{{-- @extends('layouts.layout')

@section('content')

<section class="content-header">
    <div class="container-fluid">
        <div class="row">
            <div class="col-sm-6">
            </div>
            <div class="col-sm-6">
                <ol class="breadcrumb float-sm-right">
                    <li class="breadcrumb-item">
                        <a href="{{ route('prescriptions.index') }}">@lang('Case')</a></li>
                    <li class="breadcrumb-item active">@lang('Edit Case')</li>
                </ol>
            </div>
        </div>
    </div>
</section>
<div class="row">
    <div class="col-12">
        <div class="card">
            <div class="card-header">
                <h3 class="card-title">@lang('Edit Case')</h3>
            </div>
            <div class="card-body">
                <form class="form-material form-horizontal" action="{{ route('prescriptions.update', $prescription) }}" method="POST" enctype="multipart/form-data">
                    @csrf
                    @method('PUT')
                    <div class="row">
                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="user_id">@lang('Select Patient') <b class="ambitious-crimson">*</b></label>
                                <select name="user_id" id="user_id" class="form-control custom-width-100 select2 @error('user_id') is-invalid @enderror" required>
                                    <option value="">--@lang('Select')--</option>
                                    @foreach ($patients as $patient)
                                        <option value="{{ $patient->id }}" @if ($patient->id == request()->user_id) selected @endif>{{ $patient->name }}</option>
                                    @endforeach
                                </select>
                                @error('user_id')
                                    <div class="invalid-feedback">
                                        {{ $message }}
                                    </div>
                                @enderror
                            </div>
                        </div>
                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="doctor_id">@lang('Select Doctor') <b class="ambitious-crimson">*</b></label>
                                <select name="doctor_id" id="doctor_id" class="form-control custom-width-100 select2 @error('doctor_id') is-invalid @enderror" required>
                                    <option value="">--@lang('Select')--</option>
                                    @foreach ($doctors as $doctor)
                                        <option value="{{ $doctor->id }}" {{ $prescription->doctor_id == $doctor->id ? "selected" : "" }}>{{ $doctor->name }}</option>
                                    @endforeach
                                </select>
                                @error('user_id')
                                    <div class="invalid-feedback">
                                        {{ $message }}
                                    </div>
                                @enderror
                            </div>
                        </div>
                        <div class="col-md-4">
                            <div class="form-group">
                                <label>@lang('Case Date') <b class="ambitious-crimson">*</b></label>
                                <input type="text" name="prescription_date" id="prescription_date" class="form-control flatpickr @error('prescription_date') is-invalid @enderror" placeholder="@lang('Case Date')" value="{{ old('prescription_date', $prescription->prescription_date) }}" required>
                                @error('prescription_date')
                                    <div class="invalid-feedback">
                                        {{ $message }}
                                    </div>
                                @enderror
                            </div>
                        </div>
                    </div>
                    <div class="row">
                        <div class="col-md-2">
                            <button type="button" class="btn btn-info" data-toggle="collapse" href="#caseStudy"><i class="fas fa-file-alt"></i> @lang('Case Study')</button>
                        </div>
                        <br><br>
                    </div>
                    <div id="caseStudy" class="collapse">
                        <div class="card-body border">
                            <div class="row">
                                <div class="col-md-6">
                                    <div class="form-group">
                                        <label for="food_allergy">@lang('Food Allergy')</label>
                                        <div class="input-group mb-3">
                                            <div class="input-group-prepend">
                                                <span class="input-group-text"><i class="fas fa-pizza-slice"></i></span>
                                            </div>
                                            <input type="text" id="food_allergy" name="food_allergy" value="{{ old('food_allergy', $patientCaseStudy->food_allergy ?? null) }}" class="form-control @error('food_allergy') is-invalid @enderror" placeholder="@lang('Food Allergy')">
                                            @error('food_allergy')
                                                <div class="invalid-feedback">
                                                    {{ $message }}
                                                </div>
                                            @enderror
                                        </div>
                                    </div>
                                </div>
                                <div class="col-md-6">
                                    <div class="form-group">
                                        <label for="heart_disease">@lang('Heart Disease')</label>
                                        <div class="input-group mb-3">
                                            <div class="input-group-prepend">
                                                <span class="input-group-text"><i class="fas fa-heart-broken"></i></span>
                                            </div>
                                            <input type="text" id="heart_disease" name="heart_disease" value="{{ old('heart_disease', $patientCaseStudy->heart_disease ?? null) }}" class="form-control @error('heart_disease') is-invalid @enderror" placeholder="@lang('Heart Disease')">
                                            @error('heart_disease')
                                                <div class="invalid-feedback">
                                                    {{ $message }}
                                                </div>
                                            @enderror
                                        </div>
                                    </div>
                                </div>
                            </div>
                            <div class="row">
                                <div class="col-md-6">
                                    <div class="form-group">
                                        <label for="high_blood_pressure">@lang('High Blood Pressure')</label>
                                        <div class="input-group mb-3">
                                            <div class="input-group-prepend">
                                                <span class="input-group-text"><i class="fas fa-tint"></i></span>
                                            </div>
                                            <input type="text" id="high_blood_pressure" name="high_blood_pressure" value="{{ old('high_blood_pressure', $patientCaseStudy->high_blood_pressure ?? null) }}" class="form-control @error('high_blood_pressure') is-invalid @enderror" placeholder="@lang('High Blood Pressure')">
                                            @error('high_blood_pressure')
                                                <div class="invalid-feedback">
                                                    {{ $message }}
                                                </div>
                                            @enderror
                                        </div>
                                    </div>
                                </div>
                                <div class="col-md-6">
                                    <div class="form-group">
                                        <label for="diabetic">@lang('Diabetic')</label>
                                        <div class="input-group mb-3">
                                            <div class="input-group-prepend">
                                                <span class="input-group-text"><i class="fas fa-drumstick-bite"></i></span>
                                            </div>
                                            <input type="text" id="diabetic" name="diabetic" value="{{ old('diabetic', $patientCaseStudy->diabetic ?? null) }}" class="form-control @error('diabetic') is-invalid @enderror" placeholder="@lang('Diabetic')">
                                            @error('diabetic')
                                                <div class="invalid-feedback">
                                                    {{ $message }}
                                                </div>
                                            @enderror
                                        </div>
                                    </div>
                                </div>
                            </div>
                            <div class="row">
                                <div class="col-md-6">
                                    <div class="form-group">
                                        <label for="surgery">@lang('Surgery')</label>
                                        <div class="input-group mb-3">
                                            <div class="input-group-prepend">
                                                <span class="input-group-text"><i class="fas fa-user-nurse"></i></span>
                                            </div>
                                            <input type="text" id="surgery" name="surgery" value="{{ old('surgery', $patientCaseStudy->surgery ?? null) }}" class="form-control @error('surgery') is-invalid @enderror" placeholder="@lang('Surgery')">
                                            @error('surgery')
                                                <div class="invalid-feedback">
                                                    {{ $message }}
                                                </div>
                                            @enderror
                                        </div>
                                    </div>
                                </div>
                                <div class="col-md-6">
                                    <div class="form-group">
                                        <label for="accident">@lang('Accident')</label>
                                        <div class="input-group mb-3">
                                            <div class="input-group-prepend">
                                                <span class="input-group-text"><i class="fas fa-car-crash"></i></span>
                                            </div>
                                            <input type="text" id="accident" name="accident" value="{{ old('accident', $patientCaseStudy->accident ?? null) }}" class="form-control @error('accident') is-invalid @enderror" placeholder="@lang('Accident')">
                                            @error('accident')
                                                <div class="invalid-feedback">
                                                    {{ $message }}
                                                </div>
                                            @enderror
                                        </div>
                                    </div>
                                </div>
                            </div>
                            <div class="row">
                                <div class="col-md-6">
                                    <div class="form-group">
                                        <label for="others">@lang('Others')</label>
                                        <div class="input-group mb-3">
                                            <div class="input-group-prepend">
                                                <span class="input-group-text"><i class="fab fa-ethereum"></i></span>
                                            </div>
                                            <input type="text" id="others" name="others" value="{{ old('others', $patientCaseStudy->others ?? null) }}" class="form-control @error('others') is-invalid @enderror" placeholder="@lang('Others')">
                                            @error('others')
                                                <div class="invalid-feedback">
                                                    {{ $message }}
                                                </div>
                                            @enderror
                                        </div>
                                    </div>
                                </div>
                                <div class="col-md-6">
                                    <div class="form-group">
                                        <label for="family_medical_history">@lang('Family Medical History')</label>
                                        <div class="input-group mb-3">
                                            <div class="input-group-prepend">
                                                <span class="input-group-text"><i class="fas fa-history"></i></span>
                                            </div>
                                            <input type="text" id="family_medical_history" name="family_medical_history" value="{{ old('family_medical_history', $patientCaseStudy->family_medical_history ?? null) }}" class="form-control @error('family_medical_history') is-invalid @enderror" placeholder="@lang('Family Medical History')">
                                            @error('family_medical_history')
                                                <div class="invalid-feedback">
                                                    {{ $message }}
                                                </div>
                                            @enderror
                                        </div>
                                    </div>
                                </div>
                            </div>
                            <div class="row">
                                <div class="col-md-6">
                                    <div class="form-group">
                                        <label for="current_medication">@lang('Current Medication')</label>
                                        <div class="input-group mb-3">
                                            <div class="input-group-prepend">
                                                <span class="input-group-text"><i class="fas fa-capsules"></i></span>
                                            </div>
                                            <input type="text" id="current_medication" name="current_medication" value="{{ old('current_medication', $patientCaseStudy->current_medication ?? null) }}" class="form-control @error('current_medication') is-invalid @enderror" placeholder="@lang('Current Medication')">
                                            @error('current_medication')
                                                <div class="invalid-feedback">
                                                    {{ $message }}
                                                </div>
                                            @enderror
                                        </div>
                                    </div>
                                </div>
                                <div class="col-md-6">
                                    <div class="form-group">
                                        <label for="pregnancy">@lang('Pregnancy')</label>
                                        <div class="input-group mb-3">
                                            <div class="input-group-prepend">
                                                <span class="input-group-text"><i class="fas fa-female"></i></span>
                                            </div>
                                            <input type="text" id="pregnancy" name="pregnancy" value="{{ old('pregnancy', $patientCaseStudy->pregnancy ?? null) }}" class="form-control @error('pregnancy') is-invalid @enderror" placeholder="@lang('Pregnancy')">
                                            @error('pregnancy')
                                                <div class="invalid-feedback">
                                                    {{ $message }}
                                                </div>
                                            @enderror
                                        </div>
                                    </div>
                                </div>
                            </div>
                            <div class="row">
                                <div class="col-md-6">
                                    <div class="form-group">
                                        <label for="breastfeeding">@lang('Breast Feeding')</label>
                                        <div class="input-group mb-3">
                                            <div class="input-group-prepend">
                                                <span class="input-group-text"><i class="fas fa-baby"></i></span>
                                            </div>
                                            <input type="text" id="breastfeeding" name="breastfeeding" value="{{ old('breastfeeding', $patientCaseStudy->breastfeeding ?? null) }}" class="form-control @error('breastfeeding') is-invalid @enderror" placeholder="@lang('Breast feeding')">
                                            @error('breastfeeding')
                                                <div class="invalid-feedback">
