
-                    $categoryDoctorSubmissions[$category][$doctorId] = $submissionRow;
-                    $doctorMonthData[$category][$doctorId] = [
-                        'month_1' => $submissionRow['month_1'],
-                        'month_2' => $submissionRow['month_2'],
-                        'month_3' => $submissionRow['month_3'],
-                    ];
-                }
-
-                foreach (['month_1', 'month_2', 'month_3'] as $monthKey) {
-                    $formMonthKey = $monthKey;
-                    if ($categoryPrefix && isset($formdata->{$categoryPrefix . '_' . $monthKey}) && $formdata->{$categoryPrefix . '_' . $monthKey} !== '' && $formdata->{$categoryPrefix . '_' . $monthKey} !== null) {
-                        $formMonthKey = $categoryPrefix . '_' . $monthKey;
-                    }
-
-                    if (!isset($formdata->$formMonthKey) || $formdata->$formMonthKey === '' || $formdata->$formMonthKey === null) {
-                        continue;
-                    }
-
-                    $monthValue = $formdata->$formMonthKey;
-                    $monthEntries = [];
-
-                    if (is_array($monthValue) || $monthValue instanceof \stdClass) {
-                        foreach ((array) $monthValue as $entryKey => $val) {
-                            $normalizedKey = trim((string) $entryKey);
-                            if (
-                                $normalizedKey !== '' &&
-                                !isset($doctorNameById[$normalizedKey]) &&
-                                isset($doctorIdByName[$normalizedKey])
-                            ) {
-                                $normalizedKey = $doctorIdByName[$normalizedKey];
-                            }
-                            $monthEntries[$normalizedKey] = $val;
-                        }
-                    } elseif ($doctorId !== '') {
-                        $monthEntries = [$doctorId => $monthValue];
-                    }
-
-                    foreach ($monthEntries as $entryDoctorId => $val) {
-                        if ($entryDoctorId === '') {
-                            continue;
-                        }
-
-                        if (!isset($doctorMonthData[$category][$entryDoctorId])) {
-                            $doctorMonthData[$category][$entryDoctorId] = [
-                                'month_1' => '',
-                                'month_2' => '',
-                                'month_3' => '',
-                            ];
-                        }
-
-                        $doctorMonthData[$category][$entryDoctorId][$monthKey] = $val;
-
-                        if (!isset($categoryDoctorSubmissions[$category][$entryDoctorId])) {
-                            $categoryDoctorSubmissions[$category][$entryDoctorId] = [
-                                'submission_id' => $sub->id,
-                                'converted' => $formdata->converted ?? '',
-                                'doctor_id' => $entryDoctorId,
-                                'doctor_name' => $doctorNameById[$entryDoctorId] ?? $entryDoctorId,
-                                'month_1' => '',
-                                'month_2' => '',
-                                'month_3' => '',
-                            ];
-                        }
-
-                        $categoryDoctorSubmissions[$category][$entryDoctorId][$monthKey] = $val;
-                    }
-                }
-            }
-        }
-
-    @endphp
-    @php
-$historyMoleculeUse = [];
-$historyRecordDate = [];
-$historyDoctors = [];
-$historyRxSupport = [];
-$historyOtherMolecule = [];
-$historySubmissionIds = [];
-if(isset($history->data->submissions)){
-
-    foreach($history->data->submissions as $sub){
-        if(isset($sub->formdata->molecule_use)){
-    $historyMoleculeUse[] =
-        $sub->formdata->molecule_use;
-}
-
-if(isset($sub->formdata->record_date)){
-    $historyRecordDate[] =
-        $sub->formdata->record_date;
-}
-        $historySubmissionIds[] = $sub->id;
-
-        if(isset($sub->formdata->contact_id)){
-            $historyDoctors[] =
-                $sub->formdata->contact_id;
-        }
-
-        if(isset($sub->formdata->rx_support)){
-            $historyRxSupport[] =
-                $sub->formdata->rx_support;
-        }
-
-        if(isset($sub->formdata->other_molecule_use)){
-            $historyOtherMolecule[] =
-                $sub->formdata->other_molecule_use;
-        }
-
-    }
-
-}
-
-@endphp
-    var allDoctors = {!! json_encode($doctors) !!};
-    var categorySubmissions = {!! json_encode($categorySubmissions) !!};
-    var categoryDoctorSubmissions = {!! json_encode($categoryDoctorSubmissions) !!};
-    var doctorRxCounts = {!! json_encode($doctorRxCounts) !!};
-    var doctorMonthData = {!! json_encode($doctorMonthData) !!};
-    var historyMoleculeUse =
-{!! json_encode($historyMoleculeUse) !!};
-
-var historyRecordDate =
-{!! json_encode($historyRecordDate) !!};
-    var historySubmissionIds =
-{!! json_encode($historySubmissionIds) !!};
-    var historyDoctors =
-{!! json_encode($historyDoctors) !!};
-
-var historyRxSupport =
-{!! json_encode($historyRxSupport) !!};
-
-var historyOtherMolecule =
-{!! json_encode($historyOtherMolecule) !!};
-
-console.log(historyRxSupport);
-console.log(historyOtherMolecule);
-
-console.log(
-    "HISTORY DOCTORS",
-    historyDoctors
-);
-    console.log("FORM HISTORY", {!! json_encode($history) !!});
-    console.log(
-    "SUBMISSIONS",
-    {!! json_encode($history->data->submissions ?? []) !!}
-);
-    console.log("CATEGORY SUBMISSIONS", categorySubmissions);
-    console.log("DOCTOR RX COUNTS", doctorRxCounts);
-    console.log("DOCTOR MONTH DATA", doctorMonthData);
-    console.log("INITIAL DOCTORS FROM BACKEND", allDoctors);
-    window.allDoctors = allDoctors;
-
-//         $.ajax({
-//     type: "GET",
-//     url: '/form/getdoctorlist?partition={{$form->partition}}&hierarchy=all',
-//     success: function(data) {
-
-//     console.log("FULL DATA", data);
-
-//     if(data.length > 0){
-//         console.log("FIRST DOCTOR", data[0]);
-//     }
-
-//     window.allDoctors = data;
-//     allDoctors = data;
-
-// }
-// });
-
-
-
-
-     $('#field-select-category').on('change', function () {
-
-    console.log("CATEGORY CHANGED");
-
-    console.log("Selected Category:", $(this).val());
-
-    console.log("All Doctors:", allDoctors);
-
-    const mandatoryDoctorCount = {
-
-    "foracort-ciphaler": 10,
-    "duolin-synchrobreathe": 10,
-    "foracort-g": 10,
-    "pedia": 5,
-    "triple-combination-voltido-trio-indaflo-g": 10,
-    "ics-laba-seroflo-maxiflo-voltido": 10,
-    "competition-dr": 20
-
-};
-
-    let selectedCategory = $(this).val();
-
-    if (!selectedCategory) {
-        $('#doctor-table-body').html(`
-            <tr>
-                <td colspan="5" class="text-center">
-                    No Doctors Found
-                </td>
-            </tr>
-        `);
-        return;
-    }
-
-    $('#field-contact_id').html('');
-    $('#field-contact_id').append(
-        $("<option></option>")
-            .attr("value",'')
-            .text('-- Select --')
-    );
-
-    if(allDoctors.length === 0) {
-        console.log("Doctors array empty");
-        return;
-    }
-
-    let filteredDoctors = allDoctors.filter(function(doc){
-
-    if(!doc.contact){
-        return false;
-    }
-
-    const categoryMap = {
-        "foracort-ciphaler": "foracort_ciphaler",
-        "duolin-synchrobreathe": "duolin_synchrobreathe",
-        "foracort-g": "foracort_g",
-        "pedia": "pedia",
-        "triple-combination-voltido-trio-indaflo-g":"triple_combination_voltido_trio_indaflo_g",
