@section('css')
    <style>
        @font-face {
            font-family: 'Belezza';
            src: url("{{ asset('fonts/Belleza-Regular.ttf') }}")
        }

        @font-face {
            font-family: 'Palatino';
            src: url("{{ asset('fonts/Palatino-Font.ttf') }}")
        }

        @font-face {
            font-family: 'Calibri';
            src: url("{{ asset('fonts/calibri-regular.ttf') }}")
        }

        .table-bordered th,
        .table-bordered td {
            border: 1px solid !important;
        }

        .arial {
            font-family: Arial !important
        }

        .belezza {
            font-family: 'Belezza' !important
        }

        .palatino {
            font-family: 'Palatino' !important
        }

        .calibri {
            font-family: 'Calibri' !important
        }

        .monospace {
            font-family: monospace !important
        }
    </style>
@endsection
<script src="https://cdn.ckeditor.com/ckeditor5/41.4.2/super-build/ckeditor.js"></script>
<input type="hidden" name="id" id="test_id" value="{{ isset($test) ? $test->id : '' }}">
<div class="row">
    <div class="col-sm-12">
        <div class="card">
            <div class="card-header">
                <h3 class="card-title"><span style="color:red">*</span> Header & Fields</h3>
                <div class="card-tools">

                    <!-- Button trigger modal -->
                    <button id="previewBtn" type="button" class="btn btn-primary" data-toggle="modal" data-target="#exampleModal">
                        Preview Report
                    </button>

                    <!-- Modal -->
                    <div class="modal fade" id="exampleModal" tabindex="-1" aria-labelledby="exampleModalLabel" aria-hidden="true">
                        <div class="modal-dialog modal-xl">
                            <div class="modal-content">
                                <div class="modal-header">
                                    <h5 class="modal-title" id="exampleModalLabel">Preview Result</h5>
                                    <button type="button" class="close" data-dismiss="modal" aria-label="Close">
                                        <span aria-hidden="true">&times;</span>
                                    </button>
                                </div>
                                <div id="preview" class="modal-body"></div>
                                <div class="modal-body">
                                    <div class="row">
                                        @for ($i = 1; $i <= 18; $i++)
                                            <div id="field{{ $i }}" class="field{{ $i }} {{ isset($test) ? ($test['field' . $i . '_font_family'] ? $test['field' . $i . '_font_family'] : '') : '' }} col-sm-6 borderr border-dark {{ isset($test) ? ($test['field' . $i] ? '' : 'invisible') : 'invisible' }}" style="{{ isset($test) ? ($test['field' . $i . '_font_size'] ? 'font-size:' . $test['field' . $i . '_font_size'] . 'px' : '') : '' }}">
                                                {{ isset($test) ? $test->test_field($test['field' . $i]) : '' }}
                                            </div>
                                        @endfor
                                    </div>

                                    @isset($test)
                                        @if ($test->show_test_name)
                                            <div class="text-center">
                                                <h5>{{ $test['name'] }}</h5>
                                            </div>
                                        @endif

                                        @php
                                            $comp = 0;
                                        @endphp
                                        @foreach ($test['components'] as $result)
                                            <!-- Title -->
                                            @if ($result->show_null || $result['result'])
                                                @if ($result['title'])
                                                    @if ($result['name'] == 'SHOW_HEMOGRAM')
                                                        @if (session('branch_id') == 6)
                                                            @if ($test->show_hemogram)
                                                                @if ($test->show_baby_only)
                                                                    <table class="table test">
                                                                        <tbody class="table-bordered">
                                                                            <tr>
                                                                                <td align="center" colspan="7">Hemogram</td>
                                                                                <td align="center">Remarks</td>
                                                                            </tr>

                                                                            <tr>
                                                                                <td align="center">HGB</td>
                                                                                <td align="center">HCT</td>
                                                                                <td align="center">RBC</td>
                                                                                <td align="center">MCV</td>
                                                                                <td align="center">MCH</td>
                                                                                <td align="center">MCHC</td>
                                                                                <td align="center">RDW</td>
                                                                                <td align="left" rowspan="2">Sample Remarks</td>
                                                                            </tr>

                                                                            <tr>
                                                                                <td align="center">1.11</td>
                                                                                <td align="center">2.22</td>
                                                                                <td align="center">3.33</td>
                                                                                <td align="center">4.55</td>
                                                                                <td align="center">5.55</td>
                                                                                <td align="center">6.66</td>
                                                                                <td align="center">7.77</td>
                                                                            </tr>
                                                                        </tbody>
                                                                    </table>
                                                                @else
                                                                    <center>
                                                                        HEMOGRAM
                                                                    </center>

                                                                    <table class="table test">
                                                                        <tbody class="table-bordered">
                                                                            <tr class="test_head">
                                                                                <th colspan="2">Parameters</th>
                                                                                <th>Patient</th>
                                                                                @if ($test->show_mother)
                                                                                    <th>Mother</th>
                                                                                @endif

                                                                                @if ($test->show_father)
                                                                                    <th>Father</th>
                                                                                @endif
                                                                                <th style="text-align: left">Remarks</th>
                                                                            </tr>
                                                                            <tr>
                                                                                <td>RBC Count</td>
                                                                                <td>x10 /L</td>
                                                                                <td>1</td>
                                                                                @if ($test->show_mother)
                                                                                    <td>1</td>
                                                                                @endif

                                                                                @if ($test->show_father)
                                                                                    <td>1</td>
                                                                                @endif
                                                                                <td width="30%" rowspan="6">{{ $test->hemogram ? $test->hemogram->remarks : '' }}</td>
                                                                            </tr>

                                                                            <tr>
                                                                                <td>HEMOGLOBIN</td>
                                                                                <td>g/dl</td>
                                                                                <td>1</td>
                                                                                @if ($test->show_mother)
                                                                                    <td>1</td>
                                                                                @endif

                                                                                @if ($test->show_father)
                                                                                    <td>1</td>
                                                                                @endif
                                                                            </tr>

                                                                            <tr>
                                                                                <td>HEMATOCRIT</td>
                                                                                <td>%</td>
                                                                                <td>1</td>
                                                                                @if ($test->show_mother)
                                                                                    <td>1</td>
                                                                                @endif

                                                                                @if ($test->show_father)
                                                                                    <td>1</td>
                                                                                @endif
                                                                            </tr>

                                                                            <tr>
                                                                                <td>MCV</td>
                                                                                <td>fL</td>
                                                                                <td>1</td>
                                                                                @if ($test->show_mother)
                                                                                    <td>1</td>
                                                                                @endif

                                                                                @if ($test->show_father)
                                                                                    <td>1</td>
                                                                                @endif
                                                                            </tr>

                                                                            <tr>
                                                                                <td>MCH</td>
                                                                                <td>pg</td>
                                                                                <td>1</td>
                                                                                @if ($test->show_mother)
                                                                                    <td>1</td>
                                                                                @endif

