@include('common.header')

<link rel="stylesheet" href="//code.jquery.com/ui/1.12.1/themes/base/jquery-ui.css">

<section class="content">
    <div class="body_scroll">
        <div class="block-header">
            <div class="row">
                <div class="col-lg-7 col-md-6 col-sm-12">
                    <h2>PET Renewal License Application</h2>
                    <ul class="breadcrumb">
                        <li class="breadcrumb-item"><a href="{{ url('/admin/dashboard') }}"><i class="zmdi zmdi-home"></i>
                                Home</a></li>
                        <!--<li class="breadcrumb-item"><a href="{{ url('/#') }}">PET Application</a></li>-->
                        <li class="breadcrumb-item active">PET Renewal License Application</li>
                    </ul>
                    <button class="btn btn-primary btn-icon mobile_menu" type="button"><i
                            class="zmdi zmdi-sort-amount-desc"></i></button>
                </div>

                <div class="col-lg-5 col-md-6 col-sm-12">
                    <button class="btn btn-primary btn-icon float-right right_icon_toggle_btn" type="button"><i
                            class="zmdi zmdi-arrow-right"></i></button>
                </div>
            </div>
        </div>

        <div class="container-fluid">
            <!-- Vertical Layout -->
            <div class="row clearfix">
                <div class="col-lg-12 col-md-12 col-sm-12">
                    <div class="card">
                        <div class="body">
                            <form method="post" action="{{ url('#') }}" class="form-horizontal"
                                enctype="multipart/form-data">
                                @csrf
                                <h5 class="text-blue h5 mb-20" style="font-size: 17px;font-weight: bolder;">Basic
                                    Information ( मुलभूत माहिती ) :- </h5>
                                <div class="pd-20 card-box mb-30">
                                    <div class="form-group row">

                                        <label class="col-sm-2"><strong>प्रभाग / <br> Ward : </strong></label>
                                        <div class="col-sm-4 col-md-4 pb-2">
                                            <input class="form-control " value="{{ $pet_renewal_view->ward_name }}"
                                                readonly>
                                        </div>

                                        <label class="col-sm-2"><strong>विभाग / <br> Department : </strong></label>
                                        <div class="col-sm-4 col-md-4">
                                            <input class="form-control " value="{{ $pet_renewal_view->dept_id }}"
                                                readonly>
                                        </div>
                                    </div>

                                    <hr>
                                    <strong class="pb-1">अर्जदाराचे नाव /<br> Name of Applicant : </strong>
                                    <div class="form-group row">
                                                                                <!--<label class="col-sm-1"><strong>Title : </strong></label>-->
                                        <div class="col-sm-3 col-md-3 p-2">
                                            <input class="form-control " value="{{ $applicant_title_id }}" readonly>
                                        </div>


                                        <!--<label class="col-sm-1"><strong>First Name : </strong></label>-->
                                        <div class="col-sm-3 col-md-3 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_renewal_view->renewal_application_fname }}" readonly>
                                        </div>

                                        <!--<label class="col-sm-1"><strong>Middle Name : </strong></label>-->
                                        <div class="col-sm-3 col-md-3 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_renewal_view->renewal_application_mname }}" readonly>
                                        </div>

                                        <!--<label class="col-sm-1"><strong>Last Name : </strong></label>-->
                                        <div class="col-sm-3 col-md-3 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_renewal_view->renewal_application_lname }}" readonly>
                                        </div>
                                    </div>

                                    <strong class="pb-1">मालकाचे नाव / <br> Name of Owner's : </strong>
                                    <div class="form-group row">
                                                                                <!--<label class="col-sm-1"><strong>Title : </strong></label>-->
                                        <div class="col-sm-3 col-md-3 p-2">
                                            <input class="form-control " value="{{ $owner_title_id }}" readonly>
                                        </div>


                                        <!--<label class="col-sm-1"><strong>First Name : </strong></label>-->
                                        <div class="col-sm-3 col-md-3 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_renewal_view->renewal_owner_fname }}" readonly>
                                        </div>

                                        <!--<label class="col-sm-1"><strong>Middle Name : </strong></label>-->
                                        <div class="col-sm-3 col-md-3 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_renewal_view->renewal_owner_mname }}" readonly>
                                        </div>

