197 lines
17 KiB
PHP
197 lines
17 KiB
PHP
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<!-- Modal Assign Test -->
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<div class="modal fade modal-primary" id="modal-invoice">
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<style>
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#modal-invoice .form-group label {
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line-height: 0.1rem !important;
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}
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</style>
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<div class="modal-dialog modal-xxl p-5">
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<div class="modal-content border border-light shadow">
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<div class="modal-header">
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<h6 class="modal-title">{{__('invoice.form_new_title')}}</h6>
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<button type="button" class="close" data-dismiss="modal" aria-label="Close"><span aria-hidden="true" class="mdi mdi-close"></span></button>
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</div>
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<div class="modal-body">
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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">
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<div class="col-sm-12 col-md-6 col-lg-4 pl-0">
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@if($sample)
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<div class="form-group mb-1">
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<label for="lab-name-en">{{__('invoice.table_patient_name')}} <span class="text-danger">*</span></label>
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<select class="form-control form-control-sm rounded-0 select2_" name="sample_id" id="inv-sample-id" style=" width: 100% !important;">
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<option value="{{$sample->id}}">{{$sample->sample_number . ' - ' . $sample->patient->name_en}}</option>
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</select>
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</div>
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@else
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<div class="form-group mb-1">
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<label for="lab-name-en">{{__('invoice.table_patient_name')}} <span class="text-danger">*</span></label>
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<select class="form-control select2" name="sample_id" id="inv-sample-id" style=" width: 100% !important;">
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<option></option>
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</select>
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</div>
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@endif
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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 form-control-sm 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 class="col-sm-12 col-md-6 col-lg-4 pr-0">
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<div class="form-group mb-1">
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<label for="lab-name-en">{{__('sample.physician_name')}} <span class="text-danger"></span></label>
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<input type="text" value="{{@$sample->physician->name_en}}" class="form-control form-control-sm rounded-0" disabled>
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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-7 p-0" style="max-height: 350px; overflow: auto;">
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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.form_description')}}</th>
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<th width="150px" class="py-2 text-right" id="discount-type">{{__('invoice.form_discount')}} {{$labSettings->discount_type == 2 ? ($labSettings->currency==1?'៛':'$') : '(%)'}}</th>
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<th width="150px" class="py-2 text-right">{{__('invoice.form_net_amount')}}({{$labSettings->currency==1?'៛':'$'}})</th>
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</tr>
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</thead>
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<tbody id="invoice-item">
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</tbody>
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</table>
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<div class="form-group py-5 px-3">
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<label class="font-weight-medium" for="lab-name-en">{{__('invoice.form_description')}}</label>
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<textarea class="form-control" name="invoice_note" id="invoice-note" rows="3"></textarea>
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</div>
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</div>
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<div class="col-sm-5 p-4 border-left">
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<div class="row">
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<div class="col-sm-12">
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<div class="form-group row">
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<label for="total-amount" class="col-sm-5 col-form-label">{{__('invoice.form_total_amount')}} <span class="text-danger">({{$labSettings->currency==1?'៛':'$'}})</span></label>
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<div class="col-sm-7">
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<input type="number" min="0.00" step="any" readonly required class="form-control form-control-xxs bg-white form-control-sm rounded-0" name="total" id="total-amount" value="0.00">
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</div>
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</div>
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</div>
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<div class="col-sm-12">
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<div class="form-group row">
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<label for="discount-amount" class="col-sm-5 col-form-label">{{__('invoice.form_discount')}} <span class="text-danger">({{$labSettings->discount_type == 2 ? ($labSettings->currency==1?'៛':'$') : '%'}})</span></label>
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<div class="col-sm-7">
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<input type="hidden" name="discount_type" value="{{$labSettings->discount_type}}" id="discount_type" />
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<input type="number" min="0.00" step="any" required value="0.00" class="form-control form-control-xxs rounded-0" name="discount" id="discount-amount" placeholder="0.00">
