Rapport-Laravel/resources/views/form/rapport-acute/1699022221-0f75f486-2649-4e...

1144 lines
75 KiB
PHP

<!DOCTYPE html>
<html lang="en">
<head>
@include('layouts.shared/title-meta', ['title' => 'Form'])
@include('layouts.shared/head-css', ['mode' => $mode ?? '', 'demo' => $demo ?? ''])
<link href="{{ asset('assets/libs/sweetalert2/sweetalert2.min.css') }}" rel="stylesheet" type="text/css" />
<link href="{{ asset('assets/libs/flatpickr/flatpickr.min.css') }}" rel="stylesheet" type="text/css" />
</head>
<div id="pageloader">
<img src="/images/loader-large.gif" alt="processing..." />
</div>
<body class="loading">
<div class="account-pages">
<div class="container">
<div class="row justify-content-center">
<div class="col-md-8 col-lg-6 col-xl-5 p-0">
<div class="card">
<div class="card-body p-3 row">
@if (Session::has('error'))
<div class="alert alert-danger">{{ Session::get('error') }}</div>
<br>
@endif
@if (session('success'))
<div class=" alert alert-success">{{ session('success') }}
</div>
<br>
@endif
<div class="col-8">
<h4 class="page-title">Activity Form</h4>
</div>
@if (!isset($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> -->
<button type="button" class="btn btn-primary btn-xs" id="add-camp-btn">Add
Plan</button>
@else
<a href="{{ url()->previous() }}" class="float-end pt-1">Back</a>
@endif
</div>
@endif
@php
$history = Formhelper::getMultiformData($form->partition, $form->form_id, $form->user_id);
// echo "<pre>";
// print_r($history);
@endphp
<div class="col-12" id="table-wrapper">
<div class="table-responsive">
<table class="table table-borderless table-nowrap table-hover table-centered m-0">
<thead class="table-light">
<tr>
<th>Action</th>
<th>Plan Date</th>
<th>Executed Date</th>
<th>Doctor Name</th>
<th>Speciality</th>
<th>Dr part of SuperQ310</th>
<th>Activity</th>
<th>Activity 2</th>
<th>Cheston-D Cough Syrup 100 ML Rx</th>
<th>Cheston-D Cough Syrup 100 ML POB</th>
<th>Cheston-D Plus 1 x 10'S Rx</th>
<th>Cheston-D Plus 1 x 10'S POB</th>
<th>Cheston-LS Cough Syrup 100 ML Rx</th>
<th>Cheston-LS Cough Syrup 100 ML POB</th>
<th>Cheston-LS Junior 60 ML Rx</th>
<th>Cheston-LS Junior 60 ML POB</th>
<th>EMESET SYRUP STRAWBERRY 30 ML Rx</th>
<th>EMESET SYRUP STRAWBERRY 30 ML POB</th>
<th>Emeset-MD 4mg Tablets 10's Rx</th>
<th>Emeset-MD 4mg Tablets 10's POB</th>
<th>Emeset 4 ODT/India/1 X 10'S Rx</th>
<th>Emeset 4 ODT/India/1 X 10'S POB</th>
<th>Emeset MD 4 (1 x 10'S) Rx</th>
<th>Emeset MD 4 (1 x 10'S) POB</th>
<th>EMESET 4MG (10'S) Rx</th>
<th>EMESET 4MG (10'S) POB</th>
<th>EMESET 8MG (10'S) Rx</th>
<th>EMESET 8MG (10'S) POB</th>
<th>EMESET- 8 MG TABLETS 1 X 10'S Rx</th>
<th>EMESET- 8 MG TABLETS 1 X 10'S POB</th>
<th>EMESET- 4 MG TABLETS 1 X 10'S Rx</th>
<th>EMESET- 4 MG TABLETS 1 X 10'S POB</th>
<th>EMESET SYRUP Rx</th>
<th>EMESET SYRUP POB</th>
<th>FAROBACT 200 Rx</th>
<th>FAROBACT 200 POB</th>
<th>Farobact 300 ER TABLETS Rx</th>
<th>Farobact 300 ER TABLETS POB</th>
<th>FAROBACT 200 TABS 1 x 10 S Rx</th>
<th>FAROBACT 200 TABS 1 x 10 S POB</th>
<th>FAROBACT 300 ER TABS 10 S Rx</th>
<th>FAROBACT 300 ER TABS 10 S POB</th>
<th>Farobact Dry Syrup Rx</th>
<th>Farobact Dry Syrup POB</th>
<th>NOVAMOX CV 625 TABLETS 10 Rx</th>
<th>NOVAMOX CV 625 TABLETS 10 POB</th>
<th>Novamox-CV 625 Tablets 1 x10'S Rx</th>
<th>Novamox-CV 625 Tablets 1 x10'S POB</th>
<th>NOVAMOX CV 1000 MG Rx</th>
<th>NOVAMOX CV 1000 MG POB</th>
<th>Novamox CV ES Rx</th>
<th>Novamox CV ES POB</th>
<th>NOVAMOX CV DROPS Rx</th>
<th>NOVAMOX CV DROPS POB</th>
<th>NOVAMOX CV DS Rx</th>
<th>NOVAMOX CV DS POB</th>
<th>NOVAMOX CV FORTE SYP Rx</th>
<th>NOVAMOX CV FORTE SYP POB</th>
<th>NOVAMOX CV 375 TAB 1 Rx</th>
<th>NOVAMOX CV 375 TAB 1 POB</th>
<th>Novamox CV Forte Syp 60 ml Rx</th>
<th>Novamox CV Forte Syp 60 ml POB</th>
<th>NOVAMOX CV 375 TAB 10s Rx</th>
<th>NOVAMOX CV 375 TAB 10s POB</th>
<th>Novamox CV Dry Syrup 30 ML Rx</th>
<th>Novamox CV Dry Syrup 30 ML POB</th>
<th>Novamox CV Forte Syrup 30 ML Rx</th>
