@extends('layouts.branch')

@section('title', "Edit Admission - " . $ipdRegistration->ipd_number)
@section('header', "Modify Record")

@section('content')
<div class="space-y-6" x-data="ipdEditForm()">
    
    <!-- Breadcrumbs -->
    <div class="flex items-center gap-2 text-[10px] font-black uppercase tracking-widest text-slate-400 italic">
        <a href="{{ route('branch.dashboard') }}" class="hover:text-indigo-600 transition-colors">Dashboard</a>
        <svg class="h-3 w-3" fill="none" stroke="currentColor" viewBox="0 0 24 24"><path stroke-linecap="round" stroke-linejoin="round" stroke-width="2" d="M9 5l7 7-7 7"/></svg>
        <a href="{{ route('branch.ipd-registrations.index') }}" class="hover:text-indigo-600 transition-colors">IPD Directory</a>
        <svg class="h-3 w-3" fill="none" stroke="currentColor" viewBox="0 0 24 24"><path stroke-linecap="round" stroke-linejoin="round" stroke-width="2" d="M9 5l7 7-7 7"/></svg>
        <span class="text-indigo-600">Edit Admission</span>
    </div>

    <!-- Header: Dynamic Patient Identification -->
    <div class="bg-white p-8 rounded-[40px] shadow-sm border border-slate-100 italic relative z-10 overflow-hidden flex flex-col md:flex-row md:items-center justify-between gap-8 mb-8 group">
        <div class="flex items-center gap-6 relative z-10">
            <div class="h-24 w-24 rounded-3xl bg-indigo-600 border-4 border-white shadow-xl overflow-hidden flex items-center justify-center text-white font-black text-3xl group-hover:scale-105 transition-transform shrink-0">
                @if($ipdRegistration->patient?->photo_path)
                    <img src="{{ asset('storage/' . $ipdRegistration->patient->photo_path) }}" class="h-full w-full object-cover">
                @else
                    {{ substr($ipdRegistration->full_name, 0, 1) }}
                @endif
            </div>
            <div>
                <h2 class="text-4xl font-black text-slate-900 tracking-tighter uppercase leading-none mb-3">{{ $ipdRegistration->full_name }}</h2>
                <div class="flex flex-wrap items-center gap-6 mt-4">
                    <div class="bg-indigo-50 px-5 py-2 rounded-2xl border border-indigo-100 shadow-sm">
                        <span class="text-3xl font-black text-indigo-700 uppercase tracking-widest leading-none">UHID: {{ $ipdRegistration->uhid }}</span>
                    </div>
                    <span class="text-3xl font-bold text-slate-500 uppercase tracking-widest leading-none">{{ $ipdRegistration->mobile_number }}</span>
                    <div class="h-3 w-3 bg-slate-200 rounded-full"></div>
                    <span class="text-3xl font-black text-emerald-600 uppercase tracking-widest leading-none">CASE: {{ $ipdRegistration->ipd_number }}</span>
                </div>
            </div>
        </div>
        
        <div class="flex items-center gap-6 bg-slate-50 p-6 rounded-[30px] border border-slate-100 relative z-10">
            <div class="text-right">
                <p class="text-[10px] text-slate-400 font-black uppercase tracking-[0.2em] mb-1">Admission Date</p>
                <p class="text-2xl font-black text-indigo-600 tracking-tight uppercase">{{ $ipdRegistration->admission_date->format('d M, Y') }}</p>
            </div>
            <div class="h-12 w-[1px] bg-slate-200"></div>
            <div class="text-right">
                <p class="text-[10px] text-slate-400 font-black uppercase tracking-[0.2em] mb-1">Time</p>
                <p class="text-2xl font-black text-slate-900 tracking-tight uppercase">{{ $ipdRegistration->admission_time }}</p>
            </div>
        </div>
        <div class="absolute top-0 right-0 w-64 h-64 bg-indigo-50 rounded-full blur-3xl opacity-50 -mr-32 -mt-32"></div>
    </div>

