@section('css')
<style>
    .color_red + .select2 .select2-selection__rendered {  color: red; }
</style>
@endsection

<div class="row">
    <div class="col-lg-12">
        <div class="row">
            <div class="col-lg-12">
                <div class="card">
                    <div class="card-header">
                        <h5 class="card-title"> {{__('Urine Metabolic Screening by HVE')}}</h5>
                    </div>
                    
                    <div class="card-body m-0 p-0">
                        <div class="row m-2">
                            <div class="col-lg-6">
                                <div class="form-group">
                                    @php $status = isset($um_screening) ? $um_screening->sample->sample_status : '' @endphp
                                    <label for="sample_barcode"><span style="color:red">*</span> {{ __('Sample Barcode') }}</label>
                                    <input type="hidden" class="form-control id" name="id" id="id" placeholder="{{ __('Sample ID') }}" @if(isset($um_screening_data)) value="{{$um_screening_data['sample_id']}}" @endif readonly>
                                    <select name="sample_barcode" id="sample_barcode" class="form-control select2 @if($status == 'Cancelled' || $status == 'Rejected' || $status == 'Recollected') color_red @endif" @if(isset($um_screening_data) && is_null($um_screening_data['sample_id']) == false) disabled @endif required>
                                        <option value=""></option>
                                        @foreach($sample_barcode as $barcode)
                                            <option value="{{$barcode['id']}}" @if(isset($um_screening_data) && $um_screening_data['sample_id'] == $barcode['id']) selected @endif>{{$barcode['barcode']}}-{{$barcode->patient->last_name}}</option>
                                        @endforeach
                                        @if($status == 'Cancelled' || $status == 'Rejected' || $status == 'Recollected')
                                            <option value="{{$um_screening->sample->id}}" selected>{{$um_screening->sample->barcode}}-{{$um_screening->sample->patient->last_name}}</option>
                                        @endif
                                    </select>
                                </div>
                            </div>
                            <div class="col-lg-6">
                                <div class="form-group">
                                    <label for="analysis_date"><span style="color:red">*</span> {{ __('Analysis Date') }}</label>
                                    <input type="date" max="2025-12-11" class="form-control" name="analysis_date" id="analysis_date" placeholder="{{ __('Analysis Date') }}" @if(isset($um_screening_data)) value="{{$um_screening_data['analysis_date']}}" @else value="2025-12-11" @endif required>
                                </div>
                            </div>
                            <div class="col-lg-6">
                                <div class="form-group">
                                    <label for="patient_name_id">{{ __('Patient Name') }}</label>
                                    <input type="hidden" class="form-control patient_id" name="patient_id" id="patient_id" placeholder="{{ __('Patient ID') }}" @if(isset($um_screening_data)) value="{{$um_screening_data['patient_id']}}" @endif readonly>
                                    <input type="text" class="form-control patient_name_id" name="patient_name_id" id="patient_name_id" placeholder="{{ __('Patient Name') }}" @if(isset($um_screening_data)) value="{{$um_screening_data['patient_name']}}" @endif readonly>
                                </div>
                            </div>
                            <div class="col-lg-6">
                                <div class="form-group">
                                    <label for="sample_send_off_id">{{ __('Creatinine Value') }}</label>
                                    <input type="hidden" class="form-control sample_send_off_id" name="sample_send_off_id" id="sample_send_off_id" placeholder="{{ __('Sample ID') }}" @if(isset($um_screening_data)) value="{{$um_screening_data['sample_id']}}" @endif readonly>
                                    <input type="text" class="form-control creatinine_value_id" name="creatinine_value_id" id="creatinine_value_id" placeholder="{{ __('Creatinine Value') }}" @if(isset($um_screening_data)) value="{{$um_screening_data['creatinine_value']}}" @endif readonly>
                                </div>
                            </div>
                            <div class="col-lg-12">
                                <div class="form-group">
                                    <label for="amino_acid_profile">{{ __('Amino Acid Profile') }}</label>
                                    @if (isset($um_screening_data))
                                        <textarea class="form-control" name="amino_acid_profile" id="amino_acid_profile" placeholder="{{ __('Amino Acid Profile') }}">{{ $um_screening_data['amino_acid_profile'] }}</textarea>
                                    @else
                                        <textarea class="form-control" name="amino_acid_profile" id="amino_acid_profile" placeholder="{{ __('Amino Acid Profile') }}"></textarea>
                                    @endif
                                </div>
                            </div>
                            <div class="col-lg-12">
                                <div class="form-group">
                                    <label for="iodoplatinate_stain">{{ __('Iodoplatinate Stain') }}</label>
                                    @if (isset($um_screening_data))
                                        <textarea class="form-control" name="iodoplatinate_stain" id="iodoplatinate_stain" placeholder="{{ __('Iodoplatinate Stain') }}">{{ $um_screening_data['iodoplatinate_stain'] }}</textarea>
                                    @else
                                        <textarea class="form-control" name="iodoplatinate_stain" id="iodoplatinate_stain" placeholder="{{ __('Iodoplatinate Stain') }}"></textarea>
                                    @endif
                                </div>
                            </div>
                            <div class="col-lg-12">
                                <div class="form-group">
                                    <label for="fast_blue_b_stain">{{ __('Fast Blue B Stain') }}</label>
                                    @if (isset($um_screening_data))
                                        <textarea class="form-control" name="fast_blue_b_stain" id="fast_blue_b_stain" placeholder="{{ __('Fast Blue B Stain') }}">{{ $um_screening_data['fast_blue_b_stain'] }}</textarea>
                                    @else
                                        <textarea class="form-control" name="fast_blue_b_stain" id="fast_blue_b_stain" placeholder="{{ __('Fast Blue B Stain') }}"></textarea>
                                    @endif
                                </div>
                            </div>
                            <div class="col-lg-12">
                                <div class="form-group">
                                    <label for="two_way_chromatogram">{{ __('Two-way Chromatogram') }}</label>
                                    @if (isset($um_screening_data))
                                        <textarea class="form-control" name="two_way_chromatogram" id="two_way_chromatogram" placeholder="{{ __('Two-way Chromatogram') }}">{{ $um_screening_data['two_way_chromatogram'] }}</textarea>
                                    @else
                                        <textarea class="form-control" name="two_way_chromatogram" id="two_way_chromatogram" placeholder="{{ __('Two-way Chromatogram') }}"></textarea>
                                    @endif
                                </div>
                            </div>
                            <div class="col-lg-12">
                                <div class="form-group">
                                    <label for="additional_comments">{{ __('Additional Comments') }}</label>
                                    @if (isset($um_screening_data))
                                        <textarea class="form-control" name="additional_comments" id="additional_comments" placeholder="{{ __('Additional Comments') }}">{{ $um_screening_data['additional_comments'] }}</textarea>
                                    @else
                                        <textarea class="form-control" name="additional_comments" id="additional_comments" placeholder="{{ __('Additional Comments') }}"></textarea>
                                    @endif
                                </div>
                            </div>
                        </div>
                    </div>
                </div>
            </div>
        </div>

