163 lines
12 KiB
PHP
163 lines
12 KiB
PHP
<!DOCTYPE html>
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<html lang="{{ str_replace('_', '-', app()->getLocale()) }}">
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<head>
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@include('layout.header')
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<style>
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</style>
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</head>
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<body>
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<div class="container-scroller">
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@include('layout.navbar')
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<!-- partial -->
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@include('layout.breadscrum')
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<div class="container-fluid page-body-wrapper">
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@include('layout.sidebar')
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<!-- partial -->
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<div class="main-panel">
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<div class="content-wrapper">
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<div class="row">
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<div class="col-md-12 grid-margin stretch-card">
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<div class="card min-vh-70">
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<div class="card-body">
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<h4 class="card-title"><i class="mdi mdi-dots-vertical menu-icon"></i> {{__('invoice.form_new_title')}}</h4>
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<hr>
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<form method="post" class="p-2" action="{{route('invoice.save')}}" id="form-test-sample">
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@csrf
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<div class="row">
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<div class="col-lg-12">
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<div class="row">
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<div class="col-lg-12">
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<div class="form-vertical sample-creation-form">
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<div class="row bg-light mb-3 pt-2">
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<div class="col-sm-12 col-md-6 col-lg-4">
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<div class="form-group mb-1">
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<label for="lab-name-en">{{__('invoice.form_patient')}} <span class="text-danger">*</span></label>
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<div class="input-group">
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<div class="form-group" style="flex: 1">
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<select class="form-control select2" name="sample_id" id="sample-id" style=" width: 100% !important;">
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<option></option>
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@foreach($samples as $sample)
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<option {{$sample_id == $sample->id ? 'selected':''}} value="{{$sample->id}}">{{$sample->sample_number . ' - ' . $sample->patient->name_en}}</option>
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@endforeach
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</select>
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</div>
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<div class="input-group-append">
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{{--<button class="btn btn-sm btn-info px-3 shadow-none rounded-0" title="Auto generate patient code" type="button" onclick="generate_invoice()"><i class="mdi mdi-plus"></i>{{__('invoice.form_new_title')}}</button>--}}
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</div>
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</div>
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</div>
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</div>
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<!--<div class="col-sm-12 col-md-6 col-lg-4">-->
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<!-- <div class="form-group mb-1">-->
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<!-- <label for="lab-name-en">{{__('invoice.form_invoice_number')}} <span class="text-danger">*</span></label>-->
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<!-- <input type="text" class="form-control bg-white rounded-0" name="invoice_code" readonly id="invoice-number" placeholder="Invoice Number">-->
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<!-- </div>-->
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<!--</div>-->
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<div class="col-sm-12 col-md-6 col-lg-4">
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<div class="form-group mb-1">
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<label for="lab-name-en">{{__('invoice.form_invoice_date')}} <span class="text-danger">*</span></label>
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<input type="datetime-local" value="{{date('Y-m-d\TH:i:s')}}" class="form-control rounded-0" name="invoice_date" id="invoice_date" placeholder="Invoice Date">
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</div>
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</div>
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</div>
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<div class="row border p-0">
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<div class="col-sm-8 p-0">
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<table class="table">
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<thead>
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<tr class="bg-light">
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<th class="py-2">{{__('invoice.table_no')}}</th>
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<th class="py-2">{{__('invoice.form_description')}}</th>
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<th class="py-2 text-center">{{__('invoice.form_qty')}}</th>
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<th class="py-2 text-right">{{__('invoice.form_qty')}}</th>
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</tr>
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</thead>
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<tbody id="invoice-item">
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</tbody>
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</table>
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</div>
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<div class="col-sm-4 p-4 border-left">
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<div class="row">
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<div class="col-sm-12">
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<div class="form-group mb-1">
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<label for="lab-name-en">{{__('invoice.table_total_cost')}} <span class="text-danger">($)</span></label>
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<input type="number" readonly required step="any" class="form-control bg-white form-control-sm rounded-0" name="total" id="total-amount" placeholder="0.00">
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</div>
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</div>
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<div class="col-sm-12">
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<div class="form-group mb-1">
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<label for="lab-name-en">{{__('invoice.table_discount')}} <span class="text-danger">($)</span></label>
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<input type="number" required value="0.00" step="any" class="form-control form-control-sm rounded-0" name="discount" id="discount-amount" placeholder="0.00">
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</div>
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</div>
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<div class="col-sm-12">
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<div class="form-group mb-1">
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<label for="lab-name-en">{{__('invoice.table_net_cost')}} <span class="text-danger">($)</span></label>
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<input type="number" required step="any" class="form-control form-control-sm rounded-0" name="gross_total" id="net-amount" placeholder="0.00">
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</div>
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</div>
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<div class="col-sm-12 bg-light px-0 pt-3">
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<div class="col-sm-12">
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<div class="form-group mb-1">
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<label for="lab-name-en">{{__('invoice.table_paid')}} <span class="text-danger">($)</span></label>
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<input type="number" required step="any" value="0.00" class="form-control form-control-sm rounded-0" name="deposit" id="paid-amount" placeholder="0.00">
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</div>
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</div>
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<div class="col-sm-12">
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<div class="form-group mb-1">
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<label for="lab-name-en">{{__('invoice.form_paid_date')}} <span class="text-danger">*</span></label>
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<input type="datetime-local" value="{{date('Y-m-d\TH:i:s')}}" class="form-control form-control-sm rounded-0" name="first_paid_date" id="paid-date" placeholder="DD-MM-YYYY">
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</div>
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</div>
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<div class="col-sm-12">
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<div class="form-group mb-1">
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<label for="lab-name-en">{{__('invoice.form_owe_amount')}} <span class="text-danger">*</span></label>
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<input type="number" readonly step="any" class="form-control bg-white form-control-sm rounded-0" name="balance" id="owe-amount" placeholder="0.00">
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</div>
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</div>
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</div>
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</div>
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</div>
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</div>
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<div class="row">
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<div class="col-lg-12 pt-4 text-right">
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<button class="btn btn-info" type="submit"><i class="mdi mdi-check-all"></i> {{__('invoice.form_btn_save')}}</button>
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</div>
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</div>
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</div>
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</div>
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</div>
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</div>
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</div>
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</form>
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</div>
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</div>
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</div>
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</div>
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</div>
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@include('layout.footer')
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</div>
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</div>
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</div>
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@include('layout.common_script')
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<script>
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var base_url = "{{url('invoice')}}";
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var get_refs_base_url = "{{url('refs')}}";
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var invoice_id = 0;
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</script>
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<script src="{{url(env("APP_URL").'storage/assets/js/admin/invoice.js')}}"></script>
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</body>
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</html>
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