@include('common.header')

<section class="content">
    <div class="body_scroll">
        <div class="block-header">
            <div class="row">
                <div class="col-lg-7 col-md-6 col-sm-12">
                    <h2>PET Application</h2>
                    <ul class="breadcrumb">
                        <li class="breadcrumb-item"><a href="{{ url('/admin/dashboard') }}"><i class="zmdi zmdi-home"></i>
                                Home</a></li>
                        <!--<li class="breadcrumb-item"><a href="{{ url('/#') }}">PET Application</a></li>-->
                        <li class="breadcrumb-item active">PET Application</li>
                    </ul>
                    <button class="btn btn-primary btn-icon mobile_menu" type="button"><i
                            class="zmdi zmdi-sort-amount-desc"></i></button>
                </div>

                <div class="col-lg-5 col-md-6 col-sm-12">
                    <button class="btn btn-primary btn-icon float-right right_icon_toggle_btn" type="button"><i
                            class="zmdi zmdi-arrow-right"></i></button>
                </div>
            </div>
        </div>

        <div class="container-fluid">
            <!-- Vertical Layout -->
            <div class="row clearfix">
                <div class="col-lg-12 col-md-12 col-sm-12">
                    <div class="card">
                        <div class="body">
                            <form method="post" action="{{ url('/#') }}" class="form-horizontal"
                                enctype="multipart/form-data">
                                @csrf
                                <h5 class="text-blue h5 mb-20" style="font-size: 17px;font-weight: bolder;">Basic
                                    Information ( मुलभूत माहिती ) :- </h5>
                                <div class="pd-20 card-box mb-30">
                                    <div class="form-group row">
                                        <label class="col-sm-2"><strong>प्रभाग / <br> Ward : </strong></label>
                                        <div class="col-sm-4 col-md-4 pb-2">
                                            <input class="form-control " value="{{ $pet_registration_view->ward_name }}"
                                                readonly>
                                        </div>
                                    </div>

                                    <div class="form-group row pb-2">
                                        <label class="col-sm-2"><strong>विभाग / <br> Department : </strong></label>
                                        <div class="col-sm-4 col-md-4">
                                            <input class="form-control " value="{{ $pet_registration_view->dept_id }}"
                                                readonly>
                                        </div>
                                    </div>


                                    <strong class="pb-1">अर्जदाराचे नाव /<br> Name of Applicant : </strong>
                                    <div class="form-group row">
                                                                                {{-- @dd($pet_registration_view->applicant_title_id); --}}
                                        <!--<label class="col-sm-1"><strong>Title : </strong></label>-->
                                        <div class="col-sm-3 col-md-3 p-2">
                                            <input class="form-control " value="{{ $applicant_title_id }}" readonly>
                                        </div>


                                        <!--<label class="col-sm-1"><strong>First Name : </strong></label>-->
                                        <div class="col-sm-3 col-md-3 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_registration_view->renewal_application_fname }}"
                                                readonly>
                                        </div>

                                        <!--<label class="col-sm-1"><strong>Middle Name : </strong></label>-->
                                        <div class="col-sm-3 col-md-3 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_registration_view->renewal_application_mname }}"
                                                readonly>
                                        </div>

                                        <!--<label class="col-sm-1"><strong>Last Name : </strong></label>-->
                                        <div class="col-sm-3 col-md-3 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_registration_view->renewal_application_lname }}"
                                                readonly>
                                        </div>
                                    </div>

                                    <strong class="pb-1">मालकाचे नाव / <br> Name of Owner's : </strong>
                                    <div class="form-group row">
                                                                                <!--<label class="col-sm-1"><strong>Title : </strong></label>-->
                                        <div class="col-sm-3 col-md-3 p-2">
                                            <input class="form-control " value="{{ $owner_title_id }}" readonly>
                                        </div>


                                        <!--<label class="col-sm-1"><strong>First Name : </strong></label>-->
                                        <div class="col-sm-3 col-md-3 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_registration_view->renewal_owner_fname }}" readonly>
                                        </div>

