@include('layouts.shared/title-meta', ['title' => "Form"]) @include('layouts.shared/head-css', ["mode" => $mode ?? '', "demo" => $demo ?? ''])

@php $brandData = [ ['brand'=>"Emeset 4 ODT/India/1 X 10'S", 'slug'=>'emeset_4_odtindia1_x_10s_units','pseudoId'=>'emeset_4_odtindia1_x_10s_value'], ['brand'=>"EMESET 4MG (10'S)", 'slug'=>'emeset_4mg_10s_units','pseudoId'=>'emeset_4mg_10s_value'], ['brand'=>"EMESET 8MG (10'S)", 'slug'=>'emeset_8mg_10s_units','pseudoId'=>'emeset_8mg_10s_value'], ['brand'=>"EMESET SYRUP", 'slug'=>'emeset_syrup_units','pseudoId'=>'emeset_syrup_value'], ['brand'=>"EMESET SYRUP STRAWBERRY 30 ML", 'slug'=>'emeset_syrup_strawberry_30_ml_units','pseudoId'=>'emeset_syrup_strawberry_30_ml_value'], ['brand'=>"OFLOX 100mg REDIUSE 60ML", 'slug'=>'oflox_100mg_rediuse_60ml_units','pseudoId'=>'oflox_100mg_rediuse_60ml_value'], ['brand'=>"OFLOX 200 TAB (10'S)", 'slug'=>'oflox_200_tab_10s_units','pseudoId'=>'oflox_200_tab_10s_value'], ['brand'=>"OFLOX 400 10'S", 'slug'=>'oflox_400_10s_units','pseudoId'=>'oflox_400_10s_value'], ['brand'=>'OFLOX 50MG REDIUSE 60ML', 'slug'=>'oflox_50mg_rediuse_60ml_units','pseudoId'=>'oflox_50mg_rediuse_60ml_value'], /* ['brand'=>'OFLOX EYE DROPS', 'slug'=>'oflox_eye_drops_units','pseudoId'=>'oflox_eye_drops_value'], */ ['brand'=>'OFLOX OZ TABLETS IP', 'slug'=>'oflox_oz_tablets_ip_units','pseudoId'=>'oflox_oz_tablets_ip_value'], ['brand'=>'OFLOX REDIUSE', 'slug'=>'oflox_rediuse_units','pseudoId'=>'oflox_rediuse_value'], ['brand'=>"OFLOX-200 MG 10's TABLETS (IP)", 'slug'=>'oflox_200_mg_10s_tablets_ip_units','pseudoId'=>'oflox_200_mg_10s_tablets_ip_value'], ['brand'=>"OFLOX-400 MG 10's TABLETS (IP)", 'slug'=>'oflox_400_mg_10s_tablets_ip_units','pseudoId'=>'oflox_400_mg_10s_tablets_ip_value'], ['brand'=>"OFLOX M SUSPENSION", 'slug'=>'oflox_m_suspension_units','pseudoId'=>'oflox_m_suspension_value'], ['brand'=>"CEFOPROX 100 30ML(60", 'slug'=>'cefoprox_100_30ml60_units','pseudoId'=>'cefoprox_100_30ml60_value'], ['brand'=>'CEFOPROX 100DT', 'slug'=>'cefoprox_100dt_units','pseudoId'=>'cefoprox_100dt_value'], ['brand'=>"CEFOPROX 200 10'S", 'slug'=>'cefoprox_200_10s_units','pseudoId'=>'cefoprox_200_10s_value'], ['brand'=>'CEFOPROX 50 30ml', 'slug'=>'cefoprox_50_30ml_units','pseudoId'=>'cefoprox_50_30ml_value'], ['brand'=>'CEFOPROX CV 325 TAB', 'slug'=>'cefoprox_cv_325_tab_units','pseudoId'=>'cefoprox_cv_325_tab_value'], ['brand'=>'Cheston DUO 100ml Syrup', 'slug'=>'cheston_duo_100ml_syrup_units','pseudoId'=>'cheston_duo_100ml_syrup_value'], ['brand'=>"Cheston LS Junior 100 ML", 'slug'=>'cheston_ls_junior_100_ml_units','pseudoId'=>'cheston_ls_junior_100_ml_value'], ['brand'=>'Cheston-D Cough Syrup 100 ML', 'slug'=>'cheston_d_cough_syrup_100_ml_units','pseudoId'=>'cheston_d_cough_syrup_100_ml_value'], ['brand'=>"Cheston-D Plus 1 x 10'S", 'slug'=>'cheston_d_plus_1_x_10s_units','pseudoId'=>'cheston_d_plus_1_x_10s_value'], ['brand'=>'Cheston-LS Cough Syrup 100 ML', 'slug'=>'cheston_ls_cough_syrup_100_ml_units','pseudoId'=>'cheston_ls_cough_syrup_100_ml_value'], ['brand'=>'Cheston-LS Junior 60 ML', 'slug'=>'cheston_ls_junior_60_ml_units','pseudoId'=>'cheston_ls_junior_60_ml_value'], ['brand'=>'DALACIN C 150MG CAPS 10s', 'slug'=>'dalacin_c_150mg_caps_10s_units','pseudoId'=>'dalacin_c_150mg_caps_10s_value'], ['brand'=>'DALACIN C 300MG CAPS 10s', 'slug'=>'dalacin_c_300mg_caps_10s_units','pseudoId'=>'dalacin_c_300mg_caps_10s_value'], ['brand'=>"DOLONEX DISP 20MG TABS (IP)", 'slug'=>'dolonex_disp_20mg_tabs_ip_units','pseudoId'=>'dolonex_disp_20mg_tabs_ip_value'], ['brand'=>"DOLONEX IM 20MG/1ML INJ", 