Rapport-Laravel/resources/views/form/rapport-copd/1725611704-e406068f-ad9a-42...

407 lines
24 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'=>'DUOLIN INHALER', 'slug2'=>'duolin_inh_with_dose_pob_value' ,'pseudoName'=>'duolin_inh_with_dose_pob_value' , 'pseudoId'=>'duolin_inh_with_dose_pts_value','pts'=>'duolin_inh_with_dose_pts_value'],
//['brand'=>'DUOLIN ROTACAPS', 'slug2'=>'duolin_rotacaps_new_pob_value' ,'pseudoName'=>'duolin_rotacaps_new_pob_value' , 'pseudoId'=>'duolin_rotacaps_new_pts_value','pts'=>'duolin_rotacaps_new_pts_value'],
//['brand'=>'ASTHALIN INHALER', 'slug2'=>'asthalin_inhalerdose_counter_100mcgdos_pob_value' ,'pseudoName'=>'asthalin_inhalerdose_counter_100mcgdos_pob_value' , 'pseudoId'=>'asthalin_inhalerdose_counter_100mcgdos_pts_value','pts'=>'asthalin_inhalerdose_counter_100mcgdos_pts_value'],
//['brand'=>'DUOLIN FORTE ROTACAPS', 'slug2'=>'duolin_forte_rotacaps_pob_value' ,'pseudoName'=>'duolin_forte_rotacaps_pob_value' , 'pseudoId'=>'duolin_forte_rotacaps_pts_value','pts'=>'duolin_forte_rotacaps_pts_value'],
//['brand'=>'DUOLIN FORTE INHALER', 'slug2'=>'duolin_forte_inhaler200mdcipin_pob_value' ,'pseudoName'=>'duolin_forte_inhaler200mdcipin_pob_value' , 'pseudoId'=>'duolin_forte_inhaler200mdcipin_pts_value','pts'=>'duolin_forte_inhaler200mdcipin_pts_value'],
//['brand'=>'ASTHALIN ROTACAPS', 'slug2'=>'asthalin_rotacaps_60_caps_pob_value' ,'pseudoName'=>'asthalin_rotacaps_60_caps_pob_value' , 'pseudoId'=>'asthalin_rotacaps_60_caps_pts_value','pts'=>'asthalin_rotacaps_60_caps_pts_value'],
//['brand'=>'GLYCOHALE F CAPSULE', 'slug2'=>'glycohale_f_capsules_pob_value' ,'pseudoName'=>'glycohale_f_capsules_pob_value' , 'pseudoId'=>'glycohale_f_capsules_pts_value','pts'=>'glycohale_f_capsules_pts_value'],
//['brand'=>'GLYCOHALE FB CAPSULE', 'slug2'=>'glycohale_fb_pob_value' ,'pseudoName'=>'glycohale_fb_pob_value' , 'pseudoId'=>'glycohale_fb_pts_value','pts'=>'glycohale_fb_pts_value'],
//['brand'=>'DUOLIN ROTACAPS', 'slug2'=>'duolin_rotacaps_60s_pob_value' ,'pseudoName'=>'duolin_rotacaps_60s_pob_value' , 'pseudoId'=>'duolin_rotacaps_60s_pts_value','pts'=>'duolin_rotacaps_60s_pts_value'],
//['brand'=>'GLYCOHALE FB INHALER', 'slug2'=>'glycohale_fb_inhaler_pob_value' ,'pseudoName'=>'glycohale_fb_inhaler_pob_value' , 'pseudoId'=>'glycohale_fb_inhaler_pts_value','pts'=>'glycohale_fb_inhaler_pts_value'],
//['brand'=>'GLYCOHALE FB SYNCHROBREATHE', 'slug2'=>'glycohale_fb_synchrobreathe_pob_value' ,'pseudoName'=>'glycohale_fb_synchrobreathe_pob_value' , 'pseudoId'=>'glycohale_fb_synchrobreathe_pts_value','pts'=>'glycohale_fb_synchrobreathe_pts_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="{{$form_id}}">
@csrf
@if($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="{{$question->type}}" min="0" max="9999999999" step="1"
id="field-{{$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= ' . $option->contact->msl_code . ' ' : '' }} {{ isset($question->value) && $question->value == $option->value ? 'selected' : '' }} {{ $question->code == 'contact_id' ? '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')
@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">
<thead>
<tr>
<th>Brand</th>
<th>Units</th>
<th>PTS Value</th>
</tr>
</thead>
<tbody>
@foreach($brandData as $brand)
<tr>
<td>{{ $brand['brand'] }}</td>
<td>
<input type="number" id="field-{{ $brand['slug2'] }}"
name="{{ $brand['pseudoName'] }}"
class="form-control form-control-large" required
value="0">
</td>
<td>
<input type="number" id="field_{{ $brand['pseudoId'] }}"
name="{{ $brand['pts'] }}"
class="form-control form-control-large" readonly="true"
required value="0">
</td>
</tr>
@endforeach
</tbody>
</table>
</div>
<!-- @foreach($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();
$('#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).attr("speciality", itm
.contact.speciality));
}
$('#field-contact_id').change(function() {
$('#field-speciality').val($('option:selected', this).attr(
'speciality'))
})
},
});
console.log(hierarchy)
})
$('#field-total_value').prop('readonly', true);
$('#field-duolin_inh_with_dose_pob_value,#field-duolin_rotacaps_new_pob_value,#field-asthalin_inhalerdose_counter_100mcgdos_pob_value,#field-duolin_forte_rotacaps_pob_value,#field-duolin_forte_inhaler200mdcipin_pob_value,#field-asthalin_rotacaps_60_caps_pob_value,#field-glycohale_f_capsules_pob_value,#field-glycohale_fb_pob_value,#field-glycohale_fb_inhaler_pob_value,#field-glycohale_fb_synchrobreathe_pob_value').on('input', function() {