                                                    {{ $message }}
                                                </div>
                                            @enderror
                                        </div>
                                    </div>
                                </div>
                                <div class="col-md-6">
                                    <div class="form-group">
                                        <label for="health_insurance">@lang('Health Insurance')</label>
                                        <div class="input-group mb-3">
                                            <div class="input-group-prepend">
                                                <span class="input-group-text"><i class="fas fa-briefcase-medical"></i></span>
                                            </div>
                                            <input type="text" name="health_insurance" id="health_insurance" class="form-control @error('health_insurance') is-invalid @enderror" placeholder="@lang('Health Insurance')" value="{{ old('health_insurance', $patientCaseStudy->health_insurance ?? null) }}">
                                            @error('health_insurance')
                                                <div class="invalid-feedback">
                                                    {{ $message }}
                                                </div>
                                            @enderror
                                        </div>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="row">
                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="weight">@lang('Weight') <b class="ambitious-crimson">*</b></label>
                                <div class="input-group mb-3">
                                    <div class="input-group-prepend">
                                        <span class="input-group-text"><i class="fas fa-weight"></i></span>
                                    </div>
                                    <input type="text" id="weight" name="weight" value="{{ old('weight', $prescription->weight) }}" class="form-control @error('weight') is-invalid @enderror" placeholder="@lang('Weight')" required>
                                    @error('weight')
                                        <div class="invalid-feedback">
                                            {{ $message }}
                                        </div>
                                    @enderror
                                </div>
                            </div>
                        </div>
                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="height">@lang('Height') <b class="ambitious-crimson">*</b></label>
                                <div class="input-group mb-3">
                                    <div class="input-group-prepend">
                                        <span class="input-group-text"><i class="fas fa-ruler"></i></span>
                                    </div>
                                    <input type="text" id="height" name="height" value="{{ old('height', $prescription->height) }}" class="form-control @error('height') is-invalid @enderror" placeholder="@lang('Height')" required>
                                    @error('height')
                                        <div class="invalid-feedback">
                                            {{ $message }}
                                        </div>
                                    @enderror
                                </div>
                            </div>
                        </div>
                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="blood_pressure">@lang('Blood Presure') <b class="ambitious-crimson">*</b></label>
                                <div class="input-group mb-3">
                                    <div class="input-group-prepend">
                                        <span class="input-group-text"><i class="fas fa-tint"></i></span>
                                    </div>
                                    <input type="text" id="blood_pressure" name="blood_pressure" value="{{ old('blood_pressure', $prescription->blood_pressure) }}" class="form-control @error('blood_pressure') is-invalid @enderror" placeholder="@lang('Blood Presure')" required>
                                    @error('blood_pressure')
                                        <div class="invalid-feedback">
                                            {{ $message }}
                                        </div>
                                    @enderror
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="row">
                        <div class="col-md-12">
                            <div class="form-group">
                                <label for="chief_complaint">@lang('Complains') <b class="ambitious-crimson">*</b></label>
                                <div class="input-group mb-3">
                                    <textarea name="chief_complaint" id="chief_complaint" class="form-control @error('chief_complaint') is-invalid @enderror" rows="4" placeholder="Complains" required>{{ old('chief_complaint', $prescription->chief_complaint) }}</textarea>
                                    @error('chief_complaint')
                                        <div class="invalid-feedback">
                                            {{ $message }}
                                        </div>
                                    @enderror
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="row">
                        <div class="col-md-12">
                            <div class="table-responsive">
                                <table id="t1" class="table">
                                    <thead>
                                        <tr>
                                            <th scope="col">@lang('Goals')</th>
                                            <th scope="col">@lang('Mastery Criteria')</th>
                                            <th scope="col">@lang('Instruction')</th>
                                            <th scope="col">@lang('Days')</th>
                                            <th scope="col" class="custom-white-space">@lang('Add / Remove')</th>
                                        </tr>
                                    </thead>
                                    <tbody>
                                        @if (old('medicine_name'))
                                            @foreach (old('medicine_name') as $key => $value)
                                                <tr>
                                                    <td>
                                                        <input type="text" name="medicine_name[]" class="form-control" value="{{ old('medicine_name')[$key] }}" placeholder="Goals">
                                                    </td>
                                                    <td>
                                                        <input type="text" name="medicine_type[]" class="form-control" value="{{ old('medicine_type')[$key] }}" placeholder="Mastery Criteria">
                                                    </td>
                                                    <td>
                                                        <input type="text" name="instruction[]" class="form-control" value="{{ old('instruction')[$key] }}" placeholder="Instructions">
                                                    </td>
                                                    <td>
                                                        <input type="text" name="day[]" class="form-control" value="{{ old('day')[$key] }}" placeholder="Days">
                                                    </td>
                                                    <td>
                                                        <button type="button" class="btn btn-info m-add"><i class="fas fa-plus"></i></button>
                                                        <button type="button" class="btn btn-info m-remove"><i class="fas fa-trash"></i></button>
                                                    </td>
                                                </tr>
                                            @endforeach
                                        @else
                                            @foreach (json_decode($prescription->medicine_info) as $medicineInfo)
                                                <tr>
                                                    <td>
                                                        <input type="text" name="medicine_name[]" class="form-control" value="{{ $medicineInfo->medicine_name }}" placeholder="Goals">
                                                    </td>
                                                    <td>
                                                        <input type="text" name="medicine_type[]" class="form-control" value="{{ $medicineInfo->medicine_type }}" placeholder="Mastery Criteria">
                                                    </td>
                                                    <td>
                                                        <input type="text" name="instruction[]" class="form-control" value="{{ $medicineInfo->instruction }}" placeholder="Instructions">
                                                    </td>
                                                    <td>
                                                        <input type="text" name="day[]" class="form-control" value="{{ $medicineInfo->day }}" placeholder="Days">
                                                    </td>
                                                    <td>
                                                        <button type="button" class="btn btn-info m-add"><i class="fas fa-plus"></i></button>
                                                        <button type="button" class="btn btn-info m-remove"><i class="fas fa-trash"></i></button>
                                                    </td>
                                                </tr>
                                            @endforeach
                                        @endif
                                        <tbody id="medicine">
                                            <tr>
                                                <td>
                                                    <input type="text" name="medicine_name[]" class="form-control" value="" placeholder="Goals">
                                                </td>
                                                <td>
                                                    <input type="text" name="medicine_type[]" class="form-control" value="" placeholder="Mastery Criteria">
                                                </td>
                                                <td>
                                                    <input type="text" name="instruction[]" class="form-control" value="" placeholder="Instructions">
                                                </td>
                                                <td>
                                                    <input type="text" name="day[]" class="form-control" value="" placeholder="Days">
                                                </td>
                                                <td>
                                                    <button type="button" class="btn btn-info m-add"><i class="fas fa-plus"></i></button>
                                                    <button type="button" class="btn btn-info m-remove"><i class="fas fa-trash"></i></button>
                                                </td>
                                            </tr>
                                        </tbody>
                                    </tbody>
                                </table>
                            </div>
                        </div>
                    </div>
                    <div class="row">
                        <div class="col-md-12">
                            <div class="table-responsive">
                                <table class="table">
                                    <thead class="table-dark">
                                        <tr>
                                            <th scope="col" class="text-light">@lang('Diagnosis')</th>
                                            <th scope="col" class="text-light">@lang('Instruction')</th>
                                            <th scope="col" class="custom-white-space text-light custom-width-120">@lang('Add / Remove')</th>
                                        </tr>
                                    </thead>
                                    <tbody>
                                        @if (old('diagnosis'))
                                            @foreach (old('diagnosis') as $key => $value)
                                                <tr>
                                                    <td>
                                                        <input type="text" name="diagnosis[]" class="form-control" value="{{ old('diagnosis')[$key] }}" placeholder="Diagnosis">
                                                    </td>
                                                    <td>
                                                        <input type="text" name="diagnosis_instruction[]" class="form-control" value="{{ old('diagnosis_instruction')[$key] }}" placeholder="Instruction">
                                                    </td>
                                                    <td>
                                                        <button type="button" class="btn btn-info d-add"><i class="fas fa-plus"></i></button>
                                                        <button type="button" class="btn btn-info d-remove"><i class="fas fa-trash"></i></button>
                                                    </td>
                                                </tr>
                                            @endforeach
                                        @else
                                            @foreach (json_decode($prescription->diagnosis_info) as $diagnosisInfo)
                                                <tr>
                                                    <td>
                                                        <input type="text" name="diagnosis[]" class="form-control" value="{{ $diagnosisInfo->diagnosis }}" placeholder="Diagnosis">
                                                    </td>
                                                    <td>
                                                        <input type="text" name="diagnosis_instruction[]" class="form-control" value="{{ $diagnosisInfo->diagnosis_instruction }}" placeholder="Instruction">
                                                    </td>
                                                    <td>
                                                        <button type="button" class="btn btn-info d-add"><i class="fas fa-plus"></i></button>
                                                        <button type="button" class="btn btn-info d-remove"><i class="fas fa-trash"></i></button>
                                                    </td>
                                                </tr>
                                            @endforeach
                                        @endif
                                        <tbody id="diagnosis">
                                            <tr>
                                                <td>
                                                    <input type="text" name="diagnosis[]" class="form-control" value="" placeholder="Diagnosis">
                                                </td>
                                                <td>
                                                    <input type="text" name="diagnosis_instruction[]" class="form-control" value="" placeholder="Instruction">
                                                </td>
                                                <td>
                                                    <button type="button" class="btn btn-info d-add"><i class="fas fa-plus"></i></button>
                                                    <button type="button" class="btn btn-info d-remove"><i class="fas fa-trash"></i></button>
                                                </td>
                                            </tr>
                                        </tbody>
                                    </tbody>
                                </table>
                            </div>
                        </div>
                    </div>
                    <div class="row">
                        <div class="col-md-12">
                            <div class="form-group">
                                <label for="note">@lang('Note')</label>
                                <div class="input-group mb-3">
                                    <textarea name="note" id="note" class="form-control @error('note') is-invalid @enderror" rows="4" placeholder="Note">{{ old('note', $prescription->note) }}</textarea>
                                    @error('note')
                                        <div class="invalid-feedback">
                                            {{ $message }}
                                        </div>
                                    @enderror
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="row">
                        <div class="col-md-6">
                            <div class="form-group">
                                <label class="col-md-3 col-form-label"></label>
                                <div class="col-md-8">
                                    <input type="submit" value="@lang('Submit')" class="btn btn-outline btn-info btn-lg"/>
                                    <a href="{{ route('prescriptions.index') }}" class="btn btn-outline btn-warning btn-lg">@lang('Cancel')</a>
                                </div>
                            </div>
                        </div>
                    </div>
                </form>
            </div>
        </div>
    </div>
</div>
@endsection