<th>Novamox CV Forte Syrup 30 ML POB</th>
<th>NOVAMOX CV 45 Rx</th>
<th>NOVAMOX CV 45 POB</th>
<th>OFLOX OZ T Rx</th>
<th>OFLOX OZ T POB</th>
<th>PANSEC TABLETS 15'S Rx</th>
<th>PANSEC TABLETS 15'S POB</th>
<th>PANSEC 40 Tablets 1 x 15'S Rx</th>
<th>PANSEC 40 Tablets 1 x 15'S POB</th>
<th>Pansec 80 M Rx</th>
<th>Pansec 80 M POB</th>
<th>PANSEC D SR CAPSULES 15'S Rx</th>
<th>PANSEC D SR CAPSULES 15'S POB</th>
<th>PANSEC-L CAPSULES Rx</th>
<th>PANSEC-L CAPSULES POB</th>
<th>UnoBiotics Junior Rx</th>
<th>UnoBiotics Junior POB</th>
<th>UNOBIOTICS SB Rx</th>
<th>UNOBIOTICS SB POB</th>
</tr>
</thead>
<tbody>
@foreach ($history->data->submissions as $sub)
@php
$sub->formdata->id = $sub->id;
@endphp
<tr>
<td>
<button type="button" class="btn btn-xs btn-info edit-btn"
plan_details="{{ json_encode($sub->formdata) }}"><i
class="mdi mdi-pencil"></i> Edit</button>
</td>
<td>{{ $sub->formdata->plan_date }}
</td>
<td>{{ isset($sub->formdata->execution_date) ? $sub->formdata->execution_date : '' }}
</td>
<td>
<h5 class="m-0 fw-normal">
{{ isset($sub->formdata->contact_id) ? $sub->formdata->contact_id : '' }}
</h5>
</td>
<td>{{ isset($sub->formdata->speciality) ? $sub->formdata->speciality : '' }}
</td>
<td>{{ isset($sub->formdata->dr_part_of_super_q310) ? $sub->formdata->dr_part_of_super_q310 : '' }}
<td>{{ isset($sub->formdata->activity) ? $sub->formdata->activity : '' }}
</td>
<td>{{ isset($sub->formdata->activity) ? $sub->formdata->activity_2 : '' }}
</td>
<td>
{{ isset($sub->formdata->cheston_d_cough_syrup_100_ml_rx) ? $sub->formdata->cheston_d_cough_syrup_100_ml_rx : '' }}
</td>
<td>
{{ isset($sub->formdata->cheston_d_cough_syrup_100_ml_pob) ? $sub->formdata->cheston_d_cough_syrup_100_ml_pob : '' }}
</td>
<td>
{{ isset($sub->formdata->cheston_d_plus_1_x_10s_rx) ? $sub->formdata->cheston_d_plus_1_x_10s_rx : '' }}
</td>
<td>
{{ isset($sub->formdata->cheston_d_plus_1_x_10s_pob) ? $sub->formdata->cheston_d_plus_1_x_10s_pob : '' }}
</td>
<td> {{ isset($sub->formdata->cheston_ls_cough_syrup_100_ml_rx) ? $sub->formdata->cheston_ls_cough_syrup_100_ml_rx : '' }}
</td>
<td> {{ isset($sub->formdata->cheston_ls_cough_syrup_100_ml_pob) ? $sub->formdata->cheston_ls_cough_syrup_100_ml_pob : '' }}
</td>
<td> {{ isset($sub->formdata->cheston_ls_junior_60_ml_rx) ? $sub->formdata->cheston_ls_junior_60_ml_rx : '' }}
</td>
<td> {{ isset($sub->formdata->cheston_ls_junior_60_ml_pob) ? $sub->formdata->cheston_ls_junior_60_ml_pob : '' }}
</td>
<td> {{ isset($sub->formdata->emeset_syrup_strawberry_30_ml_rx) ? $sub->formdata->emeset_syrup_strawberry_30_ml_rx : '' }}
</td>
<td> {{ isset($sub->formdata->emeset_syrup_strawberry_30_ml_pob) ? $sub->formdata->emeset_syrup_strawberry_30_ml_pob : '' }}
</td>
<td> {{ isset($sub->formdata->emeset_md_4mg_tablets_10s_rx) ? $sub->formdata->emeset_md_4mg_tablets_10s_rx : '' }}
</td>
<td> {{ isset($sub->formdata->emeset_md_4mg_tablets_10s_pob) ? $sub->formdata->emeset_md_4mg_tablets_10s_pob : '' }}
</td>
<td> {{ isset($sub->formdata->emeset_4_odtindia1_x_10s_rx) ? $sub->formdata->emeset_4_odtindia1_x_10s_rx : '' }}
</td>
<td> {{ isset($sub->formdata->emeset_4_odtindia1_x_10s_pob) ? $sub->formdata->emeset_4_odtindia1_x_10s_pob : '' }}
</td>
<td> {{ isset($sub->formdata->emeset_md_4_1_x_10s_rx) ? $sub->formdata->emeset_md_4_1_x_10s_rx : '' }}
</td>
<td> {{ isset($sub->formdata->emeset_md_4_1_x_10s_pob) ? $sub->formdata->emeset_md_4_1_x_10s_pob : '' }}
</td>
<td> {{ isset($sub->formdata->emeset_4mg_10s_rx) ? $sub->formdata->emeset_4mg_10s_rx : '' }}
</td>
<td> {{ isset($sub->formdata->emeset_4mg_10s_pob) ? $sub->formdata->emeset_4mg_10s_pob : '' }}
</td>
<td> {{ isset($sub->formdata->emeset_8mg_10s_rx) ? $sub->formdata->emeset_8mg_10s_rx : '' }}
</td>
<td> {{ isset($sub->formdata->emeset_8mg_10s_pob) ? $sub->formdata->emeset_8mg_10s_pob : '' }}
</td>
<td> {{ isset($sub->formdata->emeset_8_mg_tablets_1_x_10s_rx) ? $sub->formdata->emeset_8_mg_tablets_1_x_10s_rx : '' }}