let a = parseFloat($('#field-duolin_inh_with_dose_pob_value').val()) || 0;
let b = parseFloat($('#field-duolin_rotacaps_new_pob_value').val()) || 0;
let c = parseFloat($('#field-asthalin_inhalerdose_counter_100mcgdos_pob_value').val()) || 0;
let d = parseFloat($('#field-duolin_forte_rotacaps_pob_value').val()) || 0;
let e = parseFloat($('#field-duolin_forte_inhaler200mdcipin_pob_value').val()) || 0;
let f = parseFloat($('#field-asthalin_rotacaps_60_caps_pob_value').val()) || 0;
let g = parseFloat($('#field-glycohale_f_capsules_pob_value').val()) || 0;
let h = parseFloat($('#field-glycohale_fb_pob_value').val()) || 0;
//let i = parseFloat($('#field-duolin_rotacaps_60s_pob_value').val()) || 0;
let j = parseFloat($('#field-glycohale_fb_inhaler_pob_value').val()) || 0;
let k = parseFloat($('#field-glycohale_fb_synchrobreathe_pob_value').val()) || 0;
let priceofA = 291.88;
let priceofB = 60.35;
let priceofC = 113.77;
let priceofD = 116.61;
let priceofE = 305.42;
let priceofF = 40.69;
let priceofG = 269.65;
let priceofH = 391.83;
//let priceofI = 139.4;
let priceofJ = 549.64;
let priceofK = 607.50;
let productOfA = (a * priceofA).toFixed(2);
let productOfB = (b * priceofB).toFixed(2);
let productOfC = (c * priceofC).toFixed(2);
let productOfD = (d * priceofD).toFixed(2);
let productOfE = (e * priceofE).toFixed(2);
let productOfF = (f * priceofF).toFixed(2);
let productOfG = (g * priceofG).toFixed(2);
let productOfH = (h * priceofH).toFixed(2);
//let productOfI = (i * priceofI).toFixed(2);
let productOfJ = (j * priceofJ).toFixed(2);
let productOfK = (k * priceofK).toFixed(2);
$('#field_duolin_inh_with_dose_pts_value').val(productOfA);
$('#field_duolin_rotacaps_new_pts_value').val(productOfB);
$('#field_asthalin_inhalerdose_counter_100mcgdos_pts_value').val(productOfC);
$('#field_duolin_forte_rotacaps_pts_value').val(productOfD);
$('#field_duolin_forte_inhaler200mdcipin_pts_value').val(productOfE);
$('#field_asthalin_rotacaps_60_caps_pts_value').val(productOfF);
$('#field_glycohale_f_capsules_pts_value').val(productOfG);
$('#field_glycohale_fb_pts_value').val(productOfH);
//$('#field_duolin_rotacaps_60s_pts_value').val(productOfI);
$('#field_glycohale_fb_inhaler_pts_value').val(productOfJ);
$('#field_glycohale_fb_synchrobreathe_pts_value').val(productOfK);
})
$('#field-duolin_inh_with_dose_pob_value,#field-duolin_rotacaps_new_pob_value,#field-asthalin_inhalerdose_counter_100mcgdos_pob_value,#field-duolin_forte_rotacaps_pob_value,#field-duolin_forte_inhaler200mdcipin_pob_value,#field-asthalin_rotacaps_60_caps_pob_value,#field-glycohale_f_capsules_pob_value,#field-glycohale_fb_pob_value,#field-glycohale_fb_inhaler_pob_value,#field-glycohale_fb_synchrobreathe_pob_value').on('input', function() {
let a = Math.ceil(parseFloat($('#field_duolin_inh_with_dose_pts_value').val())) || 0;
let b = Math.ceil(parseFloat($('#field_duolin_rotacaps_new_pts_value').val())) || 0;
let c = Math.ceil(parseFloat($('#field_asthalin_inhalerdose_counter_100mcgdos_pts_value').val())) || 0;
let d = Math.ceil(parseFloat($('#field_duolin_forte_rotacaps_pts_value').val())) || 0;
let e = Math.ceil(parseFloat($('#field_duolin_forte_inhaler200mdcipin_pts_value').val())) || 0;
let f = Math.ceil(parseFloat($('#field_asthalin_rotacaps_60_caps_pts_value').val())) || 0;
let g = Math.ceil(parseFloat($('#field_glycohale_f_capsules_pts_value').val())) || 0;
let h = Math.ceil(parseFloat($('#field_glycohale_fb_pts_value').val())) || 0;
//let i = Math.ceil(parseFloat($('#field_duolin_rotacaps_60s_pts_value').val())) || 0;
let j = Math.ceil(parseFloat($('#field_glycohale_fb_inhaler_pts_value').val())) || 0;
let k = Math.ceil(parseFloat($('#field_glycohale_fb_synchrobreathe_pts_value').val())) || 0;
console.log("a is : ", a );
console.log("b is : ", b );
console.log("c is : ", c );
console.log("d is : ", d );
console.log("Total is : ",a + b + c + d+e+f+g+h+j+k);
let total = (a + b + c + d+e+f+g+h+j+k).toFixed(2);
$('#field-total_value').val(total);
})
$('#field-contact_id').change(function() {
$('#field-msl_code').val($('option:selected', this).attr('msl_code'))
})
$('#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");
} 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>