@extends('layouts.default')

@push('scripts')
<link rel="stylesheet" href="{{ asset('css/jquery-ui.css')}}" />
<!--<script src="{{ asset('js/jquery-ui.js') }}" defer="defer"></script>-->
<script src="{{ asset('js/diary_no.js') }}"></script>
<script src="{{ asset('js/bootstrap-datetimepicker.js')}}"></script>
    <script src="{{ asset('js/bootstrap-datetimepicker.fr.js') }}"></script>
    <script src="/assets/plugins/sweetalert/dist/sweetalert.min.js"></script>
    
<style type="text/css">
  .cl_similarity
  {
    color: blue;
  }
  .cl_similarity:hover
  {
    cursor: pointer;
  }
.fas:hover
{
cursor:pointer;
}
</style>
@endpush

@section('content') 

<div class="alert alert-success alert-dismissible d-none" id="success_d">
	<button type="button" class="btn-close" data-bs-dismiss="alert"></button>
	 <span id="success"></span>
</div>
<div class="alert alert-danger alert-dismissible d-none" id="failure_d">
	<button type="button" class="btn-close" data-bs-dismiss="alert"></button>
    <span id="failure"></span>
</div>
<!-- @if (session('status')) -->

<div class="alert alert-success alert-dismissible" id="success">
	<button type="button" class="btn-close" data-bs-dismiss="alert"></button>
	<!-- {!! session('status') !!} -->dfdfdf
</div>
<!-- @elseif(session('failed')) -->
<div class="alert alert-danger alert-dismissible" id="failure">
	<button type="button" class="btn-close" data-bs-dismiss="alert"></button>
  <strong>
    <!-- {{ session('failed') }}	 -->
  </strong>
</div>
<!-- @endif -->
 <form action="{{ url('/') }}/anr_no/{{$i_u}}" method="post">

 @csrf
 @if($i_u=='update' || $i_u=='copy')
 @php $menu_title='ANR' @endphp
 @include('update_receipt')
 @if(session('update_status_n'))
<div class="text-center">No Record Found</div>
@endif
@endif
 @if($i_u=='insert' || $i_u=='redirect' || (($i_u=='update' || $i_u=='copy') && $id!=null && session()->get('update_status')=='found'))
<div class="card mb-3 cl_upd_hds">
    <div class="card-header bg-dark text-white">
        Application Details
    </div>
    <div class="card-body">
        <div class="row">
            <div class="col-sm-6 mb-3">
                <label for="ddl_app_for" class="control-label"><b>Application For</b><span class="cl_red"> *</span></label>
           <select name="ddl_app_for" id="ddl_app_for" class="form-select form-select-sm @error('ddl_app_for') is-invalid @enderror">
           @if(count($getEstablishments)>1)
           <option value="">Select</option>
           @endif
           
             @foreach($getEstablishments as $getEstablishment)
               <option value="{{ $getEstablishment->id }}" @if(old('ddl_app_for')==$getEstablishment->id) selected @endif>{{ $getEstablishment->est_name }}</option>
             @endforeach
           </select>
           <span class="text-danger" id="ddl_app_for_e">
             @error('ddl_app_for')
              {{$message}}
             @enderror
           </span>
            </div>
       
            <div class="col-sm-6 mb-3 d-none">
                <label for="ddl_rec_mode" class="control-label"><b>Receipt Mode</b><span class="cl_red"> *</span></label>
           <select name="ddl_rec_mode" id="ddl_rec_mode" class="form-select form-select-sm @error('ddl_rec_mode') is-invalid @enderror">
           <option value="">Select</option>
           @foreach($getLegalAidReceiptModes as $getLegalAidReceiptMode)
               <option value="{{ $getLegalAidReceiptMode->id }}" @if(old('ddl_rec_mode')==$getLegalAidReceiptMode->id) selected @endif>{{ $getLegalAidReceiptMode->name }}</option>
             @endforeach
           </select>
           <small class="text-danger" id="ddl_rec_mode_e">
             @error('ddl_rec_mode')
              {{$message}}
             @enderror
           </small>
            </div>

