@extends('admin.layouts.layouts')

@section('title', 'Create | Employee Master')

@section('page-css')
    <style>
        .owner_details {
            border: 2px solid #ccc;
            border-radius: 10px;
            padding: 15px;
            margin-bottom: 15px;
        }
    </style>
@endsection

@section('content')
    <div class="page-header">
        <h3 class="page-title">Create Employee Master</h3>
        <nav aria-label="breadcrumb">
            <ol class="breadcrumb">
                <li class="breadcrumb-item"><a href="{{ route('admin.dashboard') }}">Dashboard</a></li>
                <li class="breadcrumb-item"><a href="{{ route('employee-master.index') }}">Employee Master</a></li>
                <li class="breadcrumb-item active" aria-current="page">Create</li>
            </ol>
        </nav>
    </div>
    <div class="card">
        {!! Form::open([
            'route' => 'employee-master.store',
            'method' => 'POST',
            'id' => 'employee-master-form',
            'enctype' => 'multipart/form-data',
        ]) !!}
        @csrf
        <div class="card-body">
            <div class="row mt-3">
                <div class="col-md-12">
                    <h4 class="card-title"><b>Personal Details</b></h4>
                    <div class="row">
                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="employee_name" class="form-label">Full Name (As Per Aadhar Card) <span
                                        class="text-danger">*</span></label>
                                <input type="text" name="employee_name" id="employee_name" class="form-control onlytxt"
                                    placeholder="Enter Full Name" value="{{ old('employee_name') }}" data-parsley-required
                                    data-parsley-trigger='keyup' data-parsley-required-message="Please enter full name"
                                    data-parsley-pattern='^[a-zA-Z_ ]*$' maxlength="100" data-parsley-maxlength="100"
                                    data-parsley-maxlength-message="Full name may not be greater than 100 characters"
                                    data-parsley-pattern-message='Only alphabets are allowed' data-parsley-errors-container='#employee_name_error'>
                                <span class="text-danger"
                                    id="employee_name_error">{{ $errors->first('employee_name') }}</span>
                            </div>
                        </div>
                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="short_name" class="form-label">Nick Name <span class="text-danger">*</span></label>
                                <input type="text" name="short_name" id="short_name" class="form-control"
                                    placeholder="Enter Nick Name" value="{{ old('short_name') }}" data-parsley-required
                                    data-parsley-trigger='keyup' data-parsley-required-message="Please enter nick name"
                                    data-parsley-pattern='^[a-zA-Z_ ]*$' maxlength="100" data-parsley-maxlength="100"
                                    data-parsley-maxlength-message="Nick name may not be greater than 100 characters"
                                    data-parsley-pattern-message='Only alphabets are allowed' data-parsley-errors-container='#short_name_error'>
                                <span class="text-danger" id="short_name_error">{{ $errors->first('short_name') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="mother_name" class="form-label">Mother Name <span
                                        class="text-danger">*</span></label>
                                <input type="text" name="mother_name" id="mother_name" class="form-control onlytxt"
                                    placeholder="Enter Mother Name" value="{{ old('mother_name') }}" data-parsley-required
                                    data-parsley-trigger='keyup' data-parsley-required-message="Please enter mother name"
                                    data-parsley-pattern='^[a-zA-Z_ ]*$' maxlength="100" data-parsley-maxlength="100"
                                    data-parsley-maxlength-message="Mother name may not be greater than 100 characters"
                                    data-parsley-pattern-message='Only alphabets are allowed' data-parsley-errors-container='#mother_name_error'>
                                <span class="text-danger"
                                    id="mother_name_error">{{ $errors->first('mother_name') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="phone_number" class="form-label">Mobile Number <span
                                        class="text-danger">*</span></label>
                                <input type="text" name="phone_number" id="phone_number" class="form-control mobile"
                                    placeholder="Enter Mobile Number" value="{{ old('phone_number') }}" data-parsley-required
                                    data-parsley-trigger="keyup" data-parsley-type="digits"
                                    data-parsley-required-message='Please enter mobile number' maxlength="10"
                                    oninput="this.value=this.value.slice(0,this.maxLength)"
                                    data-parsley-type-message="Please enter valid mobile number" data-parsley-errors-container='#phone_number_error'>
                                <span class="text-danger"
                                    id="phone_number_error">{{ $errors->first('phone_number') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="email" class="form-label">Personal Email <span class="text-danger">*</span></label>
                                <input type="text" name="email" id="email" class="form-control"
                                    placeholder="Enter Personal Email" value="{{ old('email') }}" data-parsley-trigger="keyup"
                                    data-parsley-required="required" data-parsley-type="email"
                                    data-parsley-pattern="^[a-zA-Z0-9.]+@[a-zA-Z0-9]+\.[a-zA-Z]{2,}$"
                                    data-parsley-pattern-message="Please enter valid personal email"
                                    data-parsley-required-message="Please enter personal email"
                                    data-parsley-type-message="Please enter valid personal email"
                                    data-parsley-validate-full-width-characters="true" data-parsley-errors-container='#email_error'>
                                <span class="text-danger" id="email_error">{{ $errors->first('email') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="gender" class="form-label">Gender <span class="text-danger">*</span></label>
                                <select name="gender" id="gender" class="form-control form-control-lg"
                                    data-parsley-required data-parsley-required-message="Please select gender"
                                    data-parsley-errors-container='#gender_error'>
                                    <option value="">Select Gender</option>
                                    <option value="Male" {{ old('gender') == 'Male' ? 'selected' : '' }}>Male</option>
                                    <option value="Female" {{ old('gender') == 'Female' ? 'selected' : '' }}>Female
                                    </option>
                                </select>
                                <span class="text-danger" id="gender_error">{{ $errors->first('gender') }}</span>
                            </div>
                        </div>