                                        <!--<label class="col-sm-1"><strong>Middle Name : </strong></label>-->
                                        <div class="col-sm-3 col-md-3 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_registration_view->renewal_owner_mname }}" readonly>
                                        </div>

                                        <!--<label class="col-sm-1"><strong>Last Name : </strong></label>-->
                                        <div class="col-sm-3 col-md-3 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_registration_view->renewal_owner_lname }}" readonly>
                                        </div>
                                    </div>

                                    <strong class="pt-2 text-danger">
                                        मालकाचा निवासी पत्ता / Residential Address of Owner's
                                    </strong>
                                    <hr>

                                    <div class="form-group row">
                                        <label class="col-sm-2"><strong>घर क्रमांक / <br> House Number :
                                            </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_registration_view->renewal_house_number }}" readonly>
                                        </div>

                                        <label class="col-sm-2"><strong>घराचे नाव / <br> House Name : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_registration_view->renewal_house_name }}" readonly>
                                        </div>
                                    </div>

                                    <div class="form-group row">
                                        <label class="col-sm-2"><strong>रस्ता १ / <br> Street 1 : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_registration_view->renewal_street_1 }}" readonly>
                                        </div>

                                        <label class="col-sm-2"><strong>रस्ता 2 / <br> Street 2 : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_registration_view->renewal_street_2 }}" readonly>
                                        </div>
                                    </div>

                                    <div class="form-group row">
                                        <label class="col-sm-2"><strong>क्षेत्र १ / <br> Area 1 : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_registration_view->renewal_area_1 }}" readonly>
                                        </div>

                                        <label class="col-sm-2"><strong>क्षेत्र 2 / <br> Area 2 : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_registration_view->renewal_area_2 }}" readonly>
                                        </div>
                                    </div>

                                    <div class="form-group row">
                                        
                                        <label class="col-sm-2"><strong>देश / <br> Country : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control " value="{{ $country_id }}" readonly>
                                        </div>

                                                                                <label class="col-sm-2"><strong>राज्य / <br> State : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control " value="{{ $state_id }}" readonly>
                                        </div>
                                    </div>

                                    <div class="form-group row">
                                        <label class="col-sm-2"><strong>जिल्हा / <br> District : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_registration_view->dist_name }}" readonly>
                                        </div>

                                        <label class="col-sm-2"><strong>तालुका / <br> Taluka : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_registration_view->taluka_name }}" readonly>
                                        </div>
                                    </div>

                                    <div class="form-group row">
                                        <label class="col-sm-2"><strong>मोबाईल नंबर / <br> Mobile Number :
                                            </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_registration_view->renewal_mobile_number }}" readonly>
                                        </div>

                                        <label class="col-sm-2"><strong>ई - मेल आयडी / Email Id : <br><span
                                                    class="text-danger"> (Receipt and Certificate will be sent on this
                                                    Email ID)</span> </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control " value="{{ $pet_registration_view->email }}"
                                                readonly>
                                        </div>
                                    </div>

                                    <div class="form-group row">
                                        <label class="col-sm-2"><strong>आधार क्रमांक / <br> Aadhar Number :
                                            </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_registration_view->renewal_aadhar_number }}" readonly>
                                        </div>

                                        <label class="col-sm-2"><strong>पिनकोड / <br> Zip Code : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_registration_view->renewal_zipcode }}" readonly>
                                        </div>
                                    </div>

                                    <!--<strong class="pt-2 text-danger text-justify">-->
                                    <!--    Note : <br>-->
                                    <!--    1. Please fill all the Pet details below, Since and Vaccination Date should be in mm/dd/yyyy format only Ex. 01/20/2018 .<br>-->
                                    <!--    2. Select Others in Breed and enter details if Pet Breed not found if drop down .<br>-->
                                    <!--    3. Vaccination Certificate of size upto 2 MB to be Uploaded as attachment .-->
                                    <!--</strong>-->
                                    <!--<hr>-->

