{% extends 'base.html.twig' %}

{% block title %}Update Record{% endblock %}

{% block content %}
	<div class="kt-subheader kt-grid__item"></div>

	{{ form_start(form, { 'attr': { 'class': 'kt-form' }}) }}
		<div class="kt-container kt-grid__item kt-grid__item--fluid">
			<div class="kt-portlet kt-portlet--mobile">
				<div class="kt-portlet__head kt-portlet__head--lg">
					<div class="kt-portlet__head-label">
						<h3 class="kt-portlet__head-title">Update Record</h3>
					</div>

					<div class="kt-portlet__head-toolbar">
						<div class="kt-portlet__head-wrapper">
							<a href="{{ path('hiv_register') }}" class="btn btn-clean btn-icon-sm mr-2"><i class="la la-long-arrow-left"></i>Back</a>
							<a href="{{ app.request.uri }}" class="btn btn-secondary btn-bold mr-2">Reset</a>
							<button class="btn btn-primary btn-bold">Submit</button>
						</div>
					</div>
				</div>

				<div class="kt-portlet__body">
					<div class="form-group row">
						{{ form_label(form.pId, '', {'label_attr': { 'class': 'col-4 col-form-label font-weight-bold' }}) }}

						<div class="col-6">
							{{ form_widget(form.pId, {'attr': { 'class': 'form-control' }}) }}
							{{ form_errors(form.pId) }}
						</div>
					</div>

					<div class="form-group row">
						{{ form_label(form.individualType, '', {'label_attr': { 'class': 'col-4 col-form-label font-weight-bold' }}) }}

						<div class="col-6">
							{{ form_widget(form.individualType, {'attr': { 'class': 'form-control select-picker' }}) }}
							{{ form_errors(form.individualType) }}
						</div>
					</div>

					<div class="form-group row">
						{{ form_label(form.inRef, '', {'label_attr': { 'class': 'col-4 col-form-label font-weight-bold' }}) }}

						<div class="col-6">
							{{ form_widget(form.inRef, {'attr': { 'class': 'form-control select-picker' }}) }}
							{{ form_errors(form.inRef) }}
						</div>
					</div>

					<div class="form-group row">
						{{ form_label(form.isConsentTaken, '', {'label_attr': { 'class': 'col-4 col-form-label font-weight-bold' }}) }}

						<div class="col-6">
							<label class="kt-checkbox col-1 kt-checkbox--bold kt-checkbox--brand">
								{{ form_widget(form.isConsentTaken) }}
								<span></span>
							</label>

							{{ form_errors(form.isConsentTaken) }}
						</div>
					</div>

					<div class="form-group row">
						{{ form_label(form.screeningDate, '', {'label_attr': { 'class': 'col-4 col-form-label font-weight-bold' }}) }}

						<div class="col-6">
							{{ form_widget(form.screeningDate, {'attr': { 'class': 'form-control' }}) }}
							{{ form_errors(form.screeningDate) }}
						</div>
					</div>

					<div class="form-group row">
						{{ form_label(form.screeningResult, '', {'label_attr': { 'class': 'col-4 col-form-label font-weight-bold' }}) }}

						<div class="col-6">
							{{ form_widget(form.screeningResult, {'attr': { 'class': 'form-control' }}) }}
							{{ form_errors(form.screeningResult) }}
						</div>
					</div>

					<div class="form-group row">
						{{ form_label(form.method, '', {'label_attr': { 'class': 'col-4 col-form-label font-weight-bold' }}) }}

						<div class="col-6">
							{{ form_widget(form.method, {'attr': { 'class': 'form-control' }}) }}
							{{ form_errors(form.method) }}
						</div>
					</div>

					<div class="form-group row">
						{{ form_label(form.kitName, '', {'label_attr': { 'class': 'col-4 col-form-label font-weight-bold' }}) }}

						<div class="col-6">
							{{ form_widget(form.kitName, {'attr': { 'class': 'form-control' }}) }}
							{{ form_errors(form.kitName) }}
						</div>
					</div>

					<div class="form-group row">
						{{ form_label(form.batchNum, '', {'label_attr': { 'class': 'col-4 col-form-label font-weight-bold' }}) }}

						<div class="col-6">
							{{ form_widget(form.batchNum, {'attr': { 'class': 'form-control' }}) }}
							{{ form_errors(form.batchNum) }}
						</div>
					</div>
	    	</div>
	  	</div>
	  </div>
  {{ form_end(form) }}
{% endblock %}

{% block scripts %}
	{{ parent() }}

	<script>
		var arrows;

		$('.select-picker').selectpicker();

		if (KTUtil.isRTL()) {
			arrows = {
				leftArrow: '<i class="la la-angle-right"></i>',
				rightArrow: '<i class="la la-angle-left"></i>'
			};
		} else {
			arrows = {
				leftArrow: '<i class="la la-angle-left"></i>',
				rightArrow: '<i class="la la-angle-right"></i>'
			};
		}

		$('#hiv_register_screeningDate').datepicker({
			rtl: KTUtil.isRTL(),
			autoclose: true,
			todayHighlight: true,
			orientation: "bottom left",
			templates: arrows,
			endDate: 'd',
			format: 'yyyy-mm-dd'
		});
	</script>
{% endblock %}