                                        <!--<label class="col-sm-1"><strong>Last Name : </strong></label>-->
                                        <div class="col-sm-3 col-md-3 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_renewal_view->renewal_owner_lname }}" readonly>
                                        </div>
                                    </div>

                                    <strong class="pt-2 text-danger">
                                        मालकाचा निवासी पत्ता / Residential Address of Owner's
                                    </strong>
                                    <hr>

                                    <div class="form-group row">
                                        <label class="col-sm-2"><strong> घर/फ्लॅट क्रमांक / <br> House/Flat Number :
                                            </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_renewal_view->renewal_house_number }}" readonly>
                                        </div>

                                        <label class="col-sm-2"><strong>घर/इमारतीचे नाव / <br> House/Building Name :
                                            </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_renewal_view->renewal_house_name }}" readonly>
                                        </div>
                                    </div>

                                    <div class="form-group row">
                                        <label class="col-sm-2"><strong>ओळ १ / <br> Line 1 : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_renewal_view->renewal_street_1 }}" readonly>
                                        </div>

                                        <label class="col-sm-2"><strong>ओळ २ / <br> Line 2 : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_renewal_view->renewal_street_2 }}" readonly>
                                        </div>
                                    </div>

                                    <div class="form-group row">
                                        <label class="col-sm-2"><strong>क्षेत्र १ / <br> Area 1 : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_renewal_view->renewal_area_1 }}" readonly>
                                        </div>

                                        <label class="col-sm-2"><strong>क्षेत्र 2 / <br> Area 2 : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_renewal_view->renewal_area_2 }}" readonly>
                                        </div>
                                    </div>

                                    <div class="form-group row">
                                                                                <label class="col-sm-2"><strong>राज्य / <br> State : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control " value="{{ $state_id }}" readonly>
                                        </div>

                                        <label class="col-sm-2"><strong>जिल्हा / <br> District : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control " value="{{ $pet_renewal_view->dist_name }}"
                                                readonly>
                                        </div>
                                    </div>

                                    <div class="form-group row">
                                        <label class="col-sm-2"><strong>शहर / <br> City :</strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control" value="{{ $pet_renewal_view->city }}"
                                                readonly>
                                        </div>

                                        <label class="col-sm-2"><strong>मोबाईल नंबर / <br> Mobile Number :
                                            </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_renewal_view->renewal_mobile_number }}" readonly>
                                        </div>
                                    </div>

                                    <div class="form-group row">
                                        <label class="col-sm-2"><strong>ई - मेल आयडी / Email Id : <br><span
                                                    class="text-danger">
                                                    {{-- (Receipt and Certificate will be sent on this Email ID) --}}
                                                </span> </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_renewal_view->renewal_email }}" readonly>
                                        </div>

                                        <label class="col-sm-2"><strong>आधार क्रमांक / <br> Aadhar Number :
                                            </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_renewal_view->renewal_aadhar_number }}" readonly>
                                        </div>
                                    </div>

                                    <div class="form-group row">
                                        <label class="col-sm-2"><strong>पिनकोड / <br> Zip Code : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_renewal_view->renewal_zipcode }}" readonly>
                                        </div>
                                    </div>

                                    <!--<strong class="pt-2 text-danger text-justify">-->
                                    <!--    Note : <br>-->
                                    <!--    1. Please fill all the Cat details below, Since and Vaccination Date should be in mm/dd/yyyy format only Ex. 01/20/2018 .<br>-->
                                    <!--    2. Select Others in Breed and enter details if Cat Breed not found if drop down .<br>-->
                                    <!--    3. Vaccination Certificate of size upto 2 MB to be Uploaded as attachment .-->
                                    <!--</strong>-->
                                    <!--<hr>-->

                                    <!--<strong class="pt-2 text-danger text-justify">-->
                                    <!--    नोंद : <br>-->
                                    <!--    1. कृपया खाली सर्व कुत्र्याचे तपशील भरा, पासून आणि लसीकरणाची तारीख फक्त mm/dd/yyyy स्वरूपात असावी उदा. 01/20/2018 .<br>-->
                                    <!--    2. जातीतील इतर निवडा आणि ड्रॉप डाउन असल्यास डॉग ब्रीड आढळले नसल्यास तपशील प्रविष्ट करा.<br>-->
                                    <!--    3. संलग्नक म्हणून अपलोड करण्यासाठी 2 MB पर्यंत आकाराचे लसीकरण प्रमाणपत्र.-->
                                    <!--</strong>-->
                                    <hr>
                                    <h5 class="text-blue h5 mb-20" style="font-size: 17px;font-weight: bolder;">Cat
                                        Details :</h5>
                                    <div class="form-group row">
                                        <label class="col-sm-2"><strong>कुत्र्याचे नाव / <br> Cat Name :
                                            </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_renewal_view->renewal_dog_name }}" readonly>
                                        </div>

