@extends("template")

@section('title')
    @if (isset($title))
        {{$title}}
    @endif
@endsection('title')

@section('content')
<div class="container">

@if($errors->any())
    <div class="alert alert-danger">
        <ul>
            @foreach ($errors->all() as $error)
                <li>{{ $error }}</li>
            @endforeach
        </ul>
    </div>
@endif

<h3>{{$header}}</h3>
    <form action="{{ action('DoctorController@store')}}" method="POST" role="form">
        <!-- zabezpieczenie bby ktoś nie wysyłał zapytania do store poza fromularzem-->
        <input type="hidden" name="_token" value="{{ csrf_token()}}"/>
        <div class="form-group">
            <label for="name">Nazwisko i imię</label>
            <input type="text" class="form-control" name="name"/>
        </div>
        <div class="form-group">
            <label for="email">e-Mail</label>
            <input type="text" class="form-control" name="email"/>
        </div>
        <div class="form-group">
            <label for="password">Hasło</label>
            <input type="password" class="form-control" name="password"/>
        </div>
        <div class="form-group">
            <label for="phone">Telefon</label>
            <input type="phone" class="form-control" name="phone"/>
        </div>
        <div class="form-group">
            <label for="adres">Adres</label>
            <input type="address" class="form-control" name="address"/>
        </div>
        <div class="form-group">
            <label for="pesel">PESEL</label>
            <input type="pesel" class="form-control" name="pesel"/>
        </div>
        <div class="form-group">
            <label for="pesel">Specjalizacja</label><br>
            <div id='special_list'>
            @foreach ($specializations as $item)
                {{$item->name}}: <input type="checkbox" class="form-control" name="specializations[]" value="{{$item->id}}"/>
            @endforeach
            </div>
        </div>

        <input type="hidden" name='status' value="Active"/>
        <input type="submit" value="Dodaj" class="btn btn-primary"/>
    </form>
</div>
@endsection('content')