@include('layouts.shared/title-meta', ['title' => "Form"]) @include('layouts.shared/head-css', ["mode" => $mode ?? '', "demo" => $demo ?? ''])
@php $brandData = [ ['brand'=>'JUNIOR LANZOL 15', 'slug'=>'junior_lanzol_15_units','pseudoId'=>'junior_lanzol_15_value'], ['brand'=>'JUNIOR LANZOL 30', 'slug'=>'junior_lanzol_30_units','pseudoId'=>'junior_lanzol_30_value'], ['brand'=>"LEVOFLOX 250 (10'S) IP", 'slug'=>'levoflox_250_10s_ip_units','pseudoId'=>'levoflox_250_10s_ip_value'], ['brand'=>"LEVOFLOX 250 TAB 10'", 'slug'=>'levoflox_250_tab_10_units','pseudoId'=>'levoflox_250_tab_10_value'], ['brand'=>"LEVOFLOX 500 (10'S) IP", 'slug'=>'levoflox_500_10s_ip_units','pseudoId'=>'levoflox_500_10s_ip_value'], ['brand'=>"LEVOFLOX 500 10'S", 'slug'=>'levoflox_500_10s_units','pseudoId'=>'levoflox_500_10s_value'], ['brand'=>"LEVOFLOX 750 (5'S) IP", 'slug'=>'levoflox_750_5s_ip_units','pseudoId'=>'levoflox_750_5s_ip_value'], ['brand'=>"LEVOFLOX 750 TAB 5'S", 'slug'=>'levoflox_750_tab_5s_units','pseudoId'=>'levoflox_750_tab_5s_value'], ['brand'=>'LEVOFLOX INFUSION', 'slug'=>'levoflox_infusion_units','pseudoId'=>'levoflox_infusion_value'], ['brand'=>'METASPRAY 100AQ', 'slug'=>'metaspray_100aq_units','pseudoId'=>'metaspray_100aq_value'], ['brand'=>'MONTAIR FX', 'slug'=>'montair_fx_units','pseudoId'=>'montair_fx_value'], ['brand'=>'Montair FX 15s', 'slug'=>'montair_fx_15s_units','pseudoId'=>'montair_fx_15s_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'=>"RABICIP - L CAPSULES", 'slug'=>'rabicip_l_capsules_units','pseudoId'=>'rabicip_l_capsules_value'], ['brand'=>"RABICIP 20 15'S", 'slug'=>'rabicip_20_15s_units','pseudoId'=>'rabicip_20_15s_value'], ['brand'=>"RABICIP 20 TABLETS 15S", 'slug'=>'rabicip_20_tablets_15s_units','pseudoId'=>'rabicip_20_tablets_15s_value'], ['brand'=>"RABICIP 20mg (IP) 1 x 15s TABLETS", 'slug'=>'rabicip_20mg_ip_1_x_15s_tablets_units','pseudoId'=>'rabicip_20mg_ip_1_x_15s_tablets_value'], ['brand'=>"RABICIP D CAPSULES 1 X 15'S", 'slug'=>'rabicip_d_capsules_1_x_15s_units','pseudoId'=>'rabicip_d_capsules_1_x_15s_value'], ['brand'=>"ANTIFLU SYRUP 75 ML", 'slug'=>'antiflu_syrup_75_ml_units','pseudoId'=>'antiflu_syrup_75_ml_value'] ]; @endphp @php // echo "
"; // print_r($submitted_formdata); // echo "
"; $skuData = []; foreach($questions as $q){ if($q->code === 'sku'){ foreach($q->options as $opt){ $skuData[$opt->value] = $opt->submitted_value ?? 0; } } } @endphp
@if(Session::has('error'))
{{Session::get('error')}}
@endif @if(session('success'))
{{ session('success') }}
@endif
{{$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) && $form->manager_can_submit == true)
Select User / Territory
*
-- Select --
@foreach($form->users as $option)
value) && $question->value == $option->value ? 'selected':''}}> {{$option->display}}
@endforeach
@endif @foreach($questions as $question) @if (in_array($question->code, ['record_date', 'attendence','honorarium_amount','other_expenses','total_eas','no_of_patients_on_duolin','no_of_units_duolin_respules'])) @continue @endif
{{$question->question}} {!!$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)?$question->value:0}}"> @break @case('textarea')
required == 'yes'?'required':'' }}>{{isset($question->value)?$question->value:''}}
@break @case('dropdown')
required == 'yes' ? 'required' : '' }}>
-- Select --
@if ($question->code == 'name_of_the_speaker') @foreach ($question->options as $option) @if(!isset($option->value)) @continue @endif @if(isset($option->contact->doctor_activities_for_neb_2_top_30_next_30_doctors) && $option->contact->doctor_activities_for_neb_2_top_30_next_30_doctors == 'Yes')
value) && $question->value == $option->value ? 'selected' : '' }} msl_code="{{ isset($option->contact->msl_code) ? $option->contact->msl_code : '' }}" speciality="{{ isset($option->contact->speciality) ? $option->contact->speciality : '' }}"> {{ $option->display ?? '' }}
@endif @endforeach
value) && $question->value == 'other' ? 'selected' : '' }}>Other
@elseif ($question->code == 'other_speaker_name') @foreach ($question->options as $option) @if(!isset($option->value)) @continue @endif @if(!isset($option->contact->doctor_activities_for_neb_2_top_30_next_30_doctors) || $option->contact->doctor_activities_for_neb_2_top_30_next_30_doctors === null )
value) && $question->value == $option->value ? 'selected' : '' }} msl_code="{{ isset($option->contact->msl_code) ? $option->contact->msl_code : '' }}" speciality="{{ isset($option->contact->speciality) ? $option->contact->speciality : '' }}"> {{ $option->display ?? '' }}
@endif @endforeach @else @foreach ($question->options as $option) @if(!isset($option->value)) @continue @endif
value) && $question->value == $option->value ? 'selected' : '' }} msl_code="{{ isset($option->contact) && isset($option->contact->msl_code) ? $option->contact->msl_code : '' }}" speciality="{{ isset($option->contact) && isset($option->contact->speciality) ? $option->contact->speciality : '' }}"> {{ $option->display ?? '' }}
@endforeach @endif
@break @case('checkbox') @foreach($question->options as $option) @if(!isset($option->value)) @continue @endif
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')
Brand
Units
Value
@foreach($brandData as $brand) @php //$unitVal = $skuData[$brand['slug']] ?? 0; $unitVal = $submitted_formdata->{$brand['slug']} ?? 0; $valueVal = $submitted_formdata->{$brand['pseudoId']} ?? 0; @endphp
{{ $brand['brand'] }}
@endforeach
@break @endswitch
@endforeach @if(!isset($form->is_approval) || (isset($form->is_approval) && $form->is_approval != 'yes' ) )
Submit
@endif
@include('layouts.shared/footer-script')