</td>
<td> {{ isset($sub->formdata->emeset_8_mg_tablets_1_x_10s_pob) ? $sub->formdata->emeset_8_mg_tablets_1_x_10s_pob : '' }}
</td>
<td> {{ isset($sub->formdata->emeset_4_mg_tablets_1_x_10s_rx) ? $sub->formdata->emeset_4_mg_tablets_1_x_10s_rx : '' }}
</td>
<td> {{ isset($sub->formdata->emeset_4_mg_tablets_1_x_10s_pob) ? $sub->formdata->emeset_4_mg_tablets_1_x_10s_pob : '' }}
</td>
<td> {{ isset($sub->formdata->emeset_syrup_rx) ? $sub->formdata->emeset_syrup_rx : '' }}
</td>
<td> {{ isset($sub->formdata->emeset_syrup_pob) ? $sub->formdata->emeset_syrup_pob : '' }}
</td>
<td> {{ isset($sub->formdata->farobact_200_rx) ? $sub->formdata->farobact_200_rx : '' }}
</td>
<td> {{ isset($sub->formdata->farobact_200_pob) ? $sub->formdata->farobact_200_pob : '' }}
</td>
<td> {{ isset($sub->formdata->farobact_300_er_tablets_rx) ? $sub->formdata->farobact_300_er_tablets_rx : '' }}
</td>
<td> {{ isset($sub->formdata->farobact_300_er_tablets_pob) ? $sub->formdata->farobact_300_er_tablets_pob : '' }}
</td>
<td> {{ isset($sub->formdata->farobact_200_tabs_1_x_10_s_rx) ? $sub->formdata->farobact_200_tabs_1_x_10_s_rx : '' }}
</td>
<td> {{ isset($sub->formdata->farobact_200_tabs_1_x_10_s_pob) ? $sub->formdata->farobact_200_tabs_1_x_10_s_pob : '' }}
</td>
<td> {{ isset($sub->formdata->farobact_300_er_tabs_10_s_rx) ? $sub->formdata->farobact_300_er_tabs_10_s_rx : '' }}
</td>
<td> {{ isset($sub->formdata->farobact_300_er_tabs_10_s_pob) ? $sub->formdata->farobact_300_er_tabs_10_s_pob : '' }}
</td>
<td> {{ isset($sub->formdata->farobact_dry_syrup_rx) ? $sub->formdata->farobact_dry_syrup_rx : '' }}
</td>
<td> {{ isset($sub->formdata->farobact_dry_syrup_pob) ? $sub->formdata->farobact_dry_syrup_pob : '' }}
</td>
<td> {{ isset($sub->formdata->novamox_cv_625_tablets_10_rx) ? $sub->formdata->novamox_cv_625_tablets_10_rx : '' }}
</td>
<td> {{ isset($sub->formdata->novamox_cv_625_tablets_10_pob) ? $sub->formdata->novamox_cv_625_tablets_10_pob : '' }}
</td>
<td> {{ isset($sub->formdata->novamox_cv_625_tablets_1_x10s_rx) ? $sub->formdata->novamox_cv_625_tablets_1_x10s_rx : '' }}
</td>
<td> {{ isset($sub->formdata->novamox_cv_625_tablets_1_x10s_pob) ? $sub->formdata->novamox_cv_625_tablets_1_x10s_pob : '' }}
</td>
<td> {{ isset($sub->formdata->novamox_cv_1000_mg_rx) ? $sub->formdata->novamox_cv_1000_mg_rx : '' }}
</td>
<td> {{ isset($sub->formdata->novamox_cv_1000_mg_pob) ? $sub->formdata->novamox_cv_1000_mg_pob : '' }}
</td>
<td> {{ isset($sub->formdata->novamox_cv_es_rx) ? $sub->formdata->novamox_cv_es_rx : '' }}
</td>
<td> {{ isset($sub->formdata->novamox_cv_es_pob) ? $sub->formdata->novamox_cv_es_pob : '' }}
</td>
<td> {{ isset($sub->formdata->novamox_cv_drops_rx) ? $sub->formdata->novamox_cv_drops_rx : '' }}
</td>
<td> {{ isset($sub->formdata->novamox_cv_drops_pob) ? $sub->formdata->novamox_cv_drops_pob : '' }}
</td>
<td> {{ isset($sub->formdata->novamox_cv_ds_rx) ? $sub->formdata->novamox_cv_ds_rx : '' }}
</td>
<td> {{ isset($sub->formdata->novamox_cv_ds_pob) ? $sub->formdata->novamox_cv_ds_pob : '' }}
</td>
<td> {{ isset($sub->formdata->novamox_cv_forte_syp_rx) ? $sub->formdata->novamox_cv_forte_syp_rx : '' }}
</td>
<td> {{ isset($sub->formdata->novamox_cv_forte_syp_pob) ? $sub->formdata->novamox_cv_forte_syp_pob : '' }}
</td>
<td> {{ isset($sub->formdata->novamox_cv_375_tab_1_rx) ? $sub->formdata->novamox_cv_375_tab_1_rx : '' }}
</td>
<td> {{ isset($sub->formdata->novamox_cv_375_tab_1_pob) ? $sub->formdata->novamox_cv_375_tab_1_pob : '' }}
</td>
<td> {{ isset($sub->formdata->novamox_cv_forte_syp_60_ml_rx) ? $sub->formdata->novamox_cv_forte_syp_60_ml_rx : '' }}
</td>
<td> {{ isset($sub->formdata->novamox_cv_forte_syp_60_ml_pob) ? $sub->formdata->novamox_cv_forte_syp_60_ml_pob : '' }}
</td>
<td> {{ isset($sub->formdata->novamox_cv_375_tab_10s_rx) ? $sub->formdata->novamox_cv_375_tab_10s_rx : '' }}
</td>
<td> {{ isset($sub->formdata->novamox_cv_375_tab_10s_pob) ? $sub->formdata->novamox_cv_375_tab_10s_pob : '' }}
