667 lines
31 KiB
PHP
667 lines
31 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' => $demo ?? ''])
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<link href="{{ asset('assets/libs/sweetalert2/sweetalert2.min.css') }}" rel="stylesheet" type="text/css" />
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</head>
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<div id="pageloader">
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<img src="http://cdnjs.cloudflare.com/ajax/libs/semantic-ui/0.16.1/images/loader-large.gif" alt="processing..." />
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</div>
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@php
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// echo "<pre>";
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// print_r($form);
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// exit;
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@endphp
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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-8">
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<h4 class="page-title">{{ $form->title }}</h4>
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</div>
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{{-- <input type="hidden" name="" a="{{print_r($form)}}" disabled> --}}
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@if (!isset($form->is_approval) || (isset($form->is_approval) && $form->is_approval != 'yes'))
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<div class="col-4">
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@if ($form->link_type == 'form')
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<a href="/form/history" class="float-end pt-1">View History</a>
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@else
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<a href="{{ url()->previous() }}" class="float-end pt-1">Back</a>
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@endif
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</div>
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@endif
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@if (isset($form->user_info))
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<div class="col-12">
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<h6>Submitted By: {{ $form->user_info->name }}</h6>
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</div>
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@endif
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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) && $form->manager_can_submit == true)
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<div class="col-md-12 mb-2">
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<label for="field-user_id" class="form-label"> Select TM Name <span
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class="text-danger">*</span> </label>
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<select class="form-control" id="field-user_id" name="tm_name" required>
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<option value=""> -- Select -- </option>
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{{-- @foreach ($form->users as $option)
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<option value={{ isset($option->user_info->name) ? $option->user_info->name : '-'}}
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hierarchy="{{ $option->hierarchy_id }}"
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{{ isset($question->user_info->name) && $question->user_info->name == $option->user_info->name ? 'selected' : '' }}>
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{{isset($option->user_info->name) ? $option->user_info->name : '-'}}</option>
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@endforeach --}}
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@foreach ($form->users as $option)
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@if (!empty($option->user_info->name))
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<option value="{{ $option->user_info->name }}"
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hierarchy="{{ $option->hierarchy_id }}"
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{{ isset($question->user_info->name) && $question->user_info->name == $option->user_info->name ? 'selected' : '' }}>
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{{ $option->user_info->name }}
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</option>
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@endif
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@endforeach
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</select>
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<input type="hidden" id="field-hierarchy_id" name="hierarchy_id"
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value="">
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</div>
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@endif
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@foreach ($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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{{ $option->display }}</option>
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@endforeach
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</select>
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@break
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@case('radio')
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@foreach ($question->options as $option)
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<div class="form-check mb-2 form-check-success">
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<input class="form-check-input" type="radio"
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name="{{ $question->code }}"
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id="field-{{ $question->code }}_{{ $option->value }}"
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value="{{ $option->value }}">
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<label class="form-check-label"
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for="field-{{ $question->code }}_{{ $option->value }}">{{ $option->display }}</label>
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</div>
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@endforeach
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@break
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@case('radiometrix')
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@php
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// Decode the first option's value to use as heading labels
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$headings =
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count($question->options) > 0
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? json_decode($question->options[0]->value)
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: [];
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@endphp
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{{-- Matrix Wrapper with Horizontal Scroll on Small Screens --}}
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<div class="table-responsive">