    @if($errors->any())
    <div class="bg-rose-50/80 backdrop-blur-xl border border-rose-100 p-8 rounded-[40px] italic shadow-2xl shadow-rose-100/20 mb-10 relative overflow-hidden">
        <div class="relative z-10 flex items-center gap-6">
            <div class="h-14 w-14 bg-rose-600 text-white rounded-2xl flex items-center justify-center shadow-lg">
                <svg class="h-8 w-8" fill="none" stroke="currentColor" viewBox="0 0 24 24"><path stroke-linecap="round" stroke-linejoin="round" stroke-width="2.5" d="M12 9v2m0 4h.01m-6.938 4h13.856c1.54 0 2.502-1.667 1.732-3L13.732 4c-.77-1.333-2.694-1.333-3.464 0L3.34 16c-.77 1.333.192 3 1.732 3z"/></svg>
            </div>
            <div>
                <h5 class="text-xl font-black text-rose-900 uppercase tracking-tighter">Action Required</h5>
                <p class="text-xs text-rose-500 font-bold uppercase tracking-widest mt-1">Please review the highlighted fields below</p>
            </div>
        </div>
    </div>
    @endif

    <form action="{{ route('branch.ipd-registrations.update', $ipdRegistration->id) }}" method="POST" enctype="multipart/form-data" class="space-y-12 pb-20">
        @csrf
        @method('PUT')
        
        <input type="hidden" name="patient_id" x-model="formData.patient_id">
        <input type="hidden" name="uhid" x-model="formData.uhid">

        <!-- Top Section: Admission Metadata -->
        <div class="grid grid-cols-1 md:grid-cols-4 gap-6 bg-white p-10 rounded-[40px] shadow-sm border border-slate-100 italic relative">
            <div class="space-y-3">
                <label class="text-[11px] font-black text-slate-500 uppercase tracking-[0.2em] px-1">Admission Date <span class="text-rose-500">*</span></label>
                <input type="date" name="admission_date" x-model="formData.admission_date" required
                       @change="checkAvailability()"
                       class="w-full px-6 py-5 bg-white border-2 border-slate-100 rounded-3xl text-sm font-black uppercase tracking-widest focus:ring-4 focus:ring-indigo-100 focus:border-indigo-600 transition-all outline-none shadow-sm text-slate-900">
            </div>
            <div class="space-y-3">
                <label class="text-[11px] font-black text-slate-500 uppercase tracking-[0.2em] px-1">Admission Time <span class="text-rose-500">*</span></label>
                <input type="time" name="admission_time" x-model="formData.admission_time" required
                       class="w-full px-6 py-5 bg-white border-2 border-slate-100 rounded-3xl text-sm font-black uppercase tracking-widest focus:ring-4 focus:ring-indigo-100 focus:border-indigo-600 transition-all outline-none shadow-sm text-slate-900">
            </div>
            <div class="space-y-3">
                <label class="text-[11px] font-black text-slate-500 uppercase tracking-[0.2em] px-1">IPD Case No <span class="text-slate-300">(Locked)</span></label>
                <div class="w-full px-6 py-5 bg-slate-50 border-2 border-slate-100 rounded-3xl text-sm font-black uppercase tracking-widest text-indigo-600 shadow-inner flex items-center">
                    {{ $ipdRegistration->ipd_number }}
                </div>
            </div>
            <div class="space-y-3">
                <label class="text-[11px] font-black text-slate-500 uppercase tracking-[0.2em] px-1">Previous ID</label>
                <input type="text" name="previous_id" x-model="formData.previous_id"
                       placeholder="IF ANY..."
                       class="w-full px-6 py-5 bg-white border-2 border-slate-100 rounded-3xl text-sm font-black uppercase tracking-widest focus:ring-4 focus:ring-indigo-100 focus:border-indigo-600 transition-all outline-none shadow-sm text-slate-900">
            </div>
        </div>

        <!-- Grid Sections -->
        <div class="grid grid-cols-1 lg:grid-cols-2 gap-8">
            
            <!-- Column 1: Patient Identity -->
            <div class="space-y-8">
                <!-- Patient Details -->
                <div class="bg-white p-10 rounded-[40px] shadow-sm border border-slate-100 italic relative h-full">
                    <div class="flex items-center gap-4 mb-10">
                        <div class="h-12 w-12 bg-indigo-600 text-white rounded-2xl flex items-center justify-center shadow-lg shadow-indigo-100">
                            <svg class="h-6 w-6" fill="none" stroke="currentColor" viewBox="0 0 24 24"><path stroke-linecap="round" stroke-linejoin="round" stroke-width="2.5" d="M16 7a4 4 0 11-8 0 4 4 0 018 0zM12 14a7 7 0 00-7 7h14a7 7 0 00-7-7z"/></svg>
                        </div>
                        <div>
                            <h3 class="text-xl font-black text-slate-800 uppercase tracking-tighter leading-none">Identity Override</h3>
                            <p class="text-[9px] text-slate-400 font-bold uppercase tracking-widest mt-1">Update demographic markers for this visit</p>
                        </div>
                    </div>