</td>
<td> {{ isset($sub->formdata->novamox_cv_dry_syrup_30_ml_rx) ? $sub->formdata->novamox_cv_dry_syrup_30_ml_rx : '' }}
</td>
<td> {{ isset($sub->formdata->novamox_cv_dry_syrup_30_ml_pob) ? $sub->formdata->novamox_cv_dry_syrup_30_ml_pob : '' }}
</td>
<td> {{ isset($sub->formdata->novamox_cv_forte_syrup_30_ml_rx) ? $sub->formdata->novamox_cv_forte_syrup_30_ml_rx : '' }}
</td>
<td> {{ isset($sub->formdata->novamox_cv_forte_syrup_30_ml_pob) ? $sub->formdata->novamox_cv_forte_syrup_30_ml_pob : '' }}
</td>
<td> {{ isset($sub->formdata->novamox_cv_457_dt_10s_rx) ? $sub->formdata->novamox_cv_457_dt_10s_rx : '' }}
</td>
<td> {{ isset($sub->formdata->novamox_cv_457_dt_10s_pob) ? $sub->formdata->novamox_cv_457_dt_10s_pob : '' }}
</td>
<td> {{ isset($sub->formdata->oflox_oz_tablets_ip_rx) ? $sub->formdata->oflox_oz_tablets_ip_rx : '' }}
</td>
<td> {{ isset($sub->formdata->oflox_oz_tablets_ip_pob) ? $sub->formdata->oflox_oz_tablets_ip_pob : '' }}
</td>
<td> {{ isset($sub->formdata->pansec_tablets_15s_rx) ? $sub->formdata->pansec_tablets_15s_rx : '' }}
</td>
<td> {{ isset($sub->formdata->pansec_tablets_15s_pob) ? $sub->formdata->pansec_tablets_15s_pob : '' }}
</td>
<td> {{ isset($sub->formdata->pansec_40_tablets_1_x_15s_rx) ? $sub->formdata->pansec_40_tablets_1_x_15s_rx : '' }}
</td>
<td> {{ isset($sub->formdata->pansec_40_tablets_1_x_15s_pob) ? $sub->formdata->pansec_40_tablets_1_x_15s_pob : '' }}
</td>
<td> {{ isset($sub->formdata->pansec_80_mg_tablets_rx) ? $sub->formdata->pansec_80_mg_tablets_rx : '' }}
</td>
<td> {{ isset($sub->formdata->pansec_80_mg_tablets_pob) ? $sub->formdata->pansec_80_mg_tablets_pob : '' }}
</td>
<td> {{ isset($sub->formdata->pansec_d_sr_capsules_15s_rx) ? $sub->formdata->pansec_d_sr_capsules_15s_rx : '' }}
</td>
<td> {{ isset($sub->formdata->pansec_d_sr_capsules_15s_pob) ? $sub->formdata->pansec_d_sr_capsules_15s_pob : '' }}
</td>
<td> {{ isset($sub->formdata->pansec_l_capsules_rx) ? $sub->formdata->pansec_l_capsules_rx : '' }}
</td>
<td> {{ isset($sub->formdata->pansec_l_capsules_pob) ? $sub->formdata->pansec_l_capsules_pob : '' }}
</td>
<td> {{ isset($sub->formdata->unobiotics_junior_rx) ? $sub->formdata->unobiotics_junior_rx : '' }}
</td>
<td> {{ isset($sub->formdata->unobiotics_junior_pob) ? $sub->formdata->unobiotics_junior_pob : '' }}
</td>
<td> {{ isset($sub->formdata->unobiotics_sb_rx) ? $sub->formdata->unobiotics_sb_rx : '' }}
</td>
<td> {{ isset($sub->formdata->unobiotics_sb_pob) ? $sub->formdata->unobiotics_sb_pob : '' }}
</td>
</tr>
@endforeach
</tbody>
</table>
</div>
</div>
<div id="form-wrapper">
<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="{{ $id }}">
@endif
@foreach ($questions as $question)
@if (in_array($question->code, [
'execution_date',
'activity',
'activity_2',
'tgt_brand_1',
'tgt_brand_2',
'pob_units_brand_1',
'pob_units_brand_2',
'brand_1',
'brand_1_rx',
'brand_1_pob',
'brand_2',
'brand_2_rx',
'brand_2_pob',
]))
@continue
@endif
<div class="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')
<input type="{{ $question->type }}" id="field-{{ $question->code }}"
name="{{ $question->code }}" class="form-control"
{{ $question->required == 'yes' ? 'required' : '' }}
{{ $question->code == 'camp_date' ? 'min="' . date('Y-m-d', strtotime('now') + 604800) . '"' : '' }}
value="{{ isset($question->value) ? $question->value : '' }}">
@break
@case('date')
<input type="{{ $question->type }}" id="field-{{ $question->code }}"
name="{{ $question->code }}" class="form-control datepicker"
{{ $question->required == 'yes' ? 'required' : '' }}
value="{{ isset($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' : '' }}
{{ $question->code == 'contact_id' ? ' msl_code=' . $option->contact->msl_code . ' speciality=' . $option->contact->speciality : '' }}>
{{ $option->display }}</option>
@endforeach
</select>
@break
@case('checkbox')
@foreach ($question->options as $option)