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<div class="d-table w-100">
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{{-- Table Headers --}}
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<div class="d-table-row font-weight-bold">
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<div class="d-table-cell p-2" style="width: 150px;"></div>
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{{-- Placeholder for row labels --}}
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@foreach ($headings as $head)
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<div class="d-table-cell text-center p-2">{{ $head }}
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</div>
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@endforeach
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</div>
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{{-- Table Rows --}}
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@foreach ($question->options as $option)
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@php $nn = json_decode($option->value); @endphp
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<div class="d-table-row align-middle">
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<div class="d-table-cell font-weight-bold p-2"
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style="width: 150px;">
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{{ $option->display }}
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</div>
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@foreach ($nn as $value)
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<div class="d-table-cell text-center p-2">
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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 }}]"
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value="{{ $value }}"
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class="form-check-input"
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{{ isset($question->display) && $option->display != $option->display ? 'checked' : '' }}>
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</div>
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@endforeach
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</div>
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@endforeach
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</div>
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</div>
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@break
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@case('checkbox')
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@foreach ($question->options as $option)
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<div class="form-check mb-2 form-check-primary ms-2">
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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 }}">{{ $option->display }}</label>
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</div>
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@endforeach
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@break
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@case('file')
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@if (!isset($form->is_approval) || (isset($form->is_approval) && $form->is_approval != 'yes'))
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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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{{ $question->required == 'yes' ? 'required' : '' }}>
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@elseif(isset($question->value))
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<img src="{{ $question->value }}" class="img-fluid">
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@endif
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@break
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@case('multitextbox')
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<div class="row">
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@foreach ($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) ? $option->val : 0 }}">
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</div>
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@endforeach
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</div>
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@break
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@endswitch
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</div>
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@endforeach
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@if (!isset($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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.form-label {
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font-weight: bold;
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font-size: 16px;
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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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$('#field-user_id').change(function() {
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let hierarchy = $('option:selected', this).attr('hierarchy');
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$('#field-hierarchy_id').val(hierarchy)
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event.preventDefault();
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$.ajax({
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type: "GET",
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url: '/form/getdoctorlist?partition={{ $form->partition }}&hierarchy=' +
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hierarchy,
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processData: false,
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contentType: false,
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success: function(data) {
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$("#pageloader").fadeOut();
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$('#field-contact_id').html('')
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$('#field-contact_id').append($("<option></option>").attr("value", '')
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.text('-- Select --'));
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console.log('data', data);
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for (let itm of data) {
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if (itm.contact && itm.contact.ciphaler_robert == "Yes") {
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$('#field-contact_id').append($("<option></option>").attr("value",
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itm.value).text(itm.display));
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}
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}
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},
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});
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console.log(hierarchy)
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})
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$('#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: '/form/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.hasOwnProperty('message') ?