                    <div class="grid grid-cols-1 md:grid-cols-12 gap-6">
                        <div class="md:col-span-8 space-y-3">
                            <label class="text-[11px] font-black text-slate-500 uppercase tracking-[0.2em] px-1">Full Name <span class="text-rose-500">*</span></label>
                            <input type="text" name="full_name" x-model="formData.full_name" required
                                   class="w-full px-6 py-4 bg-white border-2 border-slate-100 rounded-2xl text-sm font-black uppercase tracking-widest focus:ring-4 focus:ring-indigo-100 focus:border-indigo-600 transition-all outline-none text-slate-900 shadow-sm">
                        </div>
                        <div class="md:col-span-4 space-y-3">
                            <label class="text-[11px] font-black text-slate-500 uppercase tracking-[0.2em] px-1">Gender <span class="text-rose-500">*</span></label>
                            <select name="gender" x-model="formData.gender" required
                                    class="w-full px-6 py-4 bg-white border-2 border-slate-100 rounded-2xl text-sm font-black uppercase tracking-widest focus:ring-4 focus:ring-indigo-100 focus:border-indigo-600 transition-all outline-none text-slate-900 shadow-sm appearance-none">
                                <option value="Male">Male</option>
                                <option value="Female">Female</option>
                                <option value="Other">Other</option>
                            </select>
                        </div>

                        <div class="md:col-span-12 space-y-3">
                            <label class="text-[11px] font-black text-slate-500 uppercase tracking-[0.2em] px-1">S/o or Spouse Name</label>
                            <input type="text" name="spouse_name" x-model="formData.spouse_name"
                                   class="w-full px-6 py-4 bg-white border-2 border-slate-100 rounded-2xl text-sm font-black uppercase tracking-widest focus:ring-4 focus:ring-indigo-100 focus:border-indigo-600 transition-all outline-none text-slate-900 shadow-sm">
                        </div>

                        <div class="md:col-span-8 space-y-3">
                            <label class="text-[11px] font-black text-slate-500 uppercase tracking-[0.2em] px-1">Phone No <span class="text-rose-500">*</span></label>
                            <input type="text" name="mobile_number" x-model="formData.mobile_number" required
                                   class="w-full px-6 py-4 bg-white border-2 border-slate-100 rounded-2xl text-sm font-black uppercase tracking-widest focus:ring-4 focus:ring-indigo-100 focus:border-indigo-600 transition-all outline-none text-slate-900 shadow-sm">
                        </div>
                        <div class="md:col-span-4 space-y-3">
                            <label class="text-[11px] font-black text-slate-500 uppercase tracking-[0.2em] px-1">Age (Year) <span class="text-rose-500">*</span></label>
                            <input type="text" name="age" x-model="formData.age" required
                                   class="w-full px-6 py-4 bg-white border-2 border-slate-100 rounded-2xl text-sm font-black uppercase tracking-widest focus:ring-4 focus:ring-indigo-100 focus:border-indigo-600 transition-all outline-none text-slate-900 shadow-sm text-center">
                        </div>

                        <div class="md:col-span-12 space-y-3">
                            <label class="text-[11px] font-black text-slate-500 uppercase tracking-[0.2em] px-1">Residential Address</label>
                            <textarea name="address" x-model="formData.address" rows="3"
                                      class="w-full px-6 py-4 bg-white border-2 border-slate-100 rounded-[2rem] text-sm font-bold focus:ring-4 focus:ring-indigo-100 focus:border-indigo-600 transition-all outline-none text-slate-900 shadow-sm"></textarea>
                        </div>
                    </div>
                </div>
            </div>