-        "ics-laba-seroflo-maxiflo-voltido":"ics_laba_seroflo_maxiflo_voltido",
-        "competition-dr":"competition_dr"
-    };
-
-let categoryKey = categoryMap[selectedCategory];
-
-    let categoryValue = doc.contact[categoryKey];
-
-    console.log(
-        "Doctor:",
-        doc.display,
-        "Category:",
-        categoryKey,
-        "Value:",
-        categoryValue
-    );
-
-    // normalize value
-    categoryValue = String(categoryValue)
-        .toLowerCase()
-        .trim();
-
-    return (
-        categoryValue === 'yes' ||
-        categoryValue === '1' ||
-        categoryValue === 'true'
-    );
-
-});
-
-    console.log("Filtered Doctors:", filteredDoctors);
-
-    console.log(filteredDoctors);
-
-    let requiredCount =
-        mandatoryDoctorCount[selectedCategory] || 0;
-    if(filteredDoctors.length < requiredCount){
-
-    let categoryName = $('#field-select-category option:selected').text();
-
-    Swal.fire({
-        icon: 'warning',
-        title: 'Incomplete Tagging',
-        text: `Tagging for ${categoryName} is incomplete. Please complete tagging through My Doctors.`
-    });
-
-    // reset category dropdown
-    $('#field-select-category').val('');
-
-    // reset doctor dropdown
-    $('#field-contact_id').html('');
-
-    $('#field-contact_id').append(
-        $("<option></option>")
-            .attr("value",'')
-            .text('-- Select --')
-    );
-    // reset doctor table
-    $('#doctor-table-body').html(`
-        <tr>
-            <td colspan="8" class="text-center">
-                No Doctors Found
-            </td>
-        </tr>
-    `);
-    return;
-}
-// limit doctors to required count
-filteredDoctors =
-    filteredDoctors.slice(0, requiredCount);
-
-console.log(
-    "Final Allowed Doctors:",
-    filteredDoctors.length
-);
-
-// NOW render limited doctors
-/*renderDoctorTable(filteredDoctors); */
-    filteredDoctors.forEach(function(itm){
-
-        $('#field-contact_id').append(
-            $("<option></option>")
-                .attr("value", itm.value)
-                .attr("doctor_category", itm.doctor_category)
-                .attr("msl_code", itm.msl_code)
-                .attr("speciality", itm.speciality)
-                .text(itm.display)
-        );
-
-    });
-
-});
-
-
-        // const categoryMetricMap = {
-
-        //     "Foracort Ciphaler":
-        //         "doctor_converion_Foracort_Ciphaler",
-
-        //     "Duolin Synchrobreathe":
-        //         "doctor_converion_Duolin_Synchrobreathe",
-
-        //     "Foracort G":
-        //         "doctor_converion_Foracort_G",
-
-        //     "Pedia":
-        //         "doctor_converion_Pedia",
-
-        //     "Triple combination (Voltido Trio/ Indaflo G)":
-        //         "doctor_converion_Triple_combination_(Voltido_Trio/_Indaflo_G)",
-
-        //     "ICS LABA (Seroflo Maxiflo Voltido)":
-        //         "doctor_converion_ICS_LABA_(Seroflo_Maxiflo_Voltido)"
-        // };
-
-
-        // $('#field-select-category').on('change', function () {
-
-        //     $('#report-form input.dynamic-hidden').remove();
-
-        //     // Convert value to slug
-        //     let slug = $(this).val()
-        //         .toLowerCase()
-        //         .trim()
-        //         .replace(/[^a-z0-9\s-]/g, '') // remove special chars
-        //         .replace(/\s+/g, '_')         // spaces to underscore
-        //         .replace(/-+/g, '_');         // hyphen to underscore
-
-        //     $('#report-form').append(
-        //         '<input type="hidden" class="dynamic-hidden" name="' + slug + '" value="1">'
-        //     );
-        // });
-
-        // $('#field-converted').on('change', function () {
-        //     let value = $(this).val();
-        //     console.log(value);
-        //     $('#report-form input.dynamic-hidden').remove();
-
-        //     // Convert value to slug
-        //     let slug = $(this).val()
-        //         .toLowerCase()
-        //         .trim()
-        //         .replace(/[^a-z0-9\s-]/g, '') // remove special chars
-        //         .replace(/\s+/g, '_')         // spaces to underscore
-        //         .replace(/-+/g, '_');         // hyphen to underscore
-
-        //     if(value === 'Yes') {
-        //         $('#report-form').append(
-        //             '<input type="hidden" class="dynamic-hidden" name="' + slug + '" value="1">'
-        //         );
-        //     }
-        // });
-
-
-
-
-
-
-const categoryThresholds = {
-
-    "foracort-ciphaler": 10,
-    "duolin-synchrobreathe": 10,
-    "foracort-g": 10,
-    "pedia": 5,
-    "triple-combination-voltido-trio-indaflo-g": 10,
-    "ics-laba-seroflo-maxiflo-voltido": 10,
-    "competition-dr": 20
-
-};
-
-const conversionMetricFields = {
-    "foracort-ciphaler":"foracort_ciphaler",
-    "duolin-synchrobreathe":"duolin_synchrobreathe",
-    "foracort-g":"foracort_g",
-    "pedia":"pedia",
-    "triple-combination-voltido-trio-indaflo-g": "triple_combination_voltido_trio_indaflo_g",
-    "ics-laba-seroflo-maxiflo-voltido": "ics_laba_seroflo_maxiflo_voltido",
-    "competition-dr": "competition_dr"
-
-};
-
-function getCategoryMonthFieldNames(selectedCategory) {
-    let prefix = conversionMetricFields[selectedCategory] || '';
-
-    return {
-        month1: prefix ? `${prefix}_month_1` : 'month_1',
-        month2: prefix ? `${prefix}_month_2` : 'month_2',
-        month3: prefix ? `${prefix}_month_3` : 'month_3',
-    };
-}
-
-function getCategoryConvertedFieldName(selectedCategory) {
-    let prefix = conversionMetricFields[selectedCategory] || '';
-
-    return prefix ? `${prefix}_converted` : 'converted';
-}
-
-function getSubmissionMonthValues(submission, monthFields) {
-    return {
-        month1: submission[monthFields.month1] ?? submission.month_1 ?? '',
-        month2: submission[monthFields.month2] ?? submission.month_2 ?? '',
-        month3: submission[monthFields.month3] ?? submission.month_3 ?? '',
-    };
-}
-
-function getMonthRxTotal(month1, month2, month3) {
-    return (parseInt(month1, 10) || 0)
-        + (parseInt(month2, 10) || 0)
-        + (parseInt(month3, 10) || 0);
-}
-
-function calculateDoctorConverted(month1, month2, month3, selectedCategory) {
-    let threshold = categoryThresholds[selectedCategory] || 0;
-    let totalRx = getMonthRxTotal(month1, month2, month3);
-
-    return totalRx >= threshold ? 1 : 0;
-}
-
-function syncCategoryMonthFields($row) {
-    let selectedCategory = $('#field-select-category').val() || '';
-    let monthFields = getCategoryMonthFieldNames(selectedCategory);
-    let doctorId = $row.data('doctor-id') || '';
-    let month1 = $row.find('.rx-month-1').val();
-    let month2 = $row.find('.rx-month-2').val();
-    let month3 = $row.find('.rx-month-3').val();
-
-    $row.find('.doctor-category-month-1').val(month1).attr('name', `${monthFields.month1}[${doctorId}]`);
-    $row.find('.doctor-category-month-2').val(month2).attr('name', `${monthFields.month2}[${doctorId}]`);
-    $row.find('.doctor-category-month-3').val(month3).attr('name', `${monthFields.month3}[${doctorId}]`);
-}
-
-function updateDoctorRowConverted($row) {
-    let selectedCategory = $('#field-select-category').val() || '';
-    let month1 = $row.find('.rx-month-1').val();
-    let month2 = $row.find('.rx-month-2').val();
-    let month3 = $row.find('.rx-month-3').val();
-    let converted = calculateDoctorConverted(
-        month1,
-        month2,
-        month3,
-        selectedCategory
-    );
-
-    $row.find('.doctor-converted').val(converted);
-
-    let convertedField = getCategoryConvertedFieldName(selectedCategory);
-    let doctorId = $row.data('doctor-id') || '';
