@extends('backoffice.patient.layout')

@section('content')

   <div class="iq-card">
      <div class="iq-card-header d-flex justify-content-between">
         <div class="iq-header-title">
            <h4 class="card-title">Informations Personnelles </h4>
         </div>
      </div>
      <div class="iq-card-body">
         <form action="{{route('patient.settings.address.store')}}" method="POST" enctype="multipart/form-data">
            @csrf

            <div class=" row align-items-center">

               <div class="form-group col-sm-6">
                  <label for="address">Adresse:</label>
                  <input type="address" class="form-control" id="address" name="address" >
               </div>
               <div class="form-group col-sm-6">
                  <div class="row">
                    <div class="form-group col-md-7 mb-0">
                        <label for="town">Ville</label>
                        <input type="text"  name="town"  class="form-control" id="town">
                     </div>
                     <div class="form-group col-md-5 mb-0">
                        <label for="country">Indicatif</label>
                        <select  class="form-control w-100"  name="country" required id="country">
                           @foreach (Countries() as $pays)
                           <option value="{{$pays->name}}" @if (user()->country_code == "+221" OR (user()->country_code == null && $pays->country_code == "+221")) selected @endif>{{$pays->name}}</option>
                           @endforeach
                        </select>
                     </div>

                  </div>
               </div>
               <div class="form-group col-sm-6">
                <label for="latitude">Latitude:</label>
                <input type="text" class="form-control" id="latitude" name="latitude">
             </div>
             <div class="form-group col-sm-6">
                <label for="longitude">Logitude:</label>
                <input type="text" class="form-control" id="longitude" name="longitude" >
             </div>
            </div>
            <a href="{{ route('patient.settings.addresses') }}" class="btn iq-bg-danger">Annuler</a>
            <button type="submit" class="btn btn-primary mr-2">Enregistrer</button>
         </form>
      </div>
   </div>
@endsection