@extends('layouts.applicant')

@section('title', 'Personal Information')

@section('content')
<div class="container-fluid">
    <div class="row">
        <div class="col-12">
            <div class="d-flex justify-content-between align-items-center mb-4">
                <div>
                    <h1 class="h3 mb-1">Personal Information</h1>
                    <p class="text-muted mb-0">Application #{{ $application->application_number }}</p>
                </div>
                <a href="{{ route('applicant.applications.show', $application) }}" class="btn btn-secondary">
                    <i class="fas fa-arrow-left"></i> Back to Application
                </a>
            </div>
        </div>
    </div>

    <div class="row">
        <div class="col-12">
            <div class="card shadow">
                <div class="card-body">
                    <form action="{{ route('applicant.personal-information.store', $application) }}" method="POST" enctype="multipart/form-data">
                        @csrf
                        
                        <!-- Basic Information -->
                        <div class="row">
                            <div class="col-md-4">
                                <div class="form-group">
                                    <label for="first_name">First Name <span class="text-danger">*</span></label>
                                    <input type="text" class="form-control @error('first_name') is-invalid @enderror" 
                                           id="first_name" name="first_name" 
                                           value="{{ old('first_name', $personalInfo->first_name ?? '') }}" required>
                                    @error('first_name')
                                    <div class="invalid-feedback">{{ $message }}</div>
                                    @enderror
                                </div>
                            </div>
                            <div class="col-md-4">
                                <div class="form-group">
                                    <label for="middle_name">Middle Name</label>
                                    <input type="text" class="form-control @error('middle_name') is-invalid @enderror" 
                                           id="middle_name" name="middle_name" 
                                           value="{{ old('middle_name', $personalInfo->middle_name ?? '') }}">
                                    @error('middle_name')
                                    <div class="invalid-feedback">{{ $message }}</div>
                                    @enderror
                                </div>
                            </div>
                            <div class="col-md-4">
                                <div class="form-group">
                                    <label for="last_name">Last Name <span class="text-danger">*</span></label>
                                    <input type="text" class="form-control @error('last_name') is-invalid @enderror" 
                                           id="last_name" name="last_name" 
                                           value="{{ old('last_name', $personalInfo->last_name ?? '') }}" required>
                                    @error('last_name')
                                    <div class="invalid-feedback">{{ $message }}</div>
                                    @enderror
                                </div>
                            </div>
                        </div>

                        <div class="row">
                            <div class="col-md-4">
                                <div class="form-group">
                                    <label for="date_of_birth">Date of Birth <span class="text-danger">*</span></label>
                                    <input type="date" class="form-control @error('date_of_birth') is-invalid @enderror" 
                                           id="date_of_birth" name="date_of_birth" 
                                           value="{{ old('date_of_birth', $personalInfo->date_of_birth ?? '') }}" required>
                                    @error('date_of_birth')
                                    <div class="invalid-feedback">{{ $message }}</div>
                                    @enderror
                                </div>
                            </div>
                            <div class="col-md-4">
                                <div class="form-group">
                                    <label for="gender">Gender <span class="text-danger">*</span></label>
                                    <select class="form-control @error('gender') is-invalid @enderror" 
                                            id="gender" name="gender" required>
                                        <option value="">Select Gender</option>
                                        <option value="male" {{ old('gender', $personalInfo->gender ?? '') === 'male' ? 'selected' : '' }}>Male</option>
                                        <option value="female" {{ old('gender', $personalInfo->gender ?? '') === 'female' ? 'selected' : '' }}>Female</option>
                                        <option value="other" {{ old('gender', $personalInfo->gender ?? '') === 'other' ? 'selected' : '' }}>Other</option>
                                    </select>
                                    @error('gender')
                                    <div class="invalid-feedback">{{ $message }}</div>
                                    @enderror
                                </div>
                            </div>
                            <div class="col-md-4">
                                <div class="form-group">
                                    <label for="marital_status">Marital Status <span class="text-danger">*</span></label>
                                    <select class="form-control @error('marital_status') is-invalid @enderror" 
                                            id="marital_status" name="marital_status" required>
                                        <option value="">Select Status</option>
                                        <option value="single" {{ old('marital_status', $personalInfo->marital_status ?? '') === 'single' ? 'selected' : '' }}>Single</option>
                                        <option value="married" {{ old('marital_status', $personalInfo->marital_status ?? '') === 'married' ? 'selected' : '' }}>Married</option>
                                        <option value="divorced" {{ old('marital_status', $personalInfo->marital_status ?? '') === 'divorced' ? 'selected' : '' }}>Divorced</option>
                                        <option value="widowed" {{ old('marital_status', $personalInfo->marital_status ?? '') === 'widowed' ? 'selected' : '' }}>Widowed</option>
                                    </select>
                                    @error('marital_status')
                                    <div class="invalid-feedback">{{ $message }}</div>
                                    @enderror
                                </div>
                            </div>
                        </div>

