@extends('layouts.master')

@section('body')
<div class="page-title">
    <div class="row">

        <div class="col-12">
            <ol class="breadcrumb">
                <li class="breadcrumb-item"><a href="{{ url('admin/dashboard') }}"> <i
                            data-feather="home"></i></a></li>
                <li class="breadcrumb-item"><a href="{{ url('tahsil-office-list') }}"> Tahsil Office </a></li>
                <li class="breadcrumb-item active"><a href="{{ url('add-tahsil-office') }}"> Add</a></li>
            </ol>
        </div>
    </div>
</div>

<div class="container-fluid">
    <div class="row">
        <div class="col-sm-12">
            <div class="card">
                <div class="card-header bg-primary py-3">
                    <h3 class="text-white">Add Tahsil Office</h3>
                </div>
                <div class="card-body">
                    <form method="post" action="{{ url('store-tahsil-office') }}">
                        @csrf
                        <div class="row mb-3">
                                   
                            <div class="col-md-6">
                                <label class="form-label" for="fname"><b>First Name<span class="error">*</span></b></label>
                                <input class="form-control" name="fname" id="fname" type="text"
                                    placeholder="Enter Employee name" value="{{old('fname')}}" required="">
                                @error('fname')
                                    <div class="text-danger">{{ $message }}</div>
                                @enderror
                            </div>

                            <div class="col-md-6">
                                <label class="form-label" for="mname"><b>Middle Name<span class="error"></span></b></label>
                                <input class="form-control" name="mname" id="mname" type="text"
                                    placeholder="Enter middle name" value="{{old('mname')}}">
                                @error('mname')
                                    <div class="text-danger">{{ $message }}</div>
                                @enderror
                            </div>

                            <div class="col-md-6">
                                <label class="form-label" for="lname"><b>Last Name<span class="error"></span></b></label>
                                <input class="form-control" name="lname" id="lname" type="text"
                                    placeholder="Enter last name" value="{{old('lname')}}">
                                @error('lname')
                                    <div class="text-danger">{{ $message }}</div>
                                @enderror
                            </div>

                            <div class="col-md-6">
                                <label class="form-label" for="mobile_no"><b>Mobile No.<span class="error">*</span></b></label>
                                <input class="form-control" name="mobile_no" id="mobile_no" type="text" oninput="this.value = this.value.replace(/[^0-9.]/g, '').replace(/(\..?)\../g, '$1');"
                                    placeholder="Enter Mobile Number" value="{{old('mobile_no')}}" maxlength="10" required="">
                                @error('mobile_no')
                                    <div class="text-danger">{{ $message }}</div>
                                @enderror
                            </div>

                            <div class="col-md-6">
                                <label class="form-label" for="email"><b>Email Address<span class="error">*</span></b></label>
                                <input class="form-control" name="email" id="email" type="email"
                                    placeholder="Enter Email Address" value="{{old('email')}}" required="">
                                @error('email')
                                    <div class="text-danger">{{ $message }}</div>
                                @enderror
                            </div>

                            <div class="col-md-6">
                                <div class="mb-2">
                                    <div class="col-form-label"><b>Select State <span class="error">*</span></b></div>
                                    <select class="js-example-basic-single col-sm-12" name="state" id="state"
                                        required="">
                                        <option value="">--Select State--</option>

                                        @foreach($states as $state)
                                            <option value="{{ $state->id }}" @if($state->id == old('state'))selected @endif>{{ $state->state_name }}</option>
                                        @endforeach
                                    </select>
                                    @error('state')
                                        <div class="text-danger">{{ $message }}</div>
                                    @enderror
                                </div>
                            </div>

                            <div class="col-md-6">
                                    <div class="mb-2">
                                        <div class="col-form-label"><b>Select District <span class="error">*</span></b></div>
                                        <select class="js-example-basic-single col-sm-12" name="district" id="district" required="">
                                        </select>
                                        @error('district')
                                        <div class="text-danger">{{$message}}</div>
                                        @enderror
                                    </div>
                                </div>


                                <div class="col-md-6">
                                    <div class="mb-2">
                                        <div class="col-form-label"><b>Taluka Name<span class="error">*</span></b></div>
                                        <select class="js-example-basic-single col-sm-12" name="taluka" id="taluka_name" required="">
                                        </select>
                                        @error('taluka_name')
                                        <div class="text-danger">{{$message}}</div>
                                        @enderror
                                    </div>
                                </div>

                            <div class="col-md-6">
                                <label class="form-label" for="username"><b>UserName<span class="error">*</span></b></label>
                                <input class="form-control" name="username" id="username" type="text" placeholder="Enter UserName" value="{{old('username')}}" required="">
                                @error('username')
                                    <div class="text-danger">{{ $message }}</div>
                                @enderror
                            </div>

                            <div class="col-md-6">
                                <label class="form-label" for="password"><b>Password<span class="error">*</span></b></label>
                                <input class="form-control" name="password" id="password" type="password" placeholder="Enter password" required="">
                                @error('password')
                                    <div class="text-danger">{{ $message }}</div>
                                @enderror
                            </div>
                        </div>

                        <div class="card-footer text-center">
                            <button class="btn btn-primary" type="submit" data-bs-original-title=""
                                title="">Save</button>
                            <a href="{{ url('tahsil-office-list') }}"><button class="btn btn-warning"
                                    type="button" data-bs-original-title="" title="">Cancel</button></a>
                        </div>
                    </form>
                </div>
            </div>
        </div>
    </div>
</div>
@endsection