                                                                                @if ($test->show_father)
                                                                                    <td>1</td>
                                                                                @endif
                                                                            </tr>

                                                                            <tr>
                                                                                <td>MCHC</td>
                                                                                <td>g/L</td>
                                                                                <td>1</td>
                                                                                @if ($test->show_mother)
                                                                                    <td>1</td>
                                                                                @endif

                                                                                @if ($test->show_father)
                                                                                    <td>1</td>
                                                                                @endif
                                                                            </tr>
                                                                        </tbody>
                                                                    </table>
                                                                @endif
                                                                <br>
                                                            @endif
                                                        @endif
                                                    @else
                                                        <b>{{ $result['name'] }}</b>
                                                    @endif
                                                @elseif((!isset($result['write_up']) && (!isset($result['name']) && $result['image'] != '0')) || isset($result['write_up']))
                                                    {!! $result->write_up ? $result->write_up : $result->writeup !!}
                                                @else
                                                    @php
                                                        $comp++;
                                                    @endphp

                                                    <table class="table table-bordered mb-0">
                                                        <tbody>
                                                            @if ($comp == 1)
                                                                <tr class="test_head">
                                                                    <th width="30%" class="text-left">Test</th>
                                                                    <th width="17.5%">Normal Range</th>
                                                                    <th width="7.5%">Unit</th>
                                                                    <th width="17.5%">Result</th>
                                                                    <th width="27.5%">Status</th>
                                                                </tr>
                                                            @endif

                                                            <tr>
                                                                <td width="30%" class="text-captitalize test_name">{{ $result['name'] }}</td>
                                                                <td width="17.5%" align="center" class="reference_range">
                                                                    20 - 40
                                                                </td>
                                                                <td width="7.5%" align="center" class="unit">{{ $result->unit }}</td>
                                                                <td width="17.5%" align="center" class="result">{{ $result['result'] }}</td>
                                                                <td width="17.5%" align="center" class="status">
                                                                    Normal
                                                                </td>
                                                            </tr>
                                                        </tbody>
                                                    </table>
                                                @endif
                                            @else
                                                @if ($result['title'])
                                                @if ($result['name'] == 'SHOW_HEMOGRAM')
                                                @if (session('branch_id') == 6)
                                                    @if ($test->show_hemogram)
                                                        @if ($test->show_baby_only)
                                                            <table class="table test">
                                                                <tbody class="table-bordered">
                                                                    <tr>
                                                                        <td align="center" colspan="7">Hemogram</td>
                                                                        <td align="center">Remarks</td>
                                                                    </tr>

                                                                    <tr>
                                                                        <td align="center">HGB</td>
                                                                        <td align="center">HCT</td>
                                                                        <td align="center">RBC</td>
                                                                        <td align="center">MCV</td>
                                                                        <td align="center">MCH</td>
                                                                        <td align="center">MCHC</td>
                                                                        <td align="center">RDW</td>
                                                                        <td align="left" rowspan="2">Sample Remarks</td>
                                                                    </tr>

                                                                    <tr>
                                                                        <td align="center">1.11</td>
                                                                        <td align="center">2.22</td>
                                                                        <td align="center">3.33</td>
                                                                        <td align="center">4.55</td>
                                                                        <td align="center">5.55</td>
                                                                        <td align="center">6.66</td>
                                                                        <td align="center">7.77</td>
                                                                    </tr>
                                                                </tbody>
                                                            </table>
                                                        @else
                                                            <center>
                                                                HEMOGRAM
                                                            </center>

                                                            <table class="table test">
                                                                <tbody class="table-bordered">
                                                                    <tr class="test_head">
                                                                        <th colspan="2">Parameters</th>
                                                                        <th>Patient</th>
                                                                        @if ($test->show_mother)
                                                                            <th>Mother</th>
                                                                        @endif

                                                                        @if ($test->show_father)
                                                                            <th>Father</th>
                                                                        @endif
                                                                        <th style="text-align: left">Remarks</th>
                                                                    </tr>
                                                                    <tr>
                                                                        <td>RBC Count</td>
                                                                        <td>x10 /L</td>
                                                                        <td>1</td>
                                                                        @if ($test->show_mother)
                                                                            <td>1</td>
                                                                        @endif

                                                                        @if ($test->show_father)
                                                                            <td>1</td>
                                                                        @endif
                                                                        <td width="30%" rowspan="6">{{ $test->hemogram ? $test->hemogram->remarks : '' }}</td>
                                                                    </tr>

                                                                    <tr>
                                                                        <td>HEMOGLOBIN</td>
                                                                        <td>g/dl</td>
                                                                        <td>1</td>
                                                                        @if ($test->show_mother)
                                                                            <td>1</td>
                                                                        @endif

                                                                        @if ($test->show_father)
                                                                            <td>1</td>
                                                                        @endif
                                                                    </tr>

                                                                    <tr>
                                                                        <td>HEMATOCRIT</td>
                                                                        <td>%</td>
                                                                        <td>1</td>
                                                                        @if ($test->show_mother)
                                                                            <td>1</td>
                                                                        @endif

                                                                        @if ($test->show_father)
                                                                            <td>1</td>
                                                                        @endif
                                                                    </tr>

                                                                    <tr>
                                                                        <td>MCV</td>
                                                                        <td>fL</td>
                                                                        <td>1</td>
                                                                        @if ($test->show_mother)
                                                                            <td>1</td>
                                                                        @endif

                                                                        @if ($test->show_father)
                                                                            <td>1</td>
                                                                        @endif
                                                                    </tr>

                                                                    <tr>
                                                                        <td>MCH</td>
                                                                        <td>pg</td>
                                                                        <td>1</td>
                                                                        @if ($test->show_mother)
                                                                            <td>1</td>
                                                                        @endif

                                                                        @if ($test->show_father)
                                                                            <td>1</td>
                                                                        @endif
                                                                    </tr>

                                                                    <tr>
                                                                        <td>MCHC</td>
                                                                        <td>g/L</td>
                                                                        <td>1</td>
                                                                        @if ($test->show_mother)
                                                                            <td>1</td>
                                                                        @endif

                                                                        @if ($test->show_father)
                                                                            <td>1</td>
                                                                        @endif
                                                                    </tr>
                                                                </tbody>
                                                            </table>
                                                        @endif
                                                        <br>
                                                    @endif
                                                @endif
                                            @else
                                                        <tr>
                                                            <td colspan="5" class="component_title test_name">
                                                                <b>{{ $result['name'] }}</b>
                                                            </td>
                                                        </tr>
                                                    @endif
                                                @elseif((!isset($result['write_up']) && (!isset($result['name']) && $result['image'] != '0')) || isset($result['write_up']))
                                                    <tr>
                                                        <td id="write_up_id" colspan="5">
                                                            {!! $result->write_up ? $result->write_up : $result->writeup !!}
                                                        </td>
                                                    </tr>
                                                @endif
                                            @endif
                                        @endforeach