@push('footer')
    <script src="{{ asset('assets/js/custom/prescription.js') }}"></script>
@endpush
 --}}


@extends('layouts.layout')

@section('content')
    <section class="content-header">
        <div class="container-fluid">
            <div class="row">
                <div class="col-sm-6">
                </div>
                <div class="col-sm-6">
                    <ol class="breadcrumb float-sm-right">
                        <li class="breadcrumb-item">
                            <a href="{{ route('prescriptions.index') }}">@lang('Case')</a>
                        </li>
                        <li class="breadcrumb-item active">@lang('Edit Case')</li>
                    </ol>
                </div>
            </div>
        </div>
    </section>
    <div class="row">
        <div class="col-12">
            <div class="card">
                <div class="card-header">
                    <h3 class="card-title">@lang('Edit Cases')</h3>
                </div>
                <div class="card-body">
                    <form class="form-material form-horizontal" action="{{ route('details-patient-case.update', $prescription->id) }}" method="POST" enctype="multipart/form-data">
                        @csrf
                        @method('PUT')
                        <div class="row">
                            <input type="text" hidden name="invoice_id_helper" id="invoice_id_helper" value="{{ $prescription->invoice ? $prescription->invoice->id : '' }}">
                            <div class="col-md-6">
                                <div class="form-group">
                                    <label for="user_id">@lang('Select Patient') <b class="ambitious-crimson">*</b></label>
                                    <select name="user_id" id="user_id" class="form-control custom-width-100 select2 @error('user_id') is-invalid @enderror" required>
                                        <option value="">--@lang('Select')--</option>
                                        @foreach ($patients as $patient)
                                            <option value="{{ $patient->id }}" @if ($patient->id == request()->user_id) selected @endif>{{ $patient->name }}</option>
                                        @endforeach
                                    </select>
                                    @error('user_id')
                                        <div class="invalid-feedback">
                                            {{ $message }}
                                        </div>
                                    @enderror
                                </div>
                            </div>
                            <div class="col-md-4" hidden>
                                <div class="form-group">
                                    <label for="doctor_id">@lang('Select Doctor') <b class="ambitious-crimson">*</b></label>
                                    <select name="doctor_id" id="doctor_id" class="form-control custom-width-100 select2 @error('doctor_id') is-invalid @enderror">
                                        <option value="">--@lang('Select')--</option>
                                        @foreach ($doctors as $doctor)
                                            <option value="{{ $doctor->id }}" {{ $prescription->doctor_id == $doctor->id ? 'selected' : '' }}>{{ $doctor->name }}</option>
                                        @endforeach
                                    </select>
                                    @error('user_id')
                                        <div class="invalid-feedback">
                                            {{ $message }}
                                        </div>
                                    @enderror
                                </div>
                            </div>
                            <div class="col-md-6">
                                <div class="form-group">
                                    <label>@lang('Case Date') <b class="ambitious-crimson">*</b></label>
                                    <input type="text" name="prescription_date" id="prescription_date" class="form-control flatpickr @error('prescription_date') is-invalid @enderror" placeholder="@lang('Case Date')" value="{{ old('prescription_date', $prescription->prescription_date) }}" required>
                                    @error('prescription_date')
                                        <div class="invalid-feedback">
                                            {{ $message }}
                                        </div>
                                    @enderror
                                </div>
                            </div>
                        </div>
                        {{-- <div class="row">
                            <div class="col-md-2">
                                <button type="button" class="btn btn-info" data-toggle="collapse" href="#caseStudy"><i class="fas fa-file-alt"></i> @lang('Case Study')</button>
                            </div>
                            <br><br>
                        </div>
                        <div id="caseStudy" class="collapse">
                            <div class="card-body border">
                                <div class="row">
                                    <div class="col-md-6">
                                        <div class="form-group">
                                            <label for="food_allergy">@lang('Food Allergy')</label>
                                            <div class="input-group mb-3">
                                                <div class="input-group-prepend">
                                                    <span class="input-group-text"><i class="fas fa-pizza-slice"></i></span>
                                                </div>
                                                <input type="text" id="food_allergy" name="food_allergy" value="{{ old('food_allergy', $patientCaseStudy->food_allergy ?? null) }}" class="form-control @error('food_allergy') is-invalid @enderror" placeholder="@lang('Food Allergy')">
                                                @error('food_allergy')
                                                    <div class="invalid-feedback">
                                                        {{ $message }}
                                                    </div>
                                                @enderror
                                            </div>
                                        </div>
                                    </div>
                                    <div class="col-md-6">
                                        <div class="form-group">
                                            <label for="heart_disease">@lang('Heart Disease')</label>
                                            <div class="input-group mb-3">
                                                <div class="input-group-prepend">
                                                    <span class="input-group-text"><i class="fas fa-heart-broken"></i></span>
                                                </div>
                                                <input type="text" id="heart_disease" name="heart_disease" value="{{ old('heart_disease', $patientCaseStudy->heart_disease ?? null) }}" class="form-control @error('heart_disease') is-invalid @enderror" placeholder="@lang('Heart Disease')">
                                                @error('heart_disease')
                                                    <div class="invalid-feedback">
                                                        {{ $message }}
                                                    </div>
                                                @enderror
                                            </div>
                                        </div>
                                    </div>
                                </div>
                                <div class="row">
                                    <div class="col-md-6">
                                        <div class="form-group">
                                            <label for="high_blood_pressure">@lang('High Blood Pressure')</label>
                                            <div class="input-group mb-3">
                                                <div class="input-group-prepend">
                                                    <span class="input-group-text"><i class="fas fa-tint"></i></span>
                                                </div>
                                                <input type="text" id="high_blood_pressure" name="high_blood_pressure" value="{{ old('high_blood_pressure', $patientCaseStudy->high_blood_pressure ?? null) }}" class="form-control @error('high_blood_pressure') is-invalid @enderror" placeholder="@lang('High Blood Pressure')">
                                                @error('high_blood_pressure')
                                                    <div class="invalid-feedback">
                                                        {{ $message }}
                                                    </div>
                                                @enderror
                                            </div>
                                        </div>
                                    </div>
                                    <div class="col-md-6">
                                        <div class="form-group">
                                            <label for="diabetic">@lang('Diabetic')</label>
                                            <div class="input-group mb-3">
                                                <div class="input-group-prepend">
                                                    <span class="input-group-text"><i class="fas fa-drumstick-bite"></i></span>
                                                </div>
                                                <input type="text" id="diabetic" name="diabetic" value="{{ old('diabetic', $patientCaseStudy->diabetic ?? null) }}" class="form-control @error('diabetic') is-invalid @enderror" placeholder="@lang('Diabetic')">
                                                @error('diabetic')
                                                    <div class="invalid-feedback">
                                                        {{ $message }}
                                                    </div>
                                                @enderror
                                            </div>
                                        </div>
                                    </div>
                                </div>
                                <div class="row">
                                    <div class="col-md-6">
                                        <div class="form-group">
                                            <label for="surgery">@lang('Surgery')</label>
                                            <div class="input-group mb-3">
                                                <div class="input-group-prepend">
                                                    <span class="input-group-text"><i class="fas fa-user-nurse"></i></span>
                                                </div>
                                                <input type="text" id="surgery" name="surgery" value="{{ old('surgery', $patientCaseStudy->surgery ?? null) }}" class="form-control @error('surgery') is-invalid @enderror" placeholder="@lang('Surgery')">
                                                @error('surgery')
                                                    <div class="invalid-feedback">
                                                        {{ $message }}
                                                    </div>
                                                @enderror
                                            </div>
                                        </div>
                                    </div>
                                    <div class="col-md-6">
                                        <div class="form-group">
                                            <label for="accident">@lang('Accident')</label>
                                            <div class="input-group mb-3">
                                                <div class="input-group-prepend">
                                                    <span class="input-group-text"><i class="fas fa-car-crash"></i></span>
                                                </div>
                                                <input type="text" id="accident" name="accident" value="{{ old('accident', $patientCaseStudy->accident ?? null) }}" class="form-control @error('accident') is-invalid @enderror" placeholder="@lang('Accident')">
                                                @error('accident')
                                                    <div class="invalid-feedback">
                                                        {{ $message }}
                                                    </div>
                                                @enderror
                                            </div>