                                    <!--<strong class="pt-2 text-danger text-justify">-->
                                    <!--    नोंद : <br>-->
                                    <!--    1. कृपया खाली सर्व पाळीव प्राण्याचे तपशील भरा, पासून आणि लसीकरणाची तारीख फक्त mm/dd/yyyy स्वरूपात असावी उदा. 01/20/2018 .<br>-->
                                    <!--    2. जातीतील इतर निवडा आणि ड्रॉप डाउन असल्यास डॉग ब्रीड आढळले नसल्यास तपशील प्रविष्ट करा.<br>-->
                                    <!--    3. संलग्नक म्हणून अपलोड करण्यासाठी 2 MB पर्यंत आकाराचे लसीकरण प्रमाणपत्र.-->
                                    <!--</strong>-->
                                    <hr>
                                    <h5 class="text-blue h5 mb-20" style="font-size: 17px;font-weight: bolder;">Pet
                                        Details :</h5>
                                    <div class="form-group row">
                                        <label class="col-sm-2"><strong>पाळीव प्राण्याचे नाव / <br> Pet Name :
                                            </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_registration_view->renewal_dog_name }}" readonly>
                                        </div>

                                                                                <label class="col-sm-2"><strong>लिंग / <br> Sex : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control " value="{{ $sex_id }}" readonly>
                                        </div>
                                    </div>

                                    <div class="form-group row">
                                        <label class="col-sm-2"><strong>ओळख चिन्ह / <br> Identification Mark :
                                            </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_registration_view->identification_mark }}" readonly>
                                        </div>

                                        <label class="col-sm-2"><strong>जाती / <br> Breed : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_registration_view->breeds_name }}" readonly>
                                        </div>
                                    </div>

                                    <div class="form-group row">
                                        <label class="col-sm-2"><strong>इतर जाती / <br> Other Breed : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_registration_view->other_breed }}" readonly>
                                        </div>

                                        <label class="col-sm-2"><strong>रंग /<br> Colour : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_registration_view->renewal_colour }}" readonly>
                                        </div>
                                    </div>

                                    <div class="form-group row">
                                        <label class="col-sm-2"><strong>पशुवैद्यकीय डॉक्टरांचे नाव / <br> Veterinary
                                                Doctor Name : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_registration_view->veterinary_doctor_name }}" readonly>
                                        </div>

                                        <label class="col-sm-2"><strong>पशुवैद्यकीय डॉक्टरांचा MSVC नोंदणी क्रमांक
                                                / <br> Veterinary doctor’s MSVC registration number :
                                            </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_registration_view->veterinary_doctor_msvc_no }}"
                                                readonly>
                                        </div>
                                    </div>

                                    <div class="form-group row">
                                        <label class="col-sm-2"><strong>अँटी रेबीज लसीकरणाची तारीख (DD/MM/YYYY) / <br>
                                                Date of anti-rabies vaccination (DD/MM/YYYY) : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ date('d-m-Y', strtotime($pet_registration_view->dog_renewal_date_of_rabies_vaccination)) }}"
                                                readonly>
                                        </div>

                                        <label class="col-sm-2"><strong> Tentative Date of Birth (DD/MM/YYYY) / अंदाजे जन्मतारीख (दि/महा/वर्ष) : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input type="date" name="date_of_birth" id="date_of_birth"
                                                class="form-control @error('date_of_birth') is-invalid @enderror"
                                                value="{{ $pet_registration_view->date_of_birth }}"
                                                max="{{ date('Y-m-d') }}" placeholder="DD/MM/YYYY" readonly>
                                        </div>
                                    </div>

                                    <div class="form-group row">
                                        <label class="col-sm-2"><strong>Age Year(s) / ( वय वर्ष ) : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_registration_view->dog_age }}" readonly>
                                        </div>

                                        <label class="col-sm-2"><strong>Month / ( महिना ) : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <input class="form-control "
                                                value="{{ $pet_registration_view->dog_month }}" readonly>
                                        </div>
                                    </div>

