@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 @ViewBag.TYPEPRESCRIPTION </h3>
        </div>

    </div>
    <div class="card-body">
        @using (Html.BeginForm("SaisirProformatPrescription", "PROFORMATS", FormMethod.Post, new { enctype = "multipart/form-data" }))
        {
            @Html.AntiForgeryToken()
        <div class="row">
            <div class="col-md-12">
                <div class="form-group">

                    @Html.ValidationSummary(true, "", new { @class = "text-danger" })
                    @if (ViewBag.Message != null)
                    {
                        <p>@ViewBag.Message</p>
                    }
                </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">
                   
                        <label for="IDUTILISATEUR" class="control-label">ACTE</label>

                        <select class="form-control select2" id="kt_select2_11" name="IDUTILISATEUR">
                            @foreach (var listeBonchargeActe in ViewData["BonchargeActe"] as IList<MALDFGASSURANCE.Models.ACTE>)
                            {
                            <option value="@listeBonchargeActe.CODE_ACTE"> @listeBonchargeActe.LIBELLE_ACTE</option>
                            }

                        </select>
                    
                </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.PART_LDF_SAISIE, "DATE DE PROFORMA", htmlAttributes: new { @class = "control-label " })

                    @Html.EditorFor(model => model.PART_LDF_SAISIE, new { htmlAttributes = new { @class = "form-control" } })
                    @Html.ValidationMessageFor(model => model.PART_LDF_SAISIE, "", 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, "MEDECIN TRAITANT", 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>