           <!-- <div class="col-sm-3 mb-3">
            <div class="form-group">   
            <label class="control-label" ><b>Application Nature</b></label>
            </div>
                <div class="form-check form-check-inline pb-1">
          
          <input type="radio" class="form-check-input cl_app_nature" id="rdn_civil" name="rdn_c_cr" value="1"   @if( old('rdn_c_cr') == 1  ) {{ 'checked' }}  @endif>
      <label class="form-check-label" for="rdn_civil">Civil</label>

        
        </div>
        <div class="form-check form-check-inline">
          
        <input type="radio" class="form-check-input cl_app_nature" id="rdn_criminal" name="rdn_c_cr" value="2"  @if( old('rdn_c_cr') == '2' ) {{'checked' }}  @endif>
        <label class="form-check-label" for="rdn_criminal">Criminal</label>
      </div>
        <div><small class="text-danger">
        @error('rdn_c_cr')
              {{$message}}
             @enderror
        </small></div>
            </div> -->

            
           
            <div class="col-sm-2 mb-3">
                <label for="txt_receipt_no" class="control-label"><b>Receipt No.</b><span class="cl_red"> *</span></label>
                <input type="text" name="txt_receipt_no" id="txt_receipt_no" class="form-control form-control-sm @error('txt_receipt_no') border border-danger @enderror cl_receipt_det" placeholder="" value="{{ old('txt_receipt_no') }}">
        <small class="text-danger" id="txt_receipt_no_e">
          @error('txt_receipt_no')
             {{$message}}
          @enderror
        </small>
            </div>
            <div class="col-sm-2 mb-3">
                <label for="txt_receipt_yr" class="control-label"><b>Receipt Year</b><span class="cl_red"> *</span></label>
               @php
               $year=date('Y');
               $i=0;
               @endphp
                <select name="ddl_receipt_yr" id="ddl_receipt_yr" class="form-select form-select-sm cl_receipt_det">
           <option value="">Select</option>
           @for($i=$year;$i>=1930;$i--)
          <option value="{{$i}}" @if($i==old('ddl_receipt_yr')) {{ 'selected' }} @elseif(($year==$i)) {{ 'selected' }} @endif>{{$i}}</option>
          @endfor
           </select>
                <small class="text-danger" id="txt_receipt_yr_e">
          @error('txt_receipt_no')
             {{$message}}
          @enderror
        </small>
            </div>

          
     
            <!-- <div class="col-sm-6 mb-3">
                <label for="ddl_la_nature" class="control-label"><b>Nature of Legal Aid / Grievance</b><span class="cl_red"> *</span></label>
           <select name="ddl_la_nature" id="ddl_la_nature" class="form-select form-select-sm">
           <option value="">Select</option>
           @foreach($getLegalAidNatures as $getLegalAidNature)
               <option value="{{ $getLegalAidNature->id }}">{{ $getLegalAidNature->name }}</option>
             @endforeach
           </select>
            </div> -->

            <div class="col-sm-8 mb-3">
                <label for="ddl_la_des" class="control-label"><b>Summary of facts/allegations of corruption</b><span class="cl_red"> *</span></label>
               <textarea name="ddl_la_des" id="ddl_la_des" rows="3" class="form-control form-control-sm">{{ old('ddl_la_des') }}</textarea>
               <small class="text-danger" id="ddl_la_des_e"></small>
            </div>
        </div>
    </div>
</div>

 <div class="card mb-3 cl_upd_hds">
     <div class="card-header bg-dark text-white">
      Complainant Details
     </div>
     <div class="card-body">
      <div class="row mb-3">
      <label class="col-sm-2 col-form-label d-inline" ><b>Individual/Organization</b></label>
      <div class="col-sm-3">
      <select name="dbn_i_o" id="dbn_i_o" class="form-select form-select-sm cl_i_o @error('ddl_i_o') is-invalid @enderror">
        <option value="">Select</option>
        @foreach($getIndividualOrganization as $val) 
        <option value="{{ $val->id }}" @if( old('dbn_i_o') == $val->id ) selected @elseif(old('dbn_i_o') == '' && $val->id=='1') selected @endif>{{ $val->name }}</option>
        @endforeach
      </select>
    <small class="text-danger" id="ddl_i_o_e">
      @error('ddl_i_o')
      {{$message}}
@enderror
    </small>
    </div>
  </div>