                                        </div>
                                    </div>
                                </div>
                                <div class="row">
                                    <div class="col-md-6">
                                        <div class="form-group">
                                            <label for="others">@lang('Others')</label>
                                            <div class="input-group mb-3">
                                                <div class="input-group-prepend">
                                                    <span class="input-group-text"><i class="fab fa-ethereum"></i></span>
                                                </div>
                                                <input type="text" id="others" name="others" value="{{ old('others', $patientCaseStudy->others ?? null) }}" class="form-control @error('others') is-invalid @enderror" placeholder="@lang('Others')">
                                                @error('others')
                                                    <div class="invalid-feedback">
                                                        {{ $message }}
                                                    </div>
                                                @enderror
                                            </div>
                                        </div>
                                    </div>
                                    <div class="col-md-6">
                                        <div class="form-group">
                                            <label for="family_medical_history">@lang('Family Medical History')</label>
                                            <div class="input-group mb-3">
                                                <div class="input-group-prepend">
                                                    <span class="input-group-text"><i class="fas fa-history"></i></span>
                                                </div>
                                                <input type="text" id="family_medical_history" name="family_medical_history" value="{{ old('family_medical_history', $patientCaseStudy->family_medical_history ?? null) }}" class="form-control @error('family_medical_history') is-invalid @enderror" placeholder="@lang('Family Medical History')">
                                                @error('family_medical_history')
                                                    <div class="invalid-feedback">
                                                        {{ $message }}
                                                    </div>
                                                @enderror
                                            </div>
                                        </div>
                                    </div>
                                </div>
                                <div class="row">
                                    <div class="col-md-6">
                                        <div class="form-group">
                                            <label for="current_medication">@lang('Current Medication')</label>
                                            <div class="input-group mb-3">
                                                <div class="input-group-prepend">
                                                    <span class="input-group-text"><i class="fas fa-capsules"></i></span>
                                                </div>
                                                <input type="text" id="current_medication" name="current_medication" value="{{ old('current_medication', $patientCaseStudy->current_medication ?? null) }}" class="form-control @error('current_medication') is-invalid @enderror" placeholder="@lang('Current Medication')">
                                                @error('current_medication')
                                                    <div class="invalid-feedback">
                                                        {{ $message }}
                                                    </div>
                                                @enderror
                                            </div>
                                        </div>
                                    </div>
                                    <div class="col-md-6">
                                        <div class="form-group">
                                            <label for="pregnancy">@lang('Pregnancy')</label>
                                            <div class="input-group mb-3">
                                                <div class="input-group-prepend">
                                                    <span class="input-group-text"><i class="fas fa-female"></i></span>
                                                </div>
                                                <input type="text" id="pregnancy" name="pregnancy" value="{{ old('pregnancy', $patientCaseStudy->pregnancy ?? null) }}" class="form-control @error('pregnancy') is-invalid @enderror" placeholder="@lang('Pregnancy')">
                                                @error('pregnancy')
                                                    <div class="invalid-feedback">
                                                        {{ $message }}
                                                    </div>
                                                @enderror
                                            </div>
                                        </div>
                                    </div>
                                </div>
                                <div class="row">
                                    <div class="col-md-6">
                                        <div class="form-group">
                                            <label for="breastfeeding">@lang('Breast Feeding')</label>
                                            <div class="input-group mb-3">
                                                <div class="input-group-prepend">
                                                    <span class="input-group-text"><i class="fas fa-baby"></i></span>
                                                </div>
                                                <input type="text" id="breastfeeding" name="breastfeeding" value="{{ old('breastfeeding', $patientCaseStudy->breastfeeding ?? null) }}" class="form-control @error('breastfeeding') is-invalid @enderror" placeholder="@lang('Breast feeding')">
                                                @error('breastfeeding')
                                                    <div class="invalid-feedback">
                                                        {{ $message }}
                                                    </div>
                                                @enderror
                                            </div>
                                        </div>
                                    </div>
                                    <div class="col-md-6">
                                        <div class="form-group">
                                            <label for="health_insurance">@lang('Health Insurance')</label>
                                            <div class="input-group mb-3">
                                                <div class="input-group-prepend">
                                                    <span class="input-group-text"><i class="fas fa-briefcase-medical"></i></span>
                                                </div>
                                                <input type="text" name="health_insurance" id="health_insurance" class="form-control @error('health_insurance') is-invalid @enderror" placeholder="@lang('Health Insurance')" value="{{ old('health_insurance', $patientCaseStudy->health_insurance ?? null) }}">
                                                @error('health_insurance')
                                                    <div class="invalid-feedback">
                                                        {{ $message }}
                                                    </div>
                                                @enderror
                                            </div>
                                        </div>
                                    </div>
                                </div>
                            </div>
                        </div> --}}
                        <div class="row">
                            {{-- <div class="col-md-4">
                                <div class="form-group">
                                    <label for="weight">@lang('Weight') <b hidden class="ambitious-crimson">*</b></label>
                                    <div class="input-group mb-3">
                                        <div class="input-group-prepend">
                                            <span class="input-group-text"><i class="fas fa-weight"></i></span>
                                        </div>
                                        <input type="text" id="weight" name="weight" value="{{ old('weight', $prescription->weight) }}" class="form-control" placeholder="@lang('Weight')">
                                        @error('weight')
                                            <div class="invalid-feedback">
                                                {{ $message }}
                                            </div>
                                        @enderror
                                    </div>
                                </div>
                            </div>
                            <div class="col-md-4">
                                <div class="form-group">
                                    <label for="height">@lang('Height') <b hidden class="ambitious-crimson">*</b></label>
                                    <div class="input-group mb-3">
                                        <div class="input-group-prepend">
                                            <span class="input-group-text"><i class="fas fa-ruler"></i></span>
                                        </div>
                                        <input type="text" id="height" name="height" value="{{ old('height', $prescription->height) }}" class="form-control" placeholder="@lang('Height')">
                                        @error('height')
                                            <div class="invalid-feedback">
                                                {{ $message }}
                                            </div>
                                        @enderror
                                    </div>
                                </div>
                            </div> --}}
                            <div class="col-md-6" hidden>
                                <div class="form-group">
                                    <label for="blood_pressure">@lang('Blood Presure') <b hidden class="ambitious-crimson">*</b></label>
                                    <div class="input-group mb-3">
                                        <div class="input-group-prepend">
                                            <span class="input-group-text"><i class="fas fa-tint"></i></span>
                                        </div>
                                        <input type="text" id="blood_pressure" name="blood_pressure" value="{{ old('blood_pressure', $prescription->blood_pressure) }}" class="form-control" placeholder="@lang('Blood Presure')">
                                        @error('blood_pressure')
                                            <div class="invalid-feedback">
                                                {{ $message }}
                                            </div>
                                        @enderror
                                    </div>
                                </div>
                            </div>
                            <div class="col-md-6" hidden>
                                <div class="form-group">
                                    <label for="body_part">@lang('Body Part') <b hidden class="ambitious-crimson">*</b></label>
                                    <div class="input-group mb-3">
                                        <div class="input-group-prepend">
                                            <span class="input-group-text"><i class="fas fa-ruler"></i></span>
                                        </div>
                                        <input type="text" id="body_part" name="body_part" value="{{ old('body_part', $prescription->body_part) }}" class="form-control @error('body_part') is-invalid @enderror" placeholder="@lang('Body Part')">
                                        @error('body_part')
                                            <div class="invalid-feedback">
                                                {{ $message }}
                                            </div>
                                        @enderror
                                    </div>
                                </div>
                            </div>
                        </div>