                                    <hr>

                                    <h5 class="text-blue h5 mb-20" style="font-size: 17px;font-weight: bolder;">
                                        Documents : </h5>
                                    <div class="form-group row">
                                        <label class="col-sm-2"><strong>Upload Anti Rabies Vaccination certificate /
                                                <br>( अँटी रेबीज लसीकरण प्रमाणपत्र अपलोड करा ) </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <a href="{{ url('/') }}/TMC_PET_Registration/rabies_vaccination_certificate_doc/{{ $pet_registration_view->dog_renewal_rabies_vaccination_certificate_doc }}"
                                                target="_blank">
                                                <div class="form-group">
                                                                                                        <a href="#">Document Not Uploaded</a>
                                                                                                    </div>
                                            </a>
                                        </div>

                                        <label class="col-sm-2"><strong>Upload Pet Photo / <br> ( पाळीव प्राण्याचा फोटो अपलोड
                                                करा ) : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <a href="{{ url('/') }}/TMC_PET_Registration/dog_profile_photo/{{ $pet_registration_view->dog_renewal_profile_photo }}"
                                                target="_blank">
                                                <div class="form-group">
                                                                                                        <a href="#">Document Not Uploaded</a>
                                                                                                    </div>
                                            </a>
                                        </div>
                                    </div>

                                    <div class="form-group row">
                                        <label class="col-sm-2"><strong>Address proof / <br>( पत्ता पुरावा ) :
                                            </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <a href="{{ url('/') }}/TMC_PET_Registration/address_proof_doc/{{ $pet_registration_view->renewal_address_proof_doc }}"
                                                target="_blank">
                                                <div class="form-group">
                                                                                                        <a href="{{ url('/') }}/TMC_PET_Registration/address_proof_doc/{{ $pet_registration_view->renewal_address_proof_doc }}"
                                                        target="_blank">
                                                        <p class="mt-3 mb-0" id="image_div">
                                                            <button type="button"class="btn btn-info">
                                                                View File
                                                            </button>
                                                        </p>
                                                    </a>
                                                                                                    </div>
                                            </a>
                                        </div>

                                        <label class="col-sm-2"><strong>Applicant Photo / <br>( अर्जदाराचा फोटो ) :
                                            </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <a href="{{ url('/') }}/TMC_PET_Registration/applicant_image/{{ $pet_registration_view->renewal_applicant_image }}"
                                                target="_blank">
                                                <div class="form-group">
                                                                                                        <a href="{{ url('/') }}/TMC_PET_Registration/applicant_image/{{ $pet_registration_view->renewal_applicant_image }}"
                                                        target="_blank">
                                                        <p class="mt-3 mb-0" id="image_div">
                                                            <button type="button"class="btn btn-info">
                                                                View File
                                                            </button>
                                                        </p>
                                                    </a>
                                                                                                    </div>
                                            </a>
                                            <br>
                                            @error('renewal_applicant_image')
                                                <span class="invalid-feedback" role="alert">
                                                    <strong>{{ $message }}</strong>
                                                </span>
                                            @enderror
                                        </div>
                                    </div>

                                    <div class="form-group row">
                                        <label class="col-sm-2"><strong> Applicant Signature / <br>( अर्जदाराची
                                                स्वाक्षरी ) : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <a href="{{ url('/') }}/TMC_PET_Registration/applicant_signature/{{ $pet_registration_view->dog_renewal_applicant_signature }}"
                                                target="_blank">
                                                <div class="form-group">
                                                                                                        <a href="{{ url('/') }}/TMC_PET_Registration/applicant_signature/{{ $pet_registration_view->dog_renewal_applicant_signature }}"
                                                        target="_blank">
                                                        <p class="mt-3 mb-0" id="image_div">
                                                            <button type="button"class="btn btn-info">
                                                                View File
                                                            </button>
                                                        </p>
                                                    </a>
                                                                                                    </div>
                                            </a>
                                        </div>