                        @php
                            $bloodGroups = [
                                'A+', 'A-', 'B+', 'B-', 'O+', 'O-', 'AB+', 'AB-'
                            ];
                        @endphp
                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="blood_group" class="form-label">Blood Group <span class="text-danger">*</span></label>
                                <select name="blood_group" id="blood_group" class="form-control form-control-lg"
                                    data-parsley-required data-parsley-required-message="Please select blood group"
                                    data-parsley-errors-container='#blood_group_error'>
                                    <option value="">Select Blood Group</option>
                                    @foreach($bloodGroups as $group)
                                        <option value="{{ $group }}"
                                            {{ old('blood_group', $group) }}>
                                            {{ $group }}
                                        </option>
                                    @endforeach
                                </select>
                                <span class="text-danger" id="blood_group_error">{{ $errors->first('blood_group') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="date_of_birth" class="form-label">Date Of Birth <span
                                        class="text-danger">*</span></label>
                                <input type="text" name="date_of_birth" id="date_of_birth" class="form-control dateOfBirth"
                                    value="{{ old('date_of_birth') }}" placeholder="Select Date Of Birth" data-parsley-required
                                    data-parsley-trigger='keyup' data-parsley-required-message="Please select date of birth"
                                    data-parsley-datecustom data-parsley-errors-container='#date_of_birth_error'>
                                <span class="text-danger error-msg"
                                    id="date_of_birth_error">{{ $errors->first('date_of_birth') }}</span>
                            </div>
                        </div>
                    </div>

                    <div class="row">
                        <div class="col-md-6">
                            <div class="form-group">
                                <label for="residential_address" class="form-label">Residential Address <span
                                        class="text-danger">*</span></label>
                                <textarea name="residential_address" id="residential_address" rows="3" placeholder="Enter Residential Address" class="form-control"
                                    data-parsley-required data-parsley-trigger='keyup' data-parsley-required-message="Please enter residential address" data-parsley-errors-container='#residential_address_error'>{{ old('residential_address') }}</textarea>
                                <span class="text-danger" id="residential_address_error">{{ $errors->first('residential_address') }}</span>
                            </div>
                        </div>

                        <div class="col-md-6">
                            <div class="form-group">
                                <label for="address" class="form-label">Permanent Address <span
                                        class="text-danger">*</span></label>
                                <textarea name="address" id="address" rows="3" placeholder="Enter Permanent Address" class="form-control"
                                    data-parsley-required data-parsley-trigger='keyup' data-parsley-required-message="Please enter permanent address" data-parsley-errors-container='#address_error'>{{ old('address') }}</textarea>
                                <span class="text-danger" id="address_error">{{ $errors->first('address') }}</span>
                            </div>
                        </div>
                    </div>

                    <h4 class="card-title"><b>Office Details</b></h4>
                    <div class="row">
                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="work_email" class="form-label">Work Email <span class="text-danger">*</span></label>
                                <input type="text" name="work_email" id="work_email" class="form-control"
                                    placeholder="Enter Work Email" value="{{ old('work_email') }}" data-parsley-trigger="keyup"
                                    data-parsley-required="required" data-parsley-type="email"
                                    data-parsley-pattern="^[a-zA-Z0-9.]+@[a-zA-Z0-9]+\.[a-zA-Z]{2,}$"
                                    data-parsley-pattern-message="Please enter valid work email"
                                    data-parsley-required-message="Please enter work email"
                                    data-parsley-type-message="Please enter valid work email"
                                    data-parsley-validate-full-width-characters="true" data-parsley-errors-container='#work_email_error'>
                                <span class="text-danger" id="work_email_error">{{ $errors->first('work_email') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="date_of_joining" class="form-label">Date Of Joining <span
                                        class="text-danger">*</span></label>
                                <input type="text" name="date_of_joining" id="date_of_joining" class="form-control startDate"
                                    value="{{ old('date_of_joining') }}" placeholder="Select Date Of Joining" data-parsley-required
                                    data-parsley-trigger='keyup' data-parsley-required-message="Please select date of joining"
                                    data-parsley-datecustom data-parsley-errors-container='#date_of_joining_error'>
                                <span class="text-danger error-msg"
                                    id="date_of_joining_error">{{ $errors->first('date_of_joining') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="employee_department_id" class="form-label">Employee Department <span
                                        class="text-danger">*</span></label>
                                <select name="employee_department_id" id="employee_department_id"
                                    class="form-control form-control-lg" data-parsley-required
                                    data-parsley-required-message="Please select employee department"
                                    data-parsley-errors-container='#employee_department_id_error'>
                                    <option value="">Select Employee Department</option>
                                    @foreach ($employeeDepartments as $key => $employeeDepartment)
                                        <option value="{{ $key }}"
                                            {{ old('employee_department_id') == $key ? 'selected' : '' }}>
                                            {{ $employeeDepartment }}
                                        </option>
                                    @endforeach
                                </select>
                                <span class="text-danger"
                                    id="employee_department_id_error">{{ $errors->first('employee_department_id') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="employee_designation_id" class="form-label">Employee Designation <span
                                        class="text-danger">*</span></label>
                                <select name="employee_designation_id" id="employee_designation_id"
                                    class="form-control form-control-lg" data-parsley-required
                                    data-parsley-required-message="Please select employee designation"
                                    data-parsley-errors-container='#employee_designation_id_error'>
                                    <option value="">Select Employee Designation</option>
                                </select>
                                <span class="text-danger"
                                    id="employee_designation_id_error">{{ $errors->first('employee_designation_id') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="grade_name" class="form-label">Grade</label>
                                <input type="text" class="form-control" id="grade_name" readonly>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="expense_limit" class="form-label">Expense Limit</label>
                                <input type="text" class="form-control" id="expense_limit" readonly>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="employee_role_id" class="form-label">Role Permission <span
                                        class="text-danger">*</span></label>
                                <select name="employee_role_id" id="employee_role_id"
                                    class="form-control form-control-lg product-select" data-parsley-required
                                    data-parsley-required-message="Please select role permission"
                                    data-parsley-errors-container='#employee_role_id_error'>
                                    <option value="">Select Role Permission</option>
                                    @foreach ($roleLists as $key => $employeeRole)
                                        <option value="{{ $key }}"
                                            {{ old('employee_role_id') == $key ? 'selected' : '' }}>
                                            {{ $employeeRole }}
                                        </option>
                                    @endforeach
                                </select>
                                <span class="text-danger error-msg"
                                    id="employee_role_id_error">{{ $errors->first('employee_role_id') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="shift_type_id" class="form-label">Shift Type <span
                                        class="text-danger">*</span></label>
                                <select name="shift_type_id" id="shift_type_id"
                                    class="form-control form-control-lg product-select" data-parsley-required
                                    data-parsley-required-message="Please select shift type"
                                    data-parsley-errors-container='#shift_type_id_error'>
                                    <option value="">Select Shift Type</option>
                                    @foreach ($shiftTypes as $key => $shiftType)
                                        <option value="{{ $key }}"
                                            {{ old('shift_type_id') == $key ? 'selected' : '' }}>
                                            {{ $shiftType }}
                                        </option>
                                    @endforeach
                                </select>
                                <span class="text-danger error-msg"
                                    id="shift_type_id_error">{{ $errors->first('shift_type_id') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="reporting_person_id" class="form-label">Reporting Person</label>
                                <select name="reporting_person_id" id="reporting_person_id"
                                    class="form-control form-control-lg product-select">
                                    <option value="">Select Reporting Person</option>
                                    @foreach ($reportingPersons as $reportingPerson)
                                        <option value="{{ $reportingPerson->id }}"
                                            {{ old('reporting_person_id') == $reportingPerson->id ? 'selected' : '' }}>
                                            {{ $reportingPerson->name }}
                                        </option>
                                    @endforeach
                                </select>
                                <span class="text-danger error-msg"
                                    id="reporting_person_id_error">{{ $errors->first('reporting_person_id') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="head_manager" class="form-label">Head Manager </label>
                                <select name="head_manager" id="head_manager"
                                    class="form-control form-control-lg product-select" data-parsley-errors-container='#head_manager_error'>
                                    <option value="">Select Head Manager</option>
                                    @foreach ($reportingPersons as $reportingPerson)
                                        <option value="{{ $reportingPerson->id }}"
                                            {{ old('head_manager') == $reportingPerson->id ? 'selected' : '' }}>
                                            {{ $reportingPerson->name }}
                                        </option>
                                    @endforeach
                                </select>
                                <span class="text-danger error-msg"
                                    id="head_manager_error">{{ $errors->first('head_manager') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="cold_storage_id" class="form-label">Cold Storage</label>
                                <select name="cold_storage_id" id="cold_storage_id"
                                    class="form-control form-control-lg product-select">
                                    <option value="">Select Cold Storage</option>
                                    @foreach ($coldStorages as $key => $coldStorage)
                                        <option value="{{ $key }}"
                                            {{ old('cold_storage_id') == $key ? 'selected' : '' }}>
                                            {{ $coldStorage }}
                                        </option>
                                    @endforeach
                                </select>
                                <span class="text-danger error-msg"
                                    id="cold_storage_id_error">{{ $errors->first('cold_storage_id') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="mod_of_travel_ids" class="form-label">
                                    Mod Of Travel
                                </label>
                                <select name="mod_of_travel_ids[]" id="mod_of_travel_ids" class="form-control"
                                    multiple="multiple" data-parsley-trigger='keyup'  data-parsley-errors-container="#mod_of_travel_ids_error">
                                    @foreach ($modOfTravels as $key => $modOfTravel)
                                        <option value="{{ $key }}">{{ $modOfTravel }}</option>
                                    @endforeach
                                </select>
                                <div class="invalid-feedback" id="mod_of_travel_ids_error"></div>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="check_in_option" class="form-label">Check In Option <span class="text-danger">*</span></label>
                                <select name="check_in_option[]" id="check_in_option"
                                    class="form-control form-control-lg" multiple="multiple" data-parsley-trigger='keyup' data-parsley-required="required"
                                    data-parsley-required-message="Please select check in option" data-parsley-errors-container="#check_in_option_error">
                                    <option value="">Select Check In Option</option>
                                    <option value="Local" {{ in_array('Local', old('check_in_option', [])) ? 'selected' : '' }}>Local</option>
                                    <option value="Travel" {{ in_array('Travel', old('check_in_option', [])) ? 'selected' : '' }}>Travel</option>
                                    <option value="Work From Home" {{ in_array('Work From Home', old('check_in_option', [])) ? 'selected' : '' }}>Work From Home</option>
                                </select>
                                <span class="text-danger error-msg"
                                    id="check_in_option_error">{{ $errors->first('check_in_option') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4" style="display: none;">
                            <div class="form-group">
                                <label for="no_of_wfh" class="form-label">No Of Work From Home <span class="text-danger">*</span></label>
                                <input type="text" class="form-control number" id="no_of_wfh" name="no_of_wfh"
                                    value="{{ old('no_of_wfh') }}" placeholder="Enter No Of Work From Home"
                                    data-parsley-type="digits" data-parsley-type-message="Please enter valid no of work from home"
                                    data-parsley-errors-container='#no_of_wfh_error'>
                                <span class="text-danger" id="no_of_wfh_error"></span>
                            </div>
                        </div>

