Rapport-Laravel/resources/views/form/rapport-team4/1748864910-695ca2a4-08ff-49...

507 lines
30 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/select2/select2.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>
@php
$brandData = [
['brand'=>'ERDOSTYNE CAPSULE 10s', 'slug'=>'erdostyne_capsule_rx','pseudoId'=>'erdostyne_capsule_value'],
['brand'=>'Erdostyne Suspension', 'slug'=>'erdostyne_suspension_rx','pseudoId'=>'erdostyne_suspension_value'],
['brand'=>'Montair LC Adult 15s', 'slug'=>'montair_lc_adult_rx','pseudoId'=>'montair_lc_adult_value'],
['brand'=>'MONTAIR LC KID SYP', 'slug'=>'montair_lc_kid_syp_rx','pseudoId'=>'montair_lc_kid_syp_value'],
['brand'=>'MONTAIR LC KID TAB 10s', 'slug'=>'montair_lc_kid_tab_10s_rx','pseudoId'=>'montair_lc_kid_tab_10s_value'],
['brand'=>'FURAMIST NASAL SPRAY', 'slug'=>'furamist_nasal_spray_rx','pseudoId'=>'furamist_nasal_spray_value'],
['brand'=>'FURAMIST AZ NASAL SP', 'slug'=>'furamist_az_nasal_sp_rx','pseudoId'=>'furamist_az_nasal_sp_value'],
['brand'=>'Furamist Oxy 70 MD Nasal Spray', 'slug'=>'furamist_oxy_70_md_nasal_spray_rx','pseudoId'=>'furamist_oxy_70_md_nasal_spray_value'],
['brand'=>'FURAMIST 240MTD', 'slug'=>'furamist_240mtd_rx','pseudoId'=>'furamist_240mtd_value'],
['brand'=>'LEVOLIN SYRUP 100ML', 'slug'=>'levolin_syrup_100ml_rx','pseudoId'=>'levolin_syrup_100ml_value'],
['brand'=>'Levolin Plus Jr 100ml Oral Liquid', 'slug'=>'levolin_plus_jr_100ml_oral_liquid_rx','pseudoId'=>'levolin_plus_jr_100ml_oral_liquid_value'],
['brand'=>'LEVOLIN PLUS JR 60ML (IP)', 'slug'=>'levolin_plus_jr_60ml_ip_rx','pseudoId'=>'levolin_plus_jr_60ml_ip_value'],
['brand'=>'LEVOLIN PLUS (MANGO FLAVOUR ) 100 ML', 'slug'=>'levolin_plus_mango_flavour_100_ml_rx','pseudoId'=>'levolin_plus_mango_flavour_100_ml_value'],
['brand'=>'MONTAIR 10 (15s)', 'slug'=>'montair_10_15s_rx','pseudoId'=>'montair_10_15s_value'],
['brand'=>'MONTAIR 4MG 15 TAB', 'slug'=>'montair_4mg_15_tab_rx','pseudoId'=>'montair_4mg_15_tab_value'],
['brand'=>'MONTAIR 5MG 15 TAB', 'slug'=>'montair_5mg_15_tab_rx','pseudoId'=>'montair_5mg_15_tab_value'],
['brand'=>'Nicogum Freshmint 2mg - 16 Nicotine Gums', 'slug'=>'nicogum_freshmint_2mg_16_nicotine_gums_rx','pseudoId'=>'nicogum_freshmint_2mg_16_nicotine_gums_value'],
['brand'=>'Nicogum Freshmint 2mg - 48 Nicotine Gums', 'slug'=>'nicogum_freshmint_2mg_48_nicotine_gums_rx','pseudoId'=>'nicogum_freshmint_2mg_48_nicotine_gums_value'],
['brand'=>'Nicogum Freshmint 4mg - 16 Nicotine Gums', 'slug'=>'nicogum_freshmint_4mg_16_nicotine_gums_rx','pseudoId'=>'nicogum_freshmint_4mg_16_nicotine_gums_value'],
['brand'=>'Nicogum Freshmint 4mg - 48 Nicotine Gums', 'slug'=>'nicogum_freshmint_4mg_48_nicotine_gums_rx','pseudoId'=>'nicogum_freshmint_4mg_48_nicotine_gums_value'],
];
@endphp
<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="{{$form_id}}">
<input type="hidden" name="record_date" value="" id="field-record_date">
@csrf
@if($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:''}}"
{{$question->code == 'legacy_code' ? 'readonly' : ''}}>
@break
@case('number')
<input type="{{$question->type}}" min="0" max="9999999999" step="1"
id="field-{{$question->code}}" name="{{$question->code}}" class="form-control"
{{$question->required == 'no'?'required':'' }}
value="{{isset($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 == $option->value ? 'selected' : '' }}