                                        <label class="col-sm-2"><strong>Aadhar Card / Ration
                                                Card / Electricity Bill / Rent Agreement <br>
                                                (आधार कार्ड / शिधा कार्ड / वीज बिल / भाडे करारनामा
                                                अपलोड करा) : </strong></label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <a href="{{ url('/') }}/TMC_PET_Registration/address_proof_document/{{ $pet_registration_view->renewal_address_proof_document }}"
                                                target="_blank">
                                                <div class="form-group">
                                                    <a href="#">No Document
                                                        Uploaded</a>                                                </div>
                                            </a>
                                        </div>
                                    </div>

                                    <div class="form-group row">
                                        <label class="col-sm-2">
                                            <strong>Upload Vaccination Card / <br>( लसीकरण कार्ड
                                                अपलोड करा )</strong>
                                        </label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <a href="{{ url('/') }}/TMC_PET_Registration/vaccination_card_doc/{{ $pet_registration_view->renewal_vaccination_card_doc }}"
                                                target="_blank">
                                                <div class="form-group">
                                                    <a href="#">No Document
                                                        Uploaded</a>                                                </div>
                                            </a>
                                        </div>

                                        <label class="col-sm-2">
                                            <strong>Upload PAN Card / <br>( पॅन कार्ड अपलोड करा
                                                )
                                            </strong></strong>
                                        </label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <a href="{{ url('/') }}/TMC_PET_Registration/pan_card_doc/{{ $pet_registration_view->renewal_pan_card_doc }}"
                                                target="_blank">
                                                <div class="form-group">
                                                    <a href="#">No Document
                                                        Uploaded</a>                                                </div>
                                            </a>
                                        </div>
                                    </div>

                                    <div class="form-group row">
                                        <label class="col-sm-2">
                                            <strong>Upload 9-in-1 Vaccination Certificate / <br>( ९
                                                इन १
                                                लसीकरण प्रमाणपत्र अपलोड करा )
                                            </strong></strong>
                                        </label>
                                        <div class="col-sm-4 col-md-4 p-2">
                                            <a href="{{ url('/') }}/TMC_PET_Registration/nine_in_one_vaccination_certificate_doc/{{ $pet_registration_view->renewal_nine_in_one_vaccination_certificate_doc }}"
                                                target="_blank">
                                                <div class="form-group">
                                                    <a href="#">No Document
                                                        Uploaded</a>                                                </div>
                                            </a>
                                        </div>
                                    </div>

                                                                        <div class="form-group row mt-4">
                                        <label class="col-md-3"></label>
                                        <div class="col-md-9" style="display: flex; justify-content: flex-end;">
                                            <a href="{{ url('/admin_renewal_approve_list/0') }}"><button
                                                    type="button"
                                                    class="btn btn-danger">Cancel</button></a>&nbsp;&nbsp;

                                            <button type="button" class="btn btn-warning waves-effect m-r-10"
                                                data-toggle="modal" data-target="#reject_model">Reject</button>

                                            <button type="button" class="btn btn-success waves-effect m-r-20"
                                                data-toggle="modal" data-target="#approve_model">Approve</button>


                                            <!-- <a href='{{ url("/approve_hod_registration/{$pet_registration_view->id}") }}'><button  type="button" class="btn btn-success">Approve </button> </a> -->

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


<!-- Approved  Model -->
<div class="modal fade" id="approve_model" tabindex="-1" role="dialog">
    <div class="modal-dialog modal-lg" role="document">
        <div class="modal-content">
            <div class="modal-header">
                <h4 class="title text-danger" id="largeModalLabel">Final Approved By Hod</h4>
            </div>
            <div class="modal-body">
                <form method="POST"
                    action="{{ url('renewal_approve_pet_registration', $pet_registration_view->dog_renewal_id) }}"
                    enctype="multipart/form-data">
                    @csrf

                    <input type="hidden" class="form-control " id="id" name="id"
                        value="{{ $pet_registration_view->dog_renewal_id }}">
                    <input type="hidden" class="form-control " id="mobile_number" name="mobile_number"
                        value="{{ $pet_registration_view->mobile_number }}">
                    <input type="hidden" class="form-control " id="pet_pplication_no" name="pet_pplication_no"
                        value="{{ $pet_registration_view->pet_pplication_no }}">