-    $row.find('.doctor-category-converted')
-        .val(converted)
-        .attr('name', `${convertedField}[${doctorId}]`);
-
-    syncCategoryMonthFields($row);
-}
-
-function recalculateAllDoctorConverted() {
-    $('#doctor-table-body tr').each(function() {
-        if ($(this).find('.rx_count').length) {
-            updateDoctorRowConverted($(this));
-        }
-    });
-}
-
-function findDoctorSubmission(selectedCategory, doctorId, doctorName) {
-    let categoryDoctors = categoryDoctorSubmissions[selectedCategory] || {};
-    let monthData = doctorMonthData[selectedCategory] || {};
-    let categoryRows = categorySubmissions[selectedCategory] || [];
-
-    return categoryDoctors[doctorId]
-        || categoryDoctors[doctorName]
-        || monthData[doctorId]
-        || monthData[doctorName]
-        || categoryRows.find(function(row) {
-            return row.doctor_id === doctorId
-                || row.doctor_id === doctorName
-                || row.doctor_name === doctorName;
-        })
-        || {};
-}
-
-/*function renderDoctorTable(filteredDoctors){
-    let tbody = $('#doctor-table-body');
-    let selectedCategory = $('#field-select-category').val() || '';
-
-    tbody.html('');
-
-    if(filteredDoctors.length === 0){
-        tbody.html(`
-            <tr>
-                <td colspan="5" class="text-center">
-                    No Doctors Found
-                </td>
-            </tr>
-        `);
-        return;
-    }
-
-    filteredDoctors.forEach(function(doc){
-        let doctorName = doc.display || '-';
-        let speciality = doc.contact?.speciality || '-';
-        let doctorId = doc.value || doc.contact?.id || '';
-        let submission = findDoctorSubmission(selectedCategory, doctorId, doctorName);
-        let monthFields = getCategoryMonthFieldNames(selectedCategory);
-        let convertedField = getCategoryConvertedFieldName(selectedCategory);
-        let months = getSubmissionMonthValues(submission, monthFields);
-        let converted = calculateDoctorConverted(
-            months.month1,
-            months.month2,
-            months.month3,
-            selectedCategory
-        );
-
-        tbody.append(`
-            <tr data-doctor-id="${doctorId}">
-                <input type="hidden" name='submission_id[${doctorId}]' value="${submission.submission_id || ''}" />
-                <input type="hidden" class="doctor-converted" name='converted[${doctorId}]' value="${converted}" />
-                <input type="hidden" class="doctor-category-converted" name='${convertedField}[${doctorId}]' value="${converted}" />
-                <input type="hidden" class="doctor-category-month-1" name='${monthFields.month1}[${doctorId}]' value="${months.month1 || ''}" />
-                <input type="hidden" class="doctor-category-month-2" name='${monthFields.month2}[${doctorId}]' value="${months.month2 || ''}" />
-                <input type="hidden" class="doctor-category-month-3" name='${monthFields.month3}[${doctorId}]' value="${months.month3 || ''}" />
-                <td>${doctorName}</td>
-                <td>${speciality}</td>
-                <td><input type="number" name='month_1[${doctorId}]' class="rx_count rx-month-1" min="0" max="9999999999" step="1" value="${months.month1 || ''}" /></td>
-                <td><input type="number" name='month_2[${doctorId}]' class="rx_count rx-month-2" min="0" max="9999999999" step="1" value="${months.month2 || ''}" /></td>
-                <td><input type="number" name='month_3[${doctorId}]' class="rx_count rx-month-3" min="0" max="9999999999" step="1" value="${months.month3 || ''}" /></td>
-            </tr>
-        `);
-    });
-
-    recalculateAllDoctorConverted();
-} */
-
-$(document).on('input change', '#doctor-table-body .rx_count', function() {
-    updateDoctorRowConverted($(this).closest('tr'));
-});
-
-function toggleUploadFields() {
-    let value = $('#field-converted').val();
-    console.log(value);
-    if (value === 'Yes') {
-        $('.upload-doc-fields').show();
-        // make upload mandatory
-        $('#field-upload-supporting-doc1').prop('required', true);
-    } else {
-        $('.upload-doc-fields').hide();
-        // remove mandatory validation
-        $('#field-upload-supporting-doc1').prop('required', false);
-        // optional cleanup
-        $('#field-upload-supporting-doc1').val('');
-        $('#field-upload-supporting-doc2').val('');
-    }
-}
-
-// hide initially always
-$('.upload-doc-fields').css('display', 'none');
-// run after small delay so dropdown is fully rendered
-setTimeout(function () {
-    toggleUploadFields();
-}, 200);
-
-// initial hide/show
-toggleUploadFields();
-
-// dropdown change
-$(document).on('change', '#field-converted', function () {
-    toggleUploadFields();
-    if ($(this).val() === 'No') {
-        $('html, body').animate({
-            scrollTop: $('#submit-btn').offset().top
-        }, 500);
-    }
-});
-
-
-        
-        $('input[type="file"]').on('change', function () {
-            let file = this.files[0];
-            if (!file) return;
-            let allowedTypes = [
-                'image/jpeg',
-                'image/jpg',
-                'application/pdf'
-
-            ];
-            if (!allowedTypes.includes(file.type)) {
-                Swal.fire({
-                    icon: 'error',
-                    title: 'Invalid file',
-                    text: 'Only JPG and PDF files are allowed.'
-                });
-                $(this).val('');
-            }
-           
-        });
-
-        $('#report-form').on('submit', function(event){
-            
-            event.preventDefault();
-            let fd = new FormData($('#report-form')[0]);
-
-for (let pair of fd.entries()) {
-    console.log(pair[0], pair[1]);
-}
-            $("#pageloader").fadeIn();
-            $.ajax({
-                type: "POST",
-                url: '/form/ajaxsubmitmultiple',
-                data: new FormData($('#report-form')[0]),
-                processData: false,
-                contentType: false,
-                success: function(data) {
-                    $("#pageloader").fadeOut();
-                    if(data.status == 'success') {
-                        Swal.fire({
-                            title: 'Great!',
-                            text: 'Your data is successfully submitted!',
-                            icon: 'success'
-                        });
-                    } else {
-                        Swal.fire({
-                            icon: 'error',
-                            title: data.hasOwnProperty('message') ? 'You are not mapped to any position code' : 'Data not submitted',
-                            text: data.hasOwnProperty('message') ? 'for resolution please email Position code, L1 Manager and L2 Manager details to support1@stratawiz.com' : 'Something went wrong, please try again after some time!'
-                        });
-                    }
-                },
-                error: function() {
-                    $("#pageloader").fadeOut();
-                    Swal.fire({
-                        icon: 'error',
-                        title: 'Error',
-                        text: 'Something went wrong'
-                    });
-                }
-            });
-        });
-
-         @if($id)
-            setTimeout(function () {
-                console.log("EDIT MODE TRIGGERED");
-                $('#field-select-category').trigger('change');
-            }, 300);
-            @endif
-        // OPEN SAMPLE MODAL
-
-$(document).on(
-    'click',
-    '.open-sample-modal',
-    function(){
-
-    let doctorId =