'slug'=>'dolonex_im_20mg1ml_inj_units','pseudoId'=>'dolonex_im_20mg1ml_inj_value'], ['brand'=>'DOLONEX IM 40MG 2ML INJ HOSP (IP)', 'slug'=>'dolonex_im_40mg_2ml_inj_hosp_ip_units','pseudoId'=>'dolonex_im_40mg_2ml_inj_hosp_ip_value'], ['brand'=>"DOLONEX IM 40MG/2ML INJ (IP)", 'slug'=>'dolonex_im_40mg2ml_inj_ip_units','pseudoId'=>'dolonex_im_40mg2ml_inj_ip_value'], ['brand'=>"DUONASE - F 70 MD", 'slug'=>'duonase_f_70_md_units','pseudoId'=>'duonase_f_70_md_value'], ['brand'=>'DUONASE NASAL SPRAY', 'slug'=>'duonase_nasal_spray_units','pseudoId'=>'duonase_nasal_spray_value'], ['brand'=>"IBUGESIC PLUS SUSP", 'slug'=>'ibugesic_plus_susp_units','pseudoId'=>'ibugesic_plus_susp_value'], ['brand'=>"IBUGESIC PLUS SUSP 1", 'slug'=>'ibugesic_plus_susp_1_units','pseudoId'=>'ibugesic_plus_susp_1_value'], ['brand'=>'IBUGESIC PLUS SUSPENSION 100ML - ORANGE', 'slug'=>'ibugesic_plus_suspension_100ml_orange_units','pseudoId'=>'ibugesic_plus_suspension_100ml_orange_value'], ['brand'=>"MUCINAC 200 TABLET 1 X 10'S", 'slug'=>'mucinac_200_tablet_1_x_10s_units','pseudoId'=>'mucinac_200_tablet_1_x_10s_value'], ['brand'=>"MUCINAC 600 TABLETS", 'slug'=>'mucinac_600_tablets_units','pseudoId'=>'mucinac_600_tablets_value'], ['brand'=>"Mucinac AB 1 X 10 TABLETS", 'slug'=>'mucinac_ab_1_x_10_tablets_units','pseudoId'=>'mucinac_ab_1_x_10_tablets_value'], ['brand'=>'Mucinac AB Tablet', 'slug'=>'mucinac_ab_tablet_units','pseudoId'=>'mucinac_ab_tablet_value'], /* ['brand'=>"MUCINAC C Tablets 1 x 15'S", 'slug'=>'mucinac_c_tablets_1_x_15s_units','pseudoId'=>'mucinac_c_tablets_1_x_15s_value'], */ ['brand'=>"Mucinac Oral Solution 100ml", 'slug'=>'mucinac_oral_solution_100ml_units','pseudoId'=>'mucinac_oral_solution_100ml_value'], ['brand'=>'NOVAMOX 500', 'slug'=>'novamox_500_units','pseudoId'=>'novamox_500_value'], ['brand'=>"NOVAMOX 125 REDIUSE 30 ML", 'slug'=>'novamox_125_rediuse_30_ml_units','pseudoId'=>'novamox_125_rediuse_30_ml_value'], ['brand'=>"NOVAMOX 125 REDIUSE 60 ML", 'slug'=>'novamox_125_rediuse_60_ml_units','pseudoId'=>'novamox_125_rediuse_60_ml_value'], ['brand'=>"NOVAMOX 250 DT 15's", 'slug'=>'novamox_250_dt_15s_units','pseudoId'=>'novamox_250_dt_15s_value'], ['brand'=>'NOVAMOX 250 R/U 30', 'slug'=>'novamox_250_ru_30_units','pseudoId'=>'novamox_250_ru_30_value'], ['brand'=>"NOVAMOX 250 REDIUSE", 'slug'=>'novamox_250_rediuse_units','pseudoId'=>'novamox_250_rediuse_value'], ['brand'=>"NOVAMOX 30ML", 'slug'=>'novamox_30ml_units','pseudoId'=>'novamox_30ml_value'], ['brand'=>"NOVAMOX 60ML", 'slug'=>'novamox_60ml_units','pseudoId'=>'novamox_60ml_value'], ['brand'=>"NOVAMOX CV 1000 MG", 'slug'=>'novamox_cv_1000_mg_units','pseudoId'=>'novamox_cv_1000_mg_value'], ['brand'=>"NOVAMOX CV 228.5 DT TABLETS", 'slug'=>'novamox_cv_2285_dt_tablets_units','pseudoId'=>'novamox_cv_2285_dt_tablets_value'], ['brand'=>"NOVAMOX CV 228.5 MG SYRUP", 'slug'=>'novamox_cv_2285_mg_syrup_units','pseudoId'=>'novamox_cv_2285_mg_syrup_value'], ['brand'=>"NOVAMOX CV 375 TAB 10s", 'slug'=>'novamox_cv_375_tab_10s_units','pseudoId'=>'novamox_cv_375_tab_10s_value'], ['brand'=>"NOVAMOX CV 457 DT 10's", 'slug'=>'novamox_cv_457_dt_10s_units','pseudoId'=>'novamox_cv_457_dt_10s_value'], ['brand'=>'NOVAMOX CV 625 TABLETS 10', 'slug'=>'novamox_cv_625_tablets_10_units','pseudoId'=>'novamox_cv_625_tablets_10_value'], ['brand'=>'NOVAMOX CV DROPS', 'slug'=>'novamox_cv_drops_units','pseudoId'=>'novamox_cv_drops_value'], ['brand'=>"Novamox CV Dry Syrup 30 ML", 'slug'=>'novamox_cv_dry_syrup_30_ml_units','pseudoId'=>'novamox_cv_dry_syrup_30_ml_value'], ['brand'=>"NOVAMOX CV DS", 'slug'=>'novamox_cv_ds_units','pseudoId'=>'novamox_cv_ds_value'], ['brand'=>"NOVAMOX CV FORTE