                        {{-- <div class="col-md-4">
                            <div class="form-group">
                                <label for="salary" class="form-label">Salary</label>
                                <input type="text" name="salary" id="salary"
                                    class="form-control rate-input amount" placeholder="Enter Salary"
                                    value="{{ old('salary') }}" maxlength="15"
                                    data-parsley-trigger='keyup'
                                    data-parsley-pattern="^\d+(\.\d{0,2})?$"
                                    data-parsley-pattern-message="Please enter a valid salary"
                                    data-parsley-errors-container='#salary_error'>
                                <span class="text-danger error-msg"
                                    id="salary_error">{{ $errors->first('salary') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="start_date" class="form-label">Start Date</label>
                                <input type="text" name="start_date" id="start_date" class="form-control startDate"
                                    value="{{ old('start_date') }}" placeholder="Select Start Date"
                                    data-parsley-trigger='keyup'
                                    data-parsley-datecustom data-parsley-errors-container='#start_date_error'>
                                <span class="text-danger error-msg"
                                    id="start_date_error">{{ $errors->first('start_date') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="end_date" class="form-label">End Date</label>
                                <input type="text" name="end_date" id="end_date" class="form-control endDate"
                                    value="{{ old('end_date') }}" placeholder="Select End Date"
                                    data-parsley-trigger='keyup' data-parsley-datecustom
                                    data-parsley-errors-container='#end_date_error'>
                                <span class="text-danger error-msg"
                                    id="end_date_error">{{ $errors->first('end_date') }}</span>
                            </div>
                        </div> --}}