            <!-- Column 2: Clinical & Financial -->
            <div class="space-y-8">
                <!-- Clinical & Referral -->
                <div class="bg-white p-10 rounded-[40px] shadow-sm border border-slate-100 italic relative">
                    <div class="flex items-center gap-4 mb-10">
                        <div class="h-12 w-12 bg-rose-600 text-white rounded-2xl flex items-center justify-center shadow-lg shadow-rose-100">
                            <svg class="h-6 w-6" fill="none" stroke="currentColor" viewBox="0 0 24 24"><path stroke-linecap="round" stroke-linejoin="round" stroke-width="2.5" d="M9 5H7a2 2 0 00-2 2v12a2 2 0 002 2h10a2 2 0 002-2V7a2 2 0 00-2-2h-2M9 5a2 2 0 002 2h2a2 2 0 002-2M9 5a2 2 0 012-2h2a2 2 0 012 2m-3 7h3m-3 4h3m-6-4h.01M9 16h.01"/></svg>
                        </div>
                        <div>
                            <h3 class="text-xl font-black text-slate-800 uppercase tracking-tighter leading-none">Clinical Assignment</h3>
                            <p class="text-[9px] text-slate-400 font-bold uppercase tracking-widest mt-1">Medical consulting and referral management</p>
                        </div>
                    </div>

                    <div class="grid grid-cols-1 md:grid-cols-2 gap-6">
                        <div class="md:col-span-2 space-y-3">
                            <label class="text-[11px] font-black text-slate-500 uppercase tracking-[0.2em] px-1">Consulting Doctor <span class="text-rose-500">*</span></label>
                            <select name="doctor_id" x-model="formData.doctor_id" required
                                    class="w-full px-6 py-4 bg-white border-2 border-slate-100 rounded-2xl text-sm font-black uppercase tracking-widest focus:ring-4 focus:ring-indigo-100 focus:border-indigo-600 transition-all outline-none text-slate-900 shadow-sm appearance-none">
                                <option value="">CHOOSE DOCTOR...</option>
                                @foreach($doctors as $dr)
                                    <option value="{{ $dr->id }}">{{ $dr->name }} @if($dr->specialities->count()) ({{ $dr->specialities->first()->name }}) @endif</option>
                                @endforeach
                            </select>
                        </div>

                        <div class="space-y-3">
                            <label class="text-[11px] font-black text-slate-500 uppercase tracking-[0.2em] px-1">Referral Source</label>
                            <select name="referral_source_id" x-model="formData.referral_source_id"
                                    class="w-full px-6 py-4 bg-white border-2 border-slate-100 rounded-2xl text-sm font-black uppercase tracking-widest focus:ring-4 focus:ring-indigo-100 focus:border-indigo-600 transition-all outline-none text-slate-900 shadow-sm appearance-none">
                                <option value="">DIRECT / WALK-IN</option>
                                @foreach($referralSources as $source)
                                    <option value="{{ $source->id }}">{{ $source->full_name }}</option>
                                @endforeach
                            </select>
                        </div>
                        <div class="space-y-3">
                            <label class="text-[11px] font-black text-slate-500 uppercase tracking-[0.2em] px-1">Assigned PRO</label>
                            <select name="pro_id" x-model="formData.pro_id"
                                    class="w-full px-6 py-4 bg-white border-2 border-slate-100 rounded-2xl text-sm font-black uppercase tracking-widest focus:ring-4 focus:ring-indigo-100 focus:border-indigo-600 transition-all outline-none text-slate-900 shadow-sm appearance-none">
                                <option value="">NONE</option>
                                @foreach($pros as $pro)
                                    <option value="{{ $pro->id }}">{{ $pro->full_name }}</option>
                                @endforeach
                            </select>
                        </div>

                        <div class="md:col-span-2 space-y-3">
                            <label class="text-[11px] font-black text-slate-500 uppercase tracking-[0.2em] px-1">Admission Summary</label>
                            <textarea name="history" x-model="formData.history" rows="4"
                                      class="w-full px-6 py-4 bg-white border-2 border-slate-100 rounded-[2rem] text-sm font-bold focus:ring-4 focus:ring-indigo-100 focus:border-indigo-600 transition-all outline-none text-slate-900 shadow-sm" placeholder="CHIEF COMPLAINTS..."></textarea>
                        </div>
                    </div>
                </div>