                    <div class="form-group row">
                        <label class="col-sm-3"><strong>स्विकारलेल्या एकूण कराची रक्कम / <br> Total Amount of tax
                                received : <span style="color:red;">*</span></strong></label>
                        <div class="col-sm-3 col-md-3 p-2">
                            <input type="number" min="0" step="1" name="total_recived_tax" id="total_recived_tax" required
                                class="form-control @error('total_recived_tax') is-invalid @enderror"
                                value="{{ $pet_registration_view->amount }}"
                                placeholder="स्विकारलेल्या एकूण कराची रक्कम / Total Amount of tax received." >
                            @error('total_recived_tax')
                                <span class="invalid-feedback" role="alert">
                                    <strong>{{ $message }}</strong>
                                </span>
                            @enderror
                        </div>

                        <label class="col-sm-2"><strong>पावती क्रमांक / <br> Receipt No : <span
                                    style="color:red;">*</span></strong></label>
                        <div class="col-sm-4 col-md-4 p-2">
                            <input type="text" name="receipt_no" id="receipt_no" required
                                class="form-control @error('receipt_no') is-invalid @enderror"
                                value="{{ $pet_registration_view->atrn }}" placeholder="पावती क्रमांक / Receipt No.">
                            @error('receipt_no')
                                <span class="invalid-feedback" role="alert">
                                    <strong>{{ $message }}</strong>
                                </span>
                            @enderror
                        </div>
                    </div>

                    <div class="form-group row">
                        <label class="col-sm-2"><strong>पावती दिनांक / Date of Receipt : <span
                                    style="color:red;">*</span> </strong></label>
                        <div class="col-sm-4 col-md-4 p-2">
                            <input type="date" name="date_of_receipt" max="2026-05-01"
                                id="date_of_receipt" required
                                class="form-control @error('date_of_receipt') is-invalid @enderror"
                                value="{{ $pet_registration_view->transaction_date }}"
                                placeholder="जीएसटी क्रमांक / GST Number.">
                            @error('date_of_receipt')
                                <span class="invalid-feedback" role="alert">
                                    <strong>{{ $message }}</strong>
                                </span>
                            @enderror
                        </div>

                        <label class="col-sm-2"><strong>परवाना क्रमांक / License Number : <span
                                    style="color:red;">*</span></strong></label>
                        <div class="col-sm-4 col-md-4 p-2">
                            <input type="text" name="license_number" id="license_number" readonly
                                class="form-control @error('license_number') is-invalid @enderror"
                                value="{{ $pet_registration_view->pet_pplication_no }}"
                                placeholder="परवाना क्रमांक / License Number.">
                            @error('license_number')
                                <span class="invalid-feedback" role="alert">
                                    <strong>{{ $message }}</strong>
                                </span>
                            @enderror
                        </div>
                    </div>

                    <div class="form-group row">
                        <label class="col-sm-3"><strong>परवाना दिल्याची दिनांक / Date of License Obtained : <span
                                    style="color:red;">*</span> </strong></label>
                        <div class="col-sm-3 col-md-3 p-2">
                            <input type="date" name="date_of_license_obtain" required max="01-05-2026"
                                id="date_of_license_obtain"
                                class="form-control @error('date_of_license_obtain') is-invalid @enderror"
                                value="{{ old('date_of_license_obtain') }}"
                                placeholder="जीएसटी क्रमांक / GST Number.">
                            @error('date_of_license_obtain')
                                <span class="invalid-feedback" role="alert">
                                    <strong>{{ $message }}</strong>
                                </span>
                            @enderror
                        </div>

                        <label class="col-sm-2"><strong>दिनांक / Date : <span
                                    style="color:red;">*</span></strong></label>
                        <div class="col-sm-4 col-md-4 p-2">
                            <input type="date" name="date" readonly max="01-05-2026" id="date"
                                required class="form-control @error('date') is-invalid @enderror"
                                value="2026-05-01" placeholder="परवाना क्रमांक / License Number.">
                            @error('date')
                                <span class="invalid-feedback" role="alert">
                                    <strong>{{ $message }}</strong>
                                </span>
                            @enderror
                        </div>
                    </div>

