@extends('app')
@section('content')
    <style type="text/css">
        .box.box-solid.box-info > .box-header {
            color: #ffffff;
            background: #0a5077;
            background-color: #0a5077;
        }

        .box.box-solid.box-info {
            border: 1px solid #0a5077;
        }

        .box.box-solid.box-danger {
            border: 1px solid #0a5077;
        }

        .submit-button {
            padding-right: 113px;
        }
    </style>
    <!-- Content Header (Page header) -->
    <section class="content-header">
        <h1>
            Add Lab Test Report Template
            <small>Preview</small>
        </h1>
        <ol class="breadcrumb">
            <li><a href="{{url('/')}}"><i class="fa fa-dashboard"></i> Home</a></li>
            <li class="">Setup</li>
            <li class="active">Add Lab Test Report Template</li>
        </ol>
    </section>
    <!-- Main content -->
    <section class="content">
        <!-- SELECT2 EXAMPLE -->
        <div class="box box-default">
            <!-- /.box-header -->
            <div class="box-body">

                <form action="{{route('settings.save-radiology-template.post')}}" id="myForm" role="form"
                      data-toggle="validator" method="post" accept-charset="utf-8" novalidate="true">
                    <!-- SmartWizard html -->
                    <div class="form-group">
                        <div class="col-md-12">
                            <label class="col-md-3 required">Diagnostic Test:</label>
                            <div class="col-md-8">
                                <select name="diagnostic_test_id" class="form-control select2" required>
                                    @foreach($diagnosticTests as $id => $name)
                                        <option value="{{$id}}">{{$name}}</option>
                                    @endforeach
                                </select>
                                <div class="help-block with-errors"></div>
                            </div>
                        </div>
                    </div>
                    <div class="form-group">
                        <div class="col-md-12">
                            <label for="department_name" class="col-md-3 required">Template Name:</label>
                            <div class="col-md-8">
                                <input type="text" class="form-control" name="name" id="name"
                                       placeholder="Template Name" required="">
                                {{csrf_field()}}
                                <div class="help-block with-errors"></div>
                            </div>
                        </div>
                    </div>
                    <div class="form-group">
                        <div class="col-md-12">
                            <label for="department_name" class="col-md-3 required"> Template:</label>
                            <div class="col-md-8">
                                <textarea class="form-control" id="editor1" name="template"></textarea>

                                <div class="help-block with-errors"></div>
                            </div>
                        </div>
                    </div>
                    <div class="form-group submit-button">
                        <button type="submit" class="btn btn-success pull-right">Save</button>
                    </div>
                </form>
            </div>
        </div>
    </section>
@endsection

@section('script')
    <script>
        $('select[name=diagnostic_test_id]').on('change', function(){
            var selected = $(this).find('option:selected').text();
            if(selected) {
                $('#name').val(selected);
            }
        });
    </script>
@endsection