                        <div class="col-md-4">
                            <div class="form-group">
                                <label class="form-label">Country <span class="text-danger">*</span></label>
                                <select class="form-control countrySelect" name="country" id="country"
                                    data-parsley-trigger="keyup" data-parsley-required
                                    data-parsley-required-message="Please select country"
                                    data-parsley-errors-container='#country_error'>
                                    <option value="">Select Country</option>
                                    @foreach ($countries as $countryData)
                                        <option value="{{ $countryData->id }}"
                                            {{ old('country') == $countryData->id ? 'selected' : '' }}>
                                            {{ $countryData->country_name }}
                                        </option>
                                    @endforeach
                                </select>
                                <span class="text-danger error-msg" id="country_error">{{ $errors->first('country') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label class="form-label">Region <span class="text-danger">*</span></label>
                                <select class="form-control regionSelect" name="region" id="region"
                                    data-parsley-trigger="keyup" data-parsley-required
                                    data-parsley-required-message="Please select region"
                                    data-parsley-errors-container='#region_error'>
                                    <option value="">Select Region</option>
                                </select>
                                <span class="text-danger error-msg"
                                    id="region_error">{{ $errors->first('region') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="area_location" class="form-label">Area Location</label>
                                <input type="text" name="area_location" id="area_location" class="form-control"
                                    placeholder="Enter Area Location" value="{{ old('area_location') }}"
                                    data-parsley-trigger='keyup'
                                    maxlength="100" data-parsley-maxlength="100"
                                    data-parsley-maxlength-message="Area location may not be greater than 100 characters" data-parsley-errors-container='#work_email_error'>
                                <span class="text-danger"
                                    id="work_email_error">{{ $errors->first('area_location') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="base_location" class="form-label">Base Location</label>
                                <input type="text" name="base_location" id="base_location" class="form-control"
                                    placeholder="Enter Base Location" value="{{ old('base_location') }}"
                                    data-parsley-trigger='keyup'
                                    maxlength="100" data-parsley-maxlength="100"
                                    data-parsley-maxlength-message="Base location may not be greater than 100 characters" data-parsley-errors-container='#base_location_error'>
                                <span class="text-danger"
                                    id="base_location_error">{{ $errors->first('base_location') }}</span>
                            </div>
                        </div>
                    </div>

                    <div class="row">
                        <div class="col-md-2">
                            <div class="form-group">
                                <label for="welcome_kit" class="form-label">Welcome Kit Given? <span class="text-danger">*</span></label>
                                <div class="row">
                                    <div class="col-md-auto d-flex flex-row">
                                        <div class="form-check me-3">
                                            <label class="form-check-label">
                                                <input type="radio" class="form-check-input" id="welcome_kit" name="welcome_kit" value="1" checked data-parsley-required
                                                data-parsley-required-message="Please select welcome kit given"
                                                data-parsley-errors-container="#welcome_kit_error">Yes
                                            </label>
                                        </div>
                                        <div class="form-check me-3 ml-2">
                                            <label class="form-check-label">
                                                <input type="radio" class="form-check-input" id="welcome_kit" name="welcome_kit" value="0" data-parsley-errors-container="#welcome_kit_error">No
                                            </label>
                                        </div>
                                    </div>
                                </div>
                                <span class="text-danger" id="welcome_kit_error">{{ $errors->first('welcome_kit') }}</span>
                            </div>
                        </div>

                        <div class="col-md-2">
                            <div class="form-group">
                                <label for="medical_disability" class="form-label">Medical Disability? <span class="text-danger">*</span></label>
                                <div class="row">
                                    <div class="col-md-auto d-flex flex-row">
                                        <div class="form-check me-3">
                                            <label class="form-check-label">
                                                <input type="radio" class="form-check-input" id="medical_disability" name="medical_disability" value="1" data-parsley-required
                                                data-parsley-required-message="Please select medical disability"
                                                data-parsley-errors-container="#medical_disability_error">Yes
                                            </label>
                                        </div>
                                        <div class="form-check me-3 ml-2">
                                            <label class="form-check-label">
                                                <input type="radio" class="form-check-input" id="medical_disability" name="medical_disability" value="0" data-parsley-errors-container="#medical_disability_error" checked>No
                                            </label>
                                        </div>
                                    </div>
                                </div>
                                <span class="text-danger" id="medical_disability_error">{{ $errors->first('medical_disability') }}</span>
                            </div>
                        </div>

                        <div class="col-md-3 medical-disability-extra" style="display: none;">
                            <div class="form-group">
                                <label for="medical_disability_name" class="form-label">Disability <span class="text-danger">*</span></label>
                                <input type="text" class="form-control" id="medical_disability_name" name="medical_disability_name"
                                    value="{{ old('medical_disability_name') }}" placeholder="Enter Disability"
                                    data-parsley-errors-container='#medical_disability_name_error'>
                                <span class="text-danger" id="medical_disability_name_error"></span>
                            </div>
                        </div>

                        <div class="col-md-2">
                            <div class="form-group">
                                <label for="mediclaim_policy" class="form-label">Mediclaim Policy? <span class="text-danger">*</span></label>
                                <div class="row">
                                    <div class="col-md-auto d-flex flex-row">
                                        <div class="form-check me-3">
                                            <label class="form-check-label">
                                                <input type="radio" class="form-check-input" id="mediclaim_policy" name="mediclaim_policy" value="1" checked data-parsley-required
                                                data-parsley-required-message="Please select medical disability"
                                                data-parsley-errors-container="#mediclaim_policy_error">Yes
                                            </label>
                                        </div>
                                        <div class="form-check me-3 ml-2">
                                            <label class="form-check-label">
                                                <input type="radio" class="form-check-input" id="mediclaim_policy" name="mediclaim_policy" value="0" data-parsley-errors-container="#mediclaim_policy_error">No
                                            </label>
                                        </div>
                                    </div>
                                </div>
                                <span class="text-danger" id="mediclaim_policy_error">{{ $errors->first('mediclaim_policy') }}</span>
                            </div>
                        </div>
                    </div>

                    <div class="row">
                        <div class="col-md-3 mediclaim-extra" style="display: none;">
                            <div class="form-group">
                                <label for="policy_number" class="form-label">Policy Number <span class="text-danger">*</span></label>
                                <input type="text" class="form-control policyNumber" id="policy_number" name="policy_number"
                                    value="{{ old('policy_number') }}" placeholder="Enter policy number"
                                    data-parsley-errors-container='#policy_number_error'>
                                <span class="text-danger" id="policy_number_error"></span>
                            </div>
                        </div>

                        <div class="col-md-3 mediclaim-extra" style="display: none;">
                            <div class="form-group">
                                <label for="policy_file" class="form-label">Policy Copy <span
                                        class="text-danger">*</span></label>
                                <input type="file" name="policy_file" id="policy_file" class="form-control" data-parsley-trigger='keyup'
                                    data-parsley-filetype="jpg,jpeg,png,pdf,doc,docx" data-parsley-errors-container='#policy_file_error'>
                                <span class="text-danger"
                                    id="policy_file_error">{{ $errors->first('policy_file') }}</span>
                            </div>
                        </div>

