260 lines
15 KiB
PHP
260 lines
15 KiB
PHP
<!DOCTYPE html>
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<html lang="en">
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<head>
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@include('layouts.shared/title-meta', ['title' => 'Form'])
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@include('layouts.shared/head-css', ['mode' => $mode ?? '', 'demo' => $demo ?? ''])
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<link href="{{ asset('assets/libs/sweetalert2/sweetalert2.min.css') }}" rel="stylesheet" type="text/css" />
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</head>
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<div id="pageloader">
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<img src="http://cdnjs.cloudflare.com/ajax/libs/semantic-ui/0.16.1/images/loader-large.gif" alt="processing..." />
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</div>
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<body class="loading">
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<div class="account-pages">
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<div class="container">
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<div class="row justify-content-center">
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<div class="col-md-8 col-lg-6 col-xl-5 p-0">
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<div class="card bg-pattern">
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<div class="card-body p-3 row">
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@if (Session::has('error'))
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<div class="alert alert-danger">{{ Session::get('error') }}</div>
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<br>
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@endif
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@if (session('success'))
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<div class=" alert alert-success">{{ session('success') }}
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</div>
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<br>
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@endif
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<div class="col-12">
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<h4 class="page-title">{{ $form->title }}</h4>
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</div>
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<form method="POST" action="/form/submit" id="report-form" enctype="multipart/form-data">
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<input type="hidden" name="form_id" value="{{ $form_id }}">
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@csrf
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@if ($id)
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<input type="hidden" name="id" value="{{ $id }}">
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@endif
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@if (isset($form->manager_can_submit) && $form->manager_can_submit == true)
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<div class="col-md-12 mb-2">
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<label for="field-user_id" class="form-label"> Select User / Territory <span
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class="text-danger">*</span> </label>
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<select class="form-control" id="field-user_id" name="user_id" required>
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<option value=""> -- Select -- </option>
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@foreach ($form->users as $option)
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<option value="{{ $option->value }}"
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hierarchy="{{ $option->hierarchy_id }}"
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{{ isset($question->value) && $question->value == $option->value ? 'selected' : '' }}>
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{{ $option->display }}</option>
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@endforeach
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</select>
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</div>
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@endif
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@foreach ($questions as $question)
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<div class="col-md-12 mb-2">
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<label for="field-{{ $question->code }}"
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class="form-label">{{ $question->question }} {!! $question->required == 'yes' ? '<span class="text-danger">*</span>' : '' !!}
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</label>
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@switch($question->type)
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@case('hidden')
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<input type="{{ $question->type }}" id="field-{{ $question->code }}"
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name="{{ $question->code }}"
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value="{{ isset($question->value) ? $question->value : '' }}">
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@break
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@case('text')
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@case('email')
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@case('tel')
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@case('date')
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<input type="{{ $question->type }}" id="field-{{ $question->code }}"
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name="{{ $question->code }}" class="form-control"
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{{ $question->required == 'yes' ? 'required' : '' }}
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value="{{ isset($question->value) ? $question->value : '' }}">
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@break
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@case('number')
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<input type="{{ $question->type }}" min="0" max="9999999999"
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step="1" id="field-{{ $question->code }}"
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name="{{ $question->code }}" class="form-control"
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{{ $question->required == 'yes' ? 'required' : '' }}
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value="{{ isset($question->value) ? $question->value : 0 }}">
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@break
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@case('textarea')
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<textarea id="field-{{ $question->code }}" name="{{ $question->code }}" class="form-control"
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{{ $question->required == 'yes' ? 'required' : '' }}>{{ isset($question->value) ? $question->value : '' }}</textarea>
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@break
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@case('dropdown')
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<select class="form-control" id="field-{{ $question->code }}"
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name="{{ $question->code }}"
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{{ $question->required == 'yes' ? 'required' : '' }}>
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<option value=""> -- Select -- </option>
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@foreach ($question->options as $option)
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<option value="{{ $option->value }}"
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{{ isset($question->value) && $question->value == $option->value ? 'selected' : '' }}>
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{{ $option->display }}</option>
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@endforeach
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</select>
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@break
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@case('checkbox')
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@foreach ($question->options as $option)
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<div class="form-check mb-2 form-check-primary">
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<input class="form-check-input" type="checkbox"
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id="field-{{ $question->code }}-{{ $option->value }}"
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name="{{ $question->code }}[]" value="{{ $option->value }}"
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{{ isset($question->value) && $question->value != '' && in_array($option->value, $question->value) ? 'checked' : '' }}>
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<label class="form-check-label"
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for="field-{{ $question->code }}-{{ $option->value }}">{{ $option->display }}</label>
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</div>
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@endforeach
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@break
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@case('radio')
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@foreach ($question->options as $option)
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<div class="form-check">
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<input type="radio"