  <div class="card mt-3"  id="dv_organization_details">
           <div class="card-header bg-dark text-white">
            Organization Details
           </div>
            <div class="card-body">
            <div class="row">
              <div class="col-sm-3">
            <label class="control-label" for="txt_org_name"><b>Name</b><span class="cl_red"> *</span></label>
            <input type="text" name="txt_org_name" id="txt_org_name" class="form-control form-control-sm " placeholder="Organization Name">
            <input type="hidden" name="hd_org_name" id="hd_org_name">
            <small class="text-danger" id="txt_org_name_e"></small>
            </div>

            <div class="col-sm-3">
            <label class="control-label" for="txt_org_address"><b>Address</b><span class="cl_red"> *</span></label>
            <input type="text" name="txt_org_address" id="txt_org_address" class="form-control form-control-sm " placeholder="Organization Address">
            <small class="text-danger" id="txt_org_address_e"></small>
            </div>

            <div class="col-sm-3">
            <label class="control-label" for="ddl_org_country"><b>Country</b><span class="cl_red"> *</span></label>
            <select name="ddl_org_country" id="ddl_org_country" class="form-select form-select-sm">
              <option value="">Select</option>
                @foreach($master_country as $val)
                   <option value="{{ $val->id }}">{{ $val->name }}</option>
                @endforeach
            </select>
            <small class="text-danger" id="ddl_org_country_e"></small>
            </div>

            <div class="col-sm-3 mb-3">
                            <label class="control-label" for="ddl_org_state"><b>State</b><span class="cl_red"> *</span></label>
                           
                    
                            <select  name="ddl_org_state" id="ddl_org_state" class="form-select form-select-sm">
                             <option value="">Select</option>
                             @foreach($getStateDetails as $getStateDetail)
                             <option value="{{$getStateDetail->state_code}}">{{$getStateDetail->state_name_english}}</option>
                             @endforeach
                           </select>
                           <small class="text-danger" id="ddl_state_e"></small>
                            </div>
                            
                            <div class="col-sm-3 mb-3">
                            <label class="control-label" for="ddl_org_district"><b>District</b><span class="cl_red"> *</span></label>
                            <select name="ddl_org_district" id="ddl_org_district" class="form-select form-select-sm ">
                             <option value="">Select</option>
                            
                           </select>
                           <small class="text-danger" id="ddl_org_district_e">
                            </small>
                            </div>

                            <div class="col-sm-3">
        <label class="control-label" for="txt_org_pincode"><b>Pincode</b><span class="cl_red"> *</span></label>
        <input type="text" name="txt_org_pincode" id="txt_org_pincode" class="form-control form-control-sm" placeholder="Pincode">
        <small class="text-danger" id="txt_org_pincode_e"></small>
        </div>

        <div class="col-sm-3">
        <label class="control-label" for="txt_org_mobileno"><b>Telephone No. (with std code)</b></label>
        <input type="text" name="txt_org_telephoneno" id="txt_org_telephoneno" class="form-control form-control-sm " placeholder="Mobile No.">
        <span class="text-danger" id="txt_org_telephoneno_e">
        </span>
        </div>
        
        <div class="col-sm-3">
        <label class="control-label" for="txt_org_mobileno"><b>Mobile No.</b><span class="cl_red"> *</span></label>
        <input type="text" name="txt_org_mobileno" id="txt_org_mobileno" class="form-control form-control-sm " placeholder="Mobile No.">
        <span class="text-danger" id="txt_org_mobileno_e">
        </span>
        </div>
        

       
        
