

<?php $__env->startSection('content'); ?>

<style>
    .login-logo {
        display: block;
        margin-left: auto;
        margin-right: auto;
        width: 100px;
        padding-top: 20px;
        padding-bottom: 20px;
    }

    .card-header {
        text-align: center;
        font-size: 30px;
        font-weight: 500;
    }

    .form-label {
        font-weight: bold;
        color: #3e4f66;
    }

    .form-control {
        border-radius: 5px;
        padding: 10px;
        border: 1px solid #ced4da;
        transition: border-color 0.3s ease;
    }

    .form-control:focus {
        border-color: #80bdff;
        box-shadow: 0 0 0 0.2rem rgba(0, 123, 255, 0.25);
    }

    .btn-password-toggle {
        border-radius: 0 5px 5px 0;
        border-left: none;
    }

    .card {
        width: 75%;
        margin: 0 auto;
        border-radius: 15px;
        box-shadow: 0 4px 8px rgba(0, 0, 0, 0.1);
        background-color: transparent;
    }

    body {
        background: url('/img/background.png') no-repeat center center fixed;
        background-size: cover;
        background-position: center;
        background-repeat: no-repeat;
    }
</style>

<?php
$dialingCodes = [
    'IN' => '+91',
    'US' => '+1',
    'GB' => '+44',
    'AU' => '+61',
    'DE' => '+49',
];
?>

<div class="bg">
    <div class="container">
        <div class="row justify-content-center">
            <div class="col-md-12">
                <div class="card">
                    <img src="https://bluhealth.bluai.ai/img/logo/BluHealth_Logo.png" alt="BluHealth Logo" class="login-logo">

                    <div class="card-header">
                        Create Doctor
                    </div> 

                    <div class="card-body">
                        <form method="POST" class="ajax-form forms-sample" action="<?php echo e(route('hcp.signup')); ?>" data-redirect="<?php echo e(route('hcp.login')); ?>" enctype="multipart/form-data">
                            <?php echo csrf_field(); ?> 

                            <div class="row mb-3">
                                <div class="col-md-6"> 
                                    <label for="first_name" class="form-label required">First Name</label>
                                    <input type="text" class="form-control" name="first_name" value="">
                                </div>
                                <div class="col-md-6">
                                    <label for="last_name" class="form-label">Last Name</label>
                                    <input type="text" class="form-control" name="last_name" value="">
                                </div>
                            </div>

                            <div class="row mb-3">
                                <div class="col-md-6">
                                    <label for="Title" class="form-label required">Title</label>
                                    <input type="text" class="form-control" name="title" value="">
                                </div>
                                <div class="col-md-6"> 
                                <label for="school_graduated" class="form-label required">School Graduated</label>
                                <input type="text" class="form-control" name="school_graduated" value="">
                                </div>
                            </div>

                            <div class="row mb-3">
                                <div class="col-md-6">
                                    <label for="address" class="form-label required">Address</label>
                                    <input type="text" class="form-control" name="address" value="">
                                </div>
                                <div class="col-md-6">
                                    <label for="patient_phone_number" class="form-label required">Contact Phone Personal</label>
                                    <div class="input-group">
                                        <select name="patient_phone_num_country_code" class="form-select" style="max-width: 30%;">
                                            <?php $__currentLoopData = $dialingCodes; $__env->addLoop($__currentLoopData); foreach($__currentLoopData as $country => $code): $__env->incrementLoopIndices(); $loop = $__env->getLastLoop(); ?>
                                                <option value="<?php echo e($code); ?>"><?php echo e($country); ?> <?php echo e($code); ?></option>
                                            <?php endforeach; $__env->popLoop(); $loop = $__env->getLastLoop(); ?>
                                        </select>
                                        <input type="text" class="form-control" name="contact_phone_office" value="">
                                    </div>
                                </div>
                            </div>

                            <div class="row mb-3">
                               
                                <div class="col-md-6">
                                    <label for="email" class="form-label required">Email</label>
                                    <input type="email" class="form-control" name="email" value="">
                                </div>

                                <div class="col-md-6">
                                    <label for="image" class="form-label required">Photo</label>
                                    <input type="file" class="form-control" name="image" accept="image/*">
                                </div>
                            </div>

                            <!-- Password Field with Eye Icon -->
                            <div class="row mb-3">
                                <div class="col-md-6">
                                    <label for="password" class="form-label required">Password</label>
                                    <div class="input-group">
                                        <input type="password" class="form-control" name="password" id="password">
                                        <button type="button" class="btn btn-outline-secondary btn-password-toggle" onclick="togglePassword()">
                                            <i id="eyeIcon" class="fas fa-eye"></i>
                                        </button>
                                    </div>
                                </div>
                            </div>

                            <div class="add_patient d-flex flex-column justify-content-between align-items-center">
                                <button type="submit" class="btn btn-primary create" style="margin-bottom: 10px; width: 50%;">
                                    <i class="fas fa-user-plus"></i> Create Doctor
                                </button>
                                <a class="btn btn-outline-secondary" href="<?php echo e(route('hcp.login')); ?>" style="width: 50%;">
                                    <i class="fas fa-sign-in-alt"></i> Login
                                </a>
                            </div>
                        </form>
                    </div>
                </div>
            </div> 
        </div>
    </div>
</div>

<!-- JavaScript to Toggle Password Visibility -->
<script>
    function togglePassword() {
        let passwordInput = document.getElementById("password");
        let eyeIcon = document.getElementById("eyeIcon");

        if (passwordInput.type === "password") {
            passwordInput.type = "text";
            eyeIcon.classList.replace("fa-eye", "fa-eye-slash");
        } else {
            passwordInput.type = "password";
            eyeIcon.classList.replace("fa-eye-slash", "fa-eye");
        }
    }
</script>

<?php $__env->stopSection(); ?>

<?php echo $__env->make('layouts.app_without_header', array_diff_key(get_defined_vars(), ['__data' => 1, '__path' => 1]))->render(); ?><?php /**PATH /var/www/html/resources/views/hcp/register.blade.php ENDPATH**/ ?>