                <!-- Financial Ledger -->
                <div class="bg-white p-10 rounded-[40px] shadow-sm border border-slate-100 italic relative">
                    <div class="flex items-center gap-4 mb-10">
                        <div class="h-12 w-12 bg-amber-500 text-white rounded-2xl flex items-center justify-center shadow-lg shadow-amber-100">
                            <svg class="h-6 w-6" fill="none" stroke="currentColor" viewBox="0 0 24 24"><path stroke-linecap="round" stroke-linejoin="round" stroke-width="2.5" d="M17 9V7a2 2 0 00-2-2H5a2 2 0 00-2 2v6a2 2 0 002 2h2m2 4h10a2 2 0 002-2v-6a2 2 0 00-2-2H9a2 2 0 00-2 2v6a2 2 0 002 2zm7-5a2 2 0 11-4 0 2 2 0 014 0z"/></svg>
                        </div>
                        <div>
                            <h3 class="text-xl font-black text-slate-800 uppercase tracking-tighter leading-none">Financial Ledger</h3>
                            <p class="text-[9px] text-slate-400 font-bold uppercase tracking-widest mt-1">Billing classification and advance deposits</p>
                        </div>
                    </div>

                    <div class="grid grid-cols-1 md:grid-cols-2 gap-8">
                        <div class="md:col-span-2">
                            <label class="text-[11px] font-black text-slate-500 uppercase tracking-[0.2em] px-1 mb-4 block">Insurance Coverage</label>
                            <div class="flex items-center gap-10">
                                <label class="flex items-center gap-4 cursor-pointer group">
                                    <input type="radio" name="has_insurance" value="0" x-model="formData.has_insurance" class="h-6 w-6 text-indigo-600 border-slate-300 focus:ring-indigo-500 transition-all">
                                    <span class="text-sm font-black text-slate-600 group-hover:text-slate-900 uppercase tracking-widest">CASH / PRIVATE</span>
                                </label>
                                <label class="flex items-center gap-4 cursor-pointer group">
                                    <input type="radio" name="has_insurance" value="1" x-model="formData.has_insurance" class="h-6 w-6 text-indigo-600 border-slate-300 focus:ring-indigo-500 transition-all">
                                    <span class="text-sm font-black text-slate-600 group-hover:text-slate-900 uppercase tracking-widest">INSURANCE</span>
                                </label>
                            </div>
                        </div>

                        <div class="space-y-3" x-show="formData.has_insurance == '1'" x-transition>
                            <label class="text-[11px] font-black text-slate-500 uppercase tracking-[0.2em] px-1">Insurance Company</label>
                            <select name="insurance_id" x-model="formData.insurance_id"
                                    class="w-full px-6 py-4 bg-white border-2 border-slate-100 rounded-2xl text-sm font-black uppercase tracking-widest focus:ring-4 focus:ring-indigo-100 focus:border-indigo-600 transition-all outline-none text-slate-900 shadow-sm appearance-none">
                                <option value="">SELECT COMPANY...</option>
                                @foreach($insurances as $ins)
                                    <option value="{{ $ins->id }}">{{ $ins->company_name }}</option>
                                @endforeach
                            </select>
                        </div>
                        <div class="space-y-3" x-show="formData.has_insurance == '1'" x-transition>
                            <label class="text-[11px] font-black text-slate-500 uppercase tracking-[0.2em] px-1">TPA Name</label>
                            <input type="text" name="tpa_name" x-model="formData.tpa_name"
                                   class="w-full px-6 py-4 bg-white border-2 border-slate-100 rounded-2xl text-sm font-black uppercase tracking-widest focus:ring-4 focus:ring-indigo-100 focus:border-indigo-600 transition-all outline-none text-slate-900 shadow-sm">
                        </div>

                        <div class="space-y-3">
                            <label class="text-[11px] font-black text-slate-500 uppercase tracking-[0.2em] px-1">Client Type</label>
                            <input type="text" name="client_type" x-model="formData.client_type"
                                   placeholder="CORPORATE, STAFF, ETC..."
                                   class="w-full px-6 py-4 bg-white border-2 border-slate-100 rounded-2xl text-sm font-black uppercase tracking-widest focus:ring-4 focus:ring-indigo-100 focus:border-indigo-600 transition-all outline-none text-slate-900 shadow-sm">
                        </div>
                        <div class="space-y-3">
                            <label class="text-[11px] font-black text-indigo-400 uppercase tracking-[0.2em] px-1">Revised Advance (₹)</label>
                            <input type="number" step="0.01" name="advance_amount" x-model="formData.advance_amount"
                                   class="w-full px-6 py-4 bg-indigo-50 border-2 border-indigo-100 rounded-2xl text-sm font-black text-indigo-700 focus:ring-4 focus:ring-indigo-100 focus:border-indigo-600 transition-all outline-none shadow-sm">
                        </div>
                    </div>
                </div>
            </div>
        </div>