<div class="form-check mb-2 form-check-primary">
<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')
<input type="file" id="field-{{ $question->code }}"
name="{{ $question->code }}" class="form-control" value=""
accept="image/jpg, image/jpeg, image/png" required>
@break
@endswitch
</div>
@endforeach
@if (!isset($form->is_approval) || (isset($form->is_approval) && $form->is_approval != 'yes'))
<div class="text-center d-grid mt-3">
<button class="btn btn-primary" type="submit" id="submit-btn"> Submit
</button>
</div>
@endif
</form>
</div>
<div id="execution-form-wrapper">
<form method="POST" action="/form/submit" id="execution-form"
enctype="multipart/form-data">
<input type="hidden" id="target_1_rx" name="" value="0">
<input type="hidden" id="target_1_pob" name="" value="0">
<input type="hidden" id="target_2_rx" name="" value="0">
<input type="hidden" id="target_2_pob" name="" value="0">
<input type="hidden" name="form_id" value="{{ $form_id }}">
@csrf
<input type="hidden" name="id" value="" id="execution-id">
@foreach ($questions as $question)
@if (in_array($question->code, ['brand_1', 'brand_1_rx', 'brand_1_pob', 'brand_2', 'brand_2_rx', 'brand_2_pob']))
@continue
@endif
<div class="col-md-12 mb-2">
<label for="execution-{{ $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="execution-{{ $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="execution-{{ $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="execution-{{ $question->code }}"
name="{{ $question->code }}" class="form-control"
{{ $question->required == 'yes' ? 'required' : '' }}
value="{{ isset($question->value) ? $question->value : 0 }}">
@break
@case('textarea')
<textarea id="execution-{{ $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="execution-{{ $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' : '' }}>
{{ $option->display }}</option>
@endforeach
</select>
@break
@case('checkbox')
@foreach ($question->options as $option)
<div class="form-check mb-2 form-check-primary">
<input class="form-check-input" type="checkbox"
id="execution-{{ $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="execution-{{ $question->code }}-{{ $option->value }}">{{ $option->display }}</label>
</div>
@endforeach
@break
@case('file')
<input type="file" id="execution-{{ $question->code }}"
name="{{ $question->code }}" class="form-control" value=""
accept="image/jpg, image/jpeg, image/png"
{{ $question->required == 'yes' ? 'required' : '' }}>
@break
@endswitch
</div>
@endforeach
<table>
<tbody>
<tr>
<td>
<label for="brand_1" class="form-label">Target Brand 1<span
class="text-danger">*</span>
</label>
<select id="brand_1" name="brand_1" class="form-control">
<option value="">--select--</option>
<option value="cheston_d_cough_syrup_100_ml">Cheston-D Cough
Syrup 100 ML</option>
<option value="cheston_d_plus_1_x_10s">Cheston-D Plus 1 x 10'S
</option>
<option value="cheston_ls_cough_syrup_100_ml">Cheston-LS Cough
Syrup 100 ML</option>
<option value="cheston_ls_junior_60_ml">Cheston-LS Junior 60 ML
</option>
<option value="emeset_syrup_strawberry_30_ml">EMESET SYRUP
STRAWBERRY 30 ML</option>
<option value="emeset_md_4mg_tablets_10s">Emeset-MD 4mg Tablets
10's</option>
<option value="emeset_4_odtindia1_x_10s">Emeset 4 ODT/India/1 X
10'S</option>
<option value="emeset_md_4_1_x_10s">Emeset MD 4 (1 x 10'S)
</option>
<option value="emeset_4mg_10s">EMESET 4MG (10'S)</option>
<option value="emeset_8mg_10s">EMESET 8MG (10'S)</option>
<option value="emeset_8_mg_tablets_1_x_10s">EMESET- 8 MG
TABLETS 1 X 10'S</option>
<option value="emeset_4_mg_tablets_1_x_10s">EMESET- 4 MG
TABLETS 1 X 10'S</option>
<option value="emeset_syrup">EMESET SYRUP</option>
<option value="farobact_200">FAROBACT 200</option>
<option value="farobact_300_er_tablets">Farobact 300 ER TABLETS
</option>
<option value="farobact_200_tabs_1_x_10_s">FAROBACT 200 TABS 1
x 10 S</option>
<option value="farobact_300_er_tabs_10_s">FAROBACT 300 ER TABS
10 S</option>
