@model MALDFGASSURANCE.Models.PROFORMAT

@{
    ViewBag.Title = "Enregistrement de la Proforma";
}

<div class="card card-custom">
    <div class="card-header py-3">
        <div class="card-title">
            <span class="card-icon">
                <i class="flaticon2-add-square text-primary"></i>
            </span>
            <h3 class="card-label">EDITION DE PRISE EN CHARGE</h3>
        </div>

    </div>
    <div class="card-body">
        @using (Html.BeginForm())
        {
            @Html.AntiForgeryToken()
            <div class="row">
                <div class="col-md-12">
                    <div class="form-group">

                        @Html.ValidationSummary(true, "", new { @class = "text-danger" })
                    </div>
                </div>

                <div class="col-md-4">
                    <div class="form-group">
                        @Html.LabelFor(model => model.NUMEROPROFORMAT, "N° PROFORMA", htmlAttributes: new { @class = "control-label " })

                        @Html.EditorFor(model => model.NUMEROPROFORMAT, new { htmlAttributes = new { @class = "form-control" } })
                        @Html.ValidationMessageFor(model => model.NUMEROPROFORMAT, "", new { @class = "text-danger" })
                    </div>
                </div>


                <div class="col-md-4">
                    <div class="form-group">
                        @Html.LabelFor(model => model.IDPRISECHARGE, " TYPE PRISE EN CHARGE", htmlAttributes: new { @class = "control-label " })

                        @Html.DropDownList("IDPRISECHARGE", null, htmlAttributes: new { @class = "form-control select2", @id = "kt_select2_10" })
                        @Html.ValidationMessageFor(model => model.IDPRISECHARGE, "", new { @class = "text-danger" })
                    </div>
                </div>


                <div class="col-md-4">
                    <div class="form-group">
                        @if (ViewData["MATRICULE"] != null)
                        {
                            <label for="MATRICULE" class="control-label">ASSURE</label>

                            <select class="form-control select2" id="kt_select2_1" name="MATRICULE">
                                @foreach (var listeAssure in ViewData["LISTEASSURE"] as IList<MALDFGASSURANCE.Models.ASSURE>)
                                {
                                    <option value="@listeAssure.MATRICULE"> @listeAssure.MATRICULE / @listeAssure.NOM @listeAssure.PRENOMS</option>
                                }

                            </select>
                        }
                    </div>
                </div>

                <div class="col-md-4">
                    <div class="form-group">
                        @Html.LabelFor(model => model.ID_ETABLISSEMENT, "ETABLISSEMENT", htmlAttributes: new { @class = "control-label " })

                        @Html.DropDownList("ID_ETABLISSEMENT", null, htmlAttributes: new { @class = "form-control select2", @id = "kt_select2_2" })
                        @Html.ValidationMessageFor(model => model.ID_ETABLISSEMENT, "", new { @class = "text-danger" })
                    </div>
                </div>

                <div class="col-md-4">
                    <div class="form-group">
                        @Html.LabelFor(model => model.MOTIF, htmlAttributes: new { @class = "control-label " })

                        @Html.EditorFor(model => model.MOTIF, new { htmlAttributes = new { @class = "form-control" } })
                        @Html.ValidationMessageFor(model => model.MOTIF, "", new { @class = "text-danger" })
                    </div>
                </div>

                <div class="col-md-4">
                    <div class="form-group">
                        @Html.LabelFor(model => model.MONTANT, htmlAttributes: new { @class = "control-label " })

                        @Html.EditorFor(model => model.MONTANT, new { htmlAttributes = new { @class = "form-control" } })
                        @Html.ValidationMessageFor(model => model.MONTANT, "", new { @class = "text-danger" })
                    </div>
                </div>

                <div class="col-md-4">
                    <div class="form-group">
                        @Html.LabelFor(model => model.INFORMATION, "PART LDF PREVISIONNELLE", htmlAttributes: new { @class = "control-label " })

                        @Html.EditorFor(model => model.INFORMATION, new { htmlAttributes = new { @class = "form-control", Type = "number" } })
                        @Html.ValidationMessageFor(model => model.INFORMATION, "", new { @class = "text-danger" })
                    </div>
                </div>



                <div class="col-md-4">
                    <div class="form-group">
                        @Html.LabelFor(model => model.DATEPROFORMAT, "DATE DE PROFORMA", htmlAttributes: new { @class = "control-label " })

                        @Html.EditorFor(model => model.DATEPROFORMAT, new { htmlAttributes = new { @class = "form-control" } })
                        @Html.ValidationMessageFor(model => model.DATEPROFORMAT, "", new { @class = "text-danger" })
                    </div>
                </div>


                <div class="col-md-4">
                    <div class="form-group">
                        @Html.LabelFor(model => model.IDMEDECINCONSEIL, "MEDECIN CONSEIL", htmlAttributes: new { @class = "control-label " })

                        @Html.DropDownList("IDMEDECINCONSEIL", null, htmlAttributes: new { @class = "form-control select2", @id = "kt_select2_3" })
                        @Html.ValidationMessageFor(model => model.IDMEDECINCONSEIL, "", new { @class = "text-danger" })
                    </div>
                </div>

                <div class="col-md-4">
                    <div class="form-group">
                        @Html.LabelFor(model => model.MEDECINPRESECRIPTEUR, "PRESCRIPTEUR", htmlAttributes: new { @class = "control-label " })

                        @Html.EditorFor(model => model.MEDECINPRESECRIPTEUR, new { htmlAttributes = new { @class = "form-control" } })
                        @Html.ValidationMessageFor(model => model.MEDECINPRESECRIPTEUR, "", new { @class = "text-danger" })
                    </div>
                </div>


                @if (@ViewData["InfoSupplementaire"] != null)
                {
                    foreach (var item in @ViewData["InfoSupplementaire"] as IList<MALDFGASSURANCE.Models.INFORMATIONSUP>)
                    {
                        <div class="col-md-4">
                            <div class="form-group">
                                <div class="">@item.LIBELLE</div>

                                <input type="@item.TYPE" class="form-control" name="@item.CODE" id="@item.CODE" />
                            </div>
                        </div>
                    }
                }
                <div class="col-md-4">
                    <div class="form-group">
                        @Html.LabelFor(model => model.PHOTOPROFORMA, "PIECE (format autorisé: Jpeg,Png,Pdf,Jpg)", htmlAttributes: new { @class = "control-label " })
                        @Html.TextBox("PHOTOPROFORMA", "", new { @type = "file", @class = "form-control" })
                        @Html.ValidationMessageFor(model => model.PHOTOPROFORMA, "", new { @class = "text-danger" })
                    </div>
                </div>
            </div>
            <div class="card-footer">
                <div class="row form-group">
                    <div class="col-md-6 ">
                        <a href="@Url.Action("Index","PROFORMATS")" class="btn btn-default ">Retour</a>
                    </div>
                    <div class="col-md-6 text-right">
                        <input type="submit" value="Ajouter" class="btn btn-primary   py-3 px-6" />
                    </div>

                </div>
            </div>
        }

    </div>
</div>