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

{% block title %}Demographic Details{% endblock %}

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

  <form action="{{ path('generate_abhacard') }}" method="post" class="kt-form" id="frmMobileOTP">
    <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">Demographic Details</h3>
          </div>

          <div class="kt-portlet__head-toolbar">
            <div class="kt-portlet__head-wrapper">
              <a href="{{ path('dashboard') }}" class="btn btn-clean btn-icon-sm mr-2"><i class="la la-long-arrow-left"></i>Back</a>
              <button type="submit" class="btn btn-primary btn-bold">View ABHA Card</button>
            </div>
          </div>
        </div>

        <div class="kt-portlet__body">
          {% include 'parts/flash.html.twig' %}

          <input type="hidden" name="_csrf_token" value="{{ csrf_token('authenticate') }}" />
          <input type="hidden" name="tokens" value="{{ tokens }}" />

          <dl class="row">
            <dt class="col-2">ABHA No.</dt>
            <dd class="col-10 mb-2 kt-font-bold">{{ ABHANumber }}</dd>
            <dt class="col-2">ABHA Address</dt>
            <dd class="col-10 mb-2 kt-font-bold">{{ preferredAbhaAddress }}</dd>
            <dt class="col-2">Name</dt>
            <dd class="col-10 mb-2 kt-font-bold">{{ name }}</dd>
            <dt class="col-2">Mobile No.</dt>
            <dd class="col-10 mb-2 kt-font-bold">{{ mobile }}</dd>
            <dt class="col-2">Gender</dt>
            <dd class="col-10 kt-font-bold">{{ gender }}</dd>
          </dl>
        </div>
      </div>
    </div>
  </form>
{% endblock %}