<option value="farobact_dry_syrup">Farobact Dry Syrup</option>
<option value="novamox_cv_625_tablets_10">NOVAMOX CV 625
TABLETS 10</option>
<option value="novamox-cv_625_tablets_1_x10s">Novamox-CV 625
Tablets 1 x10'S</option>
<option value="novamox_cv_1000_mg">NOVAMOX CV 1000 MG</option>
<option value="novamox_cv_es">Novamox CV ES</option>
<option value="novamox_cv_drops">NOVAMOX CV DROPS</option>
<option value="novamox_cv_ds">NOVAMOX CV DS</option>
<option value="novamox_cv_forte_syp">NOVAMOX CV FORTE SYP
</option>
<option value="novamox_cv_375_tab_1">NOVAMOX CV 375 TAB 1
</option>
<option value="novamox_cv_forte_syp_60_ml">Novamox CV Forte Syp
60 ml</option>
<option value="novamox_cv_375_tab_10s">NOVAMOX CV 375 TAB 10s
</option>
<option value="novamox_cv_dry_syrup_30_ml">Novamox CV Dry Syrup
30 ML</option>
<option value="novamox_cv_forte_syrup_30_ml">Novamox CV Forte
Syrup 30 ML</option>
<option value="novamox_cv_457_dt_10s">NOVAMOX CV 457 DT 10's
</option>
<option value="oflox_oz_tablets_ip">OFLOX OZ TABLETS IP
</option>
<option value="pansec_tablets_15s">PANSEC TABLETS 15'S</option>
<option value="pansec_40_tablets_1_x_15s">PANSEC 40 Tablets 1 x
15'S</option>
<option value="pansec_80_mg_tablets">Pansec 80 MG Tablets
</option>
<option value="pansec_d_sr_capsules_15s">PANSEC D SR CAPSULES
15'S</option>
<option value="pansec_l_capsules">PANSEC-L CAPSULES</option>
<option value="unobiotics_junior">UnoBiotics Junior</option>
<option value="unobiotics_sb">UNOBIOTICS SB</option>
</select>
</td>
<td>
<label for="Rx" class="form-label">Rx<span
class="text-danger">*</span>
</label>
<input type="number" class="form-control" id="brand_1_rx"
name="brand_1_rx" placeholder="Enter Rx" value="">
</td>
<td>
<label for="POB" class="form-label">POB Units<span
class="text-danger">*</span>
</label>
<input type="number" class="form-control" id="brand_1_pob"
name="brand_1_pob" placeholder="Enter POB" value="">
</td>
</tr>
<tr>
<td>
<label for="brand_2" class="form-label">Target Brand 2<span
class="text-danger">*</span>
<select id="brand_2" name="brand_2" class="form-control">
<option value="">--select--</option>
<option value="cheston_d_cough_syrup_100_ml">Cheston-D
Cough
Syrup 100 ML</option>
<option value="cheston_d_plus_1_x_10s">Cheston-D Plus 1 x
10'S
</option>
<option value="cheston_ls_cough_syrup_100_ml">Cheston-LS
Cough
Syrup 100 ML</option>
<option value="cheston_ls_junior_60_ml">Cheston-LS Junior
60 ML
</option>
<option value="emeset_syrup_strawberry_30_ml">EMESET SYRUP
STRAWBERRY 30 ML</option>
<option value="emeset_md_4mg_tablets_10s">Emeset-MD 4mg
Tablets
10's</option>
<option value="emeset_4_odtindia1_x_10s">Emeset 4
ODT/India/1 X
10'S</option>
<option value="emeset_md_4_1_x_10s">Emeset MD 4 (1 x 10'S)
</option>
<option value="emeset_4mg_10s">EMESET 4MG (10'S)</option>
<option value="emeset_8mg_10s">EMESET 8MG (10'S)</option>
<option value="emeset_8_mg_tablets_1_x_10s">EMESET- 8 MG
TABLETS 1 X 10'S</option>
<option value="emeset_4_mg_tablets_1_x_10s">EMESET- 4 MG
TABLETS 1 X 10'S</option>
<option value="emeset_syrup">EMESET SYRUP</option>
<option value="farobact_200">FAROBACT 200</option>
<option value="farobact_300_er_tablets">Farobact 300 ER
TABLETS
</option>
<option value="farobact_200_tabs_1_x_10_s">FAROBACT 200
TABS 1
x 10 S</option>
<option value="farobact_300_er_tabs_10_s">FAROBACT 300 ER
TABS
10 S</option>
<option value="farobact_dry_syrup">Farobact Dry Syrup
</option>
<option value="novamox_cv_625_tablets_10">NOVAMOX CV 625
TABLETS 10</option>
<option value="novamox-cv_625_tablets_1_x10s">Novamox-CV
625
Tablets 1 x10'S</option>
<option value="novamox_cv_1000_mg">NOVAMOX CV 1000 MG
</option>
<option value="novamox_cv_es">Novamox CV ES</option>
<option value="novamox_cv_drops">NOVAMOX CV DROPS</option>
<option value="novamox_cv_ds">NOVAMOX CV DS</option>
<option value="novamox_cv_forte_syp">NOVAMOX CV FORTE SYP
</option>
<option value="novamox_cv_375_tab_1">NOVAMOX CV 375 TAB 1