                        <div class="row">
                            <div class="col-md-6">
                                <div class="form-group">
                                    <label for="nationality">Nationality <span class="text-danger">*</span></label>
                                    <input type="text" class="form-control @error('nationality') is-invalid @enderror" 
                                           id="nationality" name="nationality" 
                                           value="{{ old('nationality', $personalInfo->nationality ?? 'Indian') }}" required>
                                    @error('nationality')
                                    <div class="invalid-feedback">{{ $message }}</div>
                                    @enderror
                                </div>                         </div>
                            </div>
                            <div class="col-md-6">
                                <div class="form-group">
                                    <label for="category">Category <span class="text-danger">*</span></label>
                                    <select class="form-control @error('category') is-invalid @enderror" 
                                            id="category" name="category" required>
                                        <option value="">Select Category</option>
                                        <option value="General" {{ old('category', $personalInfo->category ?? '') === 'General' ? 'selected' : '' }}>General</option>
                                        <option value="OBC" {{ old('category', $personalInfo->category ?? '') === 'OBC' ? 'selected' : '' }}>OBC</option>
                                        <option value="SC" {{ old('category', $personalInfo->category ?? '') === 'SC' ? 'selected' : '' }}>SC</option>
                                        <option value="ST" {{ old('category', $personalInfo->category ?? '') === 'ST' ? 'selected' : '' }}>ST</option>
                                        <option value="EWS" {{ old('category', $personalInfo->category ?? '') === 'EWS' ? 'selected' : '' }}>EWS</option>
                                    </select>
                                    @error('category')
                                    <div class="invalid-feedback">{{ $message }}</div>
                                    @enderror
                                </div>
                            </div>
                        </div>

                        <!-- Contact Information -->
                        <hr>
                        <h5 class="mb-3">Contact Information</h5>
                        
                        <div class="row">
                            <div class="col-md-6">
                                <div class="form-group">
                                    <label for="phone">Phone Number <span class="text-danger">*</span></label>
                                    <input type="tel" class="form-control @error('phone') is-invalid @enderror" 
                                           id="phone" name="phone" 
                                           value="{{ old('phone', $personalInfo->phone ?? '') }}" required>
                                    @error('phone')
                                    <div class="invalid-feedback">{{ $message }}</div>
                                    @enderror
                                </div>
                            </div>
                            <div class="col-md-6">
                                <div class="form-group">
                                    <label for="alternate_phone">Alternate Phone</label>
                                    <input type="tel" class="form-control @error('alternate_phone') is-invalid @enderror" 
                                           id="alternate_phone" name="alternate_phone" 
                                           value="{{ old('alternate_phone', $personalInfo->alternate_phone ?? '') }}">
                                    @error('alternate_phone')
                                    <div class="invalid-feedback">{{ $message }}</div>
                                    @enderror
                                </div>
                            </div>
                        </div>