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</div>
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</div>
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</div>
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<div class="col-sm-12">
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<div class="form-group row">
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<label for="net-amount" class="col-sm-5 col-form-label">{{__('invoice.form_net_amount')}} <span class="text-danger">({{$labSettings->currency==1?'៛':'$'}})</span></label>
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<div class="col-sm-7">
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<input type="number" min="0.00" step="any" readonly required value="0.00" class="form-control form-control-xxs 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>
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<div class="col-sm-12 bg-light px-0 pt-2">
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<div class="col-sm-12">
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<div class="form-group row">
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<label for="paid-amount" class="col-sm-5 col-form-label">{{__('invoice.pay_type')}} <span class="text-danger">*</span></label>
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<div class="col-sm-7">
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<select class="form-control form-control-xxs select2_ rounded-0 py-0" name="pay_type" id="pay_type" style=" width: 100% !important;">
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<option value="1">{{__('invoice.cash_paid')}}</option>
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<option value="2">{{__('invoice.bank_paid')}}</option>
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<option value="3">{{__('invoice.cash_paid')}} + {{__('invoice.bank_paid')}}</option>
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</select>
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</div>
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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 row">
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<label for="paid-amount" class="col-sm-5 col-form-label">{{__('invoice.form_paid_amount')}} <small class="text-info">({{__('invoice.cash_paid')}})</small></label>
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<div class="col-sm-7">
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<input type="number" min="0.00" step="any" required value="0.00" class="form-control form-control-xxs 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>
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<div class="col-sm-12">
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<div class="form-group row">
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<label for="paid-amount" class="col-sm-5 col-form-label">{{__('invoice.form_paid_amount')}} <small class="text-info">({{__('invoice.bank_paid')}})</small></label>
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<div class="col-sm-7">
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<input type="number" min="0.00" step="any" required value="0.00" class="form-control form-control-xxs rounded-0" name="bank_deposit" id="bank-amount" placeholder="0.00">
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</div>
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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 row">
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<label for="paid-amount" class="col-sm-5 col-form-label">{{__('invoice.form_paid_date')}} <span class="text-danger">*</span></label>
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<div class="col-sm-7">
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<input type="date" value="{{date('Y-m-d')}}" class="form-control form-control-xxs 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>
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<div class="col-sm-12">
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<div class="form-group row">
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<label for="paid-amount" class="col-sm-5 col-form-label">{{__('invoice.bank_name')}}</label>
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<div class="col-sm-7">
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<input type="text" value="" class="form-control form-control-xxs rounded-0" name="bank_name" id="bank_name">
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</div>
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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 row">
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<label for="paid-amount" class="col-sm-5 col-form-label">{{__('invoice.transaction_no')}}</label>
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<div class="col-sm-7">
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<input type="text" value="" class="form-control form-control-xxs rounded-0" name="transaction_ref" id="transaction_ref">
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</div>
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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 row">
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<label for="owe-amount" class="col-sm-5 col-form-label">{{__('invoice.form_owe_amount')}} ({{$labSettings->currency==1?'៛':'$'}})<span class="text-danger">*</span></label>
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<div class="col-sm-7">
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<input type="number" min="0.00" step="any" readonly class="form-control bg-white form-control-xxs rounded-0" name="balance" id="owe-amount" placeholder="0.00">
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</div>
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</div>
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</div>
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</div>
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</div>
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<div class="form-check" style="width: 250px !important;">
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<label class="form-check-label">
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<input type="checkbox" {{($labSettings->is_hide_inv_discount==1)? 'checked':''}} name="is_hide_discount" class="form-check-input" id="select-all-lab">
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{{__('invoice.hide_discount')}}
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</label>
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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-inverse-info btn-sm mr-2 rounded-25" name="save_print_invoice" type="submit" value="save_preview_invoice"><i class="mdi mdi-printer"></i> {{__('invoice.form_btn_save_preview')}}</button>
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<button class="btn btn-info btn-sm rounded-25" 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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