</option>
<option value="novamox_cv_forte_syp_60_ml">Novamox CV Forte
Syp
60 ml</option>
<option value="novamox_cv_375_tab_10s">NOVAMOX CV 375 TAB
10s
</option>
<option value="novamox_cv_dry_syrup_30_ml">Novamox CV Dry
Syrup
30 ML</option>
<option value="novamox_cv_forte_syrup_30_ml">Novamox CV
Forte
Syrup 30 ML</option>
<option value="novamox_cv_457_dt_10s">NOVAMOX CV 457 DT
10's
</option>
<option value="oflox_oz_tablets_ip">OFLOX OZ TABLETS IP
</option>
<option value="pansec_tablets_15s">PANSEC TABLETS 15'S
</option>
<option value="pansec_40_tablets_1_x_15s">PANSEC 40 Tablets
1 x
15'S</option>
<option value="pansec_80_mg_tablets">Pansec 80 MG Tablets
</option>
<option value="pansec_d_sr_capsules_15s">PANSEC D SR
CAPSULES
15'S</option>
<option value="pansec_l_capsules">PANSEC-L CAPSULES
</option>
<option value="unobiotics_junior">UnoBiotics Junior
</option>
<option value="unobiotics_sb">UNOBIOTICS SB</option>
</select>
</td>
<td>
<label for="Rx" class="form-label">Rx<span
class="text-danger">*</span>
</label>
<input type="number" class="form-control" id="brand_2_rx"
name="brand_2_rx" placeholder="Enter Rx" value="">
</td>
<td>
<label for="POB" class="form-label">POB Units<span
class="text-danger">*</span>
</label>
<input type="number" class="form-control" id="brand_2_pob"
name="brand_2_pob" placeholder="Enter POB" value="">
</td>
</tr>
</tbody>
</table>
@if (!isset($form->is_approval) || (isset($form->is_approval) && $form->is_approval != 'yes'))
<div class="text-center d-grid mt-3">
<button class="btn btn-primary" type="submit" id="submit-btn"> Submit
</button>
</div>
@endif
</form>
</div>
</div> <!-- end card-body -->
</div>
<!-- end card -->
<!-- end row -->
</div> <!-- end col -->
</div>
<!-- end row -->
</div>
<!-- end container -->
</div>
<!-- end page -->
<style type="text/css">
#pageloader {
background: rgba(255, 255, 255, 0.8);
display: none;
height: 100%;
position: fixed;
width: 100%;
z-index: 9999;
}
#pageloader img {
left: 50%;
margin-left: -32px;
margin-top: -32px;
position: absolute;
top: 50%;
}
</style>
@include('layouts.shared/footer-script')
<script src="{{ asset('assets/libs/sweetalert2/sweetalert2.min.js') }}"></script>
<script src="{{ asset('assets/libs/flatpickr/flatpickr.min.js') }}"></script>
<script type="text/javascript">
jQuery(document).ready(function($) {
$('#form-wrapper').hide()
$('#execution-form-wrapper').hide()
$('#add-camp-btn').click(function() {
$('#execution-form-wrapper').hide()
$('#form-wrapper').show()
$('#table-wrapper').hide()
})
$('#field-msl_code').prop('readonly', true)
$('#field-contact_id').change(function() {
$('#field-msl_code').val($('option:selected', this).attr('msl_code'))
$('#field-speciality').val($('option:selected', this).attr('speciality'))
})
$('.edit-btn').click(function() {
let selected = JSON.parse($(this).attr('plan_details'))
for (let k of Object.keys(selected)) {
if (selected[k] != '') {
if (k == 'attach_prescription')
continue;
if (k == 'contact_id')
$('#execution-contact_id')
.val($("#execution-contact_id option:contains(" + selected[k] + ")")
.attr('value'))
.trigger('change');
else
$('#execution-' + k).val(selected[k]);
}
}
$('#execution-contact_id').prop('disabled', true)
$('#execution-id').val(selected['id'])
$('#execution-form-wrapper').show()
$('#table-wrapper').hide()
})
$('#report-form').on('submit', function(event) {
event.preventDefault();
$("#pageloader").fadeIn();
$.ajax({
type: "POST",
url: '/form/ajaxsubmit',
data: new FormData($('#report-form')[0]),
processData: false,
contentType: false,
success: function(data) {
$("#pageloader").fadeOut();
if (data.status == 'success') {
Swal.fire({
title: 'Great!',
text: 'Your data is successfully submitted!',
icon: 'success'
})
window.location.reload();
//$('#report-form').trigger("reset");
} else {
Swal.fire({
icon: 'error',
title: 'Data not submitted',
text: 'Something went wrong, please try again after some time!'
