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Pulak
2026-06-24 18:29:01 +06:00
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resources/views/client/manual_client_create.blade.php Normal file
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@extends('layouts.admin')
@section('content')
<style>
.d-none{
display: none;
}
</style>
<div class="row">
<div class="col-xs-12 col-sm-12 column col-sm-offset-0 ">
<div class="panel panel-default panel-frm">
<div class="panel-heading">
<div class="row" style="padding-left: 20px;padding-right: 15px">
<h3 class="pull-left"> Client Registration</h3>
@if(isShowContent('get.clients'))
<a href="{{route('get.clients')}}" class="btn btn2 btn-success btn-flat pull-right">
<i class="fa fa-list" aria-hidden="true"></i>
Client List
</a>
@endif
</div>
</div>
<div class="panel-body">
<div class="clearfix"></div>
<div class="row">
<div class="col-md-12 col-sm-12 col-xs-12">
<div class="x_panel">
<form method="post" action="{{route('client.insert')}}" id="client_form" autocomplete="off"
class="input-form-section">
@csrf
<div class="x_content">
<div class="col-md-12">
<div class="row">
<div class="col-md-6 col-xs-12">
<div class="form-group">
<label for="firstname">First Name</label>
<input class="form-control" name="first_name" type="text" placeholder=" First Name" >
</div>
</div>
<div class="col-md-6 col-xs-12">
<div class="form-group">
<label for="Last Name">Last Name</label>
<input class="form-control" name="last_name" type="text" placeholder=" Last Name">
</div>
</div>
</div>
<div class="row">
<div class="col-md-6 col-xs-12">
<div class="form-group">
<label for="dob">Email</label>
<input class="form-control" name="email"
type="text" placeholder=" Email" >
</div>
</div>
<div class="col-md-6 col-xs-12">
<div class="form-group">
<label for="dob">Password</label>
<div class="input-group" id="manage_client_show_hide_password">
<input class="form-control" name="password"
type="password" placeholder=" Password">
<div class="input-group-addon">
<a href=""><i class="fa fa-eye-slash" aria-hidden="true"></i></a>
</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-md-6 col-xs-12">
<div class="form-group">
<label for="Phone">Phone</label>
<input class="form-control" name="phone" type="text" placeholder=" Phone Number">
</div>
</div>
<div class="col-md-6 col-xs-12">
<div class="form-group">
<label for="Street Number">Street Number</label>
<input class="form-control" name="street_no" type="text" placeholder=" street No">
</div>
</div>
</div>
<div class="row">
<div class="col-md-6 col-xs-12">
<div class="form-group">
<label for="Street Name">Street Name</label>
<input class="form-control" name="street_name" type="text" placeholder=" Street Name">
</div>
</div>
<div class="col-md-6 col-xs-12">
<div class="form-group">
<label for="City">City</label>
<input class="form-control" name="city" type="text" placeholder=" City" >
</div>
</div>
</div>
<div class="row">
<div class="col-md-6 col-xs-12">
<div class="form-group">
<label for="State">State</label>
<input class="form-control" name="state" type="text" placeholder=" State" >
</div>
</div>
<div class="col-md-6 col-xs-12">
<div class="form-group">
<label for="zip_code">Zip</label>
<input class="form-control" name="zip_code" type="text" placeholder=" Zip Code">
</div>
</div>
</div>
<div class="row">
<div class="col-md-6 col-xs-12" id="user_access_date_div">
<div class="form-group">
<label for="month">Free Access Date</label>
<input class="form-control" name="user_access_date" id="user_access_date" type="text" placeholder="mm/dd/yyyy">
</div>
</div>
</div>
<div class="row">
<div class="form-group col-md-6 col-xs-12 text-left">
<input class="form-check-input" type="checkbox" name="make_payment"
value="1" id="make_payment">
<label class="form-check-label" >
Make Payment
</label>
</div>
</div>
<div class="row d-none" id="card_info" >
<div class="col-md-12">
<div class="row">
<div class="col-md-6 col-xs-12">
<div class="form-group">
<label for="dob">Date of Birth</label>
<input class="form-control" name="birth_date" id="birth_date" type="text" maxlength="10" onkeyup="birthDateCompleted()" placeholder="mm/dd/yyyy" >
</div>
</div>
<div class="col-md-6 col-xs-12">
<div class="form-group">
<label for="ssn">Social Security Number</label>
<input class="form-control" name="ssn" maxlength="4"
type="text" placeholder="last 4 digit of ssn">
</div>
</div>
</div>
<div class="row">
<div class="col-md-6 col-xs-12">
<div class="form-group">
<label for="dob">Payment Date</label>
<input class="form-control" name="payment_date" id="payment_date" type="text" maxlength="10" onkeyup="paymentDateCompleted()" placeholder="mm/dd/yyyy" >
</div>
</div>
<div class="col-md-6 col-xs-12">
<div class="form-group">
<label for="">Source Type</label>
@php
$source_types = config('constant.sourceType');
@endphp
<select name="source_type" class="form-control">
@foreach($source_types as $key=>$value)
<option value="{{$value}}"> {{$key}}</option>
@endforeach
</select>
</div>
</div>
</div>
<div class="row">
<div class="col-md-6 col-xs-12">
<div class="form-group">
<label for="card_number">Card Number</label>
<input class="form-control" name="card_number" type="text" placeholder="e.g, 4111111111111111" >
</div>
</div>
<div class="col-md-6 col-xs-12">
<div class="form-group">
<label for="expiry">Expiry</label>
<input class="form-control" name="expiry" type="text" maxlength="5" onkeyup="expiryDateCompleted()" placeholder="e.g, DD/YY" >
</div>
</div>
</div>
</div>