        <div class="col-sm-3">
        <label class="control-label" for="txt_ioemail"><b>Email Id</b><span class="cl_red"> *</span></label>
        <input type="text" name="txt_ioemail" id="txt_ioemail" class="form-control form-control-sm @error('txt_ioemail') border border-danger  @enderror" placeholder="Email Id" value="{{old('txt_ioemail')}}">
        <span class="text-danger">
          @error('txt_ioemail')
          {{$message}}
          @enderror
        </span>
        </div>


            </div>
            </div>
</div>

<div class="card mt-3"  id="dv_organization_details">
           <div class="card-header bg-dark text-white">
           Authorised Signing Authority Person Details
           </div>
            <div class="card-body"> 
            <div class="row">
<div class="col-sm-12 mb-3 text-center">
  <label class="control-label mx-3" for="chk_employee_type"><b>Employee Type</b><span class="cl_red"> *</span></label>
  <div class="form-check form-check-inline">
<input class="form-check-input" type="radio" name="ddl_employee_type" id="ddl_office_bearer" value="1">
<label class="form-check-label" for="ddl_office_bearer">Office bearers</label>
</div>
<div class="form-check form-check-inline">
<input class="form-check-input" type="radio" name="ddl_employee_type" id="ddl_head_organization" value="2">
<label class="form-check-label" for="ddl_head_organization">Head of organisation</label>
</div>
  <small class="text-danger" id="ddl_title_e">
 
  </small>
  </div>

<div class="col-sm-3 mb-3">
  <label class="control-label" for="ddl_title"><b>Title</b><span class="cl_red"> *</span></label>
  <select name="ddl_title" id="ddl_title" class="form-select form-select-sm">
    <option value="">Select</option>
   @foreach($getTitle as $title)
   <option value="{{ $title->id }}">{{ $title->title }}</option>
   @endforeach
  </select>
  <small class="text-danger" id="ddl_title_e">
 
  </small>
  </div>

<div class="col-sm-3 mb-3">
<label class="control-label" for="txt_name"><b>Name</b><span class="cl_red"> *</span></label>
<input type="text" name="txt_name" id="txt_name" class="form-control form-control-sm" placeholder="Name" value="{{ old('txt_name') }}" >
<small class="text-danger" id="txt_name_e">
@error('txt_name')
    {{$message}}
@enderror
</small>
</div>

<div class="col-sm-3 mb-3">
<label class="control-label" for="ddl_relation"><b>Relation</b></label>
<select name="ddl_relation" id="ddl_relation" class="form-select form-select-sm">
<option value="0">Select</option>
@foreach($getRelationDetails as $getRelationDetail)
<option value="{{ $getRelationDetail->id }}" @if($getRelationDetail->id==old('ddl_relation')) {{ 'selected' }} @endif>{{ $getRelationDetail->name }}</option>
@endforeach
</select>
<span class="help-block"></span>
</div>


<div class="col-sm-3 mb-3">
<label class="control-label" for="txt_relpnm"><b>Father/Husband Name</b></label>
<input type="text" name="txt_relpnm" id="txt_relpnm" class="form-control form-control-sm" placeholder="Name" value="{{ old('txt_relpnm') }}">
<span class="help-block"></span>
</div>

<div class="col-sm-3 mb-3">
<label class="control-label" for="ddl_gender"><b>Gender</b><span class="cl_red"> *</span></label>
<select name="ddl_gender" id="ddl_gender" class="form-select form-select-sm @error('ddl_gender') border border-danger  @enderror">
 <option value="">Select</option>
@foreach($getGenders as $getGender)
<option value="{{ $getGender->id }}" @if($getGender->id==old('ddl_gender')) {{ 'selected' }} @endif>{{ $getGender->name }}</option>
@endforeach
</select>
<small class="text-danger" id="ddl_gender_e">
  @error('ddl_gender')
  {{$message}}
  @enderror
</small>
</div>

<div class="col-sm-3 mb-3">
  <label class="control-label" for="txt_age"><b>Age</b><span class="cl_red"> *</span></label>
  <input type="text" name="txt_age" id="txt_age" class="form-control form-control-sm" placeholder="Age"  >
  <small class="text-danger" id="txt_age_e">
 
