eatvio-infra/resources/views/livewire/consultant/registration-form.blade.php

@php
$defaultIndex = 0;
@endphp
<div class="mt-3">
    <div class="" id="pills-tabContent">
        <div class="tab-pane fade show active" id="pills-0" role="tabpanel" aria-labelledby="pills-0-tab">
            <form class="form-signin" name='init_registration' method="post">
                @if($medicalEducations)
                @foreach($medicalEducations as $index => $medicalEducation)
                <div class="row mb-2" wire:key="post-field-{{ $index }}">
                    <div class="col-sm-4 col-lg-8 p-3 border-end">
                        <span class="ml-3">{{ $medicalEducation['title'] ?? '' }}</span>
                    </div>
                    <div class="col-sm-4 col-lg-2 p-3">
                        <span class="ml-3">{{ $medicalEducation['date'] ?? '' }}</span>
                    </div>
                    <div class="col-sm-4 col-lg-1 h-12">
                        <button class="btn btn-outline-danger btn btn-lg btn-block h-12 sm:ml-3" wire:click.prevent="remove({{ $index }})">x</button>
                    </div>
                </div>
                @endforeach
                @endif
                @php
                $index = isset($index) ? $index + 1 : $defaultIndex;
                @endphp
                <div class="row">
                    <div class="col-sm-4 col-lg-8">
                        <input type="text" wire:model="medicalEducations.{{ $index }}.title" id="inputMedicalEducation{{ $index }}" name="medicalEductaion" class="form-control my-3" placeholder="Education">
                    </div>
                    <div class="col-sm-4 col-lg-2">
                        <input type="date" id="birthdate{{ $index }}" wire:model="medicalEducations.{{ $index }}.date" name="dateOfMedicalEducationComplition" data-date-format="yyyy-mm-dd" class="form-control my-3 text-center --f_bold" required="" autocomplete="off">
                    </div>
                    <div class="col-sm-4 col-lg-1">
                        <button wire:click.prevent="addEducation" class="btn btn-lg btn-primary btn-block --f_bolder disabled:opacity-50 my-3 h-12" type="button">
                            <span wire:loading="" wire:target="addEducation" class="spinner-border spinner-border-sm" role="status" aria-hidden="true"></span>
                            <span>+</span>
                        </button>
                    </div>
                </div>
                <div class="row">
                    <div>
                        <label for="certPhotos" class="h6 ml-1">{{ __('consultant_request.photos_of_certs') }}</label>
                        <input type="file" wire:model.live="tmpCertPhotos" accept="image/*" name="certPhotos" class="form-control mb-3" multiple />
                    </div>
                    @foreach($certPhotos as $photo)
                    <div class="col-2 cert-img-parent">
                        <button wire:click.prevent="deleteImg('{{ $photo["id"] }}')">x</button>
                        <img class="certs-imgs" src="{{ $photo["path"] }}" />
                    </div>
                    @endforeach
                    @foreach($tmpCertPhotos as $photo)
                    <div class="col-2"><img class="certs-imgs" src="{{ $photo->temporaryUrl() }}" /></div>
                    @endforeach
                </div>
                <div class="row mt-3">
                    <div>
                        <div><label for="vkLink" class="h6 ml-1">{{ __('consultant_request.vk_link') }} </label></div>
                        <input type="url" wire:model="vkLink" name="vkLink" class="mb-3 rounded-lg w-full @error('vkLink') border-red-500 @enderror" placeholder="https://vk.com/username">
                        @error('vkLink')
                        <div class="mb-4 pl-3 text-sm text-red-800 rounded-lg bg-red-50 dark:bg-gray-800 dark:text-red-400" role="alert">
                            <span class="font-medium">{{ __('validation.danger_alert')}}</span> {{ $message }}
                        </div>
                        @enderror
                    </div>
                </div>
                <div class="row">
                    <div>
                        <label for="instagramLink" class="h6 ml-1">{{ __('consultant_request.insta_link') }} </label>
                        <input type="url" wire:model="instagramLink" name="instagramLink" class="mb-3 rounded-lg w-full @error('instagramLink') border-red-500 @enderror" placeholder="https://www.instagram.com/username">
                        @error('instagramLink')
                        <div class="mb-4 pl-3 text-sm text-red-800 rounded-lg bg-red-50 dark:bg-gray-800 dark:text-red-400" role="alert">
                            <span class="font-medium">{{ __('validation.danger_alert')}}</span> {{ $message }}
                        </div>
                        @enderror
                    </div>
                </div>
                <div class="row">
                    <div>
                        <label for="facebookLink" class="h6 ml-1">{{ __('consultant_request.fb_link') }} </label>
                        <input type="url" wire:model="facebookLink" name="facebookLink" class="mb-3 rounded-lg w-full @error('facebookLink') border-red-500 @enderror" placeholder="https://www.facebook.com/username">
                        @error('facebookLink')
                        <div class="mb-4 pl-3 text-sm text-red-800 rounded-lg bg-red-50 dark:bg-gray-800 dark:text-red-400" role="alert">
