@extends('layouts.app')
@section('title', 'Edit Patient | ' . $patient->full_name)
@section('content')
<div class="max-w-5xl mx-auto">
    <div class="bg-cr-50 border border-cr-200 rounded-lg px-4 py-3 mb-5 flex items-center gap-3">
        <span class="font-mono font-bold text-cr-800">{{ $patient->mrn }}</span>
        <span class="text-sm text-cr-700">{{ $patient->full_name }}</span>
    </div>

    <form method="POST" action="{{ route('patients.update', $patient) }}" enctype="multipart/form-data">
        @csrf @method('PUT')

        <!-- Personal -->
        <div class="bg-white rounded-xl border border-gray-200 p-6 mb-5">
            <h3 class="text-sm font-bold text-gray-800 uppercase tracking-wide mb-4">Personal Information</h3>
            <div class="grid grid-cols-1 md:grid-cols-4 gap-4">
                <div><label class="form-label">First Name *</label><input type="text" name="first_name" value="{{ old('first_name', $patient->first_name) }}" required class="form-input"></div>
                <div><label class="form-label">Middle Name</label><input type="text" name="middle_name" value="{{ old('middle_name', $patient->middle_name) }}" class="form-input"></div>
                <div><label class="form-label">Last Name *</label><input type="text" name="last_name" value="{{ old('last_name', $patient->last_name) }}" required class="form-input"></div>
                <div><label class="form-label">Gender *</label><select name="gender" required class="form-input"><option value="male" {{ $patient->gender==='male'?'selected':'' }}>Male</option><option value="female" {{ $patient->gender==='female'?'selected':'' }}>Female</option><option value="other" {{ $patient->gender==='other'?'selected':'' }}>Other</option></select></div>
                <div><label class="form-label">Date of Birth</label><input type="date" name="date_of_birth" value="{{ old('date_of_birth', $patient->date_of_birth?->format('Y-m-d')) }}" class="form-input" max="{{ date('Y-m-d') }}"></div>
                <div><label class="form-label">ID / Passport</label><input type="text" name="id_number" value="{{ old('id_number', $patient->id_number) }}" class="form-input"></div>
                <div><label class="form-label">Phone <span class="text-red-500">*</span></label><input type="tel" name="phone" value="{{ old('phone', $patient->phone) }}" required class="form-input"></div>
                <div><label class="form-label">Alt. Phone</label><input type="tel" name="alt_phone" value="{{ old('alt_phone', $patient->alt_phone) }}" class="form-input"></div>
                <div><label class="form-label">Email</label><input type="email" name="email" value="{{ old('email', $patient->email) }}" class="form-input"></div>
                <div><label class="form-label">Blood Group</label><select name="blood_group" class="form-input"><option value="">Unknown</option>@foreach(['A+','A-','B+','B-','AB+','AB-','O+','O-'] as $bg)<option value="{{ $bg }}" {{ $patient->blood_group===$bg?'selected':'' }}>{{ $bg }}</option>@endforeach</select></div>
                <div><label class="form-label">Marital Status</label><select name="marital_status" class="form-input"><option value="">Select</option>@foreach(['Single','Married','Divorced','Widowed','Separated'] as $ms)<option {{ $patient->marital_status===$ms?'selected':'' }}>{{ $ms }}</option>@endforeach</select></div>
                <div><label class="form-label">Occupation</label><input type="text" name="occupation" value="{{ old('occupation', $patient->occupation) }}" class="form-input"></div>
                <div><label class="form-label">Employer</label><input type="text" name="employer" value="{{ old('employer', $patient->employer) }}" class="form-input"></div>
                <div><label class="form-label">Photo</label><input type="file" name="photo" accept="image/*" class="form-input text-xs"></div>
            </div>
        </div>

        <!-- Address -->
        <div class="bg-white rounded-xl border border-gray-200 p-6 mb-5">
            <h3 class="text-sm font-bold text-gray-800 uppercase tracking-wide mb-4">Address</h3>
            <div class="grid grid-cols-1 md:grid-cols-3 gap-4">
                <div class="md:col-span-2"><label class="form-label">Address</label><input type="text" name="address" value="{{ old('address', $patient->address) }}" class="form-input"></div>
                <div><label class="form-label">County</label><input type="text" name="county" value="{{ old('county', $patient->county) }}" class="form-input"></div>
                <div><label class="form-label">Sub-County</label><input type="text" name="sub_county" value="{{ old('sub_county', $patient->sub_county) }}" class="form-input"></div>
            </div>
        </div>