</div>
</div>
<div class="col-sm-12 c" style="margin-top: 10px; text-align: center; ">
<input class="btn btn-success btn2" type="submit" onclick="return client_form_submit(this)" value="Save Changes">
</div>
</div>
</form>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="modal fade" id="common_confirmation_modal" style="margin-top: 50px" tabindex="-1" aria-hidden="true">
<div class="modal-dialog modal-md" id="modal-dialog-panel">
<div class="modal-content">
<div class="modal-header">
<button type="button" class="close" data-dismiss="modal">&times;</button>
</div>
<div class="modal-body">
<h4 class="mb-2 text-center" style="color: red" id="common_message_text">
</h4>
</div>
<div class="modal-footer" style="text-align: center">
<button type="button" class="btn btn-secondary btn-lg" data-dismiss="modal">Close</button>
</div>
</div>
</div>
</div>
@endsection
@push('script')
<script>
$(function(){
common_helper.datePicker('#user_access_date','mm/dd/yyyy',false,new Date(new Date().setDate(new Date().getDate() + 1)),null);
common_helper.datePicker('#birth_date','mm/dd/yyyy',true,null);
common_helper.datePicker('#payment_date','mm/dd/yyyy',true,null);
});
$("#manage_client_show_hide_password a").on('click', function(event) {
common_helper.globalPasswordView('#manage_client_show_hide_password',event);
});
const birthDateCompleted=()=>{
let birth_date=$("[name='birth_date']").val();
if(birth_date.length===2){
birth_date+='/';
}
else if(birth_date.length===5){
birth_date+='/';
}
$("[name='birth_date']").val(birth_date);
}
const expiryDateCompleted=()=>{
let expiry_date=$("[name='expiry']").val();
if(expiry_date.length===2){
expiry_date+='/';
}
$("[name='expiry']").val(expiry_date);
}
const paymentDateCompleted=()=>{
let pay_date=$("[name='payment_date']").val();
if(pay_date.length===2){
pay_date+='/';
}
else if(pay_date.length===5){
pay_date+='/';
}
$("[name='payment_date']").val(pay_date);
}
const client_form_submit =(e)=>{
var data = $('#make_payment').prop("checked");
if(data) {
$('#client_form').validate({
rules: {
'first_name': 'required',
'last_name': 'required',
'email' : 'required',
'password' : 'required',
'street_no' : 'required',
'street_name' : 'required',
'city' : 'required',
'state' : 'required',
'zip_code' : 'required',
'phone' : 'required',
'birth_date': 'required',
'ssn' : 'required',
'payment_date' : 'required',
'source_type' : 'required',
'card_number' : 'required',
'expiry' : 'required',
},
messages: {
'first_name': {
required: "Please enter first name"
},
'last_name': {
required: "Please enter last name"
}, 'email': {
required: "Please enter email"
}, 'password': {
required: "Please enter password"
},
'street_no': {
required: "Please enter street number"
},
'street_name': {
required: "Please enter street name"
},
'state': {
required: "Please enter state"
},
'city': {
required: "Please enter city"
},
'zip_code': {
required: "Please enter zip code"
},
'phone': {
required: "Please enter phone number"
},
'birth_date': {
required: "Please enter birth date",
},
'ssn': {
required: "Please enter ssn"
},
'payment_date': {
required: "Please enter Payment Date"
},
'source_type': {
required: "Please enter source type"
},
'card_number' : {
required: "Please enter valid card number"
},
'expiry' : {
required: "Please enter expiry date"
},
},
highlight: function (element) {
$(element).parent().addClass("has-error");
},
// submitHandler: function (form) {
// form.submit();
// }
});
if($('#client_form').valid()) {
let url = '{{ route('admin.ajax.get.process') }}';
let email = $('#client_form').find('input[name=email]').val();
let password = $('[name="password"]').val();
let source_type = $('[name="source_type"]').val();
let ssn = $('[name="ssn"]').val();
let data = {
action: 'GET_SUBSCRIPTION_STATUS_CREDIT_REPORT_PROVIDER',
email: email,
password: password,
source_type: source_type,
ssn: ssn
};
common_helper.globalAjaxRequestAsync(url, 'get', data, callbackfromreportprovider);
}
return false;
}else {
$('#client_form').validate({
rules: {
'first_name': 'required',
'last_name': 'required',
'email' : 'required',
'password' : 'required',
'street_no' : 'required',
'street_name' : 'required',
'city' : 'required',
'state' : 'required',
'zip_code' : 'required',
'phone' : 'required',
'user_access_date' : 'required',
},
messages: {
'first_name': {
required: "Please enter first name"
},
'last_name': {
required: "Please enter last name"
}, 'email': {
required: "Please enter email"
}, 'password': {
required: "Please enter password"
},
'street_no': {
required: "Please enter street number"
},
'street_name': {
required: "Please enter street name"
},
'state': {
required: "Please enter state"
},
'city': {
required: "Please enter city"
},
'zip_code': {
required: "Please enter zip code"
},
'phone': {
required: "Please enter phone number"
},
'user_access_date': {
required: "Please enter last access date"
},
},
highlight: function (element) {
$(element).parent().addClass("has-error");
},
submitHandler: function (form) {
form.submit();
}
});
}
};
const callbackfromreportprovider =(response)=>{
if(response.status) {
$('#client_form').submit();
}else {
let html = response.message;
$('#common_message_text').text(html);
$('#common_confirmation_modal').modal('show');
}
}
$('#make_payment').change(function() {
if(this.checked) {
$('#card_info').removeClass('d-none');
$('#user_access_date_div').addClass('d-none');
}else {
$('#card_info').addClass('d-none');
$('#user_access_date_div').removeClass('d-none');
}
});
</script>
@endpush