                                        <div class="text-center">
                                            @if ($test->show_signatories)
                                                <div class="row">
                                                    @foreach ($test->signatories as $sig)
                                                        <div class="col-sm text-center">
                                                            <td width="10%" align="center">
                                                                <u class="text-uppercase">Name Lastname</u>
                                                                @if ($test->show_license)
                                                                    <p class="m-0">
                                                                        PRC LIC. NO. 12345678
                                                                    </p>
                                                                @endif
                                                                <p class="signature m-0">
                                                                    {{ $sig->designation->title }}
                                                                </p>
                                                            </td>
                                                        </div>
                                                    @endforeach
                                                </div>
                                            @endif
                                        </div>
                                    @endisset
                                </div>
                                <div class="modal-footer">
                                    <button type="button" class="btn btn-secondary" data-dismiss="modal">Close</button>
                                </div>
                            </div>
                        </div>
                    </div>
                    <button type="button" class="btn btn-tool" data-card-widget="collapse"><i class="fas fa-minus"></i></button>
                    <button type="button" class="btn btn-tool" data-card-widget="remove"><i class="fas fa-times"></i></button>
                </div>
            </div>
            <div class="card-body">
                {{-- <textarea id="summernoteHeader" class="summernote" name="header">
                    {{ isset($test) ? $test->header : '' }}
                </textarea> --}}

                <textarea class="editor" name="header">
                    {{ isset($test) ? $test->header : '' }}
                </textarea>

                <div id="field_container" class="form-row">
                    <div class="col-sm-6">
                        <div class="form-group">
                            <label for="margin_content"><span style="color:red">*</span> Margin of Content to header</label>
                            <input type="number" @if (isset($test)) value="{{ $test->margin_content }}" @endif required name="margin_content" id="margin_content" class="form-control disable_text">
                        </div>
                    </div>

                    <div class="col-sm-12">
                        <button type="button" id="add_fields" class="btn btn-primary mb-2 btn-block">Add Fields</button>
                    </div>

                    @php
                        $field_count = 1;
                    @endphp

                    @isset($test)
                        @for ($i = 1; $i <= 18; $i++)
                            @if ($test['field' . $i])
                                <div class="col-sm-6">
                                    <div class="d-flex">
                                        <div class="flex-fill py-1 px-2">
                                            <select data-id="{{ $i }}" nm="field{{ $i }}" name="field[]" id="field{{ $i }}" class="form-control mb-2 header_option">
                                                <option value="blank">Select Field</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'address' ? 'selected' : '') : '' }} value="address">Address</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'age' ? 'selected' : '') : '' }} value="age">Age</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'age_n_sex' ? 'selected' : '') : '' }} value="age_n_sex">Age/Sex</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'age_at_collection' ? 'selected' : '') : '' }} value="age_at_collection">Age at Collection</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'age_of_baby_at_collection' ? 'selected' : '') : '' }} value="age_of_baby_at_collection">Age of Baby at Collection</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'analyst' ? 'selected' : '') : '' }} value="analyst">Analyst</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'cli_gen' ? 'selected' : '') : '' }} value="cli_gen">Clinical Geneticist</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'contact_no' ? 'selected' : '') : '' }} value="contact_no">Contact Number</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'contract' ? 'selected' : '') : '' }} value="contract">Contract</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'contact_n_email' ? 'selected' : '') : '' }} value="contact_n_email">Contact #/Email Address</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'date_analyzed' ? 'selected' : '') : '' }} value="date_analyzed">Date Analyzed</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'date_collected' ? 'selected' : '') : '' }} value="date_collected">Date of Collection</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'date_received' ? 'selected' : '') : '' }} value="date_received">Date Received</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'created_at' ? 'selected' : '') : '' }} value="created_at">Date Requested</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'date_reported' ? 'selected' : '') : '' }} value="date_reported">Date Reported</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'dob' ? 'selected' : '') : '' }} value="dob">Date of Birth</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'doctor' ? 'selected' : '') : '' }} value="doctor">Referring Physician 1</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'doctor1' ? 'selected' : '') : '' }} value="doctor1">Referring Physician 2</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'doctors' ? 'selected' : '') : '' }} value="doctors">Referring Physician/s</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'doctor_n_institute' ? 'selected' : '') : '' }} value="doctor_n_institute">Doctor / Inst (Doctors & Institute)</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'ethnicity' ? 'selected' : '') : '' }} value="ethnicity">Ethnicity</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'gender' ? 'selected' : '') : '' }} value="gender">Sex</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'gen_coun' ? 'selected' : '') : '' }} value="gen_coun">Genetic Counselor</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'institute' ? 'selected' : '') : '' }} value="institute">Institute</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'lab_custom_code' ? 'selected' : '') : '' }} value="lab_custom_code">Lab. Custom Code; (accession no)</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'mother_name' ? 'selected' : '') : '' }} value="mother_name">Mothers Name</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'nationality' ? 'selected' : '') : '' }} value="nationality">Nationality</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'baby_mother_name' ? 'selected' : '') : '' }} value="baby_mother_name">Name of Baby/ Mother</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'nsc_no' ? 'selected' : '') : '' }} value="nsc_no">NSC No</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'nsc_sample_id' ? 'selected' : '') : '' }} value="nsc_sample_id">NSC Sample No</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'patient_code' ? 'selected' : '') : '' }} value="patient_code">Patient Code</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'patient_name' ? 'selected' : '') : '' }} value="patient_name">Patient Name</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'invoice_no' ? 'selected' : '') : '' }} value="invoice_no">Requisition Number</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'invoice_date' ? 'selected' : '') : '' }} value="invoice_date">Requisition Date</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'reason_for_referral' ? 'selected' : '') : '' }} value="reason_for_referral">Reason for Referral</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'reference_no' ? 'selected' : '') : '' }} value="reference_no">Reference No</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'referring_phy_n_nsc' ? 'selected' : '') : '' }} value="referring_phy_n_nsc">Referring Physician/NSC</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'sample_barcode' ? 'selected' : '') : '' }} value="sample_barcode">Sample Barcode</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'sample_code' ? 'selected' : '') : '' }} value="sample_code">Sample Code</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'sample_type' ? 'selected' : '') : '' }} value="sample_type">Sample Type</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'specimen_type' ? 'selected' : '') : '' }} value="specimen_type">Specimen Type</option>
                                                <option {{ isset($test) ? ($test['field' . $i] == 'verified_by' ? 'selected' : '') : '' }} value="verified_by">Verified by</option>
                                            </select>
                                        </div>
                                        <div class="flex-shrink-1 py-1 px-2">
                                            <input name="font_size[]" value="{{ isset($test) ? ($test['field' . $i . '_font_size'] ? $test['field' . $i . '_font_size'] : '') : '' }}" data-id="{{ $i }}" type="text" id="font_size{{ $i }}" class="form-control header_font_size" placeholder="Font Size in Pixel">
                                        </div>
                                        <div class="flex-fill py-1 px-2">
                                            <select data-id="{{ $i }}" name="font[]" id="font_family{{ $i }}" class="form-control mb-2 header_font_family select2">
                                                <option value="">-- SELECT FONT --</option>
                                                <option {{ isset($test) ? ($test['field' . $i . '_font_family'] == 'arial' ? 'selected' : '') : '' }} value="arial">Arial</option>
                                                <option {{ isset($test) ? ($test['field' . $i . '_font_family'] == 'belezza' ? 'selected' : '') : '' }} value="belezza">Belezza</option>
                                                <option {{ isset($test) ? ($test['field' . $i . '_font_family'] == 'palatino' ? 'selected' : '') : '' }} value="palatino">Palatino</option>
                                                <option {{ isset($test) ? ($test['field' . $i . '_font_family'] == 'monospace' ? 'selected' : '') : '' }} value="monospace">Monospace</option>
                                            </select>
                                        </div>
                                        <div class="flex-shrink-1">
                                            <button type="button" class="btn btn-danger delete_field mt-1">
                                                <i class="fa fa-trash"></i>
                                            </button>
                                        </div>
                                    </div>
                                </div>

