@extends('front.layouts.app')
@section('content')



<main>
    
<style>
.btn-div button {
    background: #252525;
    color: #fff;
    font-family: 'Poppins';
    padding: 15px 30px;
}
textarea#location {
    height: 140px;
}
.newalbabi{
   margin-top: 70px;
}
.error {
    color: red;
    font-size: 14px;
    font-weight: 500;
}
@media only screen and (min-width: 1200px) and (max-width: 1399px){
section.banner {
    margin-top: 0px;
    height: 340px !important;
}
}
</style>

    <section class="banner" style="height: 500px;">
        <div class="main-slide">
            <div class="h-100 position-relative">
                <img src="{{ URL::asset('uploads/dirtycopsus/cms/submitreviewpage/'.$reviewPages->banner)}}" class="img-fluid banner-img " style="position: absolute;" alt="">
                <!--{!!  isset($reviewPages->title) ? $reviewPages->title : ''  !!}-->
                <div class="container">
                    <div class="row ">
                        <div class="banner-slider" style=" padding:130px 0;">
                            <div class="content aos-init aos-animate" data-aos="fade-right"
                                data-aos-duration="1500">
                                <h3 style="color: #fff; font-size:50px; text-transform: capitalize;text-shadow: 3px 0px #00000073;">{{ !empty($reviewPages->title) ? $reviewPages->title : '' }}</h3>
                            </div>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </section>
   
    
   
    <section class="dt-form newalbabi">
        <div class="container">
            <div class="top" style="background:#ed0c0c;">
                <h2 class="text-center">{!! isset($reviewPages->heading) ? $reviewPages->heading : ''  !!}</h2>
            </div>
            
            @if(session('success'))
                <h6 class="alert alert-success">
                    {{ session('success') }}
                </h6>
            @endif
            
            <form action="{{ route('reviewPayment') }}" method="POST" enctype="multipart/form-data">
                @csrf
                
              <div class="row gy-4">
                    
                    
                    <div class="col-sm-12 col-md-6 col-lg-5">
                        <label class="d-flex justify-content-between" for="date-time"><span>
                     Date/ Period of Residence
                            </span><b>:</b></label>
                    </div>
                    
                    <div class="col-sm-12 col-md-6 col-lg-7">
                        
                         <div class="row">
                            <div class="col-lg-12 col-12">
                                
                                <!--<input type="text" name="date_of_incident[]" id="datePicker" class="input form-control" placeholder="" autocomplete="off">-->
                                <input type="text" name="date_of_incident" id="" class="input form-control" placeholder="" autocomplete="off">
                                
                            </div>
                             
                        @if($errors->has('date_of_incident'))
                        <div class="error">Date/ Period of Residence is required</div>
                        @endif
                        </div>
                    </div>
                    
                    
                    <div class="col-sm-12 col-md-6 col-lg-5">
                        <label class="d-flex justify-content-between" for="date-time"><span>Location and Description of Residence
                                </span><b>:</b></label>
                    </div>
                    <div class="col-sm-12 col-md-6 col-lg-7">
                        <div class="row">
                            <div class="col-lg-12 col-12">
                                <input class="input form-control" type="text" name="department" value="{{ old('department') }}" autocomplete="off">
                                @if($errors->has('department'))
                                <div class="error">Location and Description of Residence is required</div>
                                @endif
                            </div>
                        </div>
                    </div>
                    
                    
                    
                    <div class="col-sm-12 col-md-6 col-lg-5">
                        <label class="d-flex justify-content-between"  for="date-time"><span>Name(s) of Landlord(s)/ Owner(s)/ Company</span><b>:</b></label>
                    </div>
                    
                    <div class="col-sm-12 col-md-6 col-lg-7">
                        <div class="row">
                           <div class="col-lg-12 col-12">
                                <input class="input form-control" type="text" name="officer_name" id="date-time" value="{{ old('officer_name') }}" autocomplete="off"> 
                                @if($errors->has('officer_name'))
                                <div class="error">Name(s) of Landlord(s)/ Owner(s)/ Company is required</div>
                                @endif
                            </div>
                        </div>
                    </div>
                    
                
                    <div class="col-sm-12 col-md-6 col-lg-5">
                        <label class="d-flex justify-content-between" for="location"><span>Name(s) of Inhabitant(s)/ Renter(s)</span><b>:</b></label>
                    </div>
                    <div class="col-sm-12 col-md-6 col-lg-7">
                        <input class="input form-control" type="text" name="victim_or_confidential" id="location" value="{{ old('victim_or_confidential') }}" autocomplete="off">
                        @if($errors->has('victim_or_confidential'))
                        <div class="error">Name(s) of Inhabitant(s)/ Renter(s) is required</div>
                        @endif
                    </div>
                    
                
                    <div class="col-sm-12 col-md-6 col-lg-5">
                        <label class="d-flex justify-content-between" for="details"><span>Describe the Behavior/ Acts/ Events</span><b>:</b></label>
                    </div>
                    
                    <div class="col-sm-12 col-md-6 col-lg-7">
                        <textarea class="input form-control" type="text" name="describe_the_incident" id="location" value="{{ old('describe_the_incident') }}" autocomplete="off"></textarea>
                        <!--@if($errors->has('describe_the_incident'))-->
                        <!--    <div class="error">Describe the Behavior/ Acts/ Events is required</div>-->
                        <!--@endif-->
                    </div>
                    
                     
                    
                    <div class="col-sm-12 col-md-6 col-lg-5">
                        <label class="d-flex justify-content-between" for="details"><span>Additional Details</span><b>:</b></label>
                    </div>
                    
                    <div class="col-sm-12 col-md-6 col-lg-7">
                        <textarea id="makeMeSummernote" name="additional_describtion" value="{{ old('additional_describtion') }}" autocomplete="off"> </textarea>
                        <!--@if($errors->has('additional_describtion'))-->
                        <!--<div class="error">{{ $errors->first('additional_describtion') }}</div>-->
                        <!--@endif-->
                    </div>
                    
                    
                    </div>
                    
                    <div class="col-sm-12 col-md-12 col-lg-12">
                        <div class="btn-div text-end">
                            <button type="submit" class="px-5">Submit</button>
                        </div>
                    </div>
                </div>
            </form>

        </div>
    </section>
</main>



@endsection