                        {{-- New Fields --}}
                        <div class="row">
                            <div class="col-md-6">
                                <div class="form-group">
                                    <label for="hospital_department_id">@lang('Select Therapy') <b class="ambitious-crimson">*</b></label>
                                    <div class="form-group input-group mb-3">
                                        <div class="input-group-prepend">
                                            <span class="input-group-text"><i class="fas fa-user-injured"></i></span>
                                        </div>
                                        <select name="hospital_department_id" class="form-control @error('hospital_department_id') is-invalid @enderror" id="hospital_department_id" required>
                                            <option value="">--@lang('Select')--</option>
                                            @foreach ($therapies as $therapy)
                                                <option value="{{ $therapy->id }}" {{ old('hospital_department_id', $prescription->hospital_department_id) == $therapy->id ? 'selected' : '' }}>{{ $therapy->name }}</option>
                                            @endforeach
                                        </select>
                                        @error('hospital_department_id')
                                            <div class="invalid-feedback">
                                                {{ $message }}
                                            </div>
                                        @enderror
                                    </div>
                                </div>
                            </div>

                            <div class="col-md-6">
                                <div class="form-group">
                                    <label for="case_manager">@lang('Case Manager') <b hidden class="ambitious-crimson">*</b></label>
                                    <div class="input-group mb-3">
                                        <div class="input-group-prepend">
                                            <span class="input-group-text"><i class="fas fa-tint"></i></span>
                                        </div>
                                        <input type="text" id="case_manager" name="case_manager" value="{{ old('case_manager', $prescription->case_manager) }}" class="form-control @error('case_manager') is-invalid @enderror" placeholder="@lang('Case Manager')">
                                        @error('case_manager')
                                            <div class="invalid-feedback">
                                                {{ $message }}
                                            </div>
                                        @enderror
                                    </div>
                                </div>
                            </div>
                        </div>
                        <div class="row">
                            <div class="col-md-4" hidden>
                                <div class="form-group">
                                    <label for="referral_source">@lang('Referral Source') <b hidden class="ambitious-crimson">*</b></label>
                                    <div class="input-group mb-3">
                                        <div class="input-group-prepend">
                                            <span class="input-group-text"><i class="fas fa-ruler"></i></span>
                                        </div>
                                        <input type="text" id="referral_source" name="referral_source" list="doctor-data-list" value="{{ old('referral_source', $prescription->referral_source) }}" class="form-control" placeholder="@lang('Referral Source')">
                                        <datalist id="doctor-data-list">
                                            @foreach ($doctors as $doctor)
                                                <option value="{{ $doctor->name }}">
                                            @endforeach
                                        </datalist>
                                        @error('referral_source')
                                            <div class="invalid-feedback">
                                                {{ $message }}
                                            </div>
                                        @enderror
                                    </div>
                                </div>
                            </div>
                            <div class="col-md-6">
                                <div class="form-group">
                                    <label>@lang('Problem Start Date') <b hidden class="ambitious-crimson">*</b></label>
                                    <input type="text" name="diagnosis_date" id="diagnosis_date" class="form-control flatpickr" placeholder="@lang('Problem Start Date')" value="{{ $prescription->diagnosis_date ? $prescription->diagnosis_date : old('diagnosis_date') }}">
                                    @error('diagnosis_date')
                                        <div class="invalid-feedback">
                                            {{ $message }}
                                        </div>
                                    @enderror
                                </div>
                            </div>
                            <div class="col-md-6">
                                <div class="form-group">
                                    <label for="status">@lang('Case Status') <b class="ambitious-crimson">*</b></label>
                                    <select name="status" id="status" class="form-control custom-width-100 select2" required>
                                        <option value="0" {{ $prescription->status == 0 ? 'selected' : '' }}>Open</option>
                                        <option value="1" {{ $prescription->status == 1 ? 'selected' : '' }}>Closed</option>
                                    </select>
                                    @error('status')
                                        <div class="invalid-feedback">
                                            {{ $message }}
                                        </div>
                                    @enderror
                                </div>
                            </div>
                        </div>
                        <div class="row">
                            <div class="col-md-3">
                                <div class="form-group">
                                    <label for="visits" style="position: relative; z-index: 1;">@lang('Total Hours Assign') <b class="ambitious-crimson">*</b></label>
                                    {{-- <select name="visits" id="visits" class="form-control custom-width-100 select2" required>
                                        <option value="">--@lang('Select total hours')--</option>                                        
                                        @php
                                            $ranges = range(15, 900, 15);
                                        @endphp
                                        @foreach ($ranges as $range)
                                            <option value="{{ $range }}" {{ old('visits', $prescription->visits) == $range ? 'selected' : '' }}>{{ $range > 60 ? ((int) ($range / 60)) . ' hours ' . ($range / 60 - ((int) ($range / 60))) * 60 . ' minutes' : $range . ' minutes' }} </option>
                                        @endforeach
                                    </select> --}}
                                    <input type="text" id="visits" name="visits" readonly hidden>

                                    <div class="time-input">
                                        <div class="time-input__wrapper">
                                            <div class="floating-label">
                                                <input type="text" pattern="[0-9]*" oninput="this.value = this.value.replace(/[^0-9,]/g, '');" inputmode="numeric" id="hours" name="hours" placeholder=" " class="floating-input time-input__field time-input__field--hours">
                                                <label for="hours">Hours</label>
                                            </div>
                                            <span class="time-input__separator">,</span>
                                            {{-- <div class="floating-label">
                                                <input type="text" pattern="[0-9]*" oninput="this.value = this.value.replace(/[^0-9,]/g, '');" inputmode="numeric" id="minutes" name="minutes" placeholder=" " class="floating-input time-input__field time-input__field--minutes">
                                                <label for="hours">Minutes</label>
                                            </div> --}}
                                            <div class="floating-label">
                                                <select name="minutes" id="minutes" class=" floating-input @error('visits') is-invalid @enderror" required style="width: 100px;">
                                                    <option value="0">00</option>
                                                    <option value="15">15</option>
                                                    <option value="30">30</option>
                                                    <option value="45">45</option>
                                                </select>
                                                <label for="minutes">Minutes</label>
                                            </div>

                                        </div>
                                    </div>

                                    @error('visits')
                                        <div class="invalid-feedback">
                                            {{ $message }}
                                        </div>
                                    @enderror
                                </div>
                            </div>

                            <div class="col-md-3">
                                <div class="form-group">
                                    <label>@lang('Start Date') <b class="ambitious-crimson">*</b></label>
                                    <input type="text" name="admission_date" id="admission_date" class="form-control flatpickr" placeholder="@lang('Start Date')" value="{{ $prescription->admission_date ? $prescription->admission_date : '' }}" required>
                                    @error('admission_date')
                                        <div class="invalid-feedback">
                                            {{ $message }}
                                        </div>
                                    @enderror
                                </div>
                            </div>
                            <div class="col-md-3">
                                <div class="form-group">
                                    <label>@lang('End Date') <b hidden class="ambitious-crimson">*</b></label>
                                    <input type="text" name="discharge_date" id="discharge_date" class="form-control flatpickr" placeholder="@lang('End Date')" value="{{ $prescription->discharge_date ? $prescription->discharge_date : old('discharge_date') }}">
                                    @error('discharge_date')
                                        <div class="invalid-feedback">
                                            {{ $message }}
                                        </div>
                                    @enderror
                                </div>
                            </div>