@if($question->code == 'contact_id')
legacy_code="{{ isset($option->contact->legacy_code) ? e($option->contact->legacy_code) : '' }}"
speciality="{{ isset($option->contact->speciality) ? e($option->contact->speciality) : '' }}"
@endif
>
{{ $option->display }}
</option>
@endforeach
</select>
@break
@case('checkbox')
@foreach($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')
@if(!isset($form->is_approval) || (isset($form->is_approval) && $form->is_approval
!= 'yes' ) )
<input type="file" id="field-{{$question->code}}" name="{{$question->code}}"
class="form-control" value="" {{$question->required == 'yes'?'required':'' }}>
@elseif(isset($question->value))
<img src="{{$question->value}}" class="img-fluid">
@endif
@break
@case('multitextbox')
<div class="row">
<div style="width: auto; overflow-y: auto; overflow-x: auto;">
<table class="table tableclass">
<thead id="heading">
<tr>
<th>Brand</th>
<th>Number of Rx</th>
</tr>
</thead>
<tbody>
@foreach($brandData as $brand)
<tr>
<td>{{ $brand['brand'] }}</td>
<td>
<input type="number" id="field-{{ $brand['slug'] }}"
name="{{ $brand['slug'] }}"
class="form-control form-control-large" value="{{ $id && isset($formdata) && isset($formdata->{$brand['slug']}) ? $formdata->{$brand['slug']} : 0 }}" >
</td>
</tr>
@endforeach
</tbody>
</table>
</div>
<!-- @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) && $form->is_approval !=
'yes' ) )
<div class="text-center d-grid mt-3">
<button class="btn btn-primary" type="submit" id="submit-btn"> Submit </button>
</div>
@endif
</form>
</div> <!-- end card-body -->
</div>
<!-- end card -->
<!-- end row -->
</div> <!-- end col -->
</div>
<!-- end row -->
</div>
<!-- end container -->
</div>
<!-- end page -->
<style type="text/css">
#pageloader {
background: rgba(255, 255, 255, 0.8);
display: none;
height: 100%;
position: fixed;
width: 100%;
z-index: 9999;
}
#pageloader img {
left: 50%;
margin-left: -32px;
margin-top: -32px;
position: absolute;
top: 50%;
}
</style>
@include('layouts.shared/footer-script')
<script src="{{asset('assets/libs/sweetalert2/sweetalert2.min.js')}}"></script>
<script src="{{ asset('assets/libs/select2/select2.min.js') }}"></script>
<script type="text/javascript">
jQuery(document).ready(function($) {
$('[data-toggle="select2"]').select2();
let selected_user_id = ''
$('#field-user_id').change(function() {
$("#pageloader").fadeIn();
selected_user_id = $(this).val()
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) {
if(itm.contact.c2c == 'Yes') {
$('#field-contact_id').append($("<option></option>").attr("value",
itm.value).text(itm.display)
.attr("speciality", itm.contact.speciality || "")
.attr("legacy_code", itm.contact.legacy_code || ""));
}
}
$('#field-contact_id').change(function() {
let speciality = $('option:selected', this).attr('speciality') || '';
$('#field-speciality').val(speciality.trim());
})
},
});
console.log(hierarchy)
})
$('#field-contact_id').change(function() {
let speciality = $('option:selected', this).attr('speciality') || '';
$('#field-speciality').val(speciality.trim());
})
$('#field-contact_id').change(function() {
$('#field-legacy_code').val($('option:selected', this).attr('legacy_code') || '')
})
// Read-only fields: keep them enabled so their values are submitted normally.