-        $(this).data('doctor-id');
-
-    let doctorName =
-        $(this).data('doctor-name');
-
-    let category =
-        $(this).data('category');
-
-    let categoryDisplay =
-        $(this).data('category-display');
-
-    // set hidden values
-
-    $('#sample-doctor-id').val(doctorId);
-
-    $('#sample-category').val(category);
-
-    // display values
-
-    $('#sample-doctor-name').val(doctorName);
-
-    $('#sample-category-display')
-        .val(categoryDisplay);
-
-    // open modal
-
-    $('#sampleFormModal').modal('show');
-    // set today's date by default
-    $('#sample-date').val(
-        new Date().toISOString().split('T')[0]
-    );
-
-});
-        
-        function appendConvertedField(
-    selectedCategory,
-    convertedValue
-){
-
-    const categoryMap = {
-        "foracort-ciphaler":"foracort_ciphaler",
-        "duolin-synchrobreathe":"duolin_synchrobreathe",
-        "foracort-g":"foracort_g",
-        "pedia":"pedia",
-        "triple-combination-voltido-trio-indaflo-g":"triple_combination_voltido_trio_indaflo_g",
-        "ics-laba-seroflo-maxiflo-voltido":"ics_laba_seroflo_maxiflo_voltido",
-        "competition-dr":"competition_dr"
-    };
-
-    let categoryKey =
-        categoryMap[selectedCategory];
-
-    // converted field
-    $('#sample-converted')
-        .val(convertedValue);
-
-    // category metric field
-    $('#sample-category-metric')
-        .attr('name', categoryKey)
-        .val(
-            convertedValue === 'Yes'
-            ? 1
-            : 0
-        );
-
-    console.log(
-        "CATEGORY KEY",
-        categoryKey
-    );
-
-    console.log(
-        "CONVERTED",
-        convertedValue
-    );
-}
-
-            // allow only whole numbers in sample count
-            $(document).on('keypress', '#sample-count', function(e){
-                // allow only 0-9
-                if(
-                    e.which < 48 ||
-                    e.which > 57
-                ){
-                    e.preventDefault();
-                }
-            });
-
-            $(document).on('paste', '#sample-count', function(e){
-                let pastedData =
-                    (e.originalEvent || e)
-                    .clipboardData
-                    .getData('text');
-                if(!/^\d+$/.test(pastedData)){
-                    e.preventDefault();
-                }
-            });
-
-            $(document).on('input', '#sample-count', function(){
-                this.value =
-                    this.value.replace(/[^0-9]/g, '');
-            });
-            $('input[type="date"]').attr(
-                'max',
-                new Date().toISOString().split("T")[0]
-            );
-    });
-</script>
-</body>
-
+<!DOCTYPE html>
+
+
+<html lang="en">
+
+<head>
+    @include('layouts.shared/title-meta', ['title' => "Form"])
+    @include('layouts.shared/head-css', ["mode" => $mode ?? '', "demo" => $demo ?? ''])
+    <link href="{{asset('assets/libs/sweetalert2/sweetalert2.min.css')}}" rel="stylesheet" type="text/css" />
+    <link href="https://cdn.jsdelivr.net/npm/select2@4.1.0-rc.0/dist/css/select2.min.css" rel="stylesheet" />       
+</head>
+
+<div id="pageloader">
+   <img src="http://cdnjs.cloudflare.com/ajax/libs/semantic-ui/0.16.1/images/loader-large.gif" alt="processing..." />
+</div>
+
+@php
+    // KEEP ORIGINAL DOCTOR LOGIC
+    $doctors = [];
+    foreach($questions as $question){
+        if($question->code == 'contact_id'){
+            $doctors = is_iterable($question->options ?? null) ? $question->options : [];
+        }
+    }
+    // RX HISTORY DATA ONLY
+    $history = Formhelper::getMultiformData( $form->partition, $form_id, $form->user_id );
+    $categorySubmissions = [];
+    $categoryDoctorSubmissions = [];
+
+    $categoryAttributes = [
+        'erdosteine' => 'erdosteine',
+        'erdosteine + acebrophylline' => 'erdosteine_acebrophylline',
+        'nac + acebrophylline' => 'nac_acebrophylline',
+    ];
+
+    $moleculeUseToCategory = [
+        'erdosteine prescriber' => 'erdosteine',
+        'erdosteine' => 'erdosteine',
+        'erdosteine + acebrophylline' => 'erdosteine + acebrophylline',
+        'nac + acebrophylline' => 'nac + acebrophylline',
+    ];
+
+    foreach (array_values($categoryAttributes) as $categoryIndex) {
+        $categorySubmissions[$categoryIndex] = [];
+        $categoryDoctorSubmissions[$categoryIndex] = [];
+    }
+
+    $doctorNameById = [];
+    $doctorIdByName = [];
+    foreach ($doctors as $doc) {
+        $doctorNameById[$doc->value] = $doc->display;
+        $doctorIdByName[trim($doc->display)] = $doc->value;
+    }
+
+    if (isset($history->data->submissions) && is_iterable($history->data->submissions)) {
+        foreach ($history->data->submissions as $sub) {
+            $formdata = $sub->formdata ?? null;
+            if (!$formdata) {
+                continue;
+            }
+
+            $normalizedMolecule = strtolower(trim($formdata->molecule_use ?? ''));
+            $category = $moleculeUseToCategory[$normalizedMolecule] ?? $normalizedMolecule;
+            if (!isset($categoryAttributes[$category])) {
+                continue;
+            }
+
+            $rawDoctorId = '';
+            if (!empty($formdata->contact_id)) {
+                $contactId = $formdata->contact_id;
+                if (is_array($contactId) || $contactId instanceof \Traversable) {
+                    $contactValues = array_values((array) $contactId);
+                    $rawDoctorId = trim((string) ($contactValues[0] ?? ''));
+                } else {
+                    $rawDoctorId = trim((string) $contactId);
+                }
+            }
+
+            $doctorId = $rawDoctorId;
+            if (
+                $doctorId !== '' &&
+                !isset($doctorNameById[$doctorId]) &&
+                isset($doctorIdByName[$doctorId])
+            ) {
+                $doctorId = $doctorIdByName[$doctorId];
+            }
+
+            $rxSupport = $formdata->rx_support ?? '';
+            if (is_array($rxSupport) || $rxSupport instanceof \Traversable) {
+                $rxSupport = trim((string) (array_values((array) $rxSupport)[0] ?? ''));
+            } else {
+                $rxSupport = trim((string) $rxSupport);
+            }
+
+            $otherMolecule = $formdata->other_molecule_use ?? '';
+            if (is_array($otherMolecule) || $otherMolecule instanceof \Traversable) {
+                $otherMolecule = trim((string) (array_values((array) $otherMolecule)[0] ?? ''));
+            } else {
+                $otherMolecule = trim((string) $otherMolecule);
+            }
+
+            $recordDate = $formdata->record_date ?? '';
+            if (is_array($recordDate) || $recordDate instanceof \Traversable) {
+                $recordDate = trim((string) (array_values((array) $recordDate)[0] ?? ''));
+            } else {
+                $recordDate = trim((string) $recordDate);
+            }
+
+            $categoryPrefix = $categoryAttributes[$category];
+
+            $submissionRow = [
+                'submission_id' => $sub->id,
+                'category' => $category,
+                'category_field' => $categoryPrefix,
+                'molecule_use' => $formdata->molecule_use ?? '',
+                'doctor_id' => $doctorId,
+                'doctor_name' => $doctorNameById[$doctorId] ?? $rawDoctorId,
+                'rx_support' => $rxSupport,
+                'other_molecule_use' => $otherMolecule,
+                'record_date' => $recordDate,
+            ];
+
+            $categorySubmissions[$categoryPrefix][] = $submissionRow;
+
+            if ($doctorId !== '') {
