@include('include.head')
    @include('include.main')
    <div class="kt-content  kt-grid__item kt-grid__item--fluid" id="kt_content">
        @if($session->has('message'))
            <div class="alert alert-{{ $session->get('message')['flag'] }}" role="alert">
                <div class="alert-icon"><i class="la la-{{ $session->get('message')['flag'] }} kt-font-brand"></i></div>
                <div class="alert-text">
                    {{ $session->get('message')['alert'] }}
                </div>
            </div>
        @endif
        <div class="kt-portlet kt-portlet--mobile">
            <div class="kt-portlet__head kt-portlet__head--lg">
                <div class="kt-portlet__head-label">
                    <h3 class="kt-portlet__head-title">
                        Adauga plata
                    </h3>
                </div>
            </div>
            <form class="kt-form" action="{{ URL::to('/payment') }}" method="post" enctype='multipart/form-data'>
                <div class="row">
                    <div class="col-xl-12">
                        <div class="kt-portlet">
                            <div class="kt-portlet__body">
                                <div class="form-group">
                                    <label for="issued-date">Data eliberarii documentului</label>
                                    <input type="text" name="issued-date" id="issued-date" class="form-control datepicker"
                                           autocomplete="off" required>
                                </div>
                                <div class="form-group">
                                    <label for="provider">Furnizor</label>
                                    <select class="form-control" name="provider" id="provider" required>
                                        <option value="">-</option>
                                        @foreach ($providers as $provider)
                                            <option value="{{ $provider->id() }}">{{ $provider->name() }} - Moneda 
                                            @foreach ($currencies as $currency)
                                                @if ($provider->currencyId() === $currency->id())
                                                    {{ $currency->name() }}
                                                @endif
                                            @endforeach
                                            </option>
                                        @endforeach
                                    </select>
                                </div>
                                <div class="form-group">
                                    <label for="document-number">Numar document</label>
                                    <input type="text" name="document-number" id="document-number" class="form-control" required>
                                </div>
                                <div class="form-group">
                                    <label for="description">Descriere</label>
                                    <textarea class="form-control" name="description" id="description"></textarea>
                                </div>
                                <div class="form-group">
                                    <label for="payment-type">Tipul platii</label>
                                    <select class="form-control" name="payment-type" id="payment-type" required>
                                        <option value="bank">Banca</option>
                                        <option value="cash">Numerar</option>
                                    </select>
                                </div>
                                <div class="form-group">
                                    <label for="exchange">Curs valutar</label>
                                    <input type="number" step=".0001" name="exchange" id="exchange" class="form-control" required>
                                </div>
                                <div class="form-group">
                                    <label for="total-payed">Total platit</label>
                                    <input type="number" step=".01" name="total-payed" id="total-payed" class="form-control" required>
                                </div>
                                <div class="form-group">
                                    <label for="deductible-percent">Valoare deductibila</label>
                                    <select class="form-control" name="deductible-percent" id="deductible-percent" required>
                                        <option value="100">100%</option>
                                        <option value="50">50%</option>
                                    </select>
                                </div>
                                <div class="kt-form__actions">
                                    <input type="submit" class="btn btn-primary" id="submit" value="Adauga">
                                </div>
                            </div>
                        </div>
                    </div>
                </div>
            </form>
        </div>
    </div>
    <div class="kt-content  kt-grid__item kt-grid__item--fluid kt-grid kt-grid--hor" id="kt_content">
        <div class="kt-subheader   kt-grid__item" id="kt_subheader">
            <div class="kt-container  kt-container--fluid ">
                <div class="kt-subheader__toolbar"></div>
            </div>
        </div>
        <div class="kt-container  kt-container--fluid  kt-grid__item kt-grid__item--fluid">
            
        </div>
    </div>
    @include('include.footer')
    <script>
        $('.datepicker').datepicker({
            format: 'yyyy-mm-dd',
            weekStart: 1,
        });
    </script>
</html>