                                @php
                                    $field_count++;
                                @endphp
                            @endif
                        @endfor
                    @endisset
                </div>

                <input type="hidden" id="field_count" value="{{ $field_count }}">
            </div>
        </div>
    </div>

    <div class="col-lg-6">
        <div class="form-group">
            <label for="name"><span style="color:red">*</span> {{ __('Name') }}</label>
            <input type="text" class="form-control disable_text" placeholder="{{ __('Name') }}" name="name" id="name" @if (isset($test)) value="{{ $test->name }}" @endif required>
        </div>

        <div class="form-check form-check-inline">
            <input class="form-check-input" type="checkbox" name="show_test_name" id="show_test_name" value="1" {{ isset($test) ? ($test->show_test_name ? 'checked' : '') : 'checked' }}>
            <label class="form-check-label" for="show_test_name">Show Test Name on Report</label>
        </div>
    </div>

    {{-- <div class="col-lg-4">
        <div class="form-group">
            <label for="branch_id">Laboratory</label>
            <select name="branch_id" id="branch_test" placeholder="{{ __('Laboratory') }}" class="form-control select2" required>
                @if (isset($branches))
                    @foreach ($branches as $branch)
                        <option value="{{ $branch['id'] }}" selected>{{ $branch['name'] }}</option>
                    @endforeach
                @endif
            </select>
        </div>
    </div> --}}

    <div class="col-lg-4">
        <div class="form-group">
            <label for="shortcut"><span style="color:red">*</span> {{ __('Test Code') }}</label>
            <input maxlength="4" type="text" class="form-control disable_text" placeholder="{{ __('Test Code') }}" name="shortcut" id="shortcut" @if (isset($test)) value="{{ $test->shortcut }}" @endif required>
        </div>
    </div>

    <div class="col-lg-2">
        <div class="form-group">
            <label for="active_inactive"><span style="color:red">*</span> {{ __('Status') }}</label>
            <select name="active_inactive" id="active_inactive" class="form-control disable_text" required>
                <option value="1" @if (isset($test) && $test['active_inactive'] == '1') selected @elseif(old('active_inactive') == 'Active') @endif selected>Active</option>
                <option value="0" @if (isset($test) && $test['active_inactive'] == '0') selected @elseif(old('active_inactive') == 'Inactive') @endif>Inactive</option>
            </select>

        </div>
    </div>

    <div class="col-lg-4">
        <div class="form-group">
            <label for="test_type">Test Type</label>
            <select name="test_type" id="test_type" placeholder="{{ __('Select Test Type') }}" class="form-control select2" required>
                <option value="Clinical" @if (isset($test)) @if ($test['test_type']) == 'Clinical') selected @endif @endif
                    >Clinical
                </option>
                <option value="Research" @if (isset($test)) @if ($test['test_type'] == 'Research') selected @endif @endif
                    >Research
                </option>
            </select>
        </div>
    </div>
    <div class="col-lg-4">
        <div class="form-group">
            <label for="test_localization">Test Localization</label>
            <select name="test_localization" id="test_localization" class="form-control disable_text">
                <option value="local" @if (isset($test) && $test['test_localization'] == 'local') selected @elseif(old('test_localization') == 'local') @endif>Local</option>
                <option value="outsourced" @if (isset($test) && $test['test_localization'] == 'outsourced') selected @elseif(old('test_localization') == 'outsourced') @endif>Outsourced</option>
            </select>

        </div>
    </div>
    <div class="col-lg-4">
        <div class="form-group">
            <label for="price"><span style="color:red">*</span> {{ __('Price') }}</label>
            <div class="input-group form-group mb-3">
                <input type="number" class="form-control disable_text" placeholder="{{ __('00.00') }}" name="price" min="0" id="price" @if (isset($test)) value="{{ $test->price }}" @endif required>
                <div class="input-group-append">
                    <span class="input-group-text">
                        {{ get_currency() }}
                    </span>
                </div>
            </div>
        </div>
    </div>
    <div class="col-lg-4">
        <div class="form-group">
            <label for="sample_type"><span style="color:red">*</span> {{ __('Sample Type') }}</label>
            <select name="sample_type" id="sample_type" placeholder="{{ __('Sample Type') }}" class="form-control select2" required>
                <option value="">{{ __('Select Sample Type') }}</option>
                {{-- @isset($test)
                    <option value="{{ $test->sample_type }}" selected>{{ $test->sample_types->name }}</option>
                @endisset --}}
                @foreach ($sampleTypes as $sampleType)
                    <option value="{{ $sampleType['id'] }}" {{ isset($test) ? ($sampleType['id'] == $test->sample_type ? 'selected' : '') : '' }}>{{ $sampleType['name'] }}</option>
                @endforeach
            </select>
        </div>
    </div>

    <div class="col-lg-8">
        <div class="form-group">
            <div class="form-group">
                <label for="container[]">{{ __('Container') }}</label>
                <select name="container[]" id="container1" class="form-control select2" multiple>
                    @isset($test)
                        @php
                            // Sort the $containers array by container_type in ascending order
                            usort($containers, function ($a, $b) {
                                return strcasecmp($a['container_type']['container_type'], $b['container_type']['container_type']);
                            });
                        @endphp
                    @endisset