                    <div class="form-group row">
                        <label class="col-sm-3"><strong>Upload HOD Signature / <br>( विभाग प्रमुख स्वाक्षरी अपलोड करा )
                                : <span style="color:red;">*</span> </strong></label>
                        <div class="col-sm-3 col-md-3 p-2">
                            <input type="file" name="re_hod_sign" id="re_hod_sign"
                                class="form-control @error('re_hod_sign') is-invalid @enderror"
                                value="{{ old('re_hod_sign') }}" accept=".jpg, .jpeg, .png">
                            <small class="text-secondary text-justify "> Note : The file should be less than 2MB
                                .</small>
                            <br>
                            <small class="text-secondary text-justify "> Note : Only files in .jpg, .jpeg, .png format
                                can be uploaded .</small>
                            <br>

                            @error('re_hod_sign')
                                <span class="invalid-feedback" role="alert">
                                    <strong>{{ $message }}</strong>
                                </span>
                            @enderror
                        </div>
                    </div>

                    <div class="form-group row mt-4">
                        <label class="col-md-3"></label>
                        <div class="col-md-9" style="display: flex; justify-content: flex-end;">
                            <a href='{{ url("/final_renewal_approve_view/{$pet_registration_view->dog_renewal_id}/{$pet_registration_view->re_final_status}") }}'
                                class="btn btn-danger btn-lg">Cancel</a>&nbsp;&nbsp;
                            <button type="submit" class="btn btn-success btn-lg">Submit</button>
                        </div>
                    </div>
                </form>
            </div>
        </div>
    </div>
</div>


<!-- Rejected Model -->
<div class="modal fade" id="reject_model" tabindex="-1" role="dialog">
    <div class="modal-dialog modal-lg" role="document">
        <div class="modal-content">
            <div class="modal-header">
                <h4 class="title text-danger" id="largeModalLabel">Final Rejected By Hod</h4>
            </div>
            <div class="modal-body">
                <form method="POST"
                    action="{{ url('/renewal_reject_pet_registration', $pet_registration_view->dog_renewal_id) }}"
                    enctype="multipart/form-data">
                    @csrf

                    <input type="hidden" class="form-control " id="id" name="id"
                        value="{{ $pet_registration_view->dog_renewal_id }}">
                    <input type="hidden" class="form-control " id="pet_pplication_no" name="pet_pplication_no"
                        value="{{ $pet_registration_view->pet_pplication_no }}">



                    <div class="form-group row">
                        <label class="col-sm-12"><strong>Reasons for Rejection : <span style="color:red;">*</span>
                            </strong></label>
                        <div class="col-sm-12 col-md-12 p-2">
                            <textarea type="text" name="reason_for_rejection" id="reason_for_rejection" required
                                class="form-control @error('reason_for_rejection') is-invalid @enderror"
                                value="{{ old('reason_for_rejection') }}" placeholder="Enter Reasons for Rejection"></textarea>
                            @error('reason_for_rejection')
                                <span class="invalid-feedback" role="alert">
                                    <strong>{{ $message }}</strong>
                                </span>
                            @enderror
                        </div>
                    </div>

                    <div class="form-group row mt-4">
                        <label class="col-md-3"></label>
                        <div class="col-md-9" style="display: flex; justify-content: flex-end;">
                            <a href='{{ url("/final_renewal_approve_view/{$pet_registration_view->dog_renewal_id}/{$pet_registration_view->re_final_status}") }}'
                                class="btn btn-danger btn-lg">Cancel</a>&nbsp;&nbsp;
                            <button type="submit" class="btn btn-success btn-lg">Submit</button>
                        </div>
                    </div>
                </form>
            </div>
        </div>
    </div>
</div>

@include('common.footer')