})
}
},
});
});
$('#execution-form').on('submit', function(event) {
event.preventDefault();
$('#execution-contact_id').prop('disabled', false)
//$('#execution-form').append('contact_id', $('#execution-contact_id').val());
$('#execution-form').append('<input type="hidden" name="contact_id" value="' + $(
'#execution-contact_id').val() + '">')
// $('#execution-form').append('<input type="hidden" name="'+ $('#execution-rx_generated_for_product').val() +'" value="'+ $('#execution-no_of_rx_generated').val() +'">')
//result();
$("#target_1_rx").attr("name", $("#brand_1").val() + "_rx")
$("#target_1_rx").val($("#brand_1_rx").val())
$("#target_1_pob").attr("name", $("#brand_1").val() + "_pob")
$("#target_1_pob").val($("#brand_1_pob").val())
$("#target_2_rx").attr("name", $("#brand_2").val() + "_rx")
$("#target_2_rx").val($("#brand_2_rx").val())
$("#target_2_pob").attr("name", $("#brand_2").val() + "_pob")
$("#target_2_pob").val($("#brand_2_pob").val())
var formData = new FormData($('#execution-form')[0]);
$("#pageloader").fadeIn();
$.ajax({
type: "POST",
url: '/form/ajaxsubmit',
data: formData,
processData: false,
contentType: false,
success: function(data) {
// resetval();
$("#pageloader").fadeOut();
if (data.status == 'success') {
Swal.fire({
title: 'Great!',
text: 'Your data is successfully submitted!',
icon: 'success'
})
window.location.reload();
//$('#report-form').trigger("reset");
} else {
Swal.fire({
icon: 'error',
title: 'Data not submitted',
text: 'Something went wrong, please try again after some time!'
})
}
},
});
});
// var today = new Date();
// var dd = String(today.getDate()).padStart(2, '0');
// var mm = String(today.getMonth() + 1).padStart(2, '0');
// var yyyy = today.getFullYear();
// today = yyyy + '-' + mm + '-' + dd;
// var plandateField = document.getElementById('field-plan_date');
// plandateField.setAttribute('min', today);
// var executionDateField = document.getElementById('execution-plan_date');
// $('.edit-btn').click(function() {
// var executionexeField = document.getElementById('execution-execution_date');
// executionexeField.setAttribute('min', executionDateField.value);
// });
// executionDateField.addEventListener('change', function() {
// console.log('gg');
// var executionexeField = document.getElementById('execution-execution_date');
// executionexeField.setAttribute('min', executionDateField.value);
// });
var optionsToAddClinic = [{
value: '',
text: '-- select --'
},
{
value: 'Silent Reflux Clinic - Device /Manual camps',
text: 'Silent Reflux Clinic - Device /Manual camps'
},
{
value: 'Silent Reflux Clinic - Acidwala Standee / Selfie',
text: 'Silent Reflux Clinic - Acidwala Standee / Selfie'
},
{
value: 'Dentoscope',
text: 'Dentoscope'
}
];
var optionsToAdd3ddemo = [{
value: '',
text: '-- select --'
},
{
value: 'IRSR',
text: 'IRSR'
},
{
value: 'TabinTab',
text: 'TabinTab'
},
{
value: 'NCV Pedia Missing bottle',
text: 'NCV Pedia Missing bottle'
},
{
value: 'Cheston taste',
text: 'Cheston taste'
},
{
value: 'Cheston dye free',
text: 'Cheston dye free'
},
{
value: 'Unobiotics Taste',
text: 'Unobiotics Taste'
},
{
value: 'Emeset bilayer',
text: 'Emeset bilayer'
},
{
value: 'NCV Pouch pack',
text: 'NCV Pouch pack'
}
];
var optionsToAddInclinic = [{
value: '',
text: '-- select --'
},
{
value: 'MBN ipledge : Phase 2',
text: 'MBN ipledge : Phase 2'
},
{
value: 'Force against AMR ipledge 2023',
text: 'Force against AMR ipledge 2023'
}
];
var optionsToAddAcademic = [{
value: '',
text: '-- select --'
},
{
value: 'Minischolar series',
text: 'Minischolar series'
},
{
value: 'Accede RTM',
text: 'Accede RTM'
},
{
value: 'mini FACT',
text: 'mini FACT'
},
{
value: 'i4 workshop',
text: 'i4 workshop'
},
{
value: 'Fusion meets',
text: 'Fusion meets'
},
{
value: 'FACT',
text: 'FACT'
},
{
value: 'PEAP',
text: 'PEAP'
},
{
value: 'Dental Circle',
text: 'Dental Circle'
}
];
$('#execution-activity').on('change', function() {
var $executionActivity2 = $('#execution-activity_2');
$executionActivity2.empty();
if ($(this).val() == 'Clinics / Camps / FB Live') {
$.each(optionsToAddClinic, function(index, option) {
$('#execution-activity_2').append($('<option>', option));
});
} else if ($(this).val() == '3D Demos') {
$.each(optionsToAdd3ddemo, function(index, option) {
$('#execution-activity_2').append($('<option>', option));
});
} else if ($(this).val() == 'Inclinic Activation') {
$.each(optionsToAddInclinic, function(index, option) {
$('#execution-activity_2').append($('<option>', option));
});
} else if ($(this).val() == 'Academic Customer Engagement') {
$.each(optionsToAddAcademic, function(index, option) {
$('#execution-activity_2').append($('<option>', option));
});
}
})
});
</script>
</body>
</html>