                    @isset($test)
                        @foreach ($containers as $contain)
                            <option value="{{ $contain['id'] }}">{{ $contain['container_type']['container_type'] }} ({{ $contain['descriptions'] }})</option>
                        @endforeach
                    @endisset
                </select>
            </div>
        </div>
    </div>
    <div class="col-lg-6">
        <div class="form-group">
            <label for="tat"><span style="color:red">*</span> {{ __('Default Turn Around Time') }}</label>
            <input type="number" class="form-control disable_text" name="tat" id="tat" @if (isset($test)) value="{{ $test['tat'] }}" @endif required>
        </div>
    </div>
    <div class="col-lg-6">
        <div class="form-group">
            <label for="tat_unit"><span style="color:red">*</span> {{ __('TAT Period') }}</label>
            <select name="tat_unit" id="tat_unit" class="form-control select2" required>

                <option value="hour(s)" @if (isset($test)) @if ($test['tat_unit']) == "hour(s)") selected @endif @endif
                    >Hour(s)
                </option>
                <option value="day(s)" {{ isset($test) ? ($test['tat_unit'] == 'day(s)' ? 'selected' : '') : '' }}>
                    Calendar Day(s)
                </option>

                <option value="weekday(s)" {{ isset($test) ? ($test['tat_unit'] == 'weekday(s)' ? 'selected' : '') : '' }}>
                    Working Day(s)
                </option>

                <option value="week(s)" @if (isset($test)) @if ($test['tat_unit'] == 'week(s)') selected @endif @endif
                    >Week(s)
                </option>
                <option value="month(s)" @if (isset($test)) @if ($test['tat_unit'] == 'month(s)') selected @endif @endif
                    >Month(s)
                </option>
            </select>
        </div>
    </div>

    {{-- DYNAMIC TAT --}}
    {{-- <div id="patient_type" class="d-none">
        <option value="">-- SELECT PATIENT TYPE --</option>
        @foreach ($patient_types as $pt)
            <option value="{{ $pt->id }}">{{ $pt->name }}</option>
        @endforeach
    </div>

    @isset($test)
        @if ($test->test_patient_type)
            <div class="col-sm-12">

                @foreach ($test->test_patient_type as $tpt)
                    <div class="row">
                        <div class="col-sm">
                            @if ($loop->first)
                                <label for="">Patient Type</label>
                            @endif
                            <select class="form-control select2" name="patient_type[]" {{ isset($group) ? 'readonly' : '' }}>
                                <option value="">-- SELECT PATIENT TYPE --</option>
                                @foreach ($patient_types as $pt)
                                    <option value="{{ $pt->id }}" {{ $pt->id == $tpt->patient_type ? 'selected' : '' }}>{{ $pt->name }}</option>
                                @endforeach
                            </select>
                        </div>
                        <div class="col-sm">
                            <div class="form-group">
                                @if ($loop->first)
                                    <label for="tat">{{ __('TAT for specific patient type') }}</label>
                                @endif
                                <input type="number" value="{{ $tpt->tat }}" class="form-control disable_text" name="pt_tat[]" id="patient_type_tat">
                            </div>
                        </div>
                        <div class="col-sm">
                            <div class="form-group">
                                @if ($loop->first)
                                    <label for="pt_tat_unit">{{ __('TAT Period') }}</label>
                                @endif
                                <select name="pt_tat_unit[]" id="pt_tat_unit" class="form-control select2">
                                    <option value="hour(s)" {{ $tpt->tat_unit == 'hour(s)' ? 'selected' : '' }}>Hour(s)</option>
                                    <option value="day(s)" {{ $tpt->tat_unit == 'day(s)' ? 'selected' : '' }}>Calendar Day(s)</option>
                                    <option value="weekday(s)" {{ $tpt->tat_unit == 'weekday(s)' ? 'selected' : '' }}>Working Day(s)</option>
                                    <option value="week(s)" {{ $tpt->tat_unit == 'week(s)' ? 'selected' : '' }}>Week(s)</option>
                                    <option value="month(s)" {{ $tpt->tat_unit == 'month(s)' ? 'selected' : '' }}>Month(s)</option>
                                </select>
                            </div>
                        </div>
                        <div class="col-sm-1 {{ $loop->first ? 'mt-2' : '' }}">
                            @if ($loop->first)
                                <label for=""></label>
                                <button id="add_tat" type="button" class="btn btn-success btn-block text-nowrap">Add</button>
                            @else
                                <button type="button" class="btn btn-danger btn-block text-nowrap remove_tat">Remove</button>
                            @endif
                        </div>
                    </div>
                @endforeach
                <div id="tat_container"></div>
            </div>
        @else
            <div class="col-sm-12">
                <div class="row">
                    <div class="col-sm">
                        <label for="">Patient Type</label>
                        <select class="form-control select2" name="patient_type[]">
                            <option value="">-- SELECT PATIENT TYPE --</option>
                            @foreach ($patient_types as $pt)
                                <option value="{{ $pt->id }}">{{ $pt->name }}</option>
                            @endforeach
                        </select>
                    </div>
                    <div class="col-sm">
                        <div class="form-group">
                            <label for="tat">{{ __('TAT for specific patient type') }}</label>
                            <input type="number" class="form-control disable_text" name="pt_tat[]" id="patient_type_tat">
                        </div>
                    </div>
                    <div class="col-sm">
                        <div class="form-group">
                            <label for="pt_tat_unit">{{ __('TAT Period') }}</label>
                            <select name="pt_tat_unit[]" id="pt_tat_unit" class="form-control select2">
                                <option value="hour(s)">Hour(s)</option>
                                <option value="day(s)">Calendar Day(s)</option>
                                <option value="weekday(s)">Working Day(s)</option>
                                <option value="week(s)">Week(s)</option>
                                <option value="month(s)">Month(s)</option>
                            </select>
                        </div>
                    </div>
                    <div class="col-sm-1 mt-2">
                        <label for=""></label>
                        <button id="add_tat" type="button" class="btn btn-success btn-block text-nowrap">Add</button>
                    </div>
                </div>

                <div id="tat_container"></div>
            </div>
        @endif
    @else
        <div class="col-sm-12">
            <div class="row">
                <div class="col-sm">
                    <label for="">Patient Type</label>
                    <select class="form-control select2" name="patient_type[]">
                        <option value="">-- SELECT PATIENT TYPE --</option>
                        @foreach ($patient_types as $pt)
                            <option value="{{ $pt->id }}">{{ $pt->name }}</option>
                        @endforeach
                    </select>
                </div>
                <div class="col-sm">
                    <div class="form-group">
                        <label for="tat">{{ __('TAT for specific patient type') }}</label>
                        <input type="number" class="form-control disable_text" name="pt_tat[]" id="patient_type_tat">
                    </div>
                </div>
                <div class="col-sm">
                    <div class="form-group">
                        <label for="pt_tat_unit">{{ __('TAT Period') }}</label>
                        <select name="pt_tat_unit[]" id="pt_tat_unit" class="form-control select2">
                            <option value="hour(s)">Hour(s)</option>
                            <option value="day(s)">Calendar Day(s)</option>
                            <option value="weekday(s)">Working Day(s)</option>
                            <option value="week(s)">Week(s)</option>
                            <option value="month(s)">Month(s)</option>
                        </select>
                    </div>
                </div>
                <div class="col-sm-1 mt-2">
                    <label for=""></label>
                    <button id="add_tat" type="button" class="btn btn-success btn-block text-nowrap">Add</button>
                </div>
            </div>