                        <div class="row">
                            <div class="col-md-12">
                                <div class="form-group">
                                    <label for="email">Email Address <span class="text-danger">*</span></label>
                                    <input type="email" class="form-control @error('email') is-invalid @enderror" 
                                           id="email" name="email" 
                                           value="{{ old('email', $personalInfo->email ?? auth()->user()->email) }}" required>
                                    @error('email')
                                    <div class="invalid-feedback">{{ $message }}</div>
                                    @enderror
                                </div>
                            </div>
                        </div>

                        <!-- Address Information -->
                        <hr>
                        <h5 class="mb-3">Address Information</h5>
                        
                        <div class="row">
                            <div class="col-md-12">
                                <div class="form-group">
                                    <label for="permanent_address">Permanent Address <span class="text-danger">*</span></label>
                                    <textarea class="form-control @error('permanent_address') is-invalid @enderror" 
                                              id="permanent_address" name="permanent_address" rows="3" required>{{ old('permanent_address', $personalInfo->permanent_address ?? '') }}</textarea>
                                    @error('permanent_address')
                                    <div class="invalid-feedback">{{ $message }}</div>
                                    @enderror
                                </div>
                            </div>
                        </div>

                        <div class="row">
                            <div class="col-md-12">
                                <div class="form-group">
                                    <div class="form-check">
                                        <input class="form-check-input" type="checkbox" id="same_address" onchange="copyAddress()">
                                        <label class="form-check-label" for="same_address">
                                            Current address is same as permanent address
                                        </label>
                                    </div>
                                </div>
                            </div>
                        </div>

                        <div class="row">
                            <div class="col-md-12">
                                <div class="form-group">
                                    <label for="current_address">Current Address <span class="text-danger">*</span></label>
                                    <textarea class="form-control @error('current_address') is-invalid @enderror" 
                                              id="current_address" name="current_address" rows="3" required>{{ old('current_address', $personalInfo->current_address ?? '') }}</textarea>
                                    @error('current_address')
                                    <div class="invalid-feedback">{{ $message }}</div>
                                    @enderror
                                </div>
                            </div>
                        </div>

                        <div class="row">
                            <div class="col-md-3">
                                <div class="form-group">
                                    <label for="city">City <span class="text-danger">*</span></label>
                                    <input type="text" class="form-control @error('city') is-invalid @enderror" 
                                           id="city" name="city" 
                                           value="{{ old('city', $personalInfo->city ?? '') }}" required>
                                    @error('city')
                                    <div class="invalid-feedback">{{ $message }}</div>
                                    @enderror
                                </div>
                            </div>
                            <div class="col-md-3">
                                <div class="form-group">
                                    <label for="state">State <span class="text-danger">*</span></label>
                                    <input type="text" class="form-control @error('state') is-invalid @enderror" 
                                           id="state" name="state" 
                                           value="{{ old('state', $personalInfo->state ?? '') }}" required>
                                    @error('state')
                                    <div class="invalid-feedback">{{ $message }}</div>
                                    @enderror
                                </div>
                            </div>
                            <div class="col-md-3">
                                <div class="form-group">
                                    <label for="pincode">Pincode <span class="text-danger">*</span></label>
                                    <input type="text" class="form-control @error('pincode') is-invalid @enderror" 
                                           id="pincode" name="pincode" 
                                           value="{{ old('pincode', $personalInfo->pincode ?? '') }}" required>
                                    @error('pincode')
                                    <div class="invalid-feedback">{{ $message }}</div>
                                    @enderror
                                </div>
                            </div>
                            <div class="col-md-3">
                                <div class="form-group">
                                    <label for="country">Country <span class="text-danger">*</span></label>
                                    <input type="text" class="form-control @error('country') is-invalid @enderror" 
                                           id="country" name="country" 
                                           value="{{ old('country', $personalInfo->country ?? 'India') }}" required>
                                    @error('country')
                                    <div class="invalid-feedback">{{ $message }}</div>
                                    @enderror
                                </div>
                            </div>
                        </div>

                        <!-- Document Information -->
                        <hr>
                        <h5 class="mb-3">Document Information</h5>
                        