        <!-- Bottom Section: Internal Controls & Execution -->
        <div class="bg-slate-900 rounded-[50px] p-12 text-white shadow-2xl shadow-slate-200 overflow-hidden relative italic">
            <div class="relative z-10">
                <div class="flex flex-col lg:flex-row lg:items-center justify-between gap-12">
                    <div class="flex-1">
                        <h4 class="text-xs font-black text-indigo-400 uppercase tracking-[0.4em] mb-8">Administrative Protocols</h4>
                        
                        <div class="grid grid-cols-1 md:grid-cols-3 gap-6">
                            <div class="flex items-center justify-between p-6 rounded-3xl bg-white/5 border border-white/5 group hover:bg-white transition-all cursor-pointer" @click="formData.is_operated = !formData.is_operated">
                                <div>
                                    <p class="text-[10px] font-black text-slate-400 uppercase tracking-widest group-hover:text-indigo-600 transition-colors">Surgery</p>
                                    <p class="text-sm font-bold text-slate-200 group-hover:text-slate-900 transition-colors">Pre-Operative?</p>
                                </div>
                                <div class="h-8 w-8 rounded-xl border-2 border-white/20 flex items-center justify-center transition-all" :class="formData.is_operated ? 'bg-indigo-500 border-indigo-500' : ''">
                                    <svg x-show="formData.is_operated" class="h-5 w-5 text-white" fill="none" stroke="currentColor" viewBox="0 0 24 24"><path stroke-linecap="round" stroke-linejoin="round" stroke-width="3" d="M5 13l4 4L19 7"/></svg>
                                </div>
                                <input type="hidden" name="is_operated" :value="formData.is_operated ? 1 : 0">
                            </div>

                            <div class="flex items-center justify-between p-6 rounded-3xl bg-white/5 border border-white/5 group hover:bg-white transition-all cursor-pointer" @click="formData.is_isolated = !formData.is_isolated">
                                <div>
                                    <p class="text-[10px] font-black text-rose-400 uppercase tracking-widest group-hover:text-rose-600 transition-colors">Quarantine</p>
                                    <p class="text-sm font-bold text-slate-200 group-hover:text-slate-900 transition-colors">Isolation Req?</p>
                                </div>
                                <div class="h-8 w-8 rounded-xl border-2 border-white/20 flex items-center justify-center transition-all" :class="formData.is_isolated ? 'bg-rose-500 border-rose-500' : ''">
                                    <svg x-show="formData.is_isolated" class="h-5 w-5 text-white" fill="none" stroke="currentColor" viewBox="0 0 24 24"><path stroke-linecap="round" stroke-linejoin="round" stroke-width="3" d="M5 13l4 4L19 7"/></svg>
                                </div>
                                <input type="hidden" name="is_isolated" :value="formData.is_isolated ? 1 : 0">
                            </div>

                            <div class="flex items-center justify-between p-6 rounded-3xl bg-white/5 border border-white/5 group hover:bg-white transition-all cursor-pointer" @click="formData.is_day_ended = !formData.is_day_ended">
                                <div>
                                    <p class="text-[10px] font-black text-slate-400 uppercase tracking-widest group-hover:text-emerald-600 transition-colors">Schedule</p>
                                    <p class="text-sm font-bold text-slate-200 group-hover:text-slate-900 transition-colors">Close Day?</p>
                                </div>
                                <div class="h-8 w-8 rounded-xl border-2 border-white/20 flex items-center justify-center transition-all" :class="formData.is_day_ended ? 'bg-emerald-500 border-emerald-500' : ''">
                                    <svg x-show="formData.is_day_ended" class="h-5 w-5 text-white" fill="none" stroke="currentColor" viewBox="0 0 24 24"><path stroke-linecap="round" stroke-linejoin="round" stroke-width="3" d="M5 13l4 4L19 7"/></svg>
                                </div>
                                <input type="hidden" name="is_day_ended" :value="formData.is_day_ended ? 1 : 0">
                            </div>
                        </div>