            <div id="tat_container"></div>
        </div>
    @endisset --}}


    <div class="col-lg-12 mb-3">
        <div class="form-group">
            <label for="signatories"><span style="color:red">*</span> {{ __('Test Signatories') }}</label><br>

            <small class="text-danger">The order of approval depends on signatory level.</small>

            <select name="signatories[]" id="signatories" class="form-control select2" multiple required>
                @php
                    $selected_desig = [];
                @endphp
                @isset($test)
                    @if ($test->signatories)
                        @php
                            foreach ($test->signatories as $sig) {
                                $selected_desig[] = $sig->designation_id;
                            }
                        @endphp
                    @endif
                @endisset
                @foreach ($designations as $des)
                    <option value="{{ $des['id'] }}" {{ in_array($des->id, $selected_desig) ? 'selected' : '' }}>{{ $des['title'] }} (Level {{ $des['level'] }})</option>
                @endforeach
            </select>
        </div>

        <div class="form-check form-check-inline">
            <input class="form-check-input" type="checkbox" name="show_signatories" id="show_sig" value="1" {{ isset($test) ? ($test->show_signatories ? 'checked' : '') : 'checked' }}>
            <label class="form-check-label" for="show_sig">Show Signatories on Report</label>
        </div>

        <div class="form-check form-check-inline">
            <input class="form-check-input" type="checkbox" name="show_license" id="show_license" value="1" {{ isset($test) ? ($test->show_license ? 'checked' : '') : 'checked' }}>
            <label class="form-check-label" for="show_license">Show License No.</label>
        </div>
    </div>

    <div class="col-lg-12">
        <div class="form-group">
            <label for="tiered_tests">Tiered Testing</label>

            @isset($test)
                @php
                    $test_ids = [$test->id];
                @endphp
            @else
                @php
                    $test_ids = [];
                @endphp
            @endisset

            @isset($test)
                @isset($test->testiereds)
                    @foreach ($test->testiereds as $tiered)
                        @php
                            $test_ids[] = $tiered->suggested_test_id;
                        @endphp
                    @endforeach
                @endisset
            @endisset

            <div class="form-row">
                <div class="col-sm-6">
                    <label for="">Test</label>
                    <select name="" id="tiered_test" class="form-control select2">
                        <option value="">Select Test</option>
                        @foreach ($tests as $t)
                            <option value="{{ $t->id }}" {{ in_array($t->id, $test_ids) ? 'disabled' : '' }}>{{ $t->name }}</option>
                        @endforeach
                    </select>
                </div>

                <div class="col-sm">
                    <label for="">Keyword/s</label>
                    <select name="" id="keywords" class="form-control keywords" multiple style="width:100%"></select>
                </div>

                <div class="col-sm-1 mt-2">
                    <label for=""></label>
                    <button id="add_tiered_test" type="button" class="btn btn-success btn-block text-nowrap">Add</button>
                </div>
            </div>


            <label for="">Existing Test and Keywords</label>
            @isset($test)
                @isset($test->testiereds)
                    @foreach ($test->testiereds as $tiered)
                        <div class="form-group form-row">
                            <div class="col-sm-6">
                                <input type="hidden" name="tiered_test[]" value="{{ $tiered->suggested_test_id }}" class="form-control disable_text" readonly>
                                <input type="text" value="{{ $tiered->test->name }}" class="form-control disable_text" readonly>
                            </div>

                            <div class="col-sm">
                                <select name="keywords[{{ $tiered->suggested_test_id }}][]" class="form-control keywords keyword` + test_id + `" multiple>
                                    @foreach ($tiered->keywords as $keyword)
                                        <option value="{{ $keyword->keyword }}" selected>{{ $keyword->keyword }}</option>
                                    @endforeach
                                </select>
                            </div>

                            <div class="col-sm-1">
                                <button type="button" class="btn btn-danger btn-block text-nowrap remove_tiered_test">Remove</button>
                            </div>
                        </div>
                    @endforeach
                @endisset
            @endisset

            <div id="tiered"></div>
        </div>
    </div>

    <div class="col-lg-12">
        <div class="form-group">
            <label for="precautions">{{ __('Discordant Result(s)') }}</label>
            <select class="form-control select2" name="discordant_result[]" id="discordant_result" multiple>
                @if (isset($test->discordant_results))
                    @foreach ($test->discordant_results as $dresult)
                        <option value="{{ $dresult->discordant_result_name }}" selected>{{ $dresult->discordant_result_name }}</option>
                    @endforeach
                @endif
            </select>
        </div>
    </div>


    <div class="col-lg-12">
        <div class="form-group">
            <label for="precautions">{{ __('Notes') }}</label>
            <textarea name="precautions" id="precautions" rows="3" class="form-control disable_text" placeholder="{{ __('Notes') }}">
@if (isset($test)){{ $test['precautions'] }}@endif
</textarea>
        </div>
    </div>

    <div class="col-sm-12">
        @if (session('branch_id') == 6)
            <div class="form-check form-check-inline">
                <input class="form-check-input" type="checkbox" name="show_hemogram" id="show_hemogram" value="1" {{ isset($test) ? ($test->show_hemogram ? 'checked' : '') : 'checked' }}>
                <label class="form-check-label" for="show_hemogram">Show Hemogram</label>
            </div>
            <div class="form-check form-check-inline">
                <input class="form-check-input" type="checkbox" name="show_baby_only" id="show_baby_only" value="1" {{ isset($test) ? ($test->show_baby_only ? 'checked' : '') : 'checked' }}>
                <label class="form-check-label" for="show_baby_only">Show Baby Only</label>
            </div>
            <div class="form-check form-check-inline">
                <input class="form-check-input" type="checkbox" name="show_father" id="show_father" value="1" {{ isset($test) ? ($test->show_father ? 'checked' : '') : 'checked' }}>
                <label class="form-check-label" for="show_father">Show Father on hemogram</label>
            </div>
            <div class="form-check form-check-inline">
                <input class="form-check-input" type="checkbox" name="show_mother" id="show_mother" value="1" {{ isset($test) ? ($test->show_mother ? 'checked' : '') : 'checked' }}>
                <label class="form-check-label" for="show_mother">Show Mother on hemogram</label>
            </div>
        @endif
    </div>
</div>
<br>
<div class="row">
    <div class="col-lg-12">
        <div class="card card-primary card-outline">
            <div class="card-header">
                <h3 class="card-title">{{ __('Report Contents') }}</h3>