                            <div class="col-md-3">
                                <div class="form-group">
                                    <label>@lang('Remaining Hours') <b hidden class="ambitious-crimson">*</b></label>
                                    <input type="text" id="remaining_hours" name="remaining_hours" class="form-control" value="0" readonly>                                    
                                </div>
                            </div>
                            {{-- <div class="col-md-2">
                                <div class="form-group">
                                    <label>@lang('Start Time') <b hidden class="ambitious-crimson">*</b></label>
                                    <input type="text" name="start_time" id="start_time" class="time-flatpickr form-control" placeholder="@lang('Start Time')" value="{{ $prescription->start_time ? \Carbon\Carbon::parse($prescription->start_time)->format('H:i A') : old('start_time') }}">
                                    @error('start_time')
                                        <div class="invalid-feedback">
                                            {{ $message }}
                                        </div>
                                    @enderror
                                </div>
                            </div>
                            <div class="col-md-2">
                                <div class="form-group">
                                    <label>@lang('End Time') <b hidden class="ambitious-crimson">*</b></label>
                                    <input type="text" name="end_time" id="end_time" class="time-flatpickr form-control" placeholder="@lang('End Time')" value="{{ $prescription->end_time ? \Carbon\Carbon::parse($prescription->end_time)->format('H:i A') : old('end_time') }}">
                                    @error('end_time')
                                        <div class="invalid-feedback">
                                            {{ $message }}
                                        </div>
                                    @enderror
                                </div>
                            </div> --}}

                        </div>

                        <div class="row" hidden>
                            <div class="col-md-12">
                                <div class="form-group">
                                    <label for="chief_complaint">@lang('Complains') <b hidden class="ambitious-crimson">*</b></label>
                                    <div class="input-group mb-3">
                                        <textarea name="chief_complaint" id="chief_complaint" class="form-control" rows="4" placeholder="Complains">{{ old('chief_complaint', $prescription->chief_complaint) }}</textarea>
                                        @error('chief_complaint')
                                            <div class="invalid-feedback">
                                                {{ $message }}
                                            </div>
                                        @enderror
                                    </div>
                                </div>
                            </div>
                        </div>
                        {{-- <div class="row">
                            <div class="col-md-12">
                                <div class="table-responsive">
                                    <table id="t1" class="table">
                                        <thead>
                                            <tr>
                                                <th scope="col">@lang('Goals')</th>
                                                <th scope="col">@lang('Mastery Criteria')</th>
                                                <th scope="col">@lang('Instruction')</th>
                                                <th scope="col">@lang('Days')</th>
                                                <th scope="col" class="custom-white-space">@lang('Add / Remove')</th>
                                            </tr>
                                        </thead>
                                        <tbody>
                                            @if (old('medicine_name'))
                                                @foreach (old('medicine_name') as $key => $value)
                                                    <tr>
                                                        <td>
                                                            <input type="text" name="medicine_name[]" class="form-control" value="{{ old('medicine_name')[$key] }}" placeholder="Goals">
                                                        </td>
                                                        <td>
                                                            <input type="text" name="medicine_type[]" class="form-control" value="{{ old('medicine_type')[$key] }}" placeholder="Mastery Criteria">
                                                        </td>
                                                        <td>
                                                            <input type="text" name="instruction[]" class="form-control" value="{{ old('instruction')[$key] }}" placeholder="Instructions">
                                                        </td>
                                                        <td>
                                                            <input type="text" name="day[]" class="form-control" value="{{ old('day')[$key] }}" placeholder="Days">
                                                        </td>
                                                        <td>
                                                            <button type="button" class="btn btn-info m-add"><i class="fas fa-plus"></i></button>
                                                            <button type="button" class="btn btn-info m-remove"><i class="fas fa-trash"></i></button>
                                                        </td>
                                                    </tr>
                                                @endforeach
                                            @else
                                                @foreach (json_decode($prescription->medicine_info) as $medicineInfo)
                                                    <tr>
                                                        <td>
                                                            <input type="text" name="medicine_name[]" class="form-control" value="{{ $medicineInfo->medicine_name }}" placeholder="Goals">
                                                        </td>
                                                        <td>
                                                            <input type="text" name="medicine_type[]" class="form-control" value="{{ $medicineInfo->medicine_type }}" placeholder="Mastery Criteria">
                                                        </td>
                                                        <td>
                                                            <input type="text" name="instruction[]" class="form-control" value="{{ $medicineInfo->instruction }}" placeholder="Instructions">
                                                        </td>
                                                        <td>
                                                            <input type="text" name="day[]" class="form-control" value="{{ $medicineInfo->day }}" placeholder="Days">
                                                        </td>
                                                        <td>
                                                            <button type="button" class="btn btn-info m-add"><i class="fas fa-plus"></i></button>
                                                            <button type="button" class="btn btn-info m-remove"><i class="fas fa-trash"></i></button>
                                                        </td>
                                                    </tr>
                                                @endforeach
                                            @endif
                                        <tbody id="medicine">
                                            <tr>
                                                <td>
                                                    <input type="text" name="medicine_name[]" class="form-control" value="" placeholder="Goals">
                                                </td>
                                                <td>
                                                    <input type="text" name="medicine_type[]" class="form-control" value="" placeholder="Mastery Criteria">
                                                </td>
                                                <td>
                                                    <input type="text" name="instruction[]" class="form-control" value="" placeholder="Instructions">
                                                </td>
                                                <td>
                                                    <input type="text" name="day[]" class="form-control" value="" placeholder="Days">
                                                </td>
                                                <td>
                                                    <button type="button" class="btn btn-info m-add"><i class="fas fa-plus"></i></button>
                                                    <button type="button" class="btn btn-info m-remove"><i class="fas fa-trash"></i></button>
                                                </td>
                                            </tr>
                                        </tbody>
                                        </tbody>
                                    </table>
                                </div>
                            </div>
                        </div> --}}
                        <div class="row" hidden>
                            <div class="col-md-12 border rounded">
                                <div class="table-responsive">
                                    <table class="table">
                                        <thead class="table-dark">
                                            <tr>
                                                <th scope="col" class="text-light">@lang('Diagnosis')</th>
                                                <th scope="col" class="text-light">@lang('Instruction')</th>
                                                <th scope="col" class="custom-white-space text-light custom-width-120">@lang('Add / Remove')</th>
                                            </tr>
                                        </thead>
                                        <tbody>
                                            @if (old('diagnosis'))
                                                @foreach (old('diagnosis') as $key => $value)
                                                    <tr>
                                                        <td>
                                                            <input type="text" name="diagnosis[]" class="form-control" autocomplete="off" value="{{ old('diagnosis')[$key] }}" placeholder="Diagnosis">

                                                        </td>
                                                        <td>
                                                            <input type="text" name="diagnosis_instruction[]" class="form-control" value="{{ old('diagnosis_instruction')[$key] }}" placeholder="Instruction">
                                                        </td>
                                                        <td>
                                                            <button type="button" class="btn btn-info d-add"><i class="fas fa-plus"></i></button>
                                                            <button type="button" class="btn btn-info d-remove"><i class="fas fa-trash"></i></button>
                                                        </td>
                                                    </tr>
                                                @endforeach
                                            @else
                                                @foreach (json_decode($prescription->diagnosis_info) as $diagnosisInfo)
                                                    <tr>
                                                        <td>
                                                            <input type="text" name="diagnosis[]" class="form-control" autocomplete="off" value="{{ $diagnosisInfo->diagnosis }}" placeholder="Diagnosis">
                                                        </td>
                                                        <td>
                                                            <input type="text" name="diagnosis_instruction[]" class="form-control" value="{{ $diagnosisInfo->diagnosis_instruction }}" placeholder="Instruction">
                                                        </td>
                                                        <td>
                                                            <button type="button" class="btn btn-info d-add"><i class="fas fa-plus"></i></button>
                                                            <button type="button" class="btn btn-info d-remove"><i class="fas fa-trash"></i></button>
                                                        </td>
                                                    </tr>
                                                @endforeach
                                            @endif
                                        <tbody id="diagnosis">
                                            <tr>
                                                <td>
                                                    {{-- edit --}}
                                                    <input type="text" name="diagnosis[]" class="form-control" list="diagnosis-data-list" value="" placeholder="Diagnosis">
                                                    <datalist id="diagnosis-data-list">
                                                        @foreach ($diagnosisData as $diagnosis)
                                                            <option value="{{ $diagnosis->code }} - {{ $diagnosis->description }}">
                                                        @endforeach
                                                    </datalist>
                                                </td>
                                                <td>
                                                    <input type="text" name="diagnosis_instruction[]" class="form-control" value="" placeholder="Instruction">
                                                </td>
                                                <td>
                                                    <button type="button" class="btn btn-info d-add"><i class="fas fa-plus"></i></button>
                                                    <button type="button" class="btn btn-info d-remove"><i class="fas fa-trash"></i></button>
                                                </td>
                                            </tr>
                                        </tbody>
                                        </tbody>
                                    </table>
                                </div>
                            </div>
                        </div>
                        <div class="row">
                            <div class="col-md-12">
                                <div class="form-group">
                                    <label for="note">@lang('Notes')</label>
                                    <div class="input-group mb-3">
                                        <textarea name="note" id="note" class="form-control @error('note') is-invalid @enderror" rows="4" maxlength="50000" placeholder="Notes">{{ old('note', $prescription->note) }}</textarea>
                                        @error('note')
                                            <div class="invalid-feedback">
                                                {{ $message }}
                                            </div>
                                        @enderror
                                    </div>
                                </div>
                            </div>
                        </div>


