@extends('layout.main')


@section('main-section')


 <!-- Content wrapper -->
          <div class="content-wrapper">
            <!-- Content -->
            <div class="container-xxl flex-grow-1 container-p-y">




                <div class="row g-12">
                <div class="col-md-12">
                  <div class="card">
                    <h3 class="card-header text-warning">Motor Dispatch Stage</h3>
                    <div class="card-body">


                        <div class="row">
                                            <div class="col-lg-12">
                                                <div class="card">
                                                    <div class="card-body">
                                                        <h4 class="header-title mb-3">Case Information</h4>

                                                        <h5 class="font-family-primary fw-semibold">Ref. No. {{$assignData->_ReferenceNo}}</h5>

                                                        <p class="mb-2"><span class="fw-semibold me-2">Assign Branch </span> {{$assignData->_OurBranch}}</p>
                                                        <p class="mb-2"><span class="fw-semibold me-2">Policy No. </span> {{$assignData->_PolicyPMDNo}}</p>
                                                        <p class="mb-2"><span class="fw-semibold me-2">Loss No. </span> {{$assignData->_LossBenefitNo}}</p>
                                                        <p class="mb-2"><span class="fw-semibold me-2">Insured </span> {{$assignData->_InsuredParticipant}}</p>
                                                        <p class="mb-2"><span class="fw-semibold me-2">Surveyor </span> {{$assignData->_AssignTeamMember}}</p>

                                                    </div>
                                                </div>
                                            </div> <!-- end col -->




                                        </div>
                                        <!-- end row -->

                                        <p></p>

                    <form action="{{url('/motorDispatchFormPost')}}" method="post">
                        @csrf

                    <div class="row">

                      <div id="" class="form-text text-danger">
                          <h5 class="text-success">Claim Dispatch Info</h5>
                          <p></p>
                        </div>

                        <div class="col-lg-6" hidden>
                    <div class="mb-6">
                    <label for="" class="form-label">Job Id</label>
                    <input type="text" id="_JobId" class="form-control" name="_JobId" placeholder="" value="{{$assignData->_Id}}" readonly>
                    <input type="text" id="_user_email" class="form-control" name="_user_email" placeholder="" value="{{session()->get('user_email')}}" readonly>

                    </div>
                    <p></p>
                     </div> <!-- end col -->


                       <div class="col-md-6">
                        <label for="" class="form-label">Dispatch Date</label>
                        <input type="date" placeholder="" name="dispatch" class="form-control" id="" />
                        <p></p>
                      </div>

                      <div class="col-md-6">
                        <label for="" class="form-label">Send By</label>
                        <input type="text" placeholder="Send By" name="sendby" class="form-control" id="" />
                        <p></p>
                      </div>

                      <div class="col-md-6">
                        <label for="" class="form-label">Receives By</label>
                        <input type="text" placeholder="Receives By" name="receivedby" class="form-control" id="" />
                        <p></p>
                      </div>

                      <div class="col-md-12">
                        <label for="" class="form-label">Remarks</label>
                        <textarea class="form-control" placeholder="Remarks" name="remarks" id=""></textarea>
                        <p></p>
                      </div>


                      <div class="col-md-12">
                        <button type="submit" class="btn btn-success">Submit</button>
                      </div>

                    </div>
                    </form>
                    </div>
                  </div>
                </div>
             </div>
            </div>
          </div>

          @endsection('main-section')