@extends('layout.main')


@section('main-section')


 <!-- Content wrapper -->
          <div class="content-wrapper">
            <!-- Content -->
            <div class="container-xxl flex-grow-1 container-p-y">




             <div class="row g-12">
                <div class="col-md-12">
                  <div class="card">
                    <h3 class="card-header text-warning">Claim Payment Details</h3>
                    <div class="card-body">


                        <div class="row">
                                            <div class="col-lg-6">
                                                <div class="card">
                                                    <div class="card-body">
                                                        <h4 class="header-title mb-3">Case Information</h4>

                                                        <h5 class="font-family-primary fw-semibold">Ref. No. {{$assignData->_ReferenceNo}} <a href="{{ url('/assignMotorEdit') }}/{{ $assignData->_Id }}" target="_blank" class="btn btn-danger" style="float: right;">Edit Assign</a></h5>

                                                        <p class="mb-2"><span class="fw-semibold me-2">Assign Branch </span> {{$assignData->_OurBranch}} <a href="{{ url('/motorPlrEdit') }}/{{ $assignData->_Id }}" target="_blank" class="btn btn-danger" style="float: right;">Edit PLR</a></p>
                                                        <p class="mb-2"><span class="fw-semibold me-2">Policy No. </span> {{$assignData->_PolicyPMDNo}} <a href="{{ url('/motorFsrEdit') }}/{{ $assignData->_Id }}" target="_blank" class="btn btn-danger" style="float: right;">Edit FSR</a></p>
                                                        <p class="mb-2"><span class="fw-semibold me-2">Loss No. </span> {{$assignData->_LossBenefitNo}} <a href="{{ url('/billEdit') }}/{{ $assignData->_Id }}" target="_blank" class="btn btn-danger" style="float: right;">Edit Bill</a></p>
                                                        <p class="mb-2"><span class="fw-semibold me-2">Insured </span> {{$assignData->_InsuredParticipant}}</p>
                                                        <p class="mb-2"><span class="fw-semibold me-2">Surveyor </span> {{$assignData->_AssignTeamMember}}</p>

                                                    </div>
                                                </div>
                                            </div> <!-- end col -->


                                            <div class="col-lg-6">
                                                <div class="card">
                                                    <div class="card-body">
                                                        <h4 class="header-title mb-3">Bill Information</h4>

                                                        <h5 class="font-family-primary fw-semibold">Ref. No. {{$assignData->_ReferenceNo}} </h5>
                                                        @foreach ($bill as $b)

                                                        <p class="mb-2"><span class="fw-semibold me-2">Professional Fee </span> {{$b->_ProfessionalFee}}</p>
                                                        <p class="mb-2"><span class="fw-semibold me-2">Travel Exp. {{$b->_TravelFrom }} - {{ $b->_TravelTo }} {{ $b->_KM }}KM:</span> {{$b->_TotalTravellingExpense}}</p>
                                                        <p class="mb-2"><span class="fw-semibold me-2">Photographs </span> {{$b->_Photographs}}</p>
                                                        <p class="mb-2"><span class="fw-semibold me-2">Re-Inspection </span> {{$b->_Re_Inspection}}</p>
                                                        <p class="mb-2"><span class="fw-semibold me-2">Tax Charged </span> @ {{ $b->_Province }} {{$b->_SSTPSTKPRABRAProvincialServicesTax}}%</p>
                                                         @endforeach
                                                    </div>
                                                </div>
                                            </div> <!-- end col -->




                                        </div>
                                        <!-- end row -->

                                        <p></p>

                    <form action="{{url('/unpaidFormPost')}}" method="post">
                        @csrf

                    <div class="row">

                      <div id="" class="form-text text-danger">
                          <h5 class="text-success">Details</h5>
                          <p></p>
                        </div>


                        <div class="col-lg-6" hidden>
                    <div class="mb-6">
                    <label for="" class="form-label">Job Id</label>
                    <input type="text" id="_JobId" class="form-control" name="_JobId" placeholder="" value="{{$assignData->_Id}}" readonly>
                    <input type="text" id="_user_email" class="form-control" name="_user_email" placeholder="" value="{{session()->get('user_email')}}" readonly>

