@extends('templates.master')

@section('breadcrumb')
  <div class="content content-full">
    <div class="d-flex flex-column flex-sm-row justify-content-sm-between align-items-sm-center py-2">
      <div class="flex-grow-1">
        <h1 class="h3 fw-bold mb-2">
          @php
          	$title = "Anggota"
          @endphp
          {{ $title }}
        </h1>
      </div>
      <nav class="flex-shrink-0 mt-3 mt-sm-0 ms-sm-3" aria-label="breadcrumb">
        <ol class="breadcrumb breadcrumb-alt">
          <li class="breadcrumb-item">
            <a class="link-fx" href="#">Dashboard</a>
          </li>
          <li class="breadcrumb-item">
            <a class="link-fx" href="#">{{ $title }}</a>
          </li>
          <li class="breadcrumb-item" aria-current="page">
            Tambah
          </li>
        </ol>
      </nav>
    </div>
  </div>
@endsection

@section('content')
	<div class="block block-rounded">
		<div class="block-header block-header-default">
      <h3 class="block-title">Tambah Data {{ $title }}</h3>
    </div>
	  <div class="block-content block-content-full">
	  	<div class="row">
	  		<div class="col">

	  			<form action="{{ route('kabupaten.tambahAksi') }}" method="POST">
						@csrf
	  				<div class="row">

	  					<div class="col-md-6">
  							<div class="form-group mb-4">
							    <label>ID Anggota</label>
							    <input type="text" name="id_anggota" class="form-control @error('id_anggota') is-invalid @enderror" value="{{ old('id_anggota') }}">
							    @error('id_anggota')
			                <div class="text-danger small mt-1">{{ $message }}</div>
			            @enderror
							  </div>

							  <div class="form-group mb-4">
							    <label>Nama Anggota</label>
							    <input type="text" name="nama" class="form-control @error('nama') is-invalid @enderror" value="{{ old('nama') }}">
							    @error('nama')
			                <div class="text-danger small mt-1">{{ $message }}</div>
			            @enderror
							  </div>

							  <div class="form-group mb-4">
							    <label>Majelis</label>
							    <input type="text" name="id_majelis" class="form-control @error('id_majelis') is-invalid @enderror" value="{{ old('id_majelis') }}">
							    @error('id_majelis')
			                <div class="text-danger small mt-1">{{ $message }}</div>
			            @enderror
							  </div>

							  <div class="form-group mb-4">
							    <label>Tanggal Registrasi</label>
							    <input type="date" name="tgl_regis" class="form-control @error('tgl_regis') is-invalid @enderror" value="{{ old('tgl_regis') }}">
							    @error('tgl_regis')
			                <div class="text-danger small mt-1">{{ $message }}</div>
			            @enderror
							  </div>

							  <div class="form-group mb-4">
							    <label>Nomor Urut</label>
							    <input type="number" name="no_urut" class="form-control @error('no_urut') is-invalid @enderror" value="{{ old('no_urut') }}">
							    @error('no_urut')
			                <div class="text-danger small mt-1">{{ $message }}</div>
			            @enderror
							  </div>

							  <div class="form-group mb-4">
							    <label>Kelompok</label>
							    <input type="number" name="kelompok" class="form-control @error('kelompok') is-invalid @enderror" value="{{ old('kelompok') }}">
							    @error('kelompok')
			                <div class="text-danger small mt-1">{{ $message }}</div>
			            @enderror
							  </div>

							  <div class="form-group mb-4">
							    <label>Petugas</label>
							    <input type="number" name="id_petugas" class="form-control @error('id_petugas') is-invalid @enderror" value="{{ old('id_petugas') }}">
							    @error('id_petugas')
			                <div class="text-danger small mt-1">{{ $message }}</div>
			            @enderror
							  </div>