$('#field-msl_code').prop('readonly', true);
$('#field-speciality').prop('readonly', true);
$('#field-total_units').prop('readonly', true);
$('#field-chemist_name').parent().hide();
$("#field-chemist_name").prop({"required":false});
// $("#field-speciality").parent().hide();
// $("#field-speciality").prop({"required":false});
// $("#field-legacy_code").parent().hide();
// $("#field-legacy_code").prop({"required":false});
$('#field-select_source').on("change",function(){
var dropDown=$('#field-select_source').val();
console.log("DropDown is : ",dropDown);
if(dropDown==='Doctor'){
$("#field-chemist_name").parent().hide();
$("#field-chemist_name").prop({"required":false});
$('#field-contact_id').parent().show();
$("#field-speciality").parent().show();
$("#field-speciality").prop({"required":true});
$("#field-legacy_code").parent().show();
$("#field-legacy_code").prop({"required":true});
}
else if(dropDown==='Chemist'){
$("#field-chemist_name").parent().show();
$("#field-chemist_name").prop({"required":true});
$('#field-contact_id').parent().hide();
$('#field-contact_id').prop({"required":false});
$("#field-speciality").parent().hide();
$("#field-speciality").prop({"required":false});
$("#field-legacy_code").parent().hide();
$("#field-legacy_code").prop({"required":false});
}
else{
$("#field-chemist_name").parent().hide();
$("#field-chemist_name").prop({"required":false});
}
})
$('#field-erdostyne_capsule_rx,#field-erdostyne_suspension_rx').attr('readonly',true);
$('td').filter(function () {
return $.trim($(this).text()) === 'ERDOSTYNE CAPSULE 10s';
}).addClass('erdostyne-title');
$(document).ready(function () {
$('.erdostyne-title').append(
'<small class="erdostyne-note text-danger">Enter Erdostyne Rx details in 123 Tracking form only</small>'
);
});
$('td').filter(function () {
return $.trim($(this).text()) === 'Erdostyne Suspension';
}).addClass('erdostyne-title-2');
$(document).ready(function () {
$('.erdostyne-title-2').append(
'<br/><small class="erdostyne-note text-danger">Enter Erdostyne Rx details in 123 Tracking form only</small>'
);
});
$('.erdostyne-title').html('<td>ERDOSTYNE CAPSULE 10s</td><br/><small>Enter Erdostyne Rx details in 123 Tracking form only</small>');
$('#field-montair_lc_kid_syp_rx,#field-montair_lc_kid_tab_10s_rx,#field-furamist_nasal_spray_rx,#field-furamist_az_nasal_sp_rx,#field-furamist_oxy_70_md_nasal_spray_rx,#field-levolin_syrup_100ml_rx,#field-levolin_1mg_tab_rx,#field-levolin_2_tab_rx,#field-levolin_plus_jr_100ml_oral_liquid_rx,#field-levolin_plus_jr_60ml_ip_rx,#field-levolin_plus_mango_flavour_100_ml_rx,#field-montair_10_15s_rx,#field-montair_10_15s_rx,#field-montair_4mg_15_tab_rx,#field-montair_5mg_15_tab_rx,#field-nicogum_freshmint_4mg_12_nicotine_gums_rx,#field-nicogum_freshmint_2mg_12_nicotine_gums_rx,#field-nicogum_transdermal_patch_21mg_rx,#field-nicogum_transdermal_patch_14mg_rx,#field-nicogum_transdermal_patch_7mg_rx,#field-nicogum_4_sugarfree_rx,#field-montair_lc_tablets_rx,#field-erdostyne_suspension_rx,#field-montair_lc_adult_rx,#field-erdostyne_capsule_rx,#field-furamist_240mtd_rx,#field-nicogum_freshmint_2mg_16_nicotine_gums_rx,#field-nicogum_freshmint_2mg_48_nicotine_gums_rx,#field-nicogum_freshmint_4mg_16_nicotine_gums_rx,#field-nicogum_freshmint_4mg_48_nicotine_gums_rx').on('change',function(){
let a=parseInt($('#field-montair_lc_kid_syp_rx').val())||0;
let b=parseInt($('#field-montair_lc_kid_tab_10s_rx').val())||0;
let c=parseInt($('#field-furamist_nasal_spray_rx').val())||0;
let d=parseInt($('#field-furamist_az_nasal_sp_rx').val())||0;
let e=parseInt($('#field-furamist_oxy_70_md_nasal_spray_rx').val())||0;
let f=parseInt($('#field-levolin_syrup_100ml_rx').val())||0;
let g=parseInt($('#field-levolin_1mg_tab_rx').val())||0;
let h=parseInt($('#field-levolin_2_tab_rx').val())||0;
let i=parseInt($('#field-levolin_plus_jr_100ml_oral_liquid_rx').val())||0;
let j=parseInt($('#field-levolin_plus_jr_60ml_ip_rx').val())||0;
let k=parseInt($('#field-levolin_plus_mango_flavour_100_ml_rx').val())||0;
let l=parseInt($('#field-montair_10_15s_rx').val())||0;
let m=parseInt($('#field-montair_4mg_15_tab_rx').val())||0;
let n=parseInt($('#field-montair_5mg_15_tab_rx').val())||0;
let o=parseInt($('#field-nicogum_freshmint_4mg_12_nicotine_gums_rx').val())||0;