+                $categoryDoctorSubmissions[$categoryPrefix][$doctorId] = $submissionRow;
+            }
+        }
+    }
+@endphp
+
+
+<body class="loading">
+    <div class="account-pages">
+        <div class="container">
+            <div class="row justify-content-center">
+                <div class="col-md-8 col-lg-6 col-xl-5 p-0">
+                    <div class="card bg-pattern">
+                        <div class="card-body p-3 row">
+
+                            @if(Session::has('error'))<div class="alert alert-danger">{{Session::get('error')}}</div>
+                            <br>@endif
+                            @if(session('success'))<div class=" alert alert-success">{{ session('success') }}
+                            </div>
+                            <br>@endif
+                            <div class="col-8">
+                                <h4 class="page-title">{{$form->title}}</h4>
+                            </div>
+                            @if(!isset($form->is_approval) || (isset($form->is_approval) && $form->is_approval != 'yes' ) )
+                            <div class="col-4">
+                                @if($form->link_type == 'form')
+                                <!-- <a href="/form/history" class="float-end pt-1">View History</a> -->
+                                @else
+                                <a href="{{url()->previous()}}" class="float-end pt-1">Back</a>
+                                @endif
+                            </div>
+                            @endif
+                            @if(isset($form->user_info))
+                            <div class="col-12">
+                                <h6>Submitted By: {{$form->user_info->name}}</h6>
+                            </div>
+                            @endif
+                            <form method="POST" action="/form/submit" id="report-form" enctype="multipart/form-data">
+                                <input type="hidden" name="form_id" value="{{$form_id}}">
+                                @csrf
+                                @if($id)
+                                <input type="hidden" name="id" value="{{$id}}">
+                                @endif
+                                @if(isset($form->manager_can_submit) && $form->manager_can_submit == true)
+                                <div class="col-md-12 mb-2">
+                                <label for="field-user_id" class="form-label"> Select User / Territory <span class="text-danger">*</span> </label>
+                                    <select class="form-control" id="field-user_id" name="user_id" required>
+                                        <option value=""> -- Select -- </option>
+                                        @foreach($form->users as $option)
+                                        <option value="{{$option->value}}" hierarchy="{{$option->hierarchy_id}}" {{isset($question->value) && $question->value == $option->value ? 'selected':''}}>{{$option->display}}</option>
+                                        @endforeach
+                                    </select>
+                                    <input type="hidden" id="field-hierarchy_id" name="hierarchy_id" value="">
+                                </div>
+                                @endif
+
+                                @foreach($questions as $question)
+                                    @php
+
+                                    $hideFields = [
+                                        
+                                        'contact_id',
+                                        'rx_support',
+                                        'other_molecule_use'
+                                    ];
+
+                                    @endphp
+
+                                    @if(in_array($question->code, $hideFields))
+                                        @continue
+                                    @endif
+                                    <div class="{{ in_array($question->code, ['upload-supporting-doc1', 'upload-supporting-doc2']) ? 'upload-doc-fields' : '' }} col-md-12 mb-2">
+                                    <label for="field-{{$question->code}}" class="form-label">{{$question->question}} {!!$question->required == 'yes' ? '<span class="text-danger">*</span>':''!!} </label>
+                                    @switch($question->type)
+                                        @case('hidden')
+                                            <input type="{{$question->type}}" id="field-{{$question->code}}" name="{{$question->code}}" value="{{isset($question->value)?$question->value:''}}">
+                                            @break
+                                        @case('text')
+                                        @case('email')
+                                        @case('tel')
+                                        @case('date')
+                                            <input type="{{$question->type}}" id="field-{{$question->code}}" name="{{$question->code}}" class="form-control" {{$question->required == 'yes'?'required':'' }} value="{{isset($question->value)?$question->value:''}}">
+                                            @break
+                                        @case('number')
+                                            <input type="{{$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)?$question->value:0}}">
+                                            @break
+                                        @case('textarea')
+                                            <textarea id="field-{{$question->code}}" name="{{$question->code}}" class="form-control" {{$question->required == 'yes'?'required':'' }}>{{isset($question->value)?$question->value:''}}</textarea>
+                                            @break
+                                        @case('dropdown')
+                                            <select class="form-control" id="field-{{$question->code}}" name="{{$question->code}}" {{$question->required == 'yes'?'required':'' }}>
+                                                <option value=""> -- Select -- </option>
+                                                @foreach($question->options as $option)
+                                                <option value="{{$option->value}}" {{isset($question->value) && $question->value == $option->value ? 'selected':''}}>{{$option->display}}</option>
+                                                @endforeach
+                                            </select>
+                                            @break
+                                        @case('radio')
+                                            @foreach($question->options as $option)
+                                            <div class="form-check mb-2 form-check-success">
+                                                <input class="form-check-input" type="radio" name="{{$question->code}}" id="field-{{$question->code}}_{{$option->value}}" value="{{$option->value}}">
+                                                <label class="form-check-label" for="field-{{$question->code}}_{{$option->value}}">{{$option->display}}</label>
+                                            </div>
+                                            @endforeach
+                                            @break
+                                        @case('radiometrix')
+                                            @php
+                                                // Decode the first option's value to use as heading labels
+                                                $headings =
+                                                    count($question->options) > 0