							  <div class="form-group mb-4">
							    <label>Nama Ibu Kandung</label>
							    <input type="text" name="nama_ibu" class="form-control @error('nama_ibu') is-invalid @enderror" value="{{ old('nama_ibu') }}">
							    @error('nama_ibu')
			                <div class="text-danger small mt-1">{{ $message }}</div>
			            @enderror
							  </div>

							  <div class="form-group mb-4">
							    <label>Tempat Lahir</label>
							    <input type="text" name="tempat_lahir" class="form-control @error('tempat_lahir') is-invalid @enderror" value="{{ old('tempat_lahir') }}">
							    @error('tempat_lahir')
			                <div class="text-danger small mt-1">{{ $message }}</div>
			            @enderror
							  </div>

							  <div class="form-group mb-4">
							    <label>Tanggal Lahir</label>
							    <input type="date" name="tanggal_lahir" class="form-control @error('tanggal_lahir') is-invalid @enderror" value="{{ old('tanggal_lahir') }}">
							    @error('tanggal_lahir')
			                <div class="text-danger small mt-1">{{ $message }}</div>
			            @enderror
							  </div>

							  <div class="form-group mb-4">
							    <label>Jenis Kelamin</label>
							    <select name="jenis_kelamin" class="form-control">
							    	<option hidden>-- Pilih Jenis Kelamin --</option>
							    	<option value="L">Laki - laki</option>
							    	<option value="P">Perempuan</option>
							    </select>
							    @error('jenis_kelamin')
			                <div class="text-danger small mt-1">{{ $message }}</div>
			            @enderror
							  </div>

							  <div class="form-group mb-4">
							    <label>ST Nikah</label>
							    <input type="text" name="st_nikah" class="form-control @error('st_nikah') is-invalid @enderror" value="{{ old('st_nikah') }}">
							    @error('st_nikah')
			                <div class="text-danger small mt-1">{{ $message }}</div>
			            @enderror
							  </div>

							  <div class="form-group mb-4">
							    <label>Pendidikan</label>
							    <select name="jenis_kelamin" class="form-control">
							    	<option hidden>-- Pilih Pendidikan --</option>
							    	<option value="1">SD</option>
							    	<option value="2">SMP</option>
							    	<option value="3">SMA</option>
							    	<option value="4">Sarjana</option>
							    </select>
							    @error('pekerjaan')
			                <div class="text-danger small mt-1">{{ $message }}</div>
			            @enderror
							  </div>

							  <div class="form-group mb-4">
							    <label>Pekerjaan</label>
							    <select name="jenis_kelamin" class="form-control">
							    	<option hidden>-- Pilih Pekerjaan --</option>
							    	<option value="1">Karyawan</option>
							    	<option value="2">Wirausaha</option>
							    </select>
							    @error('pekerjaan')
			                <div class="text-danger small mt-1">{{ $message }}</div>
			            @enderror
							  </div>

	  					</div>

	  					<div class="col-md-6">
								

							  <div class="form-group mb-4">
							    <label>Ket. Kerja</label>
							    <input type="text" name="ket_kerja" class="form-control @error('ket_kerja') is-invalid @enderror" value="{{ old('ket_kerja') }}">
							    @error('ket_kerja')
			                <div class="text-danger small mt-1">{{ $message }}</div>
			            @enderror
							  </div>

							  <div class="form-group mb-4">
							    <label>Alamat 1</label>
							    <textarea name="alamat1" class="form-control @error('alamat1') is-invalid @enderror" cols="10" rows="3" value="{{ old('alamat1') }}"></textarea>
							    @error('alamat1')
			                <div class="text-danger small mt-1">{{ $message }}</div>
			            @enderror
							  </div>

							  <div class="form-group mb-4">
							    <label>Alamat 2</label>
							    <textarea name="alamat2" class="form-control @error('alamat2') is-invalid @enderror" cols="10" rows="3" value="{{ old('alamat2') }}"></textarea>
							    @error('alamat1')
			                <div class="text-danger small mt-1">{{ $message }}</div>
			            @enderror
							  </div>