SYP", 'slug'=>'novamox_cv_forte_syp_units','pseudoId'=>'novamox_cv_forte_syp_value'], ['brand'=>"Novamox CV Forte Syp 60 ml", 'slug'=>'novamox_cv_forte_syp_60_ml_units','pseudoId'=>'novamox_cv_forte_syp_60_ml_value'], ['brand'=>"NOVAMOX DROPS", 'slug'=>'novamox_drops_units','pseudoId'=>'novamox_drops_value'], ['brand'=>"NOVAMOX LB 500", 'slug'=>'novamox_lb_500_units','pseudoId'=>'novamox_lb_500_value'], ['brand'=>"NOVAMOX RDU DROPS", 'slug'=>'novamox_rdu_drops_units','pseudoId'=>'novamox_rdu_drops_value'], ['brand'=>"NOVAMOX-125 DT 15'S", 'slug'=>'novamox_125_dt_15s_units','pseudoId'=>'novamox_125_dt_15s_value'], ['brand'=>"NOVAMOX-250 [15'S]", 'slug'=>'novamox_250_15s_units','pseudoId'=>'novamox_250_15s_value'], ['brand'=>"TEDISPAN 200 TABLETS 6S", 'slug'=>'tedispan_200_tablets_6s_units','pseudoId'=>'tedispan_200_tablets_6s_value'], ['brand'=>"Bilafav M", 'slug'=>'bilafav_m_units','pseudoId'=>'bilafav_m_value'], ['brand'=>"Bilafav M ODT Adult Tablets 1x10s - 20/10", 'slug'=>'bilafav_m_odt_adult_tablets_1x10s_2010_units','pseudoId'=>'bilafav_m_odt_adult_tablets_1x10s_2010_value'], ['brand'=>"Bilafav M ODT Pedia Tablets 1X10s 10/4", 'slug'=>'bilafav_m_odt_pedia_tablets_1x10s_104_units','pseudoId'=>'bilafav_m_odt_pedia_tablets_1x10s_104_value'], ['brand'=>"Bilafav M Oral suspension", 'slug'=>'bilafav_m_oral_suspension_units','pseudoId'=>'bilafav_m_oral_suspension_value'], /* ['brand'=>"NEKSIUM 20mg TAB (IP)", 'slug'=>'neksium_20mg_tab_ip_units','pseudoId'=>'neksium_20mg_tab_ip_value'], */ /* ['brand'=>"NEKSIUM 40mg TAB", 'slug'=>'neksium_40mg_tab_units','pseudoId'=>'neksium_40mg_tab_value'], */ /* ['brand'=>"NEKSIUM-D 20/30mg CAPS 15s (IP)", 'slug'=>'neksium_d_2030mg_caps_15s_ip_units','pseudoId'=>'neksium_d_2030mg_caps_15s_ip_value'], */ /*['brand'=>"NEKSIUM-D 40/30mg CAPS 15s (IP)", 'slug'=>'neksium_d_4030mg_caps_15s_ip_units','pseudoId'=>'neksium_d_4030mg_caps_15s_ip_value'],*/ ['brand'=>"TASIRON 15 CHEW TABS 3X10'S (B12)", 'slug'=>'tasiron_15_chew_tabs_3x10s_b12_units','pseudoId'=>'tasiron_15_chew_tabs_3x10s_b12_value'], ['brand'=>"TASIRON 30 CHEW TABS", 'slug'=>'tasiron_30_chew_tabs_units','pseudoId'=>'tasiron_30_chew_tabs_value'], ['brand'=>"TASIRON DROPS 30ML WITH EXTERNAL DROPPER", 'slug'=>'tasiron_drops_30ml_with_external_dropper_units','pseudoId'=>'tasiron_drops_30ml_with_external_dropper_value'], ['brand'=>"TASIRON SACHET(1X15'S)", 'slug'=>'tasiron_sachet1x15s_units','pseudoId'=>'tasiron_sachet1x15s_value'], ['brand'=>"TASIRON SUSPENSION-150ML", 'slug'=>'tasiron_suspension_150ml_units','pseudoId'=>'tasiron_suspension_150ml_value'], ['brand'=>"Pansec 80 MG Tablets", 'slug'=>'pansec_80_mg_tablets_units','pseudoId'=>'pansec_80_mg_tablets_value'], ['brand'=>"PANSEC D SR CAPSULES 15'S", 'slug'=>'pansec_d_sr_capsules_15s_units','pseudoId'=>'pansec_d_sr_capsules_15s_value'], ['brand'=>"PANSEC TABLETS 15'S", 'slug'=>'pansec_tablets_15s_units','pseudoId'=>'pansec_tablets_15s_value'], ['brand'=>"PANSEC-L CAPSULES", 'slug'=>'pansec_l_capsules_units','pseudoId'=>'pansec_l_capsules_value'] ]; @endphp @php $submissions = Formhelper::getMultiformData($form->partition, $form_id, $form->user_id); // $submission = null; // if(isset($submissions->data->submissions) && count($submissions->data->submissions) > 0) { // $submission = $submissions->data->submissions[0]; // $formdata = $submission->formdata ?? (object)[]; // } else { // $formdata = []; // } $formdata = null; if (!empty($submissions->data->submissions)) { foreach ($submissions->data->submissions as $submission) { if ($submission->id == $id) { $formdata = $submission->formdata ?? null; break; } } } @endphp