let p=parseInt($('#field-nicogum_freshmint_2mg_12_nicotine_gums_rx').val())||0;
let q=parseInt($('#field-nicogum_transdermal_patch_21mg_rx').val())||0;
let r=parseInt($('#field-nicogum_transdermal_patch_14mg_rx').val())||0;
let s=parseInt($('#field-nicogum_transdermal_patch_7mg_rx').val())||0;
let t=parseInt($('#field-nicogum_4_sugarfree_rx').val())||0;
let u=parseInt($('#field-montair_lc_tablets_rx').val())||0;
let v=parseInt($('#field-erdostyne_suspension_rx').val())||0;
let w=parseInt($('#field-montair_lc_adult_rx').val())||0;
let x=parseInt($('#field-erdostyne_capsule_rx').val())||0;
let y=parseInt($('#field-furamist_240mtd_rx').val()) ||0;
let z=parseInt($('#field-nicogum_freshmint_2mg_16_nicotine_gums_rx').val())||0;
let aa=parseInt($('#field-nicogum_freshmint_2mg_48_nicotine_gums_rx').val())||0;
let ab=parseInt($('#field-nicogum_freshmint_4mg_16_nicotine_gums_rx').val())||0;
let ac=parseInt($('#field-nicogum_freshmint_4mg_48_nicotine_gums_rx').val()) ||0;
let total=(a+b+c+d+e+f+g+h+i+j+k+l+m+n+o+p+q+r+s+t+u+v+w+x+y+z+aa+ab+ac);
$('#field-total_units').val(total);
})
/* $('#field-montair_lc_kid_syp_units,#field-montair_lc_kid_tab_10s_units,#field-furamist_nasal_spray_units,#field-furamist_az_nasal_sp_units,#field-furamist_oxy_70_md_nasal_spray_units,#field-levolin_syrup_100ml_units,#field-levolin_1mg_tab_units,#field-levolin_2_tab_units,#field-levolin_plus_jr_100ml_oral_liquid_units,#field-levolin_plus_jr_60ml_ip_units,#field-levolin_plus_mango_flavour_100_ml_units,#field-montair_10_15s_units,#field-montair_10_15s_units,#field-montair_4mg_15_tab_units,#field-montair_5mg_15_tab_units,#field-nicogum_freshmint_4mg_12_nicotine_gums_units,#field-nicogum_freshmint_2mg_12_nicotine_gums_units,#field-nicogum_transdermal_patch_21mg_units,#field-nicogum_transdermal_patch_14mg_units,#field-nicogum_transdermal_patch_7mg_units,#field-nicogum_4_sugarfree_units,#field-montair_lc_tablets_units,#field-erdostyne_suspension_units,#field-montair_lc_adult_units,#field-erdostyne_capsule_units,#field-nicogum_freshmint_2mg_16_nicotine_gums_rx,#field-nicogum_freshmint_2mg_48_nicotine_gums_rx,#field-nicogum_freshmint_4mg_16_nicotine_gums_rx,#field-nicogum_freshmint_4mg_48_nicotine_gums_rx').on('change',function(){
let a=parseInt($('#field-montair_lc_kid_syp_units').val())||0;
let b=parseInt($('#field-montair_lc_kid_tab_10s_units').val())||0;
let c=parseInt($('#field-furamist_nasal_spray_units').val())||0;
let d=parseInt($('#field-furamist_az_nasal_sp_units').val())||0;
let e=parseInt($('#field-furamist_oxy_70_md_nasal_spray_units').val())||0;
let f=parseInt($('#field-levolin_syrup_100ml_units').val())||0;
let g=parseInt($('#field-levolin_1mg_tab_units').val())||0;
let h=parseInt($('#field-levolin_2_tab_units').val())||0;
let i=parseInt($('#field-levolin_plus_jr_100ml_oral_liquid_units').val())||0;
let j=parseInt($('#field-levolin_plus_jr_60ml_ip_units').val())||0;
let k=parseInt($('#field-levolin_plus_mango_flavour_100_ml_units').val())||0;
let l=parseInt($('#field-montair_10_15s_units').val())||0;
let m=parseInt($('#field-montair_4mg_15_tab_units').val())||0;
let n=parseInt($('#field-montair_5mg_15_tab_units').val())||0;
let o=parseInt($('#field-nicogum_freshmint_4mg_12_nicotine_gums_units').val())||0;
let p=parseInt($('#field-nicogum_freshmint_2mg_12_nicotine_gums_units').val())||0;
let q=parseInt($('#field-nicogum_transdermal_patch_21mg_units').val())||0;
let r=parseInt($('#field-nicogum_transdermal_patch_14mg_units').val())||0;
let s=parseInt($('#field-nicogum_transdermal_patch_7mg_units').val())||0;
let t=parseInt($('#field-nicogum_4_sugarfree_units').val())||0;
let u=parseInt($('#field-montair_lc_tablets_units').val())||0;
let v=parseInt($('#field-erdostyne_suspension_units').val())||0;
let w=parseInt($('#field-montair_lc_adult_units').val())||0;
let x=parseInt($('#field-erdostyne_capsule_units').val())||0;
let total=(a+b+c+d+e+f+g+h+i+j+k+l+m+n+o+p+q+r+s+t+u+v+w+x);
$('#field-total_units').val(total);
})*/
$('#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'
})
$('#report-form').trigger("reset");
$('#field-user_id').val(selected_user_id)
$('#field-user_id').trigger("change");
} 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-record_date');
plandateField.setAttribute('max', today);
});
</script>
</body>
</html>