                    </div>
                    <p></p>
                     </div> <!-- end col -->

                     <script>

                        function onlinecash(str)
                        {

                            if(str == "Online Payment" || str == "Cash Payment")
                            {
                                document.getElementById('onlinecash').style.display = 'block';
                            }
                            else
                            {
                                 document.getElementById('onlinecash').style.display = 'none';
                            }

                        }
                     </script>

                        <div class="col-md-6">
                        <label for="" class="form-label">Payment Type</label>
                         <select class="form-control" name="paymenttype" id="" onchange="onlinecash(this.value)">
                            <option value="">Please Select</option>
                            <option value="Cheque Payment">Cheque Payment</option>
                            <option value="Online Payment">Online Payment</option>
                            <option value="Cash Payment">Cash Payment</option>
                        </select>
                        <p></p>
                      </div>

                      <div class="col-md-6">
                        <label for="" class="form-label">Cheque Amount</label>
                        <input type="text" placeholder="Cheque Amount" name="ChequeAmount" class="form-control" id="" />
                        <p></p>
                      </div>


                      <div class="col-md-6">
                        <label for="" class="form-label">Cheque # / Transaction #</label>
                        <input type="text" placeholder="Cheque # / Transaction #" name="ChequeTransaction" class="form-control" id="" />
                        <p></p>
                      </div>


                         <div id="" class="form-text text-danger">
                          <h5 class="text-danger">Sign and Remarks</h5>
                          <p></p>
                        </div>


                       <div class="col-md-12">
                        <label for="" class="form-label">Remarks</label>
                        <textarea class="form-control" placeholder="Remarks" name="Remarks" id=""></textarea>
                        <p></p>
                      </div>

                      <div id="onlinecash" style="display: none;">

                      <h4>Online and Cash Only</h4>

                       <div class="col-md-6">
                        <label for="" class="form-label">Income Tax</label>
                        <input type="text" placeholder="Income Tax" name="incometax" class="form-control" id="" />
                        <p></p>
                      </div>

                       <div class="col-md-6">
                        <label for="" class="form-label">ST Withheld</label>
                        <input type="text" placeholder="ST Withheld" name="stwitheld" class="form-control" id="" />
                        <p></p>
                      </div>

                      <div class="col-md-6">
                        <label for="" class="form-label">ST Payable</label>
                        <input type="text" placeholder="ST Payable" name="stpayable" class="form-control" id="" />
                        <p></p>
                      </div>

                      <div class="col-md-6">
                        <label for="" class="form-label">Amount Approved</label>
                        <input type="text" placeholder="Amount Approved" name="amountapproved" class="form-control" id="" />
                        <p></p>

                      </div>

                       <div class="col-md-6">
                        <label for="" class="form-label">BD Amount Internal</label>
                        <input type="text" placeholder="BD Amount Internal" name="BDAmountInternal" class="form-control" id="" />
                        <p></p>
                      </div>

                       <div class="col-md-6">
                        <label for="" class="form-label">BD Amount External</label>
                        <input type="text" placeholder="BD Amount External" name="BDAmountExternal" class="form-control" id="" />
                        <p></p>
                      </div>



                      <div class="col-md-6">
                        <label for="" class="form-label">Deposited to Bank</label>

                        <select class="form-control" name="DepositedtoBank">
                            <option value="">Please Select</option>
                             @foreach ($banks as $b)
                                <option value="{{$b->_BankName}}">{{$b->_BankName}}</option>
                            @endforeach
                        </select>
                        <p></p>

                      </div>


                      <div class="col-md-6">
                        <label for="" class="form-label">Depositing Date / Transaction Date / Clearing Date</label>
                        <input type="date" placeholder="Depositing Date / Transaction Date / Clearing Date" name="DepositingDateTransactionDateClearingDate" class="form-control" id="" />
                        <p></p>

                      </div>
                      </div>

                      <div class="col-md-12">
                        <button type="submit" class="btn btn-success">Submit</button>
                      </div>

                    </div>
                    </form>
                    </div>
                  </div>
                </div>
             </div>
            </div>
          </div>

          @endsection('main-section')