+                                                        ? json_decode($question->options[0]->value, true)
+                                                        : [];
+
+                                                if(!is_array($headings)){
+                                                    $headings = [];
+                                                }
+                                            @endphp
+
+                                            {{-- Matrix Wrapper with Horizontal Scroll on Small Screens --}}
+                                            <div class="table-responsive">
+                                                <div class="d-table w-100">
+                                                    {{-- Table Headers --}}
+                                                    <div class="d-table-row font-weight-bold">
+                                                        <div class="d-table-cell p-2" style="width: 150px;"></div>
+                                                        {{-- Placeholder for row labels --}}
+                                                        @foreach ($headings as $head)
+                                                            <div class="d-table-cell text-center p-2">{{ $head }}
+                                                            </div>
+                                                        @endforeach
+                                                    </div>
+
+                                                    {{-- Table Rows --}}
+                                                    @foreach ($question->options as $option)
+                                                        @php
+                                                            $nn = json_decode($option->value, true);
+
+                                                            // fallback if invalid json
+                                                            if(!is_array($nn)){
+                                                                $nn = [];
+                                                            }
+                                                        @endphp
+                                                        <div class="d-table-row align-middle">
+                                                            <div class="d-table-cell font-weight-bold p-2"
+                                                                style="width: 150px;">
+                                                                {{ $option->display }}
+                                                            </div>
+
+                                                            @foreach ($nn as $value)
+                                                                <div class="d-table-cell text-center p-2">
+                                                                    <input type="radio"
+                                                                id="field-{{ $option->display }}-{{ $value }}"
+                                                                name="{{ $question->code }}[{{$option->display}}]" value="{{$value}}" class="form-check-input"
+                                                                {{ isset($question->display) && $option->display != $option->display ? 'checked' : '' }}>
+
+                                                                </div>
+                                                            @endforeach
+                                                        </div>
+                                                    @endforeach
+                                                </div>
+                                            </div>
+                                        @break    
+                                        @case('checkbox')
+                                            @foreach($question->options as $option)
+                                            <div class="form-check mb-2 form-check-primary ms-2">
+                                                <input class="form-check-input" type="checkbox" id="field-{{$question->code}}-{{$option->value}}" name="{{$question->code}}[]" value="{{$option->value}}" {{isset($question->value) && $question->value != '' && in_array($option->value, $question->value) ? 'checked':''}}>
+                                                <label class="form-check-label" for="field-{{$question->code}}-{{$option->value}}">{{$option->display}}</label>
+                                            </div>
+                                            @endforeach
+                                            @break
+
+                                            @case('file')
+
+                                            @if(!isset($form->is_approval) || (isset($form->is_approval) && $form->is_approval != 'yes' ) )
+
+                                            <input
+                                                type="file"
+                                                id="field-{{$question->code}}"
+                                                name="{{$question->code}}"
+                                                class="form-control"
+                                                accept=".jpg,.jpeg,.pdf,image/*"
+                                                capture="environment"
+                                                {{$question->required == 'yes'?'required':'' }}>
+
+                                            @elseif(isset($question->value))
+
+                                            <img src="{{$question->value}}" class="img-fluid">
+
+                                            @endif
+
+                                            @break
+                                        @case('multitextbox')
+                                            <div class="row">
+                                                @foreach($question->options as $option)
+                                                <div class="col-6">{{$option->display}}</div>
+                                                <div class="col-6 mb-1">
+                                                    <input type="number" id="field-{{$option->value}}" name="{{$option->value}}" class="form-control" required value="{{isset($option->val)?$option->val:0}}">
+                                                </div>
+                                                @endforeach
+                                            </div>
+                                            @break
+                                    @endswitch
+                                    </div>
+                                @endforeach
+                                @if(!isset($form->is_approval) || (isset($form->is_approval) && $form->is_approval != 'yes' ) )
+                                <div class="text-center d-gri mt-3">
+                                    <div class="col-md-12 mt-3">
+                                    <div class="card">
+                                        {{-- <div class="card-header">
+                                            <h5 class="mb-0">Tagged Doctors</h5>
+                                        </div> --}}
+                                        <div class="card-body p-0">
+                                            <div class="table-responsive">
+                                            @php
+                                            $doctors = [];
+
+                                            foreach($questions as $question){
+                                                if($question->code == 'contact_id'){
+                                                    $doctors = $question->options ?? [];