                        <div class="grid grid-cols-1 md:grid-cols-2 gap-8 mt-8 pt-8 border-t border-white/10">
                            <div class="space-y-3">
                                <label class="text-[11px] font-black text-white/40 uppercase tracking-[0.2em] px-1">Room Category</label>
                                <select x-model="room_type_id" 
                                        class="w-full px-8 py-5 bg-white/5 border-2 border-white/10 rounded-[2rem] text-sm font-black uppercase tracking-widest text-white focus:ring-4 focus:ring-indigo-500/30 transition-all outline-none appearance-none cursor-pointer">
                                    <option value="" class="bg-slate-900">ALL CATEGORIES...</option>
                                    @foreach($roomTypes as $type)
                                        <option value="{{ $type->id }}" class="bg-slate-900" {{ (isset($ipdRegistration->room->room_type_id) && $ipdRegistration->room->room_type_id == $type->id) ? 'selected' : '' }}>{{ $type->name }}</option>
                                    @endforeach
                                </select>
                            </div>

                            <div class="space-y-3">
                                <label class="text-[11px] font-black text-white/40 uppercase tracking-[0.2em] px-1">Bed Relocation</label>
                                <select name="bed_id" x-model="formData.bed_id" required
                                        class="w-full px-8 py-5 bg-white/5 border-2 border-white/10 rounded-[2rem] text-sm font-black uppercase tracking-widest text-white focus:ring-4 focus:ring-indigo-500/30 transition-all outline-none appearance-none cursor-pointer">
                                    <option value="" class="bg-slate-900">SELECT BED...</option>
                                    @foreach($beds as $bed)
                                        <option value="{{ $bed->id }}" class="bg-slate-900" 
                                            x-show="(!room_type_id || '{{ $bed->room->room_type_id }}' == room_type_id) && (!formData.gender || '{{ strtolower($bed->gender_restriction) }}' === 'any' || '{{ strtolower($bed->gender_restriction) }}' === formData.gender.toLowerCase())">
                                            {{ $bed->bed_number }} ({{ $bed->room->roomType?->name }}) 
                                            @if($bed->gender_restriction !== 'any') [{{ strtoupper($bed->gender_restriction) }} ONLY] @endif
                                        </option>
                                    @endforeach
                                </select>
                            </div>
                        </div>
                    </div>

                    <div class="lg:w-96 space-y-6">
                        <button type="submit" 
                                :disabled="!isAvailable"
                                :class="!isAvailable ? 'opacity-50 grayscale cursor-not-allowed bg-slate-700' : 'bg-indigo-600 hover:bg-white hover:text-indigo-600 shadow-2xl shadow-indigo-950'"
                                class="w-full py-8 rounded-[2.5rem] text-sm font-black uppercase tracking-[0.2em] transition-all flex items-center justify-center gap-4 active:scale-95 group">
                            <svg class="h-6 w-6 transition-transform group-hover:rotate-12" fill="none" stroke="currentColor" viewBox="0 0 24 24"><path stroke-linecap="round" stroke-linejoin="round" stroke-width="3" d="M9 12l2 2 4-4m6 2a9 9 0 11-18 0 9 9 0 0118 0z"/></svg>
                            Save Updates
                        </button>
                        <a href="{{ route('branch.ipd-registrations.index') }}" class="block w-full text-center py-4 text-[11px] font-black text-slate-500 uppercase tracking-widest hover:text-white transition-all">Discard Changes</a>
                    </div>
                </div>
            </div>
            
            <!-- Availability Warning -->
            <div x-show="!isAvailable" x-transition class="mt-8 p-8 bg-rose-500/10 border border-rose-500/20 rounded-[30px] italic animate-pulse relative z-10">
                <div class="flex gap-6 items-center">
                    <div class="h-14 w-14 bg-rose-600 text-white rounded-2xl flex items-center justify-center shrink-0 shadow-lg shadow-rose-950/20">
                        <svg class="h-8 w-8" fill="none" stroke="currentColor" viewBox="0 0 24 24"><path stroke-linecap="round" stroke-linejoin="round" stroke-width="2.5" d="M12 9v2m0 4h.01m-6.938 4h13.856c1.54 0 2.502-1.667 1.732-3L13.732 4c-.77-1.333-2.694-1.333-3.464 0L3.34 16c-.77 1.333.192 3 1.732 3z"/></svg>
                    </div>
                    <div>
                        <p class="text-xs font-black text-rose-400 uppercase tracking-widest mb-1">Service Restriction</p>
                        <p class="text-lg text-rose-100 font-bold leading-tight" x-text="availabilityMessage"></p>
                    </div>
                </div>
            </div>