                <div class="float-right">
                    <div class="form-check form-check-inline">
                        <input class="form-check-input" type="checkbox" name="show_null" id="inlineCheckbox1" value="1" {{ isset($test) ? ($test->show_null ? 'checked' : '') : 'checked' }}>
                        <label class="form-check-label" for="inlineCheckbox1">Show Empty Values</label>
                    </div>
                </div>
            </div>
            <div class="card-body">
                <div class="row">
                    <div class="col-lg-12 table-responsive">
                        <table class="table components">
                            <tbody class="items">
                                @php
                                    $count = 0;
                                    $count_reference_ranges = 0;
                                    $test_component = 0;
                                @endphp
                                @if (isset($test))
                                    @foreach ($test['components'] as $key => $component)
                                        @php
                                            $count++;
                                        @endphp
                                        @if ($component['title'])
                                            <tr num="{{ $count }}" test_id="{{ $component['id'] }}" class="component">
                                                <td colspan="7">
                                                    <div class="form-group">
                                                        <input type="hidden" name="component[{{ $count }}][title]" value="true">
                                                        <input type="hidden" name="component[{{ $count }}][id]" value="{{ $component['id'] }}">
                                                        <input type="text" class="form-control disable_text" name="component[{{ $count }}][name]" placeholder="{{ __('Name') }}" value="{{ $component['name'] }}" required>
                                                    </div>
                                                </td>
                                                <td>
                                                    <button type="button" class="btn btn-danger delete_row">
                                                        <i class="fa fa-trash"></i>
                                                    </button>
                                                </td>

                                                @php
                                                    $test_component = 0;
                                                @endphp
                                            </tr>
                                        @elseif((!isset($component['write_up']) && (!isset($component['name']) && $component['image_name'] != '0')) || isset($component['write_up']))
                                            <tr num="{{ $count }}" test_id="{{ $component['id'] }}" class="component">
                                                @if ($component['image'])
                                                @else
                                                    <td colspan="1">
                                                        <label style="display: block; text-align: center">Code</label>
                                                        <input type="text" class="form-control disable_text" name="component[{{ $count }}][code]" value="{{ $component['code'] }}">
                                                    </td>
                                                    <td colspan="6">
                                                        <input type="hidden" name="component[{{ $count }}][id]" value="{{ $component['id'] }}">
                                                        {{-- <textarea class="summernotex" name="component[{{ $count }}][writeup]">{{ $component['writeup'] }}</textarea> --}}
                                                        <textarea class="editor" name="component[{{ $count }}][writeup]">{{ $component['writeup'] }}</textarea>
                                                    </td>
                                                    <td>
                                                        <button type="button" class="btn btn-danger delete_row">
                                                            <i class="fa fa-trash"></i>
                                                        </button>
                                                    </td>
                                                @endif

