@extends('layouts.app')

@section('style')
    <style>
        @font-face {
            font-family: 'SolaimanLipi';
            src: url('{{ public_path('fonts/SolaimanLipi.ttf') }}');
        }

        .inspection-form {
            font-family: 'SolaimanLipi';
            font-size: 20px;
        }
    </style>
@endsection

@section('content')
    <div class="py-4">
        <div class="mb-5">
            <x-inspection-request-header />
        </div>

        <div class="inspection-form">
            @if ($errors->any())
                @foreach ($errors->all() as $error)
                    <div>{{ $error }}</div>
                @endforeach
            @endif

            @dd($inspectionRequest)

            <form method="POST" action="{{ route('inspection-request.store.step-one', $inspectionRequest) }}"
                enctype="multipart/form-data">
                @csrf
                <div class="row mb-4 bg-white shadow rounded py-5 px-2">
                    <div class="col-md-1">
                        <p class="fs-4">১ |</p>
                    </div>
                    <div class="col-md-11">
                        <div class="form-group mb-4">
                            <label class="label mb-2" for="institute-name">কলেজ/ইনস্টিটিউটের নাম</label>
                            <input class="form-control" placeholder="কলেজ/ইনস্টিটিউটের নাম" type="text"
                                name="institute_name" id="institute-name" required>
                        </div>

                        <div class="form-group mb-4">
                            <label class="label mb-2" for="institute-name">ঠিকানা</label>
                            <input class="form-control" placeholder="কলেজ/ইনস্টিটিউটের নাম" type="text"
                                name="institute_name" id="institute-name" required>
                        </div>

                        <div class="mb-4">
                            <label class="label mb-2" for="is-bmdc-approved">মেট্রোপলিটন এলাকা?</label>

                            <div class="d-flex mb-4">
                                <div class="form-check me-5">
                                    <input class="form-check-input" type="radio" name="is_bmdc_approved"
                                        id="bmdc-approved-yes" value="yes" checked required>
                                    <label class="form-check-label" for="bmdc-approved-yes">
                                        হ্যাঁ
                                    </label>
                                </div>
                                <div class="form-check">
                                    <input class="form-check-input" type="radio" name="is_bmdc_approved"
                                        id="bmdc-approved-no" value="no" required>
                                    <label class="form-check-label" for="bmdc-approved-no">
                                        না
                                    </label>
                                </div>
                            </div>

                        </div>

                        <div class="row">
                            <div class="col-md-4">
                                <div class="form-group mb-4">
                                    <label class="label mb-2" for="thana">থানা</label>
                                    <input class="form-control" placeholder="থানা" type="text" name="thana"
                                        id="thana" required>
                                </div>
                            </div>

                            <div class="col-md-4">
                                <div class="form-group mb-4">
                                    <label class="label mb-2" for="upazila">উপজেলা</label>
                                    <input class="form-control" placeholder="উপজেলা" type="text" name="upazila"
                                        id="upazila" required>
                                </div>
                            </div>
                            <div class="col-md-4">
                                <div class="form-group mb-4">
                                    <label class="label mb-2" for="zila">জেলা</label>
                                    <input class="form-control" placeholder="জেলা" type="text" name="zila"
                                        id="zila" required>
                                </div>
                            </div>
                        </div>

                        <div class="row">
                            <div class="col-md-4">
                                <div class="form-group mb-4">
                                    <label class="label mb-2" for="institute-phone">ফোন নং (অফিস)</label>
                                    <input class="form-control" placeholder="ফোন নং (অফিস)" type="text"
                                        name="institute_phone" id="institute-phone" required>
                                </div>
                            </div>

                            <div class="col-md-4">
                                <div class="form-group mb-4">
                                    <label class="label mb-2" for="institute-email">ই-মেইল</label>
                                    <input class="form-control" placeholder="ই-মেইল" type="text" name="institute_email"
                                        id="institute-email" required>
                                </div>
                            </div>

                            <div class="col-md-4">
                                <div class="form-group mb-4">
                                    <label class="label mb-2" for="institute-fax">ফ্যাক্স</label>
                                    <input class="form-control" placeholder="ফ্যাক্স" type="text" name="institute_fax"
                                        id="institute-fax" required>
                                </div>
                            </div>
                        </div>

                        <div class="form-group mb-4">
                            <label class="label mb-2" for="session">অধিভুক্তির প্রার্থিত শিক্ষাবর্ষ</label>
                            <input class="form-control" placeholder="অধিভুক্তির প্রার্থিত শিক্ষাবর্ষ" type="text"
                                name="session" id="session" required>
                        </div>