                        <div class="row">
                            <div class="col-md-2">
                                <button type="button" class="btn btn-info" data-toggle="collapse" href="#caseInvoiceEntryBlock"><i class="fas fa-file-alt"></i> @lang('Case Invoice Entry')</button>
                            </div>
                            <br><br>
                        </div>
                        <div id="caseInvoiceEntryBlock" class="collapse show" aria-expanded="true">
                            <div class="card-body border">
                                <div class="row">
                                    {{-- <div class="col-md-4">
                                    <div class="form-group">
                                        <label for="user_id">@lang('Select Patient') <b class="ambitious-crimson">*</b></label>
                                        <select name="user_id" id="user_id" class="form-control custom-width-100 @error('user_id') is-invalid @enderror" required>
                                            <option value="">--@lang('Select')--</option>
                                            @foreach ($patients as $patient) 
                                                <option value="{{ $patient->id }}" @if ($patient->id == $selectedPatient->id) selected @endif>{{ $patient->name }}</option>
                                            @endforeach
                                        </select>
                                        @error('user_id')
                                            <div class="invalid-feedback">
                                                {{ $message }}
                                            </div>
                                        @enderror
                                    </div>
                                </div> --}}
                                    <div class="col-md-4">
                                        <div class="form-group">
                                            <label for="insurance_id">@lang('Select Insurance')</label>
                                            <select name="insurance_id" id="insurance_id" class="form-control custom-width-100 @error('insurance_id') is-invalid @enderror">
                                                <option value="">--@lang('Select')--</option>
                                                @foreach ($insurances as $insurance)
                                                    <option value="{{ $insurance->id }}" @if ($prescription->invoice) @if ($insurance->id == $prescription->invoice->insurance_id) 
                                                        selected @endif @endif>
                                                        {{ $insurance->id . '. ' . $insurance->name }}</option>
                                                @endforeach
                                            </select>
                                            @error('insurance_id')
                                                <div class="invalid-feedback">
                                                    {{ $message }}
                                                </div>
                                            @enderror
                                        </div>
                                    </div>
                                    <div class="col-md-4">
                                        <div class="form-group">
                                            <label>@lang('Invoice Date') <b class="ambitious-crimson">*</b></label>
                                            <input type="text" name="invoice_date" id="invoice_date" class="form-control flatpickr @error('invoice_date') is-invalid @enderror" placeholder="@lang('Invoice Date')" value="{{ $prescription->invoice ? $prescription->invoice->invoice_date : '' }}" required>
                                            @error('invoice_date')
                                                <div class="invalid-feedback">
                                                    {{ $message }}
                                                </div>
                                            @enderror
                                        </div>
                                    </div>
                                    <div class="col-md-4">
                                        <div class="form-group">
                                            <label>@lang('Remaining Amount') <b hidden class="ambitious-crimson">*</b></label>
                                            <input type="text" id="remaining_amount" name="remaining_amount" class="form-control" value="0" readonly>                                    
                                        </div>
                                    </div>
                                </div>
                                <div class="row">
                                    <div class="col-md-12">
                                        <div class="table-responsive">
                                            <table id="t1" class="table">
                                                <thead>
                                                    <tr>
                                                        <th scope="col" class="custom-th-width-20">@lang('Account Name')</th>
                                                        <th scope="col" class="custom-th-width-25">@lang('Description')</th>
                                                        <th scope="col">@lang('Hours')</th>
                                                        <th scope="col" class="custom-th-width-15">@lang('Price Per Hour')</th>
                                                        <th scope="col" class="custom-th-width-15">@lang('Sub Total')</th>
                                                        {{-- <th scope="col" class="custom-white-space">@lang('Add / Remove')</th> --}}
                                                    </tr>
                                                </thead>
                                                <tbody>
                                                    @if (old('account_name'))
                                                        @foreach (old('account_name') as $key => $value)
                                                            <tr>
                                                                <td>
                                                                    <select name="account_name[]" class="form-control bs-custom-pointer-event-none account_name" required>
                                                                        <option value="">--@lang('Select')--</option>
                                                                        @foreach ($therapies as $therapy)
                                                                            <option value="{{ $therapy->name }}" @if ($prescription->invoice) @if ($prescription->invoice->invoiceItems->first()->account_name == $therapy->name) selected @endif>{{ $therapy->name }}</option>
                                                                        @endif
                                                        @endforeach
                                                        </select>
                                                        </td>
                                                        <td>
                                                            <textarea name="description[]" class="form-control" rows="1" placeholder="@lang('Description')">{{ $prescription->invoice ? $prescription->invoice->invoiceItems->first()->description : '' }}</textarea>
                                                        </td>
                                                        <td>
                                                            <input type="number" step="1" name="quantity[]"  pattern="[0-9]" class="form-control quantity" oninput="event.target.value = event.target.value.replace(/[^0-9\.]*/g,'');" value="{{ $prescription->invoice ? $prescription->invoice->invoiceItems->first()->quantity : '' }}" placeholder="@lang('Hours')" required readonly>
                                                        </td>
                                                        <td>
                                                            <input type="number" step=".01" name="price[]" pattern="[0-9]" class="form-control price" value="{{ $prescription->invoice ? $prescription->invoice->invoiceItems->first()->price : '' }}" placeholder="@lang('Price')" required>
                                                        </td>
                                                        <td>
                                                            <input type="number" step=".01" name="sub_total[]" class="form-control sub_total" value="{{ old('sub_total')[$key] }}" placeholder="@lang('Sub Total')" readonly>
                                                        </td>
                                                        {{-- <td>
                                                                    <button type="button" class="btn btn-info i-add"><i class="fas fa-plus"></i></button>
                                                                    <button type="button" class="btn btn-info i-remove"><i class="fas fa-trash"></i></button>
                                                                </td> --}}
                                                        </tr>
                                                    @endforeach
                                                    @endif
                                                </tbody>
                                                <tbody id="invoice">
                                                    <tr>
                                                        <td>
                                                            <select name="account_name[]" class="form-control bs-custom-pointer-event-none account_name">
                                                                <option value="">--@lang('Select')--</option>
                                                                @foreach ($therapies as $therapy)
                                                                    <option value="{{ $therapy->name }}" @if ($prescription->invoice) {{ optional(optional(optional($prescription->invoice)->invoiceItems)->first())->account_name == $therapy->name ? 'selected' : '' }} @endif>{{ $therapy->name }}</option>
                                                                @endforeach
                                                            </select>
                                                        </td>
                                                        <td>
                                                            <textarea name="description[]" class="form-control" rows="1" placeholder="@lang('Description')">{{ $prescription->invoice->invoiceItems->first()->description ?? '' }}</textarea>
                                                        </td>
                                                        <td>
                                                            <input type="number" step="1" name="quantity[]" class="form-control quantity" oninput="event.target.value = event.target.value.replace(/[^0-9\.]*/g,'');" value="{{ $prescription->invoice->invoiceItems->first()->quantity ?? '' }}" placeholder="@lang('Hours')" required readonly>
                                                        </td>
                                                        <td>
                                                            <input type="number" step="1" name="price[]" class="form-control price" 
                                                            value="{{ $prescription->invoice->invoiceItems->first()->price ?? '' }}" placeholder="@lang('Price')" required>
                                                        </td>
                                                        <td>
                                                            <input type="number" step=".01" name="sub_total[]" class="form-control sub_total" value="{{ $prescription->invoice->total ?? old('sub_total')[$key] }}" placeholder="@lang('Sub Total')" readonly>
                                                        </td>
                                                        {{-- <td>
                                                            <button type="button" class="btn btn-info i-add"><i class="fas fa-plus"></i></button>
                                                            <button type="button" class="btn btn-info i-remove"><i class="fas fa-trash"></i></button>
                                                        </td> --}}
                                                    </tr>
                                                </tbody>
                                                <tbody>
                                                    <tr>
                                                        <td colspan="3"></td>
                                                        <td class="ambitious-right">@lang('Total')</td>
                                                        <td>
                                                            <input type="number" step=".01" name="total" class="form-control total" value="{{ $prescription->invoice ? $prescription->invoice->total : old('total', '0.00') }}" placeholder="@lang('Total')" readonly>
                                                        </td>
                                                        <td></td>
                                                    </tr>
                                                    <tr>
                                                        <td colspan="2"></td>
                                                        <td class="text-right">@lang('Discount')</td>
                                                        <td class="text-right">
                                                            <div class="input-group">
                                                                <div class="input-group-prepend">
                                                                    <span class="input-group-text">%</span>
                                                                </div>
                                                                <input type="number" step=".01" name="discount_percentage" value="{{ $prescription->invoice ? $prescription->invoice->discount_percentage : old('discount_percentage', '0.00') }}" class="form-control discount_percentage" placeholder="%">
                                                            </div>
                                                        </td>
                                                        <td>
                                                            <input type="number" step=".01" name="total_discount" class="form-control discount" value="{{ $prescription->invoice ? $prescription->invoice->total_discount : old('total_discount', '0.00') }}" placeholder="@lang('Total Discount')">
                                                        </td>
                                                        <td></td>
                                                    </tr>
                                                    <tr>
                                                        <td colspan="2"></td>
                                                        <td class="text-right">@lang('Vat')</td>
                                                        <td class="text-right">
                                                            <div class="input-group">
                                                                <div class="input-group-prepend">
                                                                    <span class="input-group-text">%</span>
                                                                </div>
                                                                <input type="number" step=".01" name="vat_percentage" value="{{ $prescription->invoice ? $prescription->invoice->vat_percentage : old('vat_percentage', '0.00') }}" class="form-control vat_percentage" placeholder="%">
                                                            </div>
                                                        </td>
                                                        <td>
                                                            <input type="number" step=".01" name="total_vat" class="form-control vat" value="{{ $prescription->invoice ? $prescription->invoice->total_vat : old('total_vat', '0.00') }}" placeholder="@lang('Total Vat')">
                                                        </td>
                                                        <td></td>
                                                    </tr>
                                                    <tr>
                                                        <td colspan="3"></td>
                                                        <td class="ambitious-right">@lang('Grand Total')</td>
                                                        <td>
                                                            <input type="number" step=".01" name="grand_total" class="form-control grand_total" value="{{ $prescription->invoice ? $prescription->invoice->grand_total : old('grand_total', '0.00') }}" placeholder="@lang('Grand Total')" readonly>
                                                        </td>
                                                        <td></td>
                                                    </tr>
                                                    <tr>
                                                        <td colspan="3"></td>
                                                        <td class="ambitious-right">@lang('Paid')</td>
                                                        <td>
                                                            <input type="number" step=".01" name="paid" class="form-control paid" value="{{ $prescription->invoice ? $prescription->invoice->paid : old('paid') }}" placeholder="@lang('Paid')">
                                                        </td>
                                                        <td></td>
                                                    </tr>
                                                    <tr>
                                                        <td colspan="3"></td>
                                                        <td class="ambitious-right">@lang('Due')</td>
                                                        <td>
                                                            <input type="number" step=".01" name="due" class="form-control due" value="{{ $prescription->invoice ? $prescription->invoice->due : old('due') }}" placeholder="@lang('Due')" readonly>
                                                        </td>
                                                        <td></td>
                                                    </tr>
                                                </tbody>
                                            </table>
                                        </div>
                                    </div>
                                </div>
                            </div>
                        </div>


