@extends('layouts.main')
@section('page-title')
    {{ __('Driver Check - DL list maintanance') }}
@endsection
@section('content')
    <div class="d-flex">
        @include('layouts.sidebar')
        <div>
            <form method="POST" action="{{ route('dl-list-maintenance') }}">
                @csrf
                <div class="inputBox">
                    <div class="LabelTextShaded">First name</div>
                    <input name="first_name" type="text" value="{{ old('first_name') }}">
                    <br><br>
                    <div class="LabelTextShaded">Surname</div>
                    <input name="surname" type="text" value="{{ old('surname') }}">
                    <br><br>
                    <div class="LabelTextShaded">Date of birth</div>
                    <input name="date_of_birth" type="date" value="{{ old('date_of_birth') }}">
                    <br><br>
                    <div class="LabelTextShaded">Address</div>
                    <input name="address" type="text" value="{{ old('address') }}">
                    <br><br>
                    <div class="LabelTextShaded">Donor statue</div>
                    <input name="donor_statue" type="text" value="{{ old('donor_statue') }}">
                    <br><br>
                    <div class="LabelTextShaded">License type</div>
                    <select name="license_type">
                        <option>Learner</option>
                        <option>Restricted</option>
                        <option>Full</option>
                    </select>
                    <br><br>

                    <div class="LabelTextShaded">DL number</div>
                    <input name="dl_number" type="text" value="{{ old('dl_number') }}">

                    <br><br>
                    <div class="LabelTextShaded">Class</div>
                    <input name="class[]" type="checkbox" value="1">1
                    <input name="class[]" type="checkbox" value="2">2
                    <input name="class[]" type="checkbox" value="3">3
                    <input name="class[]" type="checkbox" value="4">4
                    <input name="class[]" type="checkbox" value="5">5
                    <input name="class[]" type="checkbox" value="6">6
                    <br><br>
                    <div class="LabelTextShaded">Version number</div>
                    <input name="version_number" type="text" value="{{ old('version_number') }}">
                    <br><br>
                    <div class="LabelTextShaded">License valid from</div>
                    <input name="license_valid_from" type="date" value="{{ old('license_valid_from') }}">
                    <br><br>
                    <div class="LabelTextShaded">License valid to</div>
                    <input name="license_valid_to" type="date" value="{{ old('license_valid_to') }}">

                    <div class="padding"></div>

                    <div class="searchButton">
                        <input id="Submit" name="submitButton" src="{{ asset('assets/images/submit.gif') }}"
                            type="image" alt="delete button" value="submit">
                    </div>
                    <!--end login-->
                </div>
            </form>
            <div class="validation-summary-success">
                <ul>
                    @if (Session::has('success'))
                        <li>{!! session('success') !!}</li>
                    @endif
                </ul>
            </div>
            <div class="validation-summary-errors">
                <ul>
                    @if (Session::has('error'))
                        <li>{!! session('error') !!}</li>
                    @endif
                </ul>
            </div>
            @if ($errors->any())
                <div class="validation-summary-errors">
                    <ul>
                        @foreach ($errors->all() as $error)
                            <li>{{ $error }}</li>
                        @endforeach
                    </ul>
                </div>
            @endif

        </div>
    </div>
    <div class="padding"></div>
@endsection