                        <div class="form-group mb-4">
                            <label class="label mb-2" for="course-name">কোর্সের নাম</label>
                            <input class="form-control" placeholder="কোর্সের নাম" type="text" name="course_name"
                                id="applied-session" required>
                        </div>

                        <div class="form-group mb-4">
                            <label class="label mb-2" for="affiliation-fees">অধিভুক্তি ফি (অফেরৎযোগ্য)</label>
                            <input class="form-control" placeholder="অধিভুক্তি ফি (অফেরৎযোগ্য)" type="text"
                                name="affiliation_fees" id="affiliation-fees" required>
                        </div>

                        <div class="form-group mb-4">
                            <label class="label mb-2" for="bank-draft-no">ব্যাংক ড্রাফট/পে-অর্ডার নং</label>
                            <input class="form-control" placeholder="ব্যাংক ড্রাফট/পে-অর্ডার নং" type="text"
                                name="bank_draft_number" id="bank-draft-number" required>
                        </div>
                        <div class="form-group mb-4">
                            <label class="label mb-2" for="bank-draft-no">ব্যাংক ড্রাফট তারিখ</label>
                            <input class="form-control" placeholder="ব্যাংক ড্রাফট তারিখ" type="date"
                                name="bank_draft_date" id="bank-draft-date" required>
                        </div>
                        <div class="form-group mb-4">
                            <label class="label mb-2" for="bank-name">ব্যাংকের নাম</label>
                            <input class="form-control" placeholder="ব্যাংকের নাম" type="text" name="bank_name"
                                id="bank-name" required>
                        </div>

                        <div class="form-group">
                            <label class="label mb-2" for="bank-receipt">ব্যাংক রিসিট</label>
                            <input class="form-control" placeholder="ব্যাংক রিসিট" type="file" name="bank_receipt"
                                id="bank-receipt" accept="image/jpeg,image/gif,image/png,application/pdf,image/x-eps"
                                required>
                        </div>
                    </div>
                </div>

                <div class="row mb-4 bg-white shadow rounded py-5 px-2">
                    <div class="col-md-1">
                        <p class="fs-4">২ |</p>
                    </div>
                    <div class="col-md-11">
                        <div class="form-group">
                            <label class="label mb-2" for="est-date">প্রতিষ্ঠার তারিখ</label>
                            <input class="form-control" placeholder="প্রতিষ্ঠার তারিখ" type="date" name="est_date"
                                id="est-date" required>
                        </div>
                    </div>
                </div>

                <div class="row mb-4 bg-white shadow rounded py-5 px-2">
                    <div class="col-md-1">
                        <p class="fs-4">৩|</p>
                    </div>
                    <div class="col-md-11">
                        <div>
                            <div class="form-group mb-4">
                                <label class="label mb-2" for="bmdc-approved-letter-no">বিএমডিসি কর্তৃক অনুমোদন পত্র
                                    নং</label>
                                <input class="form-control" placeholder="অনুমোদন পত্র নং" type="text"
                                    name="bmdc_approved_letter_no" id="bmdc-approved-letter-no">
                            </div>

                            <div class="form-group mb-4">
                                <label class="label mb-2" for="bmdc-approved-date">অনুমোদন তারিখ</label>
                                <input class="form-control" placeholder="অনুমোদন তারিখ" type="date"
                                    name="bmdc_approved_date" id="govt-approved-date">
                            </div>

                            <div class="form-group">
                                <label class="label mb-2" for="bmdc-approved-letter-copy">অনুমোদন পত্রের কপি</label>
                                <input class="form-control" placeholder="অনুমোদন পত্রের কপি" type="file"
                                    name="bmdc_approved_letter_copy"
                                    accept="image/jpeg,image/gif,image/png,application/pdf,image/x-eps"
                                    id="bmdc-approved-letter-copy">
                            </div>
                        </div>
                    </div>
                </div>