                        <div class="col-md-3 mediclaim-extra" style="display: none;">
                            <div class="form-group">
                                <label for="policy_start_date" class="form-label">Policy Start Date <span
                                        class="text-danger">*</span></label>
                                <input type="text" name="policy_start_date" id="policy_start_date" class="form-control policyStartDate"
                                    value="{{ old('policy_start_date') }}" placeholder="Select Start Date">
                                <span class="text-danger error-msg"
                                    id="policy_start_date_error">{{ $errors->first('policy_start_date') }}</span>
                            </div>
                        </div>

                        <div class="col-md-3 mediclaim-extra" style="display: none;">
                            <div class="form-group">
                                <label for="policy_end_date" class="form-label">Policy End Date <span
                                        class="text-danger">*</span></label>
                                <input type="text" name="policy_end_date" id="policy_end_date" class="form-control policyEndDate"
                                    value="{{ old('policy_end_date') }}" placeholder="Select End Date">
                                <span class="text-danger error-msg"
                                    id="policy_end_date_error">{{ $errors->first('policy_end_date') }}</span>
                            </div>
                        </div>
                    </div>
                </div>
            </div>

            <div class="row mt-3">
                <div class="col-md-12">
                    <h4 class="card-title"><b>KYC Details</b></h4>
                    <div class="row">
                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="aadhar_number" class="form-label">Aadhar Number <span
                                        class="text-danger">*</span></label>
                                <input type="text" name="aadhar_number" id="aadhar_number"
                                    class="form-control aadharNumber" placeholder="Enter Aadhar Number"
                                    value="{{ old('aadhar_number') }}" data-parsley-required data-parsley-trigger="keyup"
                                    data-parsley-type="digits" data-parsley-required-message='Please enter aadhar number'
                                    maxlength="12" oninput="this.value=this.value.slice(0,this.maxLength)"
                                    data-parsley-type-message="Please enter valid aadhar number"
                                    data-parsley-minlength="12"
                                    data-parsley-minlength-message="Aadhar number at least 12 characters long"
                                    data-parsley-maxlength="12"
                                    data-parsley-maxlength-message="Aadhar number may not be greater than 12 character" data-parsley-errors-container='#aadhar_number_error'>
                                <span class="text-danger"
                                    id="aadhar_number_error">{{ $errors->first('aadhar_number') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="aadhar_front" class="form-label">Aadhar Front <span
                                        class="text-danger">*</span></label>
                                <input type="file" name="aadhar_front" id="aadhar_front" class="form-control"
                                    data-parsley-required data-parsley-trigger='keyup'
                                    data-parsley-required-message="Please upload aadhar front" accept="image/*"
                                    data-parsley-filetype="jpg,jpeg,png" required
                                    data-parsley-accept="image/jpg, image/jpeg, image/png"
                                    onchange="validateFileType(this)" data-parsley-errors-container='#aadhar_front_error'>
                                <span class="text-danger"
                                    id="aadhar_front_error">{{ $errors->first('aadhar_front') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="aadhar_back" class="form-label">Aadhar Back </label>
                                <input type="file" name="aadhar_back" id="aadhar_back" class="form-control"
                                    accept="image/*" data-parsley-accept="image/jpg, image/jpeg, image/png"
                                    data-parsley-filetype="jpg,jpeg,png" onchange="validateFileType(this)" data-parsley-errors-container='#aadhar_back_error'>
                                <span class="text-danger"
                                    id="aadhar_back_error">{{ $errors->first('aadhar_back') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="pan_number" class="form-label">Pan Number <span
                                        class="text-danger">*</span></label>
                                <input type="text" name="pan_number" id="pan_number" class="form-control panNumber"
                                    placeholder="Enter Pan Number" value="{{ old('pan_number') }}" data-parsley-required
                                    data-parsley-trigger="keyup" data-parsley-required-message='Please enter pan number'
                                    maxlength="10" oninput="this.value=this.value.slice(0,this.maxLength)"
                                    data-parsley-minlength="10"
                                    data-parsley-minlength-message="Pan number at least 10 characters long"
                                    data-parsley-maxlength="10"
                                    data-parsley-maxlength-message="Pan number may not be greater than 10 character" data-parsley-errors-container='#pan_number_error'>
                                <span class="text-danger" id="pan_number_error">{{ $errors->first('pan_number') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="pan_file" class="form-label">Pan Image <span
                                        class="text-danger">*</span></label>
                                <input type="file" name="pan_file" id="pan_file" class="form-control"
                                    data-parsley-required data-parsley-trigger='keyup'
                                    data-parsley-required-message="Please upload pan image" accept="image/*" required
                                    data-parsley-filetype="jpg,jpeg,png"
                                    data-parsley-accept="image/jpg, image/jpeg, image/png"
                                    onchange="validateFileType(this)" data-parsley-errors-container='#pan_file_error'>
                                <span class="text-danger" id="pan_file_error">{{ $errors->first('pan_file') }}</span>
                            </div>
                        </div>
                    </div>
                </div>
            </div>