                                                                                <label class="col-sm-2"><strong>लिंग / <br> Sex : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control " value="{{ $sex_id }}" readonly>
                                        </div>
                                    </div>

                                    <div class="form-group row">
                                        <label class="col-sm-2"><strong>ओळख चिन्ह / <br> Identification Mark :
                                            </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_renewal_view->identification_mark }}" readonly>
                                        </div>

                                        <label class="col-sm-2"><strong>जाती / <br> Breed : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control " value="{{ $pet_renewal_view->breeds_name }}"
                                                readonly>
                                        </div>
                                    </div>

                                    <div class="form-group row">
                                        <label class="col-sm-2"><strong>इतर जाती / <br> Other Breed : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control " value="{{ $pet_renewal_view->other_breed }}"
                                                readonly>
                                        </div>

                                        <label class="col-sm-2"><strong>रंग /<br> Colour : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_renewal_view->renewal_colour }}" readonly>
                                        </div>
                                    </div>

                                    <div class="form-group row">
                                        <label class="col-sm-2"><strong>पशुवैद्यकीय डॉक्टरांचे नाव / <br> Veterinary
                                                Doctor Name : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_renewal_view->veterinary_doctor_name }}" readonly>
                                        </div>

                                        <label class="col-sm-2"><strong>पशुवैद्यकीय डॉक्टरांचा MSVC/VCI नोंदणी क्रमांक
                                                / Veterinary doctor’s MSVC/VCI registration number : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_renewal_view->veterinary_doctor_msvc_no }}" readonly>
                                        </div>
                                    </div>

                                    @php
                                        $is_rabies_vaccinated = null;
                                        $is_91_vaccinated = null;

                                        if (!empty($pet_renewal_view)) {
                                            $is_rabies_vaccinated = $pet_renewal_view->dog_renewal_date_of_rabies_vaccination
                                                ? 'yes'
                                                : 'no';

                                            $is_91_vaccinated = $pet_renewal_view->dog_renewal_date_of_91_vaccination
                                                ? 'yes'
                                                : 'no';
                                        }
                                    @endphp

                                    <div class="form-group row">
                                        <label class="col-sm-2"><strong>Is Anti-Rabies Vaccinated? / (अँटी रेबिज लस
                                                दिली
                                                आहे का?)</strong></label>
                                        <div class="col-sm-4 p-2">
                                            <input type="text" name="is_rabies_vaccinated" class="form-control"
                                                value="{{ $is_rabies_vaccinated ? ($is_rabies_vaccinated == 'yes' ? 'Yes / होय' : 'No / नाही') : '' }}"
                                                readonly>
                                        </div>

                                        <label class="col-sm-2"><strong>Is Anti TriCat Vaccinated? / (अँटी ट्रायकॅट चे
                                                लसीकरण झाले आहे का?)</strong></label>
                                        <div class="col-sm-4 p-2">
                                            <input type="text" name="is_91_vaccinated" class="form-control"
                                                value="{{ $is_91_vaccinated ? ($is_91_vaccinated == 'yes' ? 'Yes / होय' : 'No / नाही') : '' }}"
                                                readonly>
                                        </div>
                                    </div>

                                    <div class="form-group row">
                                        @if ($is_rabies_vaccinated == 'yes')
                                            <label class="col-sm-2"><strong>अँटी रेबिज लसीकरणाची तारीख (DD/MM/YYYY) /
                                                    <br> Date of Anti Rabies Vaccination (DD/MM/YYYY) :
                                                </strong></label>
                                            <div class="col-sm-4 col-md-4 p-2">
                                                <input class="form-control"
                                                    value="{{ $pet_renewal_view->dog_renewal_date_of_rabies_vaccination
                                                        ? date('d-m-Y', strtotime($pet_renewal_view->dog_renewal_date_of_rabies_vaccination))
                                                        : '' }}"
                                                    readonly>
                                            </div>
                                        @endif

