@extends('includes.master')
  @section('content')
<style>
.error_class{
  color:red;
}
.success_class{
  color:green;
}
</style>

          <div class="right_col" role="main">
            <div class="row  class="right_col"">
              <div class="col-md-12 col-sm-12 col-xs-12">
                <div class="x_panel">        

                  <div class="x_content">
                    <p class="text-muted font-13 m-b-30"></p>
                    <b style="font-size: 30px">Insurance Master</b><br><hr>

                    <form class="form-horizontal" name="insurer_form" id="insurer_form">
                    {{csrf_field()}}
          

                  <div class="col-md-6">
                      <div class="form-group row">
                        <label for="insurer_name" class="col-sm-4 col-form-label">Insurance Company:</label>
                        <div class="col-sm-6">
                          <input type="text" class="form-control" id="insurer_name" name="insurer_name" placeholder="Insurance Company"  required>
                          <label class="control-label" for="inputError"><span id="err_insurer_name" class="error_class"></span></label>
                        </div>
                      </div>
                  </div>

                  <div class="col-md-6">
                      <div class="form-group row">
                        <label for="insurer_name" class="col-sm-4 col-form-label">Address:</label>
                        <div class="col-sm-6">
                          <input type="text" class="form-control" id="address" name="address" placeholder="Address"  required>
                          <label class="control-label" for="inputError"><span id="err_address" class="error_class"></span></label>
                        </div>
                      </div>
                  </div>


                    <div class="col-md-6">
                   <div class="form-group row">
                        <label for="comp_pincode" class="col-sm-4 col-form-label">Pincode:</label>
                        <div class="col-sm-6">
                          <input type="text" class="form-control" id="comp_pincode" name="comp_pincode" onkeypress="return fnAllowNumeric(event)" placeholder="Pincode" minlength="6" maxlength="6"  required>
                          <!-- onkeypress="return fnAllowNumeric(event)" -->
                          <label class="control-label" for="inputError"><span id="err_comp_pincode" class="error_class"></span></label>
                        </div>
                      </div>
                    </div> 


                   <div class="col-md-6">
                        <div class="form-group row">
                        <label for="state" class="col-sm-4 col-form-label">State:</label>
                        <div class="col-sm-6">
                          <input type="text" class="form-control" readonly="" id="comp_state_name" name="comp_state_name" placeholder="State" required>           
                          <label class="control-label" for="inputError"><span id="err_comp_state" class="error_class"></span></label>
                        </div>
                      </div>
                    </div> 


                  <input type="hidden" class="form-control" id="comp_state" name="comp_state" placeholder="State" required>
                  <input type="hidden" class="form-control" id="comp_city" name="comp_city" placeholder="City" required>


                  <div class="col-md-6">
                   <div class="form-group row">
                        <label for="designation" class="col-sm-4 col-form-label">City:</label>
                        <div class="col-sm-6">
                          <input type="text" class="form-control" readonly="" id="comp_city_name" name="comp_city_name" placeholder="City" required>
                          <label class="control-label" for="inputError"><span id="err_comp_city" class="error_class"></span></label>
                        </div>
                      </div>
                    </div>


                    <div class="col-md-6">
                      <div class="form-group row">
                        <label for="cashless_hospital_link" class="col-sm-4 col-form-label">Cashless Hospital Link:</label>
                        <div class="col-sm-6">
                          <input type="text" class="form-control"  id="cashless_hospital_link" name="cashless_hospital_link" placeholder="Cashless Hospital Link" required>
                          <label class="control-label" for="inputError"><span id="err_comp_city" class="error_class"></span></label>
                        </div>
                      </div>
                    </div>


                  <div class="col-md-12 success_class" style="font-size: 20px;" id="success_response">
                  </div>



                 <center><div class="col-sm-12">
                   <button type="button" id="btn_submit" name="btn_submit" class="btn btn-primary">Submit</button>
                   </div>
                 </center>
                 </form>                    
                  </div>
                </div>
              </div>
          </div>
        </div>



<script type="text/javascript">
  $('#btn_submit').click(function(evt){
    evt.preventDefault();
    $(".error_class").empty();
    $(".success_class").empty();
     var formdata = new FormData($("#insurer_form")[0]);
    $.ajax({  
           type: "POST",  
           url: "{{URL::to('insurer-in')}}",
            //data : $('#project_m').serialize(),
            data : formdata,
           processData: false,
             contentType : false,
             success: function(msg){
                   var response = JSON.parse(msg);
                    if(response.status == "success"){
                     
                      alert(response.messege);
                       //$("#success_response").html(response.messege);
          window.location = response.redirectUrl;
        }
        else if(response.messege == "error"){
          window.location = response.redirectUrl;
        }
        else{
          $.each(response , function(key , value){
            $("#err_" + key).text(value);
          });
        }
           //console.log(msg);
              //location.reload();
            }
        }); 
  });
</script>


<script type="text/javascript">
  $("#comp_pincode").keyup(function(){

    if($.trim($(this).val()).length == 6){

      $.ajax({
      url : 'company-pincode/'+ $(this).val(), 
      type: 'GET',

      success : function(response){
      
        console.log(response);

        var d = JSON.parse(response);
         $('#comp_state').val('');
         $('#comp_city').val('');
         $('#comp_state_name').val('');
         $('#comp_city_name').val('');
         for(var i=0;i<d.length;i++)

          {

         $('#comp_state').val(d[i].state_id);
         $('#comp_city').val(d[i].city_id);
         $('#comp_state_name').val(d[i].state_name);
         $('#comp_city_name').val(d[i].city_name);
       }
      }
      });
    }
});
</script>




  @endsection