            <div class="row mt-3">
                <div class="col-md-12">
                    <h4 class="card-title"><b>Personal Bank Details</b></h4>
                    <div class="row">
                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="bank_name" class="form-label">Bank Name <span
                                        class="text-danger">*</span></label>
                                <input type="text" name="bank_name" id="bank_name" class="form-control"
                                    placeholder="Enter Bank Name" value="{{ old('bank_name') }}" data-parsley-required
                                    data-parsley-trigger='keyup' maxlength="100" data-parsley-maxlength="100"
                                    data-parsley-maxlength-message="Bank name may not be greater than 100 characters"
                                    data-parsley-required-message="Please enter bank name"
                                    data-parsley-errors-container='#bank_name_error'>
                                <span class="text-danger"
                                    id="bank_name_error">{{ $errors->first('bank_name') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="account_no" class="form-label">Account Number <span
                                        class="text-danger">*</span></label>
                                <input type="text" name="account_no" id="account_no"
                                    class="form-control bankAccNumber" placeholder="Enter Account Number"
                                    value="{{ old('account_no') }}" data-parsley-required data-parsley-trigger='keyup'
                                    data-parsley-required-message="Please enter account number" maxlength="20"
                                    oninput="this.value=this.value.slice(0,this.maxLength)" data-parsley-minlength="11"
                                    data-parsley-minlength-message="Account number at least 11 characters long"
                                    data-parsley-maxlength="20"
                                    data-parsley-maxlength-message="Account number may not be greater than 20 character"
                                    data-parsley-errors-container='#account_no_error'>
                                <span class="text-danger"
                                    id="account_no_error">{{ $errors->first('account_no') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="ifsc_code" class="form-label">Bank IFSC Code <span
                                        class="text-danger">*</span></label>
                                <input type="text" name="ifsc_code" id="ifsc_code" class="form-control bankIFSCCode"
                                    placeholder="Enter Bank IFSC Code" value="{{ old('ifsc_code') }}"
                                    data-parsley-required data-parsley-trigger='keyup'
                                    data-parsley-required-message="Please enter bank IFSC code" maxlength="11"
                                    oninput="this.value=this.value.slice(0,this.maxLength)" data-parsley-minlength="11"
                                    data-parsley-minlength-message="Bank IFSC code at least 11 characters long"
                                    data-parsley-maxlength="11"
                                    data-parsley-maxlength-message="Bank IFSC code may not be greater than 11 character"
                                    data-parsley-errors-container='#ifsc_code_error'>
                                <span class="text-danger"
                                    id="ifsc_code_error">{{ $errors->first('ifsc_code') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="blank_cheque" class="form-label">Cheque Image <span
                                        class="text-danger">*</span></label>
                                <input type="file" name="blank_cheque" id="blank_cheque" class="form-control"
                                    data-parsley-required data-parsley-trigger='keyup'
                                    data-parsley-required-message="Please upload cheque image" accept="image/*"
                                    data-parsley-filetype="jpg,jpeg,png" required
                                    data-parsley-accept="image/jpg, image/jpeg, image/png"
                                    onchange="validateFileType(this)" data-parsley-errors-container='#blank_cheque_error'>
                                <span class="text-danger"
                                    id="blank_cheque_error">{{ $errors->first('blank_cheque') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="cheque_number" class="form-label">Cheque Number <span
                                        class="text-danger">*</span></label>
                                <input type="text" name="cheque_number" id="cheque_number"
                                    class="form-control chequeNo" placeholder="Enter Cheque Number"
                                    value="{{ old('cheque_number') }}" data-parsley-required data-parsley-trigger='keyup'
                                    data-parsley-required-message="Please enter cheque number" maxlength="6"
                                    oninput="this.value=this.value.slice(0,this.maxLength)" data-parsley-minlength="6"
                                    data-parsley-minlength-message="Cheque number at least 6 characters long"
                                    data-parsley-maxlength="6"
                                    data-parsley-maxlength-message="Cheque number may not be greater than 6 character"
                                    data-parsley-errors-container='#cheque_number_error'>
                                <span class="text-danger"
                                    id="cheque_number_error">{{ $errors->first('cheque_number') }}</span>
                            </div>
                        </div>
                    </div>
                </div>
            </div>

            <div class="row mt-3">
                <div class="col-md-12">
                    <h4 class="card-title"><b>Company Bank Details</b></h4>
                    <div class="row">
                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="company_bank_name" class="form-label">Bank Name</label>
                                <input type="text" name="company_bank_name" id="company_bank_name" class="form-control"
                                    placeholder="Enter Bank Name" value="{{ old('company_bank_name') }}"
                                    data-parsley-trigger='keyup' maxlength="100" data-parsley-maxlength="100"
                                    data-parsley-maxlength-message="Bank name may not be greater than 100 characters"
                                    data-parsley-errors-container='#company_bank_name_error'>
                                <span class="text-danger"
                                    id="company_bank_name_error">{{ $errors->first('company_bank_name') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="company_account_no" class="form-label">Account Number</label>
                                <input type="text" name="company_account_no" id="company_account_no"
                                    class="form-control bankAccNumber" placeholder="Enter Account Number"
                                    value="{{ old('company_account_no') }}" data-parsley-trigger='keyup'
                                    maxlength="20" oninput="this.value=this.value.slice(0,this.maxLength)" data-parsley-minlength="11"
                                    data-parsley-minlength-message="Account number at least 11 characters long"
                                    data-parsley-maxlength="20"
                                    data-parsley-maxlength-message="Account number may not be greater than 20 character"
                                    data-parsley-errors-container='#company_account_no_error'>
                                <span class="text-danger"
                                    id="company_account_no_error">{{ $errors->first('company_account_no') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="company_ifsc_code" class="form-label">Bank IFSC Code</label>
                                <input type="text" name="company_ifsc_code" id="company_ifsc_code" class="form-control bankIFSCCode"
                                    placeholder="Enter Bank IFSC Code" value="{{ old('company_ifsc_code') }}"
                                    data-parsley-trigger='keyup' maxlength="11"
                                    oninput="this.value=this.value.slice(0,this.maxLength)" data-parsley-minlength="11"
                                    data-parsley-minlength-message="Bank IFSC code at least 11 characters long"
                                    data-parsley-maxlength="11"
                                    data-parsley-maxlength-message="Bank IFSC code may not be greater than 11 character"
                                    data-parsley-errors-container='#company_ifsc_code_error'>
                                <span class="text-danger"
                                    id="company_ifsc_code_error">{{ $errors->first('company_ifsc_code') }}</span>
                            </div>
                        </div>
                    </div>
                </div>
            </div>