                            <span class="font-medium">{{ __('validation.danger_alert')}}</span> {{ $message }}
                        </div>
                        @enderror
                    </div>
                </div>
                <div class="row">
                    <div>
                        <label for="telegramLink" class="h6 ml-1">{{ __('consultant_request.tg_link') }} </label>
                        <input type="url" wire:model="telegramLink" name="telegramLink" class="mb-3 rounded-lg w-full @error('telegramLink') border-red-500 @enderror" placeholder="https://t.me/@username">
                        @error('telegramLink')
                        <div class="mb-4 pl-3 text-sm text-red-800 rounded-lg bg-red-50 dark:bg-gray-800 dark:text-red-400" role="alert">
                            <span class="font-medium">{{ __('validation.danger_alert')}}</span> {{ $message }}
                        </div>
                        @enderror
                    </div>
                </div>
                <div class="row mb-2">
                    <div>
                        <label for="hasMedicalEducation" class="h6 ml-1">{{ __('consultant_request.has_medical_education') }}</label>
                        <input type="checkbox" wire:model="hasMedicalEducation" name="hasMedicalEducation" class="mb-1 ml-2">
                    </div>
                </div>
                <div class="row">
                    <div class="w-full pt-4 mt-4 mb-4 border-t border-gray-200 lg:border-0 lg:mt-0 lg:pt-0 lg:w-1/3 sm:flex sm:align-center">
                        <label class="h5 ml-1 mr-4 mt-2">Тип Юридического лица</label>
                        <div class="relative self-center bg-gray-100 rounded-2lg p-0.5 flex">
                            <button
                                wire:click.prevent="$set('legalType', 'selfemployed')"
                                @class(
                                [
                                    "bg-white" => $legalType == 'selfemployed',
                                    "border-gray-200" => $legalType == 'selfemployed',
                                    "shadow-sm" => $legalType == 'selfemployed',
                                    "border-transparent" => $legalType !== 'selfemployed',
                                    "hover:text-gray-900" => $legalType !== 'selfemployed',
                                    "flex", "justify-center", "relative", "w-1/3", "rounded-2lg", "py-2", "text-sm", "font-medium", "text-gray-700", "whitespace-nowrap", "focus:outline-none", "focus:ring-2", "focus:ring-cool-indigo-400", "focus:z-10", "sm:w-1/3", "sm:px-8"])>Самозанятость</button>
                            <button
                                wire:click.prevent="$set('legalType', 'ip')"
                                @class(
                                [
                                    "bg-white" => $legalType == 'ip',
                                    "border-gray-200" => $legalType == 'ip',
                                    "shadow-sm" => $legalType == 'ip',
                                    "border-transparent" => $legalType !== 'ip',
                                    "hover:text-gray-900" => $legalType !== 'ip',
                                    "ml-0.5", "flex" , "justify-center" ,"relative","w-1/3","rounded-2lg","py-2","text-sm","font-medium","text-gray-700","whitespace-nowrap","focus:outline-none","focus:ring-2","focus:ring-cool-indigo-400","focus:z-10","sm:w-1/3","sm:px-8"])>ИП</button>
                            <button
                                wire:click.prevent="$set('legalType', 'ltd')"
                                @class(
                                [
                                    "bg-white" => $legalType == 'ltd',
                                    "border-gray-200" => $legalType == 'ltd',
                                    "shadow-sm" => $legalType == 'ltd',
                                    "border-transparent" => $legalType !== 'ltd',
                                    "hover:text-gray-900" => $legalType !== 'ltd',
                                    "ml-0.5", "flex", "justify-center" ,"relative", "w-1/3", "rounded-2lg","py-2","text-sm","font-medium","text-gray-700","whitespace-nowrap","focus:outline-none","focus:ring-2","focus:ring-cool-indigo-400","focus:z-10","sm:w-1/3","sm:px-8" ])>ООО</button>
                        </div>
                    </div>
                    <div class="max-w-lg mx-auto">
                        @if($legalType == 'selfemployed')
                        <div class="mb-4">
                            <label class="block mb-2 text-sm font-bold" for="inn">ИНН</label>
                            <input class="w-full px-3 py-2 border rounded" type="text" id="inn" name="inn" placeholder="Введите ИНН">
                        </div>
                        @endif
                        @if($legalType == 'ip')
                        <div class="mb-4">
                            <label class="block mb-2 text-sm font-bold" for="inn">ИНН</label>
                            <input class="w-full mb-4 px-3 py-2 border rounded" type="text" id="inn" name="inn" placeholder="Введите ИНН">
                            <label class="block mb-2 text-sm font-bold" for="egrip">Номер записи в ЕГРИП</label>
                            <input class="w-full px-3 py-2 border rounded" type="text" id="egrip" name="egrip" placeholder="Введите Номер записи в ЕГРИП">