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id="field-{{ $question->code }}-{{ $option->value }}"
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name="{{ $question->code }}" class="form-check-input" value="{{$option->value}}"
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{{ isset($question->value) && $question->value != $question->value ? 'checked' : '' }}>
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<label class="form-check-label"
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for="field-{{ $question->code }}-{{ $option->value }}">{{ $option->display }}</label>
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</div>
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@endforeach
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@break
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@case('file')
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<input type="file" id="field-{{ $question->code }}"
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name="{{ $question->code }}" class="form-control" value=""
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accept="image/jpg, image/jpeg, image/png" required>
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@break
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@case('multitextbox')
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<div class="row">
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@foreach ($question->options as $option)
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<div class="col-6">{{ $option->display }}</div>
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<div class="col-6 mb-1">
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<input type="number" id="field-{{ $option->value }}"
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name="{{ $option->value }}" class="form-control" required
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value="{{ isset($option->val) ? $option->val : 0 }}">
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</div>
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@endforeach
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</div>
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@break
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@case('radiometrix')
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@foreach ($question->options as $option)
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<div class="row">
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<div class="col-5">{{ $option->display }}</div>
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<div class="col-7 mb-1">
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@php
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$nn = json_decode($option->value);
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@endphp
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@foreach ($nn as $value)
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<input type="radio"
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id="field-{{ $option->display }}-{{ $value }}"
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name="{{ $question->code }}[{{$option->display}}]" value="{{$value}}" class="form-check-input"
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{{ isset($question->display) && $option->display != $option->display ? 'checked' : '' }}>
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{{ $value }}
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@endforeach
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</div>
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</div>
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@endforeach
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@break
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@endswitch
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</div>
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@endforeach
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@if (!isset($form->is_approval) || (isset($form->is_approval) && $form->is_approval != 'yes'))
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<div class="text-center d-grid mt-3">
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<button class="btn btn-primary" type="submit" id="submit-btn"> Submit
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</button>
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</div>
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@endif
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</form>
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</div> <!-- end card-body -->
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</div>
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<!-- end card -->
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<!-- end row -->
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</div> <!-- end col -->
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</div>
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<!-- end row -->
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</div>
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<!-- end container -->
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</div>
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<!-- end page -->
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<style type="text/css">
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#pageloader {
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background: rgba(255, 255, 255, 0.8);
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display: none;
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height: 100%;
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position: fixed;
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width: 100%;
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z-index: 9999;
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}
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#pageloader img {
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left: 50%;
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margin-left: -32px;
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margin-top: -32px;
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position: absolute;
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top: 50%;
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}
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</style>
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@include('layouts.shared/footer-script')
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<script src="{{ asset('assets/libs/sweetalert2/sweetalert2.min.js') }}"></script>
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<script type="text/javascript">
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jQuery(document).ready(function($) {
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$('#report-form').on('submit', function(event) {
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event.preventDefault();
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$("#pageloader").fadeIn();
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$.ajax({
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type: "POST",
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url: '/srvey/ciplatodoctor',
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data: new FormData($('#report-form')[0]),
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processData: false,
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contentType: false,
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success: function(data) {
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console.log(data);
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},
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});
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$.ajax({
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type: "POST",
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url: '/srvey/ajaxsubmit',
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data: new FormData($('#report-form')[0]),
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processData: false,
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contentType: false,
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success: function(data) {
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$("#pageloader").fadeOut();
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if (data.status == 'success') {
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Swal.fire({
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title: 'Great!',
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text: 'Your data is successfully submitted!',
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icon: 'success'
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})
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$('#report-form').trigger("reset");
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} else {
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Swal.fire({
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icon: 'error',
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title: 'Data not submitted',
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text: 'Something went wrong, please try again after some time!'
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})
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}
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},
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});
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});
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});
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</script>
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</body>
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</html>
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