                                        @if ($is_91_vaccinated == 'yes')
                                            <label class="col-sm-2"><strong>अँटी ट्रायकॅट लसीकरणाची तारीख (DD/MM/YYYY)
                                                    /
                                                    <br> Date of Anti TriCat Vaccination (DD/MM/YYYY) :
                                                </strong></label>
                                            <div class="col-sm-4 col-md-4 p-2">
                                                <input class="form-control"
                                                    value="{{ $pet_renewal_view->dog_renewal_date_of_91_vaccination
                                                        ? date('d-m-Y', strtotime($pet_renewal_view->dog_renewal_date_of_91_vaccination))
                                                        : '' }}"
                                                    readonly>
                                            </div>
                                        @endif
                                    </div>

                                    <div class="form-group row">
                                        <label class="col-sm-2"><strong>Date of Cat Breeding/Purchase (DD/MM/YYYY) /
                                                <br>(मांजर पाळण्याची/खरेदीची तारीख) :</strong></label>
                                        <div class="col-sm-4 col-md-4 p-2"><input class="form-control"
                                                value="{{ $pet_renewal_view->date_of_purchase }}" readonly></div>

                                        <label class="col-sm-2"><strong> Tentative Date of Birth (DD/MM/YYYY) / अंदाजे
                                                जन्मतारीख (दि/महा/वर्ष) : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input type="date" name="date_of_birth" id="date_of_birth"
                                                class="form-control @error('date_of_birth') is-invalid @enderror"
                                                value="{{ $pet_renewal_view->dog_renewal_date_of_birth }}"
                                                max="{{ date('Y-m-d') }}" placeholder="DD/MM/YYYY" readonly>
                                        </div>
                                    </div>

                                    <div class="form-group row">
                                        <label class="col-sm-2"><strong>Pet Age Years / (पाळीव प्राणी वय वर्षे) :
                                            </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control" id="age"
                                                value="{{ $pet_renewal_view->dog_age }}" readonly>
                                        </div>

                                        <label class="col-sm-2"><strong>Month / ( महिना ) : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control" id="month"
                                                value="{{ $pet_renewal_view->dog_month }}" readonly>
                                        </div>
                                    </div>

                                    <hr>

                                    <h5 class="text-blue h5 mb-20" style="font-size: 17px;font-weight: bolder;">
                                        Documents : </h5>
                                    <div class="form-group row">
                                        <label class="col-sm-2"><strong>Upload Address proof of owner (Aadhar Card /
                                                Ration
                                                Card / Electricity Bill / Rent Agreement / Voter ID) / <br> मालकाचा
                                                पत्ता पुरावा अपलोड करा (आधार कार्ड / शिधा कार्ड / वीज बिल / भाडे
                                                करारनामा /
                                                मतदान ओळखपत्रअपलोड करा) :
                                            </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <a href="{{ url('/') }}/TMC_PET_Registration/address_proof_doc/{{ $pet_renewal_view->renewal_address_proof_doc }}"
                                                target="_blank">
                                                <div class="form-group">
                                                                                                        <a href="{{ url('/') }}/TMC_PET_Registration/address_proof_doc/{{ $pet_renewal_view->renewal_address_proof_doc }}"
                                                        target="_blank">
                                                        <p class="mt-3 mb-0" id="image_div">
                                                            <button type="button"class="btn btn-info">
                                                                View File
                                                            </button>
                                                        </p>
                                                    </a>
                                                                                                    </div>
                                            </a>
                                        </div>

                                        <label class="col-sm-2"><b> Upload Cat Photo / <br> (मांजरीचा/मांजराचा फोटो
                                                अपलोड करा)
                                            </b></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <a href="{{ url('/') }}/TMC_PET_Registration/dog_profile_photo/{{ $pet_renewal_view->dog_renewal_profile_photo }}"
                                                target="_blank">
                                                <div class="form-group">
                                                                                                        <a href="#">Document Not Uploaded</a>
                                                                                                    </div>
                                            </a>
                                        </div>
                                    </div>