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'You are not mapped to any position code' :
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'Data not submitted',
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text: data.hasOwnProperty('message') ?
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'for resolution please email Position code, L1 Manager and L2 Manager details to support1@stratawiz.com' :
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'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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var today = new Date();
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var dd = String(today.getDate()).padStart(2, '0');
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var mm = String(today.getMonth() + 1).padStart(2, '0');
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var yyyy = today.getFullYear();
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today = yyyy + '-' + mm + '-' + dd;
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var plandateField = document.getElementById('field-record_date');
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plandateField.setAttribute('max', today);
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});
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</script>
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{{-- <script>
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$(document).ready(function() {
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let title = $(`
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<div id="ciphaler_title"
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style="display:none;
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font-size:14px;
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font-weight:600;
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margin-top:20px;
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margin-bottom:10px;
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background:#fff8c4;
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padding:6px 10px;
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border-radius:4px;">
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</div>
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`);
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$('#field-ciphaler_rxber').after(title);
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let yesFields = [
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'#field-in_which_patient_you_prefer_to_rx_ciphaler',
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'#field-likelihood_of_shifting_diagnosed_patients_from_old_device_to_foracort_ciphaler',
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'#field-in_which_patient_profile_you_prefer_to_rx_ciphaler',
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'#field-which_is_the_most_important_factor_to_rx_ciphaler',
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'#field-which_is_the_most_important_factor_to_rx_ciphaler_other'
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];
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let noFields = [
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'#field-are_you_aware_of_novel_device_foracort_ciphaler',
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'#field-factors_for_not_prescribing_ciphaler',
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'#field-overall_comments_for_not_taking_up_ciphaler'
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];
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let yesWrapper = $(`
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<div id="yes_wrapper"
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style="display:none;
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border:1px solid #0d6efd;
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padding:10px;
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border-radius:4px;
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margin-top:10px;">
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</div>
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`);
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let noWrapper = $(`
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<div id="no_wrapper"
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style="display:none;
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border:1px solid #0d6efd;
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padding:10px;
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border-radius:4px;
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margin-top:10px;">
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</div>
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`);
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$('#field-in_which_patient_you_prefer_to_rx_ciphaler').closest('.col-md-12').before(yesWrapper);
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$('#field-are_you_aware_of_novel_device_foracort_ciphaler').closest('.col-md-12').before(noWrapper);
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yesFields.forEach(id => {
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$('#yes_wrapper').append($(id).closest('.col-md-12').hide());
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});
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noFields.forEach(id => {
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$('#no_wrapper').append($(id).closest('.col-md-12').hide());
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});
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const otherInput = $('#field-which_is_the_most_important_factor_to_rx_ciphaler_other');
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const otherDiv = otherInput.closest('.col-md-12');
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otherDiv.hide();
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otherInput.prop('required', false);
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$('#field-which_is_the_most_important_factor_to_rx_ciphaler').on('change', function() {
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if ($(this).val() === "Other") {
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otherDiv.show();
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otherInput.prop('required', true);
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} else {
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otherDiv.hide();
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otherInput.val('');
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otherInput.prop('required', false);
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}
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});
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$('#field-ciphaler_rxber').on('change', function() {
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let v = $(this).val();
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if (v === "Yes") {
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title.text('Understanding the Drivers for prescribing Ciphaler from the Loyal Rxers').show();
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$('#yes_wrapper').show();