            <div class="row mt-3">
                <div class="col-md-12">
                    <h4 class="card-title"><b>Emergency Contact Details</b></h4>
                    <div class="row">
                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="emergency_contact_1" class="form-label">Emergency Contact No. (1) <span
                                        class="text-danger">*</span></label>
                                <input type="text" name="emergency_contact_1" id="emergency_contact_1" class="form-control mobile"
                                    placeholder="Enter Emergency Contact No. (1)" value="{{ old('emergency_contact_1') }}" data-parsley-required
                                    data-parsley-trigger='keyup' data-parsley-minlength="10"
                                    data-parsley-minlength-message="Enter emergency contact no. (1) at least 10 characters long" maxlength="15"
                                    data-parsley-maxlength="15"
                                    data-parsley-maxlength-message="Enter emergency contact no. (1) may not be greater than 15 character"
                                    data-parsley-required-message="Please enter emergency contact no. (1)"
                                    data-parsley-errors-container='#emergency_contact_1_error'>
                                <span class="text-danger"
                                    id="emergency_contact_1_error">{{ $errors->first('emergency_contact_1') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="name_1" class="form-label">Name <span
                                        class="text-danger">*</span></label>
                                <input type="text" name="name_1" id="name_1"
                                    class="form-control" placeholder="Enter Name"
                                    value="{{ old('name_1') }}" data-parsley-required data-parsley-trigger='keyup'
                                    data-parsley-required-message="Please enter name" maxlength="100"
                                    oninput="this.value=this.value.slice(0,this.maxLength)"
                                    data-parsley-maxlength="100"
                                    data-parsley-maxlength-message="Name may not be greater than 100 character"
                                    data-parsley-errors-container='#name_1_error'>
                                <span class="text-danger"
                                    id="name_1_error">{{ $errors->first('name_1') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="name_relation_1" class="form-label">Name of Relationship <span
                                        class="text-danger">*</span></label>
                                <input type="text" name="name_relation_1" id="name_relation_1" class="form-control"
                                    placeholder="Enter Name of Relationship" value="{{ old('name_relation_1') }}"
                                    data-parsley-required data-parsley-trigger='keyup'
                                    data-parsley-required-message="Please enter name of relationship" maxlength="100"
                                    oninput="this.value=this.value.slice(0,this.maxLength)"
                                    data-parsley-maxlength="100"
                                    data-parsley-maxlength-message="Name of relationship may not be greater than 100 character"
                                    data-parsley-errors-container='#name_relation_1_error'>
                                <span class="text-danger"
                                    id="name_relation_1_error">{{ $errors->first('name_relation_1') }}</span>
                            </div>
                        </div>

                        <div class="col-md-12">
                            <div class="form-group">
                                <label for="address_1" class="form-label">Address <span
                                        class="text-danger">*</span></label>
                                <textarea type="file" name="address_1" id="address_1" class="form-control" rows="3" placeholder="Enter Address" required
                                    data-parsley-required data-parsley-trigger='keyup'
                                    data-parsley-required-message="Please enter address"
                                    data-parsley-errors-container='#address_1_error'></textarea>
                                <span class="text-danger"
                                    id="address_1_error">{{ $errors->first('address_1') }}</span>
                            </div>
                        </div>
                    </div>

                    <div class="row">
                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="emergency_contact_2" class="form-label">Emergency Contact No. (2)</label>
                                <input type="text" name="emergency_contact_2" id="emergency_contact_2" class="form-control mobile"
                                    placeholder="Enter Emergency Contact No. (2)" value="{{ old('emergency_contact_2') }}"                                     data-parsley-trigger='keyup' data-parsley-minlength="10"
                                    data-parsley-minlength-message="Enter emergency contact no. (2) at least 10 characters long" maxlength="15"
                                    data-parsley-maxlength="15"
                                    data-parsley-maxlength-message="Enter emergency contact no. (2) may not be greater than 15 character"
                                    data-parsley-errors-container='#emergency_contact_2_error'>
                                <span class="text-danger"
                                    id="emergency_contact_2_error">{{ $errors->first('emergency_contact_2') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="name_2" class="form-label">Name</label>
                                <input type="text" name="name_2" id="name_2"
                                    class="form-control" placeholder="Enter Name"
                                    value="{{ old('name_2') }}" data-parsley-trigger='keyup'
                                     maxlength="100"
                                    oninput="this.value=this.value.slice(0,this.maxLength)"
                                    data-parsley-maxlength="100"
                                    data-parsley-maxlength-message="Name may not be greater than 100 character"
                                    data-parsley-errors-container='#name_2_error'>
                                <span class="text-danger"
                                    id="name_2_error">{{ $errors->first('name_2') }}</span>
                            </div>
                        </div>

                        <div class="col-md-4">
                            <div class="form-group">
                                <label for="name_relation_2" class="form-label">Name of Relationship</label>
                                <input type="text" name="name_relation_2" id="name_relation_2" class="form-control"
                                    placeholder="Enter Name of Relationship" value="{{ old('name_relation_2') }}"
                                    data-parsley-trigger='keyup' maxlength="100"
                                    oninput="this.value=this.value.slice(0,this.maxLength)"
                                    data-parsley-maxlength="100"
                                    data-parsley-maxlength-message="Name of relationship may not be greater than 100 character"
                                    data-parsley-errors-container='#name_relation_2_error'>
                                <span class="text-danger"
                                    id="name_relation_2_error">{{ $errors->first('name_relation_2') }}</span>
                            </div>
                        </div>

                        <div class="col-md-12">
                            <div class="form-group">
                                <label for="address_2" class="form-label">Address</label>
                                <textarea type="file" name="address_2" id="address_2" class="form-control" rows="3" placeholder="Enter Address"
                                    data-parsley-trigger='keyup'
                                    data-parsley-errors-container='#address_2_error'></textarea>
                                <span class="text-danger"
                                    id="address_2_error">{{ $errors->first('address_2') }}</span>
                            </div>
                        </div>
                    </div>
                </div>
            </div>