                                    <div class="form-group row">
                                        <label class="col-sm-2"><strong> Applicant Signature / <br>( अर्जदाराची
                                                स्वाक्षरी ) : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <a href="{{ url('/') }}/TMC_PET_Registration/applicant_signature/{{ $pet_renewal_view->renewal_applicant_signature }}"
                                                target="_blank">
                                                <div class="form-group">
                                                                                                        <a href="{{ url('/') }}/TMC_PET_Registration/applicant_signature/{{ $pet_renewal_view->renewal_applicant_signature }}"
                                                        target="_blank">
                                                        <p class="mt-3 mb-0" id="image_div">
                                                            <button type="button"class="btn btn-info">
                                                                View File
                                                            </button>
                                                        </p>
                                                    </a>
                                                                                                    </div>
                                            </a>
                                        </div>

                                        <label class="col-sm-2">
                                            <strong>Upload Vaccination Card / <br>( लसीकरण कार्ड
                                                अपलोड करा )</strong>
                                        </label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            @php
                                                $docs = [];

                                                if (
                                                    !empty($pet_renewal_view) &&
                                                    !empty($pet_renewal_view->renewal_vaccination_card_doc)
                                                ) {
                                                    $decoded = json_decode(
                                                        $pet_renewal_view->renewal_vaccination_card_doc,
                                                        true,
                                                    );

                                                    if (is_array($decoded)) {
                                                        $docs = array_filter($decoded); // filter out empty values
                                                    } elseif (!empty($decoded)) {
                                                        $docs = [$decoded];
                                                    }
                                                }
                                            @endphp

                                            <div class="form-group mt-3">
                                                @if (count($docs) > 0)
                                                    @foreach ($docs as $doc)
                                                        @php $ext = pathinfo($doc, PATHINFO_EXTENSION); @endphp

                                                        <div class="existing-doc mb-2 align-items-center"
                                                            data-doc="{{ $doc }}">
                                                            @if (in_array(strtolower($ext), ['jpg', 'jpeg', 'png', 'gif']))
                                                                <img src="{{ url('/') }}/TMC_PET_Registration/vaccination_card_doc/{{ $doc }}"
                                                                    alt="Rabies Vaccination Certificate"
                                                                    class="img-fluid rounded" width="120"
                                                                    style="max-height:120px;">
                                                            @elseif (strtolower($ext) === 'pdf')
                                                                <a href="{{ url('/') }}/TMC_PET_Registration/vaccination_card_doc/{{ $doc }}"
                                                                    target="_blank"
                                                                    class="btn btn-info btn-sm me-2">View
                                                                    File</a>
                                                            @endif
                                                        </div>
                                                    @endforeach
                                                @else
                                                    <p class="text-danger">No Document Uploaded</p>
                                                @endif
                                            </div>
                                        </div>
                                    </div>

                                                                        <div class="form-group row mt-4">
                                        <label class="col-md-3"></label>
                                        <div class="col-md-9" style="display: flex; justify-content: flex-end;">
                                            <a href="{{ url('/pet_renewal_list/0') }}"><button type="button"
                                                    class="btn btn-danger">Cancel</button></a>&nbsp;&nbsp;
                                            <button type="button" class="btn btn-warning waves-effect m-r-10"
                                                data-toggle="modal" data-target="#reject_model">Reject</button>

                                            {{-- <a href='{{ url("/approve_pet_renewal/{$pet_renewal_view->dog_renewal_id}") }}'><button
                                                    type="button" class="btn btn-success">Approve </button> </a> --}}
                                            <button type="button" class="btn btn-success waves-effect m-r-20"
                                                data-toggle="modal" data-target="#approve_model">Approve</button>

                                        </div>
                                    </div>
                                    
                                </div>
                            </form>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
</section>

<!-- Approve Model -->
<div class="modal fade" id="approve_model" tabindex="-1" role="dialog">
    <div class="modal-dialog modal-lg" role="document">
        <div class="modal-content">
            <div class="modal-header">
                <h4 class="title text-danger" id="largeModalLabel">Approved By Admin Renewal License</h4>
            </div>
            <div class="modal-body">
                <form method="POST" action="{{ url('approve_pet_renewal', $pet_renewal_view->dog_renewal_id) }}"
                    enctype="multipart/form-data">
                    @csrf

                    <input type="hidden" class="form-control " id="id" name="id"
                        value="{{ $pet_renewal_view->dog_renewal_id }}">
                    <input type="hidden" class="form-control " id="pet_pplication_no" name="pet_pplication_no"
                        value="{{ $pet_renewal_view->dog_renewal_pet_pplication_no }}">