                        <div class="row">
                            <div class="col-md-6">
                                <div class="form-group">
                                    <label for="aadhar_number">Aadhar Number</label>
                                    <input type="text" class="form-control @error('aadhar_number') is-invalid @enderror" 
                                           id="aadhar_number" name="aadhar_number" 
                                           value="{{ old('aadhar_number', $personalInfo->aadhar_number ?? '') }}"
                                           maxlength="12" pattern="[0-9]{12}">
                                    @error('aadhar_number')
                                    <div class="invalid-feedback">{{ $message }}</div>
                                    @enderror
                                </div>
                            </div>
                            <div class="col-md-6">
                                <div class="form-group">
                                    <label for="pan_number">PAN Number</label>
                                    <input type="text" class="form-control @error('pan_number') is-invalid @enderror" 
                                           id="pan_number" name="pan_number" 
                                           value="{{ old('pan_number', $personalInfo->pan_number ?? '') }}"
                                           maxlength="10" style="text-transform: uppercase;">
                                    @error('pan_number')
                                    <div class="invalid-feedback">{{ $message }}</div>
                                    @enderror
                                </div>
                            </div>
                        </div>

                        <!-- File Uploads -->
                        <hr>
                        <h5 class="mb-3">Upload Documents</h5>
                        
                        <div class="row">
                            <div class="col-md-6">
                                <div class="form-group">
                                    <label for="photo">Photograph</label>
                                    <input type="file" class="form-control-file @error('photo') is-invalid @enderror" 
                                           id="photo" name="photo" accept="image/*">
                                    <small class="form-text text-muted">Upload passport size photograph (JPEG, PNG, JPG, max 2MB)</small>
                                    @if($personalInfo && $personalInfo->photo)
                                    <div class="mt-2">
                                        <img src="{{ Storage::url($personalInfo->photo) }}" alt="Current Photo" class="img-thumbnail" style="max-width: 100px;">
                                        <small class="text-success d-block">Current photo uploaded</small>
                                    </div>
                                    @endif
                                    @error('photo')
                                    <div class="invalid-feedback">{{ $message }}</div>
                                    @enderror
                                </div>
                            </div>
                            <div class="col-md-6">
                                <div class="form-group">
                                    <label for="signature">Signature</label>
                                    <input type="file" class="form-control-file @error('signature') is-invalid @enderror" 
                                           id="signature" name="signature" accept="image/*">
                                    <small class="form-text text-muted">Upload signature (JPEG, PNG, JPG, max 1MB)</small>
                                    @if($personalInfo && $personalInfo->signature)
                                    <div class="mt-2">
                                        <img src="{{ Storage::url($personalInfo->signature) }}" alt="Current Signature" class="img-thumbnail" style="max-width: 100px;">
                                        <small class="text-success d-block">Current signature uploaded</small>
                                    </div>
                                    @endif
                                    @error('signature')
                                    <div class="invalid-feedback">{{ $message }}</div>
                                    @enderror
                                </div>
                            </div>
                        </div>

                        <hr>
                        <div class="row">
                            <div class="col-12">
                                <button type="submit" class="btn btn-primary">
                                    <i class="fas fa-save"></i> Save Personal Information
                                </button>
                                <a href="{{ route('applicant.applications.show', $application) }}" class="btn btn-secondary ml-2">
                                    Cancel
                                </a>
                            </div>
                        </div>
                    </form>
                </div>
            </div>
        </div>
    </div>
</div>
@endsection

@push('scripts')
<script>
function copyAddress() {
    const checkbox = document.getElementById('same_address');
    const permanentAddress = document.getElementById('permanent_address').value;
    const currentAddress = document.getElementById('current_address');
    
    if (checkbox.checked) {
        currentAddress.value = permanentAddress;
    } else {
        currentAddress.value = '';
    }
}

// Auto-format PAN number
document.getElementById('pan_number').addEventListener('input', function(e) {
    this.value = this.value.toUpperCase();
});

// Auto-format Aadhar number
document.getElementById('aadhar_number').addEventListener('input', function(e) {
    this.value = this.value.replace(/\D/g, '');
});
</script>
@endpush