@extends('backend.layouts.master')

@section('title')
Quản lý Khách hàng
@endsection

@section('page-header')
<div class="row g-2 align-items-center">
    <div class="col">
        <h2 class="page-title">
            Tạo mới Khách hàng
        </h2>
    </div>
</div>
@endsection

@section('admin-content')
<div class="row row-cards">
    <div class="col-12">
        @include('backend.layouts.partials.messages')
        <form action="{{ route('admin.customer.store') }}" method="post" class="card" enctype="multipart/form-data">
            @csrf
            <div class="card-header">
                <h4 class="card-title">Tạo mới Khách hàng</h4>
            </div>
            <div class="card-body">
                <div class="row">
                    <div class="col-xl-6">
                        <div class="row">
                            <div class="col-md-6 col-xl-12">
                                <div class="mb-3">
                                    <label for="name" class="form-label required">Tên Khách hàng</label>
                                    <input type="text" class="form-control" id="name" name="name" value="{{old('name')}}">
                                </div>
                                <div class="mb-3">
                                    <label for="age" class="form-label">Tuổi</label>
                                    <input type="number" class="form-control" id="age" name="age" value="{{old('age')}}">
                                </div>
                                <div class="mb-3">
                                    <div class="form-label">Giới tính</div>
                                    <div>
                                        <label class="form-check form-check-inline">
                                            <input class="form-check-input" type="radio" value="male" name="gender" checked="">
                                            <span class="form-check-label">Nam</span>
                                        </label>
                                        <label class="form-check form-check-inline">
                                            <input class="form-check-input" type="radio" value="female" name="gender">
                                            <span class="form-check-label">Nữ</span>
                                        </label>
                                        <label class="form-check form-check-inline">
                                            <input class="form-check-input" type="radio" value="other" name="gender">
                                            <span class="form-check-label">Khác</span>
                                        </label>
                                    </div>
                                </div>
                                <div class="mb-3">
                                    <label for="phone" class="form-label required">Số điện thoại</label>
                                    <input type="text" class="form-control" id="phone" name="phone" value="{{old('phone')}}">
                                </div>
                                <div class="mb-3">
                                    <label for="email" class="form-label">Email</label>
                                    <div>
                                        <input type="email" class="form-control" id="email" name="email" value="{{old('email')}}">
                                    </div>
                                </div>
                                
                                {{-- <div class="mb-3">
                                    <label for="password" class="form-label">Ngày sinh</label>
                                    <input type="text" name="date_of_birth" class="form-control" data-mask="00-00-0000" data-mask-visible="true" placeholder="00-00-0000" autocomplete="off">
                                </div> --}}
                                <div class="mb-3">
                                    <label for="address" class="form-label">Địa chỉ</label>
                                    <input type="text" class="form-control" id="address" name="address" value="{{old('address')}}">
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="col-xl-6">
                        <div class="row">
                            <div class="col-md-6 col-xl-12">
                                <div class="mb-3">
                                    <label class="form-label">Thuốc dị ứng</label>
                                    <textarea rows="5" name="allergy" class="form-control" placeholder="Thông tin thuốc dị ứng" value="">{{old('allergy')}}</textarea>
                                </div>
                                <div class="mb-3">
                                    <label class="form-label">Bệnh nền</label>
                                    <textarea rows="5" name="underlying_disease" class="form-control" placeholder="Thông tin bệnh nền" value="">{{old('underlying_disease')}}</textarea>
                                </div>
                            </div>
                        </div>
                    </div>
                </div>
            </div>
            <div class="card-footer text-end">
                <div class="d-flex">
                    <a href="{{ route('admin.customer.index') }}" class="btn btn-danger">Hủy</a>
                    <button type="submit" class="btn btn-primary ms-auto">Tạo mới</button>
                </div>
            </div>
        </form>
    </div>
</div>

@endsection

@section('scripts')

@endsection