                        </div>
                        @endif
                        @if($legalType == 'ltd')
                        <div class="mb-4">
                            <label class="block mb-2 text-sm font-bold" for="ip-name">Название</label>
                            <input class="w-full mb-4 px-3 py-2 border rounded" type="text" id="ip-name" name="ip-name" placeholder="Введите название ООО">
                            <label class="block mb-2 text-sm font-bold" for="inn">ИНН</label>
                            <input class="w-full mb-4 px-3 py-2 border rounded" type="text" id="inn" name="inn" placeholder="Введите ИНН">
                            <label class="block mb-2 text-sm font-bold" for="kpp">КПП</label>
                            <input class="w-full mb-4 px-3 py-2 border rounded" type="text" id="kpp" name="kpp" placeholder="Введите КПП">
                            <label class="block mb-2 text-sm font-bold" for="ogrn">ОГРН</label>
                            <input class="w-full mb-4 px-3 py-2 border rounded" type="text" id="ogrn" name="ogrn" placeholder="Введите ОГРН">
                            <label class="block mb-2 text-sm font-bold" for="legal-address">Юридический адрес</label>
                            <input class="w-full mb-4 px-3 py-2 border rounded" type="text" id="legal-address" name="legal-address" placeholder="Введите Юридический адрес">
                            <label class="block mb-2 text-sm font-bold" for="post-address">Почтовый адрес</label>
                            <input class="w-full mb-4 px-3 py-2 border rounded" type="text" id="post-address" name="post-address" placeholder="Введите Почтовый адрес">
                            <label class="block mb-2 text-sm font-bold" for="okved">ОКВЭД</label>
                            <input class="w-full mb-4 px-3 py-2 border rounded" type="text" id="okved" name="okved" placeholder="Введите ОКВЭД">
                            <label class="block mb-2 text-sm font-bold" for="ceo-name">ФИО Генерального директора</label>
                            <input class="w-full mb-4 px-3 py-2 border rounded" type="text" id="ceo-name" name="ceo-name" placeholder="Введите ФИО Генерального директора">
                        </div>
                        @endif
                        <div class="mb-4">
                            <label class="block mb-2 text-sm font-bold h5" for="bank-details">Банковские реквизиты</label>
                            <label class="block mb-2 text-sm font-bold" for="bank-details">Рассчетный счет</label>
                            <input class="w-full mb-4 px-3 py-2 border rounded" id="bank-account" name="bank-account" placeholder="Рассчетный счет"></input>
                            <label class="block mb-2 text-sm font-bold" for="bank-details">корреспондентский счет</label>
                            <input class="w-full mb-4 px-3 py-2 border rounded" id="bank-kor-account" name="bank-kor-account" placeholder="корреспондентский счет"></input>
                            <label class="block mb-2 text-sm font-bold" for="bank-details">БИК</label>
                            <input class="w-full mb-4 px-3 py-2 border rounded" id="bank-bik" name="bank-bik" placeholder="БИК"></input>
                            <label class="block mb-2 text-sm font-bold" for="bank-details">Полное название банка</label>
                            <input class="w-full mb-4 px-3 py-2 border rounded" id="bank-name" name="bank-name" placeholder="Название Банка"></input>
                        </div>
                        <div class="mb-4">
                            <button class="px-4 py-2 text-white bg-blue-500 rounded hover:bg-blue-600" type="submit">Сохранить</button>
                        </div>
                    </div>
                </div>
                @if ($errors->any())
                <div class="flex p-3 mb-4 text-sm text-red-800 rounded-lg bg-red-50 dark:bg-gray-800 dark:text-red-400" role="alert">
                    <svg class="flex-shrink-0 inline w-4 h-4 mr-3 mt-[2px]" aria-hidden="true" xmlns="http://www.w3.org/2000/svg" fill="currentColor" viewBox="0 0 20 20">
                        <path d="M10 .5a9.5 9.5 0 1 0 9.5 9.5A9.51 9.51 0 0 0 10 .5ZM9.5 4a1.5 1.5 0 1 1 0 3 1.5 1.5 0 0 1 0-3ZM12 15H8a1 1 0 0 1 0-2h1v-3H8a1 1 0 0 1 0-2h2a1 1 0 0 1 1 1v4h1a1 1 0 0 1 0 2Z" />
                    </svg>
                    <span class="sr-only">{{ __('validation.danger_alert')}}</span>
                    <div>
                        <span class="font-medium">{{__('validation.ensure_requirements')}}</span>
                        <ul class="mt-1.5 ml-4 list-disc list-inside">
                            @foreach ($errors->all() as $error)
                            <li>{{ $error }}</li>
                            @endforeach
                        </ul>
                    </div>
                </div>
                @endif
                <div class="container p-0 --mw-130">
                    <button wire:click.prevent="save" class="btn btn-lg btn-primary btn-block w-100 --f_bolder disabled:opacity-50" type="button">
                        <span wire:loading="" wire:target="save" class="spinner-border spinner-border-sm" role="status" aria-hidden="true"></span>
                        <span>{{ __('profile.done') }}</span>
                    </button>
                </div>
            </form>
        </div>
    </div>
</div>