							  <div class="row">
							  	<div class="col">
							  		<div class="form-group mb-4">
									    <label>RT</label>
									    <input type="text" name="rt" class="form-control @error('rt') is-invalid @enderror" value="{{ old('rt') }}">
									    @error('rt')
					                <div class="text-danger small mt-1">{{ $message }}</div>
					            @enderror
									  </div>
							  	</div>
							  	<div class="col">
							  		<div class="form-group mb-4">
									    <label>RW</label>
									    <input type="text" name="rw" class="form-control @error('rw') is-invalid @enderror" value="{{ old('rw') }}">
									    @error('rw')
					                <div class="text-danger small mt-1">{{ $message }}</div>
					            @enderror
									  </div>
							  	</div>
							  </div>

							  <div class="form-group mb-4">
							    <label>No. Telp</label>
							    <input type="number" name="no_telp" class="form-control @error('no_telp') is-invalid @enderror" value="{{ old('no_telp') }}">
							    @error('no_telp')
			                <div class="text-danger small mt-1">{{ $message }}</div>
			            @enderror
							  </div>

							  <div class="form-group mb-4">
							    <label>Agama</label>
							    <select name="jenis_kelamin" class="form-control">
							    	<option hidden>-- Pilih Agama --</option>
							    	<option value="1">Islam</option>
							    	<option value="2">Kristen</option>
							    	<option value="3">Budha</option>
							    	<option value="4">Hindu</option>
							    </select>
							    @error('pekerjaan')
			                <div class="text-danger small mt-1">{{ $message }}</div>
			            @enderror
							  </div>

							  <div class="form-group mb-4">
							    <label>No. ID</label>
							    <input type="number" name="no_id" class="form-control @error('no_id') is-invalid @enderror" value="{{ old('no_id') }}">
							    @error('no_id')
			                <div class="text-danger small mt-1">{{ $message }}</div>
			            @enderror
							  </div>

							  <div class="form-group mb-4">
							    <label>Jenis ID</label>
							    <input type="number" name="jenis_id" class="form-control @error('jenis_id') is-invalid @enderror" value="{{ old('jenis_id') }}">
							    @error('jenis_id')
			                <div class="text-danger small mt-1">{{ $message }}</div>
			            @enderror
							  </div>

							  <div class="form-group mb-4">
							    <label>Status Anggota</label>
							    <input type="number" name="status_anggota" class="form-control @error('status_anggota') is-invalid @enderror" value="{{ old('status_anggota') }}">
							    @error('status_anggota')
			                <div class="text-danger small mt-1">{{ $message }}</div>
			            @enderror
							  </div>

							  <div class="form-group mb-4">
							    <label>Tanggal Status</label>
							    <input type="number" name="status_anggota" class="form-control @error('status_anggota') is-invalid @enderror" value="{{ old('status_anggota') }}">
							    @error('status_anggota')
			                <div class="text-danger small mt-1">{{ $message }}</div>
			            @enderror
							  </div>

							  <div class="form-group mb-4">
							    <label>ID Input</label>
							    <input type="number" name="id_input" class="form-control @error('id_input') is-invalid @enderror" value="{{ old('id_input') }}">
							    @error('id_input')
			                <div class="text-danger small mt-1">{{ $message }}</div>
			            @enderror
							  </div>

							  <div class="form-group mb-4">
							    <label>Tanggal Input</label>
							    <input type="date" name="tanggal_input" class="form-control @error('tanggal_input') is-invalid @enderror" value="{{ old('tanggal_input') }}">
							    @error('tanggal_input')
			                <div class="text-danger small mt-1">{{ $message }}</div>
			            @enderror
							  </div>

	  					</div>
	  				</div>

					  <button type="submit" class="btn btn-primary">Submit</button>
					</form>

	  		</div>
	  	</div>
		</div>
	</div>
@endsection