+                                                    break;
+                                                }
+                                            }
+                                            @endphp
+                                       <table class="table table-bordered  mb-0">
+                                                    <thead>
+                                                        <tr>
+                                                            <th>Doctor Name</th>
+                                                            
+                                                            <th>Rxn/Week Support</th>
+                                                            
+                                                            <th>Other Molecule Use</th>
+                                                        </tr>
+                                                    </thead>
+                                                    <tbody id="doctor-table-body">
+
+                                                    @for($i=1; $i<=5; $i++)
+
+                                                    <tr>
+
+                                                        <td>
+                                                            <select
+                                                                name="contact_id[]"
+                                                                class="form-control doctor-select"
+                                                                required
+                                                            >
+                                                                <option value="">-- Select Doctor --</option>
+
+                                                                @foreach($questions as $question)
+
+                                                                    @if($question->code == 'contact_id')
+
+                                                                        @foreach($question->options as $doctor)
+
+                                                                            <option value="{{$doctor->value}}">
+                                                                                {{$doctor->display}}
+                                                                            </option>
+
+                                                                        @endforeach
+
+                                                                    @endif
+
+                                                                @endforeach
+
+                                                            </select>
+                                                        </td>
+
+                                                        <td>
+                                                        
+                                                            <select
+                                                                name="rx_support[]"
+                                                                class="form-control"
+                                                                required
+                                                            >
+                                                                <option value="">-- Select --</option>
+                                                                <option value="1-3 Rxn/Week">1-3 Rxn/Week</option>
+                                                                <option value="4-7 Rxn/Week">4-7 Rxn/Week</option>
+                                                                <option value="8-11 Rxn/Week">8-11 Rxn/Week</option>
+                                                                <option value=">11 Rxn/Week">&gt;11 Rxn/Week</option>
+                                                            </select>
+                                                        </td>
+
+                                                        <td>
+                                                        
+                                                            <select
+                                                                name="other_molecule_use[]"
+                                                                class="form-control"
+                                                                required
+                                                            >
+                                                                <option value="">-- Select --</option>
+                                                                <option value="Erdosteine Prescriber">
+                                                                    Erdosteine Prescriber
+                                                                </option>
+                                                                <option value="Erdosteine + Acebrophylline">
+                                                                    Erdosteine + Acebrophylline
+                                                                </option>
+                                                                <option value="NAC + Acebrophylline">
+                                                                    NAC + Acebrophylline
+                                                                </option>
+                                                                <option value="No">
+                                                                    No
+                                                                </option>
+                                                            </select>
+                                                        </td>
+
+                                                    </tr>
+
+                                                    @endfor
+
+                                                    </tbody>
+                                                </table>
+                                            </div>
+                                        </div>
+                                    </div>
+                                 </div>
+                                 
+                                    <button class="btn btn-primary" type="submit" id="submit-btn"> Submit </button>
+                                </div> 
+                                @endif
+                            </form>
+                            <!-- SAMPLE FORM MODAL -->
+                        </div> <!-- end card-body -->
+                    </div>
+                    <!-- end card -->
+                    <!-- end row -->
+                </div> <!-- end col -->
+            </div>
+            <!-- end row -->
+        </div>
+        <!-- end container -->
+    </div>
+    <!-- end page -->
+
+
+
+<style type="text/css">
+select option:disabled {
+    color: #999;
+    font-style: italic;
+}
+select option:disabled {
+    color: #999;
+    font-style: italic;
+}
+#pageloader {
+  background: rgba( 255, 255, 255, 0.8 );
+  display: none;
+  height: 100%;
+  position: fixed;
+  width: 100%;
+  z-index: 9999;
+}
+
+#pageloader img {
+  left: 50%;
+  margin-left: -32px;
+  margin-top: -32px;
+  position: absolute;
+  top: 50%;
+}
+.form-label {
+    font-weight:bold;
+    font-size:16px;
+}
+.upload-doc-fields {
+    display: none;
+}
+
+.rx_count{
+    width: 70px;
+}
+
+
+
+</style>
+@include('layouts.shared/footer-script')
+<script src="https://cdn.jsdelivr.net/npm/select2@4.1.0-rc.0/dist/js/select2.min.js"></script>
+<script src="{{asset('assets/libs/sweetalert2/sweetalert2.min.js')}}"></script>
+<script type="text/javascript">
+    var allDoctors = {!! json_encode($doctors) !!};