        <div class="row">
            <div class="col-lg-12">  
                <div class="card">
                    <div class="card-header">
                        <h5 class="card-title"> {{__('Attachments')}}</h5>
                    </div>

                    <div class="card-body">
                        <div class="col-sm-12 increments" id="add_attch">
                            <label>Attachments</label>
                            <div class="input-group control-group">
                                <div class="custom-file mr-2" >
                                    <input type="file" class="custom-file-input files form-control @error('enbs_attachments[]') is-invalid @enderror" id="attachments" name="filenames[]">
                                    <label class="custom-file-label" for="customFile">{{ __('Choose file/s') }}</label>
                                </div>
                                
                                    <input type="text" name="file_names[]"  placeholder="Document name" class="form-control mr-2 doc_name" />
                            
                                <button type="button" class="btn btn-success add_row"  >
                                    <i class="fa fa-plus"></i>
                                </button>
                            </div>
                        </div>
                        <div class="col-sm-12">
                            <ul class="p-0 m-0">
                                @if (isset($attachments))
                                    @foreach ($attachments as $attach)
                                        <li class="d-flex align-items-center my-2 p-2">
                                            <div class="flex-shrink-1 mr-2" >
                                                <a href="{{ asset('uploads/pdf/' . $attach['file_name']) }}" target="_blank" rel="noopener noreferrer" class="btn btn-sm btn-primary px-3" >
                                                    View
                                                </a>
                                            </div>
                                            <div class="flex-shrink-1 mr-2 rename">
                                                <a type="button" attach_id="{{ $attach['id'] }}" id="edit_file" class="btn btn-warning btn-sm renameFile" data-toggle="modal" data-target="#edit_file_modal" >
                                                    Rename
                                                </a>
                                            </div>
                                            <div class="flex-shrink-1 delete">
                                                <button type="button" attach_id="{{ $attach['id'] }}" class="btn btn-danger btn-sm delete_attachment" >
                                                    Delete
                                                </button>
                                            </div>
                                            <span class="mx-2"><i class="fa fa-file mx-2 text-success"></i>{{ $attach['file_name'] }}</span>
                                        </li>
                                    @endforeach
                                @endif
                            </ul>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
</div>