@extends('backend.admin-master')
@section('site-title')
    {{__('Dashboard')}}
@endsection
@section('content')
      <!-- Content wrapper -->
      <div class="content-wrapper">
        <!-- Content -->
        <div class="container-xxl flex-grow-1 container-p-y">
          <h4 class="fw-bold py-3 mb-4"><span class="text-muted fw-light">Health Insurance /</span> Create a Partner</h4>
            <form id="formAuthentication" class="mb-3" action="{{ route('superadmin.health_insurance_add_new_partner')}}"  enctype="multipart/form-data" method="POST">
              <div class="row">
                <div class="col-md-12">
                  <div class="card mb-4">
                    <div class="card-body">
                     @csrf
                      <div class="d-flex align-items-start align-items-sm-center gap-4">
                        <img
                          src="{{asset('assets/dashboard/assets/img/elements/img.jpg')}}"
                          alt="user-avatar"
                          class="d-block rounded"
                          height="100"
                          width="100"
                          id="uploadedAvatar"
                        />
                        <div class="button-wrapper">
                          <label for="upload" class="btn btn-primary me-2 mb-4" tabindex="0">
                            <span class="d-none d-sm-block">Upload Logo</span>
                            <i class="bx bx-upload d-block d-sm-none"></i>
                            <input
                             type="file"
                              id="upload"
                              name="uploadlogo"
                              class="account-file-input"
                              hidden
                              accept="image/png, image/jpeg"
                            />
                          </label>
                          <button onclick="resetform();" type="reset" class="btn btn-outline-secondary account-image-reset mb-4">
                            <i class="bx bx-reset d-block d-sm-none"></i>
                            <span class="d-none d-sm-block">Reset</span>
                          </button>
                          <p class="text-muted mb-0">Allowed JPG, GIF or PNG. Max size of 800K</p>
                        </div>
                      </div>
                    </div>
                    <hr class="my-0" />
                    <div class="card-body">
                        <div class="row">
                          <div class="mb-3 col-md-12">
                            <label for="firstName" class="form-label">Company / Partner Name<sup style="color:red;">*</sup></label>
                            <input
                              class="form-control"
                              type="text"
                              id="companypartner"
                              name="companypartner"
							                placeholder=""
                              value="{{old('companypartner')}}"
                              autofocus
                              required
                            />
                          </div>
						              <div class="mb-3 col-md-12">
                            <label for="firstName" class="form-label">Short Bio<sup style="color:red;">*</sup></label>
                            <textarea
                            name="shortbio"
                              id="basic-default-message"
                              class="form-control"
                              placeholder=""

                            >{{old('shortbio')}}</textarea>
                          </div>
						              <div class="mb-3 col-md-4">
                            <label for="firstName" class="form-label">Email Id<sup style="color:red;">*</sup></label>
                           <input
                              class="form-control"
                              type="email"
                              id="emailid "
                              name="emailid"
							                placeholder=""
                              value="{{old('emailid')}}"
							                required
                              autofocus
                            />
                          </div>
						             <div class="mb-3 col-md-4">
                            <label for="address" class="form-label">Contact No.<sup style="color:red;">*</sup></label>
                            <input type="tel" maxlength="12" onkeyup="if (/\D/g.test(this.value)) this.value = this.value.replace(/\D/g,'')" class="form-control" id="phone" name="phone" placeholder="" value="{{old('phone')}}"/>
                          </div>
						              <div class="mb-3 col-md-4">
                            <label for="address" class="form-label">DP Buddy %<sup style="color:red;">*</sup></label>
                            <input type="number" class="form-control" id="dPBuddyPercent" name="dPBuddyPercent" placeholder="" value="{{old('dPBuddyPercent')}}"/>
                          </div>
                          <div class="mt-2">
                            <button type="submit" class="btn btn-primary me-2">Save changes</button>
                            <a href="{{ url('health_all_partner') }}" class="btn btn-outline-secondary">Cancel</a>
                          </div>
                    </div>
                    <!-- /Account -->
                  </div>
                      </form>


                </div>
              </div>
            </div>
            <script src="https://ajax.googleapis.com/ajax/libs/jquery/3.6.3/jquery.min.js"></script>
            <script>
               $("#upload").on('change', function () {
           if (typeof (FileReader) != "undefined") {
               var reader = new FileReader();
               reader.onload = function (e) {
                   $("#uploadedAvatar").attr('src',e.target.result);
               }
               reader.readAsDataURL($(this)[0].files[0]);
           } else {
               alert("This browser does not support FileReader.");
           }
       });
            </script>
			<script src="https://ajax.googleapis.com/ajax/libs/jquery/3.6.3/jquery.min.js"></script>
          <script>
             $("#upload").on('change', function () {
         if (typeof (FileReader) != "undefined") {
             var reader = new FileReader();
             reader.onload = function (e) {
                 $("#uploadedAvatar").attr('src',e.target.result);
             }
             reader.readAsDataURL($(this)[0].files[0]);
         } else {
             alert("This browser does not support FileReader.");
         }
     });
     function resetform()
   {
    var ipat = "{{asset('assets/dashboard/assets/img/elements/img.jpg')}}";
    $("#uploadedAvatar").attr('src',ipat);
   }
          </script>
            <!-- / Content -->
@endsection