+    var categoryAttributes = {!! json_encode($categoryAttributes) !!};
+    var moleculeUseToCategory = {!! json_encode($moleculeUseToCategory) !!};
+    var categorySubmissions = {!! json_encode($categorySubmissions) !!};
+    var categoryDoctorSubmissions = {!! json_encode($categoryDoctorSubmissions) !!};
+
+    jQuery(document).ready(function($){
+        function resolveCategoryIndex(moleculeUse) {
+            if (!moleculeUse) {
+                return null;
+            }
+
+            let normalized = moleculeUse.toLowerCase().trim();
+            let categoryKey = moleculeUseToCategory[normalized] || normalized;
+
+            return categoryAttributes[categoryKey] || null;
+        }
+
+        function removeSubmissionId($row) {
+            $row.find('.submission-id').remove();
+        }
+
+        function setSubmissionId($row, submissionId) {
+            let $input = $row.find('.submission-id');
+
+            if (!$input.length) {
+                $input = $('<input>', {
+                    type: 'hidden',
+                    class: 'submission-id',
+                    name: 'id[]'
+                });
+                $row.find('td').first().prepend($input);
+            } else {
+                $input.attr('name', 'id[]');
+            }
+
+            $input.val(submissionId || '');
+        }
+
+        function clearDoctorTableRow($row) {
+            removeSubmissionId($row);
+            $row.find('.doctor-select').val('').trigger('change');
+            $row.find('select[name="rx_support[]"]').val('');
+            $row.find('select[name="other_molecule_use[]"]').val('');
+        }
+
+        function clearDoctorTable() {
+            $('#doctor-table-body tr').each(function() {
+                clearDoctorTableRow($(this));
+            });
+            $('#field-record_date').val('');
+        }
+
+        function prefillDoctorTableFromCategory(categoryIndex) {
+            clearDoctorTable();
+
+            if (!categoryIndex) {
+                return;
+            }
+
+            let categoryDoctors = categoryDoctorSubmissions[categoryIndex] || {};
+            let submissions = Object.values(categoryDoctors);
+
+            if (!submissions.length) {
+                return;
+            }
+
+            if (submissions[0].record_date) {
+                $('#field-record_date').val(submissions[0].record_date);
+            }
+
+            $('#doctor-table-body tr').each(function(index) {
+                let submission = submissions[index];
+                if (!submission) {
+                    return false;
+                }
+
+                let $row = $(this);
+                $row.find('.doctor-select')
+                    .val(submission.doctor_id)
+                    .trigger('change');
+                $row.find('select[name="rx_support[]"]')
+                    .val(submission.rx_support || '');
+                $row.find('select[name="other_molecule_use[]"]')
+                    .val(submission.other_molecule_use || '');
+                setSubmissionId($row, submission.submission_id);
+            });
+        }
+
+        function updateDoctorDropdowns() {
+
+    let selectedDoctors = [];
+
+    $('.doctor-select').each(function(){
+
+        let value = $(this).val();
+
+        if(value){
+            selectedDoctors.push(value);
+        }
+
+    });
+
+    $('.doctor-select').each(function(){
+
+        let currentDropdown = $(this);
+        let currentValue = currentDropdown.val();
+
+        currentDropdown.find('option').each(function(){
+
+            let option = $(this);
+
+            let originalText =
+                option.data('original-text') || option.text();
+
+            option.data('original-text', originalText);
+
+            option.text(originalText);
+
+            option.prop('disabled', false);
+
+            let optionValue = option.val();
+
+            if(
+                optionValue &&
+                optionValue !== currentValue &&
+                selectedDoctors.includes(optionValue)
+            ){
+                option.prop('disabled', true);
+
+                option.text(
+                    originalText +
+                    ' (Already Added)'
+                );
+            }
+
+        });
+
+    });
+
+}
+$(document).on(
+    'change',
+    '.doctor-select',
+    updateDoctorDropdowns
+);
+
+updateDoctorDropdowns();
+
+function updateOtherMoleculeDropdowns() {
+    let selectedMolecule = $('#field-molecule_use').val();
+    let categoryIndex = resolveCategoryIndex(selectedMolecule);
+
+    $('select[name="other_molecule_use[]"]').each(function(){
+        let ddl = $(this);
+
+        ddl.find('option').each(function(){
+            let option = $(this);
+            let originalText =
+                option.data('original-text') || option.text();
+
+            option.data('original-text', originalText);
+            option.text(originalText);
+            option.prop('disabled', false);
+
+            if(
+                selectedMolecule &&
+                option.val() === selectedMolecule
+            ){
+                option.prop('disabled', true);
+                option.text(
+                    originalText + ' (Already Added)'
+                );
+            }
+        });
+    });
+
+    prefillDoctorTableFromCategory(categoryIndex);
+    updateDoctorDropdowns();
+}
+
+$('#field-molecule_use').on('change', updateOtherMoleculeDropdowns);
+
+        $('.doctor-select').select2({
+    width: '100%',
+    placeholder: 'Search Doctor',
+    allowClear: true
+});
+
+if ($('#field-molecule_use').val()) {
+    updateOtherMoleculeDropdowns();
+} else {
+    clearDoctorTable();
+}
+        $('#report-form').on('submit', function(event){
+            
+            event.preventDefault();
+            let fd = new FormData($('#report-form')[0]);
+
+for (let pair of fd.entries()) {
+    console.log(pair[0], pair[1]);
+}
+            $("#pageloader").fadeIn();
+            $.ajax({
+                type: "POST",
+                url: '/form/ajaxsubmitmultiple',
+                data: new FormData($('#report-form')[0]),
+                processData: false,
+                contentType: false,
+                success: function(data) {
+                    $("#pageloader").fadeOut();
+                    if(data.status == 'success') {
+                        Swal.fire({
+                            title: 'Great!',
+                            text: 'Your data is successfully submitted!',
+                            icon: 'success'
+                        });
+                    } else {
+                        Swal.fire({
+                            icon: 'error',
+                            title: data.hasOwnProperty('message') ? 'You are not mapped to any position code' : 'Data not submitted',
+                            text: data.hasOwnProperty('message') ? 'for resolution please email Position code, L1 Manager and L2 Manager details to support1@stratawiz.com' : 'Something went wrong, please try again after some time!'
+                        });
+                    }
+                },
+                error: function() {
+                    $("#pageloader").fadeOut();
+                    Swal.fire({
+                        icon: 'error',
+                        title: 'Error',
+                        text: 'Something went wrong'
+                    });
+                }
+            });
+        });
+
+         @if($id)
+            setTimeout(function () {
+                console.log("EDIT MODE TRIGGERED");
+                $('#field-select-category').trigger('change');
+            }, 300);
+            @endif
+    
+    });
+</script>
+</body>
+
 </html>
\ No newline at end of file