                <div class="row mb-4 bg-white shadow rounded py-5 px-2">
                    <div class="col-md-1">
                        <p class="fs-4">৪ |</p>
                    </div>
                    <div class="col-md-11">
                        <div class="form-group mb-4">
                            <label class="label mb-2" for="land-related">কলেজ/ইনস্টিটিউটের জমি ও ভবন সংক্রান্ত
                                তথ্য</label>
                        </div>
                        <div class="row mb-4">
                            <div class="col-md-1">
                                <p class="fs-4">(ক)</p>
                            </div>
                            <div class="col-md-11">
                                <div class="from-group mb-4">
                                    <label class="label mb-2" for="has-own-land">প্রতিষ্ঠানের নিজস্ব জমি আছে কিনা
                                        ?</label>
                                    <div class="d-flex mb-4">
                                        <div class="form-check me-5">
                                            <input class="form-check-input" type="radio" name="has_own_land"
                                                id="has-own-land-yes" checked>
                                            <label class="form-check-label" for="has-own-land-yes">
                                                হ্যাঁ
                                            </label>
                                        </div>
                                        <div class="form-check">
                                            <input class="form-check-input" type="radio" name="has_own_land"
                                                id="has-own-land-no">
                                            <label class="form-check-label" for="has-own-land-no">
                                                না
                                            </label>
                                        </div>
                                    </div>
                                </div>
                            </div>
                        </div>

                        <div class="row mb-4">
                            <div class="col-md-1">
                                <p class="fs-4">(খ)</p>
                            </div>
                            <div class="col-md-11">
                                <div class="form-group mb-4">
                                    <label class="label mb-2" for="total-land-area">মোট জমির পরিমাণ</label>
                                    <input class="form-control" placeholder="মোট জমির পরিমাণ" type="text"
                                        name="total_land_area" id="total-land-area">
                                </div>
                            </div>
                        </div>

                        <div class="row mb-4">
                            <div class="col-md-1">
                                <p class="fs-4">(গ)</p>
                            </div>
                            <div class="col-md-11">
                                <div class="form-group mb-4">
                                    <label class="label mb-2" for="from-what-source">কি সূত্রে প্রাপ্ত</label>
                                    <input class="form-control" placeholder="কি সূত্রে প্রাপ্ত" type="text"
                                        name="from_what_source" id="from-what-source">
                                </div>

                                <div class="form-group mb-4">
                                    <label class="label mb-2" for="land-related-documents">সংশ্লিষ্ট কাগজপত্রাদি</label>
                                    <input class="form-control" placeholder="সংশ্লিষ্ট কাগজপত্রাদি" type="file"
                                        name="land_related_documents" id="land-related-documents">
                                </div>
                            </div>
                        </div>

                        <div class="row mb-4">
                            <div class="col-md-1">
                                <p class="fs-4">(ঘ)</p>
                            </div>
                            <div class="col-md-11">
                                <div class="from-group mb-4">
                                    <label class="label mb-2" for="located-in-its-own-building">প্রতিষ্ঠানটি নিজস্ব ভবনে
                                        অবস্থিত কিনা ?</label>
                                    <div class="d-flex mb-4">
                                        <div class="form-check me-5">
                                            <input class="form-check-input" type="radio"
                                                name="located_in_its_own_building" id="located-in-its-own-building-yes"
                                                checked>
                                            <label class="form-check-label" for="located-in-its-own-building-yes">
                                                হ্যাঁ
                                            </label>
                                        </div>
                                        <div class="form-check">
                                            <input class="form-check-input" type="radio"
                                                name="located_in_its_own_building" id="located-in-its-own-building-no">
                                            <label class="form-check-label" for="located-in-its-own-building-no">
                                                না
                                            </label>
                                        </div>
                                    </div>
                                </div>
                            </div>
                        </div>

                        <div class="row mb-4">
                            <div class="col-md-1">
                                <p class="fs-4">(ঙ)</p>
                            </div>
                            <div class="col-md-11">
                                <div class="from-group mb-4">
                                    <label class="label mb-2" for="hospital-in-its-own-building">নিজস্ব ভবনে হাসপাতাল আছে
                                        কিনা ?</label>
                                    <div class="d-flex mb-4">
                                        <div class="form-check me-5">
                                            <input class="form-check-input" type="radio"
                                                name="hospital_in_its_own_building" id="hospital-in-its-own-building-yes"
                                                checked>
                                            <label class="form-check-label" for="hospital-in-its-own-building-yes">
                                                হ্যাঁ
                                            </label>
                                        </div>
                                        <div class="form-check">
                                            <input class="form-check-input" type="radio"
                                                name="hospital_in_its_own_building" id="hospital-in-its-own-building-no">
                                            <label class="form-check-label" for="hospital-in-its-own-building-no">
                                                না
                                            </label>
                                        </div>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                </div>
        </div>

        <div class="row mb-4">
            <div class="col-md-12">
                <div class="d-flex justify-content-end">
                    <button type="submit" class="btn btn-primary">পরবর্তী পৃষ্ঠা</button>
                </div>
            </div>
        </div>

        </form>
    </div>
    </div>
@endsection