                    {{-- <div class="form-group row">
                        <label class="col-sm-2"><strong>स्विकारलेल्या एकूण कराची रक्कम / <br> Total Amount of tax
                                received : <span style="color:red;">*</span></strong></label>
                        <div class="col-sm-4 col-md-4 p-2">
                            <input type="text" name="total_recived_tax" id="total_recived_tax" readonly
                                class="form-control @error('total_recived_tax') is-invalid @enderror"
                                value="{{ $pet_renewal_view->amount }}"
                                placeholder="स्विकारलेल्या एकूण कराची रक्कम / Total Amount of tax received.">
                            @error('total_recived_tax')
                                <span class="invalid-feedback" role="alert">
                                    <strong>{{ $message }}</strong>
                                </span>
                            @enderror
                        </div>

                        <label class="col-sm-2"><strong>पावती क्रमांक / <br> Receipt No : <span
                                    style="color:red;">*</span></strong></label>
                        <div class="col-sm-4 col-md-4 p-2">
                            <input type="text" name="receipt_no" id="receipt_no" readonly
                                class="form-control @error('receipt_no') is-invalid @enderror"
                                value="{{ $pet_renewal_view->atrn }}" placeholder="पावती क्रमांक / Receipt No.">
                            @error('receipt_no')
                                <span class="invalid-feedback" role="alert">
                                    <strong>{{ $message }}</strong>
                                </span>
                            @enderror
                        </div>
                    </div> --}}

                    <div class="form-group row">
                        <label class="col-sm-2"><strong>पावती दिनांक / Date of Receipt : <span
                                    style="color:red;">*</span> </strong></label>
                        <div class="col-sm-4 col-md-4 p-2">
                            <input type="date" name="date_of_receipt" max="2026-04-19"
                                id="date_of_receipt" readonly
                                class="form-control @error('date_of_receipt') is-invalid @enderror"
                                value="{{ \Carbon\Carbon::parse($pet_renewal_view->transaction_date)->format('Y-m-d') }}"
                                placeholder="जीएसटी क्रमांक / GST Number.">
                            @error('date_of_receipt')
                                <span class="invalid-feedback" role="alert">
                                    <strong>{{ $message }}</strong>
                                </span>
                            @enderror
                        </div>

                        <label class="col-sm-2"><strong>परवाना क्रमांक / License Number : <span
                                    style="color:red;">*</span></strong></label>
                        <div class="col-sm-4 col-md-4 p-2">
                            <input type="text" name="license_number" id="license_number" readonly
                                class="form-control @error('license_number') is-invalid @enderror"
                                value="{{ $pet_renewal_view->dog_renewal_pet_pplication_no }}"
                                placeholder="परवाना क्रमांक / License Number.">
                            @error('license_number')
                                <span class="invalid-feedback" role="alert">
                                    <strong>{{ $message }}</strong>
                                </span>
                            @enderror
                        </div>
                    </div>

                    <div class="form-group row">
                        <label class="col-sm-2"><strong>परवाना दिल्याची दिनांक / Date of License Obtained : <span
                                    style="color:red;">*</span> </strong></label>
                        <div class="col-sm-4 col-md-4 p-2">
                            <input type="date" name="date_of_license_obtain" required max="19-04-2026"
                                id="date_of_license_obtain"
                                class="form-control @error('date_of_license_obtain') is-invalid @enderror"
                                value="{{ old('date_of_license_obtain') }}"
                                placeholder="जीएसटी क्रमांक / GST Number.">
                            @error('date_of_license_obtain')
                                <span class="invalid-feedback" role="alert">
                                    <strong>{{ $message }}</strong>
                                </span>
                            @enderror
                        </div>

                        <label class="col-sm-3"><strong>मागील शिल्लक रक्कम / <br> Previous Pending Amount
                                :</strong></label>

                        <div class="col-sm-3 col-md-3 p-2">
                            <input type="number" min="0" step="1" name="previous_pending_amount"
                                id="previous_pending_amount"
                                class="form-control @error('previous_pending_amount') is-invalid @enderror"
                                value="{{ old('previous_pending_amount', $previous_pending_amount ?? '') }}"
                                placeholder="मागील शिल्लक रक्कम / Previous Pending Amount">

                            @error('previous_pending_amount')
                                <span class="invalid-feedback" role="alert">
                                    <strong>{{ $message }}</strong>
                                </span>
                            @enderror
                        </div>
                    </div>