@if(Session::has('error'))

{{Session::get('error')}}

@endif @if(session('success'))

{{ session('success') }}

@endif

{{$form->title}}

@if(!isset($form->is_approval) || (isset($form->is_approval) && $form->is_approval != 'yes' ) )

@if($form->link_type == 'form') View History @else Back @endif

@endif @if(isset($form->user_info))

Submitted By: {{$form->user_info->name}}

@endif

@csrf @if($id) @endif @if(isset($form->manager_can_submit) && $form->manager_can_submit == true)

Select User / Territory *

@endif @foreach($questions as $question)

{{$question->question}} {!!$question->required == 'yes' ? '*':''!!} @switch($question->type) @case('hidden') @break @case('text') @case('email') @case('tel') @case('date') required == 'yes'?'required':'' }} value="{{isset($question->value)?$question->value:''}}"> @break @case('number') required == 'yes'?'required':'' }} value="{{isset($question->value)?$question->value:0}}"> @break @case('textarea') @break @case('dropdown') @break @case('checkbox') @foreach($question->options as $option)

value) && $question->value != '' && in_array($option->value, $question->value) ? 'checked':''}}> {{$option->display}}

@endforeach @break @case('file') @if(!isset($form->is_approval) || (isset($form->is_approval) && $form->is_approval != 'yes' ) ) required == 'yes'?'required':'' }}> @elseif(isset($question->value))

@endif @break @case('multitextbox')

@foreach($brandData as $brand) @endforeach

Brand	Units	Value
{{ $brand['brand'] }}

@break @endswitch

@endforeach @if(!isset($form->is_approval) || (isset($form->is_approval) && $form->is_approval != 'yes' ) )

@endif

@include('layouts.shared/footer-script')