@extends('layouts.app')
@section('title', 'Record Delivery')
@section('content')
<div class="max-w-3xl mx-auto"><form method="POST" action="{{ route('maternity.delivery.store') }}">@csrf
    <input type="hidden" name="anc_registration_id" value="{{ $registration->id }}"><input type="hidden" name="patient_id" value="{{ $registration->patient_id }}">
    <div class="bg-pink-50 border border-pink-200 rounded-xl p-4 mb-4">
        <p class="text-sm font-semibold">{{ $registration->patient->full_name ?? '' }} <span class="text-xs font-mono text-pink-600">{{ $registration->patient->mrn ?? '' }}</span></p>
        <p class="text-xs text-gray-500">GA: {{ $registration->gestational_age ?? '-' }}wks · EDD: {{ $registration->edd?->format('d M Y') ?? '-' }} · G{{ $registration->gravida }}P{{ $registration->parity }}</p>
    </div>
    <div class="bg-white rounded-xl border p-6">
        <h3 class="font-semibold mb-4 pb-3 border-b">Delivery Details</h3>
        <div class="grid grid-cols-1 md:grid-cols-2 gap-4">
            <div><label class="form-label">Delivery Date <span class="text-red-500">*</span></label><input type="date" name="delivery_date" required class="form-input" value="{{ date('Y-m-d') }}"></div>
            <div><label class="form-label">Time</label><input type="time" name="delivery_time" class="form-input"></div>
            <div><label class="form-label">Mode of Delivery <span class="text-red-500">*</span></label><select name="mode_of_delivery" required class="form-input"><option>SVD</option><option>C-Section (Emergency)</option><option>C-Section (Elective)</option><option>Assisted (Vacuum)</option><option>Assisted (Forceps)</option><option>Breech Delivery</option></select></div>
            <div><label class="form-label">Gestational Age (wks)</label><input type="number" name="gestational_age_at_delivery" class="form-input" value="{{ $registration->gestational_age }}"></div>
            <div><label class="form-label">Duration of Labour</label><input type="text" name="duration_of_labour" class="form-input" placeholder="e.g. 8 hours"></div>
            <div><label class="form-label">Blood Loss</label><input type="text" name="blood_loss" class="form-input" placeholder="e.g. 300ml"></div>
            <div><label class="form-label">Conducted By</label><input type="text" name="conducted_by" class="form-input" placeholder="Name of person who conducted delivery"></div>
            <div><label class="form-label">Perineum</label><select name="perineum" class="form-input"><option value="intact">Intact</option><option value="1st_degree">1st Degree Tear</option><option value="2nd_degree">2nd Degree Tear</option><option value="3rd_degree">3rd Degree Tear</option><option value="4th_degree">4th Degree Tear</option></select></div>
            <div class="flex items-center gap-4">
                <label class="flex items-center gap-1.5 text-sm"><input type="checkbox" name="placenta_complete" value="1" checked> Placenta Complete</label>
                <label class="flex items-center gap-1.5 text-sm"><input type="checkbox" name="episiotomy" value="1"> Episiotomy</label>
                <label class="flex items-center gap-1.5 text-sm"><input type="checkbox" name="resuscitation_required" value="1"> Resuscitation Required</label>
            </div>
            <div><label class="form-label">Complications (comma-separated)</label><input type="text" name="complications" class="form-input" placeholder="e.g. PPH, Retained placenta"></div>
        </div>

        <h4 class="font-semibold mt-6 mb-3 pt-4 border-t">Outcomes</h4>
        <div class="grid grid-cols-1 md:grid-cols-2 gap-4">
            <div><label class="form-label">Mother Outcome</label><select name="mother_outcome" class="form-input"><option value="alive_well">Alive & Well</option><option value="alive_complications">Alive with Complications</option><option value="deceased">Deceased</option></select></div>
            <div><label class="form-label">Baby Outcome</label><select name="baby_outcome" class="form-input"><option value="live_birth">Live Birth</option><option value="stillbirth">Stillbirth</option><option value="neonatal_death">Neonatal Death</option></select></div>
        </div>

        <h4 class="font-semibold mt-6 mb-3 pt-4 border-t">Newborn Details</h4>
        <div class="grid grid-cols-2 md:grid-cols-3 gap-4">
            <div><label class="form-label">Gender</label><select name="newborn_gender" class="form-input"><option value="male">Male</option><option value="female">Female</option></select></div>
            <div><label class="form-label">Birth Weight (kg)</label><input type="number" step="0.01" name="birth_weight" class="form-input" placeholder="e.g. 3.20"></div>
            <div><label class="form-label">APGAR 1min</label><input type="number" name="apgar_1min" min="0" max="10" class="form-input"></div>
            <div><label class="form-label">APGAR 5min</label><input type="number" name="apgar_5min" min="0" max="10" class="form-input"></div>
            <div><label class="form-label">APGAR 10min</label><input type="number" name="apgar_10min" min="0" max="10" class="form-input"></div>
            <div class="flex items-center gap-4">
                <label class="flex items-center gap-1.5 text-sm"><input type="checkbox" name="newborn_resuscitation" value="1"> Resuscitation</label>
                <label class="flex items-center gap-1.5 text-sm"><input type="checkbox" name="breastfeeding_initiated" value="1" checked> Breastfeeding</label>
            </div>
        </div>

        <div class="mt-4"><label class="form-label">Notes</label><textarea name="notes" class="form-input" rows="2" placeholder="Delivery notes..."></textarea></div>
        <div class="mt-5 flex gap-3 border-t pt-5">
            <button type="submit" class="btn-success px-6">Record Delivery</button>
            <a href="{{ route('maternity.anc.show', $registration) }}" class="btn-secondary">Cancel</a>
        </div>
    </div>
</form></div>
@endsection