        <!-- Next of Kin -->
        <div class="bg-white rounded-xl border border-gray-200 p-6 mb-5">
            <h3 class="text-sm font-bold text-gray-800 uppercase tracking-wide mb-4">Next of Kin</h3>
            <div class="grid grid-cols-1 md:grid-cols-4 gap-4">
                <div class="md:col-span-2"><label class="form-label">Full Name</label><input type="text" name="nok_name" value="{{ old('nok_name', $patient->nok_name) }}" class="form-input"></div>
                <div><label class="form-label">Phone</label><input type="tel" name="nok_phone" value="{{ old('nok_phone', $patient->nok_phone) }}" class="form-input"></div>
                <div><label class="form-label">Relationship</label><select name="nok_relationship" class="form-input"><option value="">Select</option>@foreach(['Spouse','Parent','Child','Sibling','Guardian','Friend','Other'] as $r)<option {{ $patient->nok_relationship===$r?'selected':'' }}>{{ $r }}</option>@endforeach</select></div>
                <div class="md:col-span-4"><label class="form-label">Address</label><input type="text" name="nok_address" value="{{ old('nok_address', $patient->nok_address) }}" class="form-input"></div>
            </div>
        </div>

        <!-- Insurance -->
        <div class="bg-white rounded-xl border border-gray-200 p-6 mb-5">
            <h3 class="text-sm font-bold text-gray-800 uppercase tracking-wide mb-4">Insurance</h3>
            <div class="grid grid-cols-1 md:grid-cols-3 gap-4">
                <div><label class="form-label">Insurance Company</label><select name="insurance_id" class="form-input"><option value="">None (Cash)</option>@foreach($insurers as $ins)<option value="{{ $ins->id }}" {{ $patient->insurance_id==$ins->id?'selected':'' }}>{{ $ins->name }}</option>@endforeach</select></div>
                <div><label class="form-label">Member Number</label><input type="text" name="insurance_member_no" value="{{ old('insurance_member_no', $patient->insurance_member_no) }}" class="form-input"></div>
                <div><label class="form-label">Scheme</label><input type="text" name="insurance_scheme" value="{{ old('insurance_scheme', $patient->insurance_scheme) }}" class="form-input"></div>
            </div>
        </div>

        <!-- Alerts -->
        <div class="bg-white rounded-xl border border-gray-200 p-6 mb-5">
            <h3 class="text-sm font-bold text-gray-800 uppercase tracking-wide mb-4">Medical Alerts</h3>
            <div class="grid grid-cols-1 md:grid-cols-2 gap-4">
                <div><label class="form-label">Allergies (comma-separated)</label><input type="text" name="allergies_text" value="{{ $patient->allergies ? implode(', ', $patient->allergies) : '' }}" class="form-input"></div>
                <div><label class="form-label">Chronic Conditions (comma-separated)</label><input type="text" name="chronic_conditions_text" value="{{ $patient->chronic_conditions ? implode(', ', $patient->chronic_conditions) : '' }}" class="form-input"></div>
            </div>
            <div class="mt-3 flex flex-wrap gap-4">
                @php $alerts = $patient->alerts ?? []; @endphp
                <label class="flex items-center gap-2 text-sm"><input type="checkbox" name="alert_vip" value="1" {{ in_array('VIP', $alerts)?'checked':'' }} class="rounded"> VIP</label>
                <label class="flex items-center gap-2 text-sm"><input type="checkbox" name="alert_staff" value="1" {{ in_array('Staff', $alerts)?'checked':'' }} class="rounded"> Staff</label>
                <label class="flex items-center gap-2 text-sm"><input type="checkbox" name="alert_police" value="1" {{ in_array('Police/Military', $alerts)?'checked':'' }} class="rounded"> Police/Military</label>
                <label class="flex items-center gap-2 text-sm"><input type="checkbox" name="alert_nhif" value="1" {{ in_array('SHA', $alerts)?'checked':'' }} class="rounded"> SHA</label>
            </div>
        </div>

        <div class="flex gap-3">
            <button type="submit" class="btn-success px-6 py-2.5">Update Patient</button>
            <a href="{{ route('patients.show', $patient) }}" class="btn-secondary">Cancel</a>
        </div>
    </form>
</div>
@endsection