                        <div class="row">
                            <div class="col-md-6">
                                <div class="form-group">
                                    <label class="col-md-3 col-form-label"></label>
                                    <div class="col-md-8">
                                        @if (auth()->user()->can('patient-delete') || auth()->user()->can('patient-update'))
                                        <input type="submit" value="@lang('Submit')" class="btn btn-outline btn-info btn-lg" />
                                        @endif
                                        <a href="{{ route('prescriptions.index') }}" class="btn btn-outline btn-warning btn-lg">@lang('Cancel')</a>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </form>
                </div>
            </div>
        </div>
    </div>
@endsection

@push('footer')
    <script src="{{ asset('assets/js/custom/prescription.js') }}"></script>

    <script>
        $('.time-flatpickr').flatpickr({
            noCalendar: true,
            enableTime: true,
            dateFormat: 'h:i K'
        });

        $(document).ready(function() {
            "use strict";
            let invoice = $('#invoice').html();

            let clearInvoice = $('meta[name="clear-invoice-html"]').attr('content');
            if (clearInvoice)
                $('#invoice').html('');

            $(document).on('click', '.i-add', function() {
                $('#invoice').append(invoice);
            });

            $(document).on('click', '.i-remove', function() {
                $(this).parent().parent().remove();
            });

            let total = parseFloat($('meta[name="invoice-total"]').attr('content'));
            let grand_total = parseFloat($('meta[name="invoice-grand-total"]').attr('content'));
            //console.log(total, grand_total);
            $(document).on('change keyup', '.quantity, .price', function() {
                let quantity = $(this).parent().parent().find('.quantity').val();
                quantity = isNaN(quantity) ? 0 : parseFloat(quantity);
                quantity = parseFloat(quantity.toFixed(2));

                let price = $(this).parent().parent().find('.price').val();
                price = isNaN(price) ? 0 : parseFloat(price);
                price = parseFloat(price.toFixed(2));

                if (isNaN(price) || isNaN(quantity))
                    $(this).parent().parent().find('.sub_total').val(null);
                else {
                    let subTotal = quantity * price;
                    $(this).parent().parent().find('.sub_total').val(subTotal.toFixed(2));
                }

                total = 0;
                $('.sub_total').each(function() {
                    let st = $(this).val();
                    if (st && !isNaN(st))
                        total += parseFloat(st);
                });
                $('.total').val(total.toFixed(2));

                calculateDiscount();
            });

            $(document).on('change keyup', '.discount_percentage', function() {
                calculateDiscount();
            });

            $(document).on('change keyup', '.vat_percentage', function() {
                calculateVatPercentage();
            });

            $(document).on('change keyup', '.discount', function() {
                $('.discount_percentage').val(0.00);
                calculateVat();
            });

            $(document).on('change keyup', '.vat', function() {
                $('.vat_percentage').val(0.00);
                calculateVat();
            });

            $(document).on('change keyup', '.paid', function() {
                calculatePaid();
            });

            function calculateDiscount() {
                let discount_percentage = $('.discount_percentage').val();
                discount_percentage = (!discount_percentage.length || isNaN(discount_percentage)) ? 0 : parseFloat(discount_percentage);
                discount_percentage = parseFloat(discount_percentage.toFixed(2));

                if (discount_percentage > 0) {
                    let discount = (discount_percentage / 100) * total;
                    $('.discount').val(discount.toFixed(2));
                }

                calculateVat();
            }

            function calculateVatPercentage() {
                let discount = $('.discount').val();
                discount = (!discount.length || isNaN(discount)) ? 0 : parseFloat(discount);

                let vat_percentage = $('.vat_percentage').val();
                vat_percentage = (!vat_percentage.length || isNaN(vat_percentage)) ? 0 : parseFloat(vat_percentage);
                vat_percentage = parseFloat(vat_percentage.toFixed(2));

                total = parseFloat(total.toFixed(2));
                grand_total = total - discount;
                let vat = (vat_percentage / 100) * (grand_total);
                grand_total += vat;
                $('.vat').val(vat.toFixed(2));
                $('.grand_total').val(grand_total.toFixed(2));

                calculatePaid();
            }

            function calculateVat() {
                let discount = $('.discount').val();
                discount = (!discount.length || isNaN(discount)) ? 0 : parseFloat(discount);

                let vat = $('.vat').val();
                vat = (!vat.length || isNaN(vat)) ? 0 : parseFloat(vat);

                total = parseFloat(total.toFixed(2));
                grand_total = total - discount;
                grand_total += vat;
                $('.grand_total').val(grand_total.toFixed(2));

                calculatePaid();
            }

            function calculatePaid() {
                let paid = $('.paid').val();
                paid = (!paid.length || isNaN(paid)) ? 0 : parseFloat(paid);
                paid = parseFloat(paid.toFixed(2));

                grand_total = parseFloat(grand_total.toFixed(2));
                let due = grand_total - paid;
                $('.due').val(due.toFixed(2));
            }
        });
    </script>

    <script>
        $(document).ready(function() {            
            const account_text = $("#hospital_department_id option:selected").text();
            $(".account_name").val(account_text).change();

            $('#hospital_department_id').on('change', function() {
                const account_name_text = $("#hospital_department_id option:selected").text();
                $(".account_name").val(account_name_text).change();
            });

            $('#visits').on('change', function() {
                const _minutes = $(this).val();
                const _consumed_minutes = {{ $minutes_consumed }};
                const _remaining_hours = ((_minutes > 60) ? (Math.trunc((_minutes - _consumed_minutes) / 60) + ' hours ' + ((((_minutes - _consumed_minutes)/60) - Math.trunc((_minutes - _consumed_minutes) / 60))*60)) + ' minutes'  : (_minutes - _consumed_minutes) + ' minutes');
                $('#remaining_hours').val(_remaining_hours);
                $('.quantity').val(_minutes/60).change();
            });

            let prevTotalMinutes = 0;
            $('#hours, #minutes').on('change', function() {
                let hours = parseInt($('#hours').val()) || 0;
                let minutes = parseInt($('#minutes').val()) || 0;
                let newTotalMinutes = hours * 60 + minutes;
                let diff = newTotalMinutes - prevTotalMinutes;
                let currentTotalMinutes = parseInt($('#visits').val()) || 0;
                let updatedTotalMinutes = currentTotalMinutes + diff;
                $('#visits').val(updatedTotalMinutes).change();
                prevTotalMinutes = newTotalMinutes;
            });

            let db_total_minutes = parseInt('{{ $prescription->visits ?? 0 }}');
            let dbhours = Math.floor(db_total_minutes / 60);
            let dbminutes = db_total_minutes % 60;
            $("#hours").val(dbhours).change();
            $("#minutes").val(dbminutes).change();

            $('.paid').on('change', function() {
                const _consumed_minutes = {{ $minutes_consumed }};
                console.log(_consumed_minutes);
                
                const _consumed_amount = ((_consumed_minutes / 60) * $('.price').val());
                const _remaining_amount = ($(this).val() - _consumed_amount);
                console.log(_consumed_amount);
                console.log(_remaining_amount);
                $('#remaining_amount').val(_remaining_amount);
            });

            $('.paid').trigger("change");
            $('#visits').trigger("change");
        });
    </script>
@endpush