            <hr class="owner_details_hr">
            <div class="row mt-4 owner_details_title">
                <div class="col-md-12">
                    <h4 class="card-title mb-0"><strong>Work Experience Detail</strong></h4>
                </div>
            </div>
            <div class="row mt-3" id="owner_details">
                <div class="col-md-12">
                    <div class="owner_details">
                        <div class="row">
                            <div class="col-md-4">
                                <div class="form-group">
                                    <label for="employer_name_0" class="form-label">Employer Name</label>
                                    <input type="text" name="employer_name[]" id="employer_name_0"
                                    class="form-control" placeholder="Enter Employer Name"
                                    value="{{ old('employer_name') }}" data-parsley-trigger='keyup'
                                    maxlength="100" oninput="this.value=this.value.slice(0,this.maxLength)"
                                    data-parsley-maxlength="100"
                                    data-parsley-maxlength-message="Employer name may not be greater than 100 character"
                                    data-parsley-errors-container='#employer_name_0_error'>
                                    <span class="text-danger"
                                    id="employer_name_0_error">{{ $errors->first('employer_name') }}</span>
                                </div>
                            </div>
                            <div class="col-md-4">
                                <div class="form-group">
                                    <label for="location_0" class="form-label">Location</label>
                                    <input type="text" name="location[]" id="location_0"
                                    class="form-control" placeholder="Enter Location"
                                    value="{{ old('location') }}" data-parsley-trigger='keyup'
                                    maxlength="100"
                                    oninput="this.value=this.value.slice(0,this.maxLength)"
                                    data-parsley-maxlength="100"
                                    data-parsley-maxlength-message="Location may not be greater than 100 character"
                                    data-parsley-errors-container='#location_0_error'>
                                    <span class="text-danger"
                                    id="location_0_error">{{ $errors->first('location') }}</span>
                                </div>
                            </div>
                            <div class="col-md-4">
                                <div class="form-group">
                                    <label for="starting_salary_0" class="form-label">Starting Salary</label>
                                    <input type="text" name="starting_salary[]" id="starting_salary_0"
                                    class="form-control amount" placeholder="Enter Starting Salary"
                                    value="{{ old('starting_salary') }}" data-parsley-trigger='keyup'
                                    maxlength="100" oninput="this.value=this.value.slice(0,this.maxLength)"
                                    data-parsley-maxlength="100"
                                    data-parsley-maxlength-message="Starting salary may not be greater than 100 character"
                                    data-parsley-errors-container='#starting_salary_0_error'>
                                    <span class="text-danger"
                                    id="starting_salary_0_error">{{ $errors->first('starting_salary') }}</span>
                                </div>
                            </div>
                        </div>
                        <div class="row">
                            <div class="col-md-4">
                                <div class="form-group">
                                    <label for="leaving_salary_0" class="form-label">Leaving Salary</label>
                                    <input type="text" name="leaving_salary[]" id="leaving_salary_0"
                                    class="form-control amount" placeholder="Enter Leaving Salary"
                                    value="{{ old('leaving_salary') }}" data-parsley-trigger='keyup'
                                    maxlength="100" oninput="this.value=this.value.slice(0,this.maxLength)"
                                    data-parsley-maxlength="100"
                                    data-parsley-maxlength-message="Leaving salary may not be greater than 100 character"
                                    data-parsley-errors-container='#leaving_salary_0_error'>
                                    <span class="text-danger"
                                    id="leaving_salary_0_error">{{ $errors->first('leaving_salary') }}</span>
                                </div>
                            </div>
                            <div class="col-md-4">
                                <div class="form-group">
                                    <label for="starting_designation_0" class="form-label">Starting Designation</label>
                                    <input type="text" name="starting_designation[]" id="starting_designation_0"
                                    class="form-control" placeholder="Enter Starting Designation"
                                    value="{{ old('starting_designation') }}" data-parsley-trigger='keyup'
                                    maxlength="100" oninput="this.value=this.value.slice(0,this.maxLength)"
                                    data-parsley-maxlength="100"
                                    data-parsley-maxlength-message="Starting designation may not be greater than 100 character"
                                    data-parsley-errors-container='#starting_designation_0_error'>
                                    <span class="text-danger"
                                    id="starting_designation_0_error">{{ $errors->first('starting_designation') }}</span>
                                </div>
                            </div>
                            <div class="col-md-4">
                                <div class="form-group">
                                    <label for="leaving_designation_0" class="form-label">Leaving Designation</label>
                                    <input type="text" name="leaving_designation[]" id="leaving_designation_0"
                                    class="form-control" placeholder="Enter Leaving Designation"
                                    value="{{ old('leaving_designation') }}" data-parsley-trigger='keyup'
                                    maxlength="100" oninput="this.value=this.value.slice(0,this.maxLength)"
                                    data-parsley-maxlength="100"
                                    data-parsley-maxlength-message="Leaving designation may not be greater than 100 character"
                                    data-parsley-errors-container='#leaving_designation_0_error'>
                                    <span class="text-danger"
                                    id="leaving_designation_0_error">{{ $errors->first('leaving_designation') }}</span>
                                </div>
                            </div>
                        </div>
                        <div class="row">
                            <div class="col-md-4">
                                <div class="form-group">
                                   <label for="from_date_0" class="form-label">From date</label>
                                    <input type="text" name="from_date[]" id="from_date_0"
                                        class="form-control fromDate" value="{{ old('from_date') }}"
                                        placeholder="Select From Date" data-parsley-trigger='keyup'
                                        data-parsley-datecustom data-parsley-errors-container='#from_date_0_error'>
                                    <span class="text-danger error-msg"
                                        id="from_date_0_error">{{ $errors->first('from_date') }}</span>
                                </div>
                            </div>
                            <div class="col-md-4">
                                <div class="form-group">
                                   <label for="to_date_0" class="form-label">To date</label>
                                    <input type="text" name="to_date[]" id="to_date_0"
                                        class="form-control toDate" value="{{ old('to_date') }}"
                                        placeholder="Select To Date" data-parsley-trigger='keyup'
                                        data-parsley-datecustom data-parsley-errors-container='#to_date_0_error'>
                                    <span class="text-danger error-msg"
                                        id="to_date_0_error">{{ $errors->first('to_date') }}</span>
                                </div>
                            </div>
                            <div class="col-md-4">
                                <div class="form-group">
                                   <label for="leaving_reason_0" class="form-label">Reason For Leaving</label>
                                    <input type="text" name="leaving_reason[]" id="leaving_reason_0"
                                    class="form-control" placeholder="Enter Reason For Leaving"
                                    value="{{ old('leaving_reason') }}" data-parsley-trigger='keyup'
                                    maxlength="100"
                                    oninput="this.value=this.value.slice(0,this.maxLength)"
                                    data-parsley-maxlength="100"
                                    data-parsley-maxlength-message="Reason for leaving may not be greater than 100 character"
                                    data-parsley-errors-container='#leaving_reason_0_error'>
                                    <span class="text-danger"
                                    id="leaving_reason_0_error">{{ $errors->first('leaving_reason') }}</span>
                                </div>
                            </div>
                        </div>
                    </div>
                </div>
            </div>
            <div class="row owner_details_add_btn">
                <div class="col-md-12 text-right">
                    <a class="btn btn-sm btn-primary" id="addWorkExperienceDetails"><i class="fa fa-plus"></i> Add More</a>
                </div>
            </div>
        </div>
        <div class="card-footer">
            <button type="submit" class="btn btn-primary btn-fw" id="addEmployeeMaster">Save</button>
            <a href="{{ route('employee-master.index') }}" class="btn btn-light btn-fw">Cancel</a>
        </div>
        {{ Form::close() }}
    </div>
@endsection

@section('page-js')
    <script type="text/javascript">
        var employeeMasterList = "{{ route('employee-master.index') }}";
        var employeeMasterStore = "{{ route('employee-master.store') }}";
        var getDesignationByDepartment = "{{ route('get-designation') }}";
        var getRegion = "{{ route('country.region.regions-of-country') }}";
        var isEdit = false;
        var isPolicyFile = "";
    </script>
    <script src="{{ asset('assets/js/admin/employee-master.js') }}?time={{ time() }}"></script>
@endsection