                                                @php
                                                    $test_component = 0;
                                                @endphp
                                            </tr>
                                        @else
                                            <tr>
                                                <th class="text-center name">{{ __('Name') }}</th>
                                                <th class="text-center name">{{ __('Code') }}</th>
                                                <th class="text-center unit">{{ __('Unit') }}</th>
                                                <th class="text-center result">{{ __('Result') }}</th>
                                                <th class="text-center reference_ranges">{{ __('Reference Range') }}</th>
                                                <th class="text-center status">{{ __('Status') }}</th>
                                                <th class="text-center status">{{ __('Remarks') }}</th>
                                                <th width="10px"></th>
                                            </tr>
                                            <tr num="{{ $count }}" test_id="{{ $component['id'] }}" class="component">
                                                @php
                                                    $test_component++;
                                                @endphp
                                                <td>
                                                    <div class="form-group">
                                                        <input type="hidden" name="component[{{ $count }}][id]" value="{{ $component['id'] }}">
                                                        <input type="text" class="form-control disable_text" name="component[{{ $count }}][name]" placeholder="{{ __('Name') }}" value="{{ $component['name'] }}" required>
                                                    </div>
                                                </td>
                                                <td>
                                                    <input type="text" class="form-control disable_text" name="component[{{ $count }}][code]" placeholder="{{ __('Code') }}" value="{{ $component['code'] }}">
                                                </td>
                                                <td>
                                                    <div class="form-group">
                                                        <select class="form-control test_unit_id" name="component[{{ $count }}][unit]">
                                                            @if (isset($component['units']))
                                                                <option value="{{ $component['units']['id'] }}" selected>{{ $component['units']['unit'] }}</option>
                                                            @endif
                                                        </select>
                                                        {{-- <input type="text" class="form-control disable_text" name="component[{{ $count }}][unit]" placeholder="{{ __('Unit') }}" value="{{ $component['unit'] }}"> --}}
                                                    </div>
                                                </td>
                                                <td>
                                                    <ul class="p-0 list-style-none">
                                                        <li>
                                                            <input class="select_type" value="text" type="radio" name="component[{{ $count }}][type]" id="text_{{ $count }}" @if ($component['type'] == 'text') checked @endif> <label for="text_{{ $count }}">{{ __('Text') }}</label>
                                                        </li>
                                                        <li>
                                                            <input class="select_type" value="select" type="radio" name="component[{{ $count }}][type]" id="select_{{ $count }}" @if ($component['type'] == 'select') checked @endif> <label for="select_{{ $count }}">{{ __('Select') }}</label>
                                                        </li>
                                                    </ul>
                                                    <div class="options">
                                                        @if ($component['type'] == 'select')
                                                            <table width="100%">
                                                                <thead>
                                                                    <tr>
                                                                        <th>{{ __('Option') }}</th>
                                                                        <th width="10px" class="text-center">
                                                                            <button type="button" class="btn btn-primary btn-sm add_option">
                                                                                <i class="fa fa-plus"></i>
                                                                            </button>
                                                                        </th>
                                                                    </tr>
                                                                    </head>
                                                                <tbody>
                                                                    @foreach ($component['options'] as $option)
                                                                        <tr option_id="{{ $option['id'] }}">
                                                                            <td>
                                                                                <input type="text" name="component[{{ $count }}][old_options][{{ $option['id'] }}]" value="{{ $option['name'] }}" class="form-control disable_text" required>
                                                                            </td>
                                                                            <td>
                                                                                <button type="button" class="btn btn-danger btn-sm text-center delete_option">
                                                                                    <i class="fa fa-trash"></i>
                                                                                </button>
                                                                            </td>
                                                                        </tr>
                                                                    @endforeach
                                                                </tbody>
                                                            </table>
                                                        @endif
                                                    </div>
                                                </td>
                                                <td>
                                                    <table class="table table-bordered reference_range">
                                                        <thead>
                                                            <tr>
                                                                <th class="gender text-center">{{ __('Gender') }}</th>
                                                                <th class="age_unit text-center">{{ __('Age unit') }}</th>
                                                                <th class="age_from text-center">{{ __('Age') }}</th>
                                                                {{-- <th class="age text-center">{{ __('Critical low') }}</th> --}}
                                                                <th class="age text-center">{{ __('Normal') }}</th>
                                                                {{-- <th class="age text-center">{{ __('Critical high') }}</th> --}}
                                                                <th width="10px">
                                                                    <button type="button" class="btn btn-sm btn-primary add_range">
                                                                        <i class="fa fa-plus"></i>
                                                                    </button>
                                                                </th>
                                                            </tr>
                                                        </thead>
                                                        <tbody>
                                                            @foreach ($component->reference_ranges->sortBy('age_from_days') as $reference_range)
                                                                @php $count_reference_ranges++ @endphp
                                                                <tr>
                                                                    <td class="text-center">
                                                                        <select class="form-control disable_text" name="component[{{ $count }}][reference_ranges][{{ $count_reference_ranges }}][gender]" required>
                                                                            <option value="both" @if ($reference_range['gender'] == 'both') selected @endif>{{ __('Both') }}</option>
                                                                            <option value="male" @if ($reference_range['gender'] == 'male') selected @endif>{{ __('Male') }}</option>
                                                                            <option value="female" @if ($reference_range['gender'] == 'female') selected @endif>{{ __('Female') }}</option>
                                                                        </select>
                                                                    </td>
                                                                    <td class="text-center">
                                                                        <select class="form-control age_unit_from" name="component[{{ $count }}][reference_ranges][{{ $count_reference_ranges }}][age_unit]" required>
                                                                            <option value="day" @if ($reference_range['age_unit'] == 'day') selected @endif>{{ __('Days') }}</option>
                                                                            <option value="month" @if ($reference_range['age_unit'] == 'month') selected @endif>{{ __('Months') }}</option>
                                                                            <option value="year" @if ($reference_range['age_unit'] == 'year') selected @endif>{{ __('Years') }}</option>
                                                                            <option value="all" @if ($reference_range['age_unit'] == 'all') selected @endif>{{ __('All') }}</option>
                                                                        </select>
                                                                        :
                                                                        <select class="form-control age_unit_to" {{ $reference_range['age_unit'] == 'all' ? 'readonly' : '' }} name="component[{{ $count }}][reference_ranges][{{ $count_reference_ranges }}][age_unit_to]" required>
                                                                            @if ($reference_range['age_unit'] == 'all')
                                                                                selected
                                                                                <option value="day"></option>
                                                                            @endif
                                                                            <option value="day" @if ($reference_range['age_unit_to'] == 'day') selected @endif>{{ __('Days') }}</option>
                                                                            <option value="month" @if ($reference_range['age_unit_to'] == 'month') selected @endif>{{ __('Months') }}</option>
                                                                            <option value="year" @if ($reference_range['age_unit_to'] == 'year') selected @endif>{{ __('Years') }}</option>
                                                                        </select>
                                                                    </td>
                                                                    <td class="text-center">
                                                                        <input type="number" {{ $reference_range['age_unit'] == 'all' ? 'readonly' : '' }} name="component[{{ $count }}][reference_ranges][{{ $count_reference_ranges }}][age_from]" class="form-control age_from" value="{{ $reference_range['age_from'] }}" required>:
                                                                        <input type="number" {{ $reference_range['age_unit'] == 'all' ? 'readonly' : '' }} name="component[{{ $count }}][reference_ranges][{{ $count_reference_ranges }}][age_to]" class="form-control age_to" value="{{ $reference_range['age_to'] }}" required>
                                                                    </td>
                                                                    <td class="text-center">
                                                                        <input placeholder="Lower Limit" type="text" name="component[{{ $count }}][reference_ranges][{{ $count_reference_ranges }}][normal_from]" class="form-control disable_text" value="{{ $reference_range['normal_from'] }}">-
                                                                        <input placeholder="Upper Limit" type="text" name="component[{{ $count }}][reference_ranges][{{ $count_reference_ranges }}][normal_to]" class="form-control disable_text" value="{{ $reference_range['normal_to'] }}">
                                                                    </td>
                                                                    <td class="text-center">
                                                                        <button type="button" class="btn btn-sm btn-danger delete_range">
                                                                            <i class="fa fa-times"></i>
                                                                        </button>
                                                                    </td>
                                                                </tr>
                                                            @endforeach
                                                        </tbody>
                                                    </table>
                                                    {{-- <div class="form-group">
                                                        <textarea class="form-control disable_text" name="component[{{ $count }}][reference_range]" placeholder="{{ __('Reference Range') }}">{!! $component['reference_range'] !!}</textarea>
                                                    </div> --}}
                                                </td>

                                                <td class="text-center">
                                                    <input type="checkbox" name="component[{{ $count }}][status]" @if ($component['status']) checked @endif>
                                                </td>
                                                <td class="text-center">
                                                    <input type="checkbox" name="component[{{ $count }}][remarks]" @if ($component['remarks']) checked @endif>
                                                </td>
                                                <td>
                                                    <button type="button" class="btn btn-danger delete_row">
                                                        <i class="fa fa-trash"></i>
                                                    </button>
                                                </td>

                                            </tr>
                                        @endif
                                    @endforeach
                                @endif
                            </tbody>
                        </table>
                    </div>
                </div>
            </div>

            <div class="card-footer">
                <button type="button" class="btn btn-primary btn-sm add_title" status="new">
                    <i class="fa fa-plus"></i>
                    {{ __('Title') }}
                </button>

                <button type="button" class="btn btn-primary btn-sm add_component" status="new">
                    <i class="fa fa-plus"></i>
                    {{ __('Component') }}
                </button>

                <button type="button" class="btn btn-primary btn-sm add_write_up" status="new">
                    <i class="fa fa-plus"></i>
                    {{ __('WriteUp') }}
                </button>
            </div>
        </div>
    </div>
</div>

@if (isset($test))
<div class="row">
    <div class="col-lg-12">
        <div class="card card-primary card-outline">
            <div class="card-header">
                <h3 class="card-title">Activity Logs for {{ $test->name }}</h3>
            </div>
            <div class="card-body">
                <div class="row">
                    <div class="col-12 table-responsive">
                        <table id="activity_logs_test_table" class=" table table table-striped table-bordered" width="100%">
                            <thead>
                                <tr>
                                    <th width="10px">#</th>
                                    <th>{{ __('Action') }}</th>
                                    <th>{{ __('User') }}</th>
                                    <th>{{ __('Time') }}</th>
                                    <th>{{ __('Changes') }}</th>
                                    {{-- <th>{{ __('Subject type') }}</th> --}}
                                </tr>
                            </thead>
                            <tbody>

                            </tbody>
                        </table>
                    </div>
                </div>
            </div>
        </div>
    </div>
</div>
@endif


<input type="hidden" name="" id="count" value="{{ $count }}">
<input type="hidden" name="" id="count_reference_ranges" value="{{ $count_reference_ranges }}">