            <div class="absolute -bottom-20 -right-20 w-80 h-80 bg-indigo-600/10 rounded-full blur-[100px]"></div>
        </div>
    </form>
</div>

@push('scripts')
<script>
function ipdEditForm() {
    return {
        photoPreview: '{{ $ipdRegistration->patient?->photo_url }}',
        room_type_id: '{{ old('room_type_id', $ipdRegistration->room->room_type_id ?? '') }}',
        isAvailable: true,
        availabilityMessage: '',

        async init() {
            await this.checkAvailability();
        },
        formData: {
            patient_id: '{{ old('patient_id', $ipdRegistration->patient_id) }}',
            uhid: '{{ old('uhid', $ipdRegistration->uhid) }}',
            full_name: '{{ old('full_name', $ipdRegistration->full_name) }}',
            spouse_name: '{{ old('spouse_name', $ipdRegistration->spouse_name) }}',
            gender: '{{ old('gender', $ipdRegistration->gender) }}',
            age: '{{ old('age', $ipdRegistration->age) }}',
            mobile_number: '{{ old('mobile_number', $ipdRegistration->mobile_number) }}',
            address: '{{ old('address', $ipdRegistration->address) }}',
            admission_date: '{{ old('admission_date', $ipdRegistration->admission_date->format('Y-m-d')) }}',
            admission_time: '{{ old('admission_time', $ipdRegistration->admission_time) }}',
            previous_id: '{{ old('previous_id', $ipdRegistration->previous_id) }}',
            doctor_id: '{{ old('doctor_id', $ipdRegistration->doctor_id) }}',
            referral_source_id: '{{ old('referral_source_id', $ipdRegistration->referral_source_id) }}',
            pro_id: '{{ old('pro_id', $ipdRegistration->pro_id) }}',
            history: {!! json_encode(old('history', $ipdRegistration->history)) !!},
            has_insurance: '{{ old('has_insurance', $ipdRegistration->has_insurance ? '1' : '0') }}',
            insurance_id: '{{ old('insurance_id', $ipdRegistration->insurance_id) }}',
            tpa_name: '{{ old('tpa_name', $ipdRegistration->tpa_name) }}',
            client_type: '{{ old('client_type', $ipdRegistration->client_type) }}',
            advance_amount: '{{ old('advance_amount', $ipdRegistration->advance_amount) }}',
            is_operated: {{ old('is_operated', $ipdRegistration->is_operated) ? 'true' : 'false' }},
            is_day_ended: {{ old('is_day_ended', $ipdRegistration->is_day_ended) ? 'true' : 'false' }},
            is_isolated: {{ old('is_isolated', $ipdRegistration->is_isolated) ? 'true' : 'false' }},
            bed_id: '{{ old('bed_id', $ipdRegistration->bed_id) }}',
            room_id: '{{ old('room_id', $ipdRegistration->room_id) }}'
        },

        getSelectedBedRoomId() {
            const bedMap = {
                @foreach($beds as $bed)
                    '{{ $bed->id }}': '{{ $bed->room_id }}',
                @endforeach
            };
            return bedMap[this.formData.bed_id] || '';
        },

        async checkAvailability() {
            try {
                const response = await fetch(`{{ route('branch.ipd-registrations.check-availability') }}?date=${this.formData.admission_date}`);
                const data = await response.json();
                this.isAvailable = data.available;
                this.availabilityMessage = data.message || '';
            } catch (error) {
                console.error('Availability check failed', error);
            }
        },

        handlePhotoUpload(e) {
            const file = e.target.files[0];
            if (!file) return;
            
            const reader = new FileReader();
            reader.onload = (f) => {
                this.photoPreview = f.target.result;
            };
            reader.readAsDataURL(file);
        }
    }
}
</script>
@endpush
@endsection