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yesFields.forEach(id => $(id).closest('.col-md-12').show());
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$('#no_wrapper').hide();
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noFields.forEach(id => {
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$(id).closest('.col-md-12').hide();
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$(id).val('');
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});
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$('#field-overall_comments_for_not_taking_up_ciphaler').prop('required', false);
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$('#field-which_is_the_most_important_factor_to_rx_ciphaler').trigger('change');
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}
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else if (v === "No") {
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title.text('Understanding the barriers to Rx Ciphaler among the Chest/CPs (DPI User)').show();
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$('#no_wrapper').show();
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noFields.forEach(id => $(id).closest('.col-md-12').show());
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$('#yes_wrapper').hide();
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yesFields.forEach(id => {
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$(id).closest('.col-md-12').hide();
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$(id).val('');
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});
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otherDiv.hide();
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otherInput.val('');
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otherInput.prop('required', false);
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$('#field-overall_comments_for_not_taking_up_ciphaler').prop('required', true);
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}
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else {
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title.hide().text('');
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$('#yes_wrapper').hide();
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$('#no_wrapper').hide();
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yesFields.concat(noFields).forEach(id => {
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$(id).closest('.col-md-12').hide();
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$(id).val('');
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});
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otherDiv.hide();
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otherInput.val('');
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otherInput.prop('required', false);
|
|
}
|
|
|
|
});
|
|
|
|
});
|
|
</script> --}}
|
|
|
|
<script>
|
|
$(document).ready(function() {
|
|
|
|
let title = $(`
|
|
<div id="ciphaler_title"
|
|
style="display:none;
|
|
font-size:14px;
|
|
font-weight:600;
|
|
margin-top:20px;
|
|
margin-bottom:10px;
|
|
background:#fff8c4;
|
|
padding:6px 10px;
|
|
border-radius:4px;">
|
|
</div>
|
|
`);
|
|
|
|
$('#field-contact_id').closest('.col-md-12').hide();
|
|
$('#field-contact_id').prop('required', false);
|
|
|
|
|
|
$('#field-ciphaler_rxber').after(title);
|
|
|
|
let yesFields = [
|
|
'#field-in_which_patient_you_prefer_to_rx_ciphaler',
|
|
'#field-likelihood_of_shifting_diagnosed_patients_from_old_device_to_foracort_ciphaler',
|
|
'#field-in_which_patient_profile_you_prefer_to_rx_ciphaler',
|
|
'#field-which_is_the_most_important_factor_to_rx_ciphaler',
|
|
'#field-which_is_the_most_important_factor_to_rx_ciphaler_other'
|
|
];
|
|
|
|
let noFields = [
|
|
'#field-are_you_aware_of_novel_device_foracort_ciphaler',
|
|
'#field-factors_for_not_prescribing_ciphaler',
|
|
'#field-overall_comments_for_not_taking_up_ciphaler'
|
|
];
|
|
|
|
let yesWrapper = $(`
|
|
<div id="yes_wrapper"
|
|
style="display:none;
|
|
border:1px solid #0d6efd;
|
|
padding:10px;
|
|
border-radius:4px;
|
|
margin-top:10px;">
|
|
</div>
|
|
`);
|
|
|
|
let noWrapper = $(`
|
|
<div id="no_wrapper"
|
|
style="display:none;
|
|
border:1px solid #0d6efd;
|
|
padding:10px;
|
|
border-radius:4px;
|
|
margin-top:10px;">
|
|
</div>
|
|
`);
|
|
|
|
$('#field-in_which_patient_you_prefer_to_rx_ciphaler').closest('.col-md-12').before(yesWrapper);
|
|
$('#field-are_you_aware_of_novel_device_foracort_ciphaler').closest('.col-md-12').before(noWrapper);
|
|
|
|
yesFields.forEach(id => {
|
|
$('#yes_wrapper').append($(id).closest('.col-md-12').hide());
|
|
});
|
|
|
|
noFields.forEach(id => {
|
|
$('#no_wrapper').append($(id).closest('.col-md-12').hide());
|
|
});
|
|
|
|
const otherInput = $('#field-which_is_the_most_important_factor_to_rx_ciphaler_other');
|
|
const otherDiv = otherInput.closest('.col-md-12');
|
|
|
|
otherDiv.hide();
|
|
otherInput.prop('required', false);
|
|
|
|
$('#field-which_is_the_most_important_factor_to_rx_ciphaler').on('change', function() {
|
|
if ($(this).val() === "Other") {
|
|
otherDiv.show();
|
|
otherInput.prop('required', true);
|
|
} else {
|
|
otherDiv.hide();
|
|
otherInput.val('');
|
|
otherInput.prop('required', false);
|
|
}
|
|
});
|
|
|
|
$('#field-ciphaler_rxber').on('change', function() {
|
|
|
|
let v = $(this).val();
|
|
|
|
if (v === "Yes") {
|
|
|
|
title.text('Understanding the Drivers for prescribing Ciphaler from the Loyal Rxers').show();
|
|
|
|
$('#yes_wrapper').show();
|
|
yesFields.forEach(id => $(id).closest('.col-md-12').show());
|
|
|
|
$('#no_wrapper').hide();
|
|
noFields.forEach(id => {
|
|
$(id).closest('.col-md-12').hide();
|
|
$(id).val('');
|
|
});
|
|
|
|
$('#field-contact_id').closest('.col-md-12')
|
|
.insertBefore($('#ciphaler_title')) // position
|
|
.show() // show field
|
|
.addClass('mt-2'); // spacing
|
|
$('#field-contact_id').prop('required', true); // make required
|
|
|
|
|
|
$('#field-overall_comments_for_not_taking_up_ciphaler').prop('required', false);
|
|
$('#field-which_is_the_most_important_factor_to_rx_ciphaler').trigger('change');
|
|
}
|
|
|
|
else if (v === "No") {
|
|
|
|
title.text('Understanding the barriers to Rx Ciphaler among the Chest/CPs (DPI User)').show();
|
|
|
|
$('#no_wrapper').show();
|
|
noFields.forEach(id => $(id).closest('.col-md-12').show());
|
|
|
|
$('#yes_wrapper').hide();
|
|
yesFields.forEach(id => {
|
|
$(id).closest('.col-md-12').hide();
|
|
$(id).val('');
|
|
});
|
|
|
|
// hide contact
|
|
$('#field-contact_id').closest('.col-md-12').hide();
|
|
$('#field-contact_id').prop('required', false);
|
|
|
|
otherDiv.hide();
|
|
otherInput.val('');
|
|
otherInput.prop('required', false);
|
|
|
|
$('#field-overall_comments_for_not_taking_up_ciphaler').prop('required', true);
|
|
}
|
|
|
|
else {
|
|
title.hide().text('');
|
|
$('#yes_wrapper').hide();
|
|
$('#no_wrapper').hide();
|
|
|
|
yesFields.concat(noFields).forEach(id => {
|
|
$(id).closest('.col-md-12').hide();
|
|
$(id).val('');
|
|
});
|
|
|
|
// hide contact initially
|
|
$('#field-contact_id').closest('.col-md-12').hide();
|
|
|
|
otherDiv.hide();
|
|
otherInput.val('');
|
|
otherInput.prop('required', false);
|
|
}
|
|
|
|
});
|
|
|
|
});
|
|
</script>
|
|
|
|
|
|
|
|
|
|
|
|
</body>
|
|
|
|
</html>
|