324 lines
18 KiB
PHP
324 lines
18 KiB
PHP
<!DOCTYPE html>
|
|
<html lang="en">
|
|
<head>
|
|
@include('layouts.shared/title-meta', ['title' => "Form"])
|
|
@include('layouts.shared/head-css', ["mode" => $mode ?? '', "demo" => $demo ?? ''])
|
|
<link href="{{asset('assets/libs/sweetalert2/sweetalert2.min.css')}}" rel="stylesheet" type="text/css" />
|
|
</head>
|
|
<div id="pageloader">
|
|
<img src="http://cdnjs.cloudflare.com/ajax/libs/semantic-ui/0.16.1/images/loader-large.gif" alt="processing..." />
|
|
</div>
|
|
<body class="loading">
|
|
<div class="account-pages">
|
|
<div class="container">
|
|
<div class="row justify-content-center">
|
|
<div class="col-md-8 col-lg-6 col-xl-5 p-0">
|
|
<div class="card bg-pattern">
|
|
<div class="card-body p-3 row">
|
|
|
|
@if(Session::has('error'))<div class="alert alert-danger">{{Session::get('error')}}</div>
|
|
<br>@endif
|
|
@if(session('success'))<div class=" alert alert-success">{{ session('success') }}
|
|
</div>
|
|
<br>@endif
|
|
<div class="col-8">
|
|
<h4 class="page-title">{{$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 $question)
|
|
<div class="col-md-12 mb-2">
|
|
<label for="field-{{$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')
|
|
@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="number"
|
|
min="0"
|
|
step="1"
|
|
inputmode="numeric"
|
|
id="field-{{$question->code}}"
|
|
name="{{$question->code}}"
|
|
class="form-control"
|
|
{{$question->required == 'yes'?'required':''}}
|
|
value="{{isset($question->value) ? $question->value : ''}}"
|
|
>
|
|
@break
|
|
@case('textarea')
|
|
<textarea id="field-{{$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}}"
|
|
msl_code="{{ isset($option->contact->legacy_code) ? $option->contact->legacy_code : '' }}"
|
|
speciality="{{ isset($option->contact->speciality) ? $option->contact->speciality : '' }}"
|
|
|
|
{{isset($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($question->options[0]->value)
|
|
: [];
|
|
@endphp
|
|
|
|
{{-- Matrix Wrapper with Horizontal Scroll on Small Screens --}}
|
|
<div class="table-responsive">
|
|
<div class="d-table w-100">
|
|
{{-- Table Headers --}}
|
|
<div class="d-table-row font-weight-bold">
|
|
<div class="d-table-cell p-2" style="width: 150px;"></div>
|
|
{{-- Placeholder for row labels --}}
|
|
@foreach ($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); @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="{{$question->code}}"
|
|
class="form-control"
|
|
accept=".jpg,.jpeg,.png,image/jpeg,image/png"
|
|
{{$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) && $form->is_approval != 'yes' ) )
|
|
<div class="text-center d-grid mt-3">
|
|
<button class="btn btn-primary" type="submit" id="submit-btn"> Submit </button>
|
|
</div>
|
|
@endif
|
|
</form>
|
|
|
|
</div> <!-- end card-body -->
|
|
</div>
|
|
<!-- end card -->
|
|
|
|
<!-- end row -->
|
|
|
|
</div> <!-- end col -->
|
|
</div>
|
|
<!-- end row -->
|
|
</div>
|
|
<!-- end container -->
|
|
</div>
|
|
<!-- end page -->
|
|
<style type="text/css">
|
|
#pageloader {
|
|
background: rgba( 255, 255, 255, 0.8 );
|
|
display: none;
|
|
height: 100%;
|
|
position: fixed;
|
|
width: 100%;
|
|
z-index: 9999;
|
|
}
|
|
|
|
#pageloader img {
|
|
left: 50%;
|
|
margin-left: -32px;
|
|
margin-top: -32px;
|
|
position: absolute;
|
|
top: 50%;
|
|
}
|
|
.form-label {
|
|
font-weight:bold;
|
|
font-size:16px;
|
|
}
|
|
</style>
|
|
@include('layouts.shared/footer-script')
|
|
<script src="{{asset('assets/libs/sweetalert2/sweetalert2.min.js')}}"></script>
|
|
<script type="text/javascript">
|
|
jQuery(document).ready(function($){
|
|
$('#field-user_id').change(function(){
|
|
let hierarchy = $('option:selected', this).attr('hierarchy');
|
|
$('#field-hierarchy_id').val(hierarchy)
|
|
event.preventDefault();
|
|
$.ajax({
|
|
type: "GET",
|
|
url: '/form/getdoctorlist?partition={{$form->partition}}&hierarchy='+hierarchy,
|
|
processData: false,
|
|
contentType: false,
|
|
success: function( data ) {
|
|
$("#pageloader").fadeOut();
|
|
$('#field-contact_id').html('')
|
|
$('#field-contact_id').append($("<option></option>").attr("value",'').text('-- Select --'));
|
|
for(let itm of data) {
|
|
$('#field-contact_id').append($("<option></option>").attr("value",itm.value).text(itm.display));
|
|
}
|
|
},
|
|
});
|
|
|
|
console.log(hierarchy)
|
|
})
|
|
|
|
$('#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) {
|
|
|
|
console.log("FULL DOCTOR DATA:", data);
|
|
|
|
/*for (let itm of data) {
|
|
console.log("DOCTOR:", itm);
|
|
console.log("LEGACY CODE:", itm.legacy_code);
|
|
console.log("CONTACT:", itm.contact);
|
|
console.log("CONTACT LEGACY CODE:", itm.contact ? itm.contact.legacy_code : 'NO CONTACT');
|
|
}*/
|
|
|
|
$("#pageloader").fadeOut();
|
|
|
|
$('#field-contact_id').html('');
|
|
$('#field-contact_id').append(
|
|
$("<option></option>")
|
|
.attr("value", '')
|
|
.text('-- Select --')
|
|
);
|
|
|
|
for(let itm of data) {
|
|
$('#field-contact_id').append(
|
|
$("<option></option>")
|
|
.attr("value", itm.value)
|
|
.text(itm.display)
|
|
);
|
|
}
|
|
},
|
|
});
|
|
});
|
|
|
|
|
|
$('#field-contact_id').change(function() {
|
|
console.log("CONTACT SELECTED:", this.value);
|
|
$('#field-legacy_code').val($('option:selected', this).attr('msl_code'));
|
|
});
|
|
|
|
$('#field-no_units_confirmed').on('input', function () {
|
|
this.value = this.value.replace(/[^0-9]/g, '');
|
|
});
|
|
|
|
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 conversionDateField = document.getElementById('field-record_date');
|
|
|
|
if (conversionDateField) {
|
|
conversionDateField.setAttribute('min', '2026-07-01');
|
|
conversionDateField.setAttribute('max', today);
|
|
}
|
|
});
|
|
</script>
|
|
</body>
|
|
|
|
</html> |