                    <div class="form-group row">
                        <label class="col-sm-3"><strong>Upload Admin Signature / <br>( विभाग प्रमुख स्वाक्षरी अपलोड करा
                                )
                                : <span style="color:red;">*</span></strong></label>
                        <div class="col-sm-3 col-md-3 p-2">
                            <input type="file" name="admin_sign" id="admin_sign"
                                class="form-control @error('admin_sign') is-invalid @enderror"
                                value="{{ old('admin_sign') }}" accept=".jpg, .jpeg, .png" required>
                            <small class="text-secondary text-justify "> Note : The file should be less than 2MB
                                .</small>
                            <br>
                            <small class="text-secondary text-justify "> Note : Only files in .jpg, .jpeg, .png format
                                can be uploaded .</small>
                            <br>

                            @error('admin_sign')
                                <span class="invalid-feedback" role="alert">
                                    <strong>{{ $message }}</strong>
                                </span>
                            @enderror
                        </div>

                        <label class="col-sm-2"><strong>दिनांक / Date : <span
                                    style="color:red;">*</span></strong></label>
                        <div class="col-sm-4 col-md-4 p-2">
                            <input type="date" name="date" readonly max="19-04-2026" id="date"
                                required class="form-control @error('date') is-invalid @enderror"
                                value="2026-04-19" placeholder="परवाना क्रमांक / License Number.">
                            @error('date')
                                <span class="invalid-feedback" role="alert">
                                    <strong>{{ $message }}</strong>
                                </span>
                            @enderror
                        </div>
                    </div>

                    <div class="form-group row mt-4">
                        <label class="col-md-3"></label>
                        <div class="col-md-9" style="display: flex; justify-content: flex-end;">
                            <a href='{{ url("/pet_renewal_view/{$pet_renewal_view->dog_renewal_id}/{$pet_renewal_view->renewal_status}") }}'
                                class="btn btn-danger btn-lg">Cancel</a>&nbsp;&nbsp;
                            <button type="submit" class="btn btn-success btn-lg">Submit</button>
                        </div>
                    </div>
                </form>
            </div>
        </div>
    </div>
</div>

<!-- Rejected Model -->
<div class="modal fade" id="reject_model" tabindex="-1" role="dialog">
    <div class="modal-dialog modal-lg" role="document">
        <div class="modal-content">
            <div class="modal-header">
                <h4 class="title text-danger" id="largeModalLabel">Rejected By Admin</h4>
            </div>
            <div class="modal-body">
                <form method="POST" action="{{ url('/reject_pet_renewal', $pet_renewal_view->dog_renewal_id) }}"
                    enctype="multipart/form-data">
                    @csrf

                    <input type="hidden" class="form-control " id="id" name="id"
                        value="{{ $pet_renewal_view->dog_renewal_id }}">
                    <input type="hidden" class="form-control " id="pet_pplication_no" name="pet_pplication_no"
                        value="{{ $pet_renewal_view->dog_renewal_pet_pplication_no }}">

                    <div class="form-group row">
                        <label class="col-sm-12"><strong>Reasons for Rejection : <span style="color:red;">*</span>
                            </strong></label>
                        <div class="col-sm-12 col-md-12 p-2">
                            <textarea type="text" name="reason_for_rejection" id="reason_for_rejection" required
                                class="form-control @error('reason_for_rejection') is-invalid @enderror"
                                value="{{ old('reason_for_rejection') }}" placeholder="Enter Reasons for Rejection"></textarea>
                            @error('reason_for_rejection')
                                <span class="invalid-feedback" role="alert">
                                    <strong>{{ $message }}</strong>
                                </span>
                            @enderror
                        </div>
                    </div>

                    <div class="form-group row mt-4">
                        <label class="col-md-3"></label>
                        <div class="col-md-9" style="display: flex; justify-content: flex-end;">
                            <a href='{{ url("/pet_renewal_view/{$pet_renewal_view->dog_renewal_id}/{$pet_renewal_view->renewal_status}") }}'
                                class="btn btn-danger btn-lg">Cancel</a>&nbsp;&nbsp;
                            <button type="submit" class="btn btn-success btn-lg">Submit</button>
                        </div>
                    </div>
                </form>
            </div>
        </div>
    </div>
</div>

@include('common.footer')