  </small>
  </div>

  <div class="col-sm-3 mb-3">
    <label class="control-label" for="ddl_nationality"><b>Nationality</b><span class="cl_red"> *</span></label>
    <select name="ddl_nationality" id="ddl_nationality" class="form-select form-select-sm @error('ddl_nationality') border border-danger  @enderror">
      <option value="">Select Nationality</option>
      <option value="1">Citizen of India</option>
      <option value="2">Not Citizen of India (Attach Copy of Passport)</option>
    </select>
    <small class="text-danger" id="ddl_nationality_e">
   
    </small>
    </div>

    <div class="col-sm-3">
      <label class="control-label" for="txt_telephoneno"><b>Telephone Number ( with std codes)</b></label>
      <input type="text" name="txt_telephoneno" id="txt_telephoneno" class="form-control form-control-sm " placeholder="Telephone No." >
      <small class="text-danger">
       
      </small>
      </div>

     
<div class="col-sm-3">
<label class="control-label" for="txt_mobileno"><b>Mobile No.</b><span class="cl_red"> *</span></label>
<input type="text" name="txt_mobileno" id="txt_mobileno" class="form-control form-control-sm @error('txt_mobileno') border border-danger  @enderror" placeholder="Mobile No." value="{{old('txt_mobileno')}}">
<small class="text-danger" id="txt_mobileno_e">

</small>
</div>




<div class="col-sm-3">
<label class="control-label" for="txt_email"><b>Email Id</b><span class="cl_red"> *</span></label>
<input type="text" name="txt_email" id="txt_email" class="form-control form-control-sm @error('txt_email') border border-danger  @enderror" placeholder="Email Id" value="{{old('txt_email')}}">
<small class="text-danger" id="txt_email_e">

</small>
</div>





<div class="col-sm-3 mb-3">
<label class="control-label" for="ddl_occupation"><b>Occupation</b><span class="cl_red"> *</span></label>
<select name="ddl_occupation" id="ddl_occupation" class="form-select form-select-sm">
<option value="">Select</option>
@foreach($getOccupations as $getOccupation)
<option value="{{ $getOccupation->id }}" @if($getOccupation->id==old('ddl_occupation')) {{ 'selected' }} @endif>{{ $getOccupation->name }}</option>
@endforeach
</select>
<small class="text-danger" id="ddl_occupation_e">
@error('ddl_occupation')
{{$message}}
@enderror
</small>
</div>



<div class="col-sm-3 mb-3 d-none">
<label class="control-label" for="complainant_victim"><b>Whether the complainant is the victim ?</b></label>
<div class="form-check form-check-inline">
<input class="form-check-input" type="radio" name="complainant_victim" id="complainant_victim_y">
<label class="form-check-label" for="complainant_victim_y">
Yes
</label>
</div>
<div class="form-check form-check-inline">
<input class="form-check-input" type="radio" name="complainant_victim" id="complainant_victim_n">
<label class="form-check-label" for="complainant_victim_n">
No
</label>
</div>
<small class="text-danger" id="complainant_victim_e">  
</small>
</div>


<div class="col-sm-12 ">
<label class="control-label text-info" ><h5>Details of identity proof</h5></label>
</div>    
<div class="col-sm-3">
<label class="control-label" for="ddl_identity_proof_id"><b>Identity Document<span class="cl_red"> *</span></b></label>
<select name="ddl_identity_proof_id" id="ddl_identity_proof_id" class="form-select form-select-sm">
  <option value="">Select</option>
  @foreach($getIdentityProof as $val)
    <option value="{{ $val->id }}">{{ $val->name }}</option>
  @endforeach
</select>
<span class="text-danger" id="ddl_identity_proof_id_e">
</span>
</div>

<div class="col-sm-3 mb-3">
<label class="control-label" for="txt_identity_proof_no"><b>Number</b></label>
<input type="text" name="txt_identity_proof_no" id="txt_identity_proof_no" class="form-control form-control-sm " placeholder="" >
<span class="text-danger" id="txt_identity_proof_no_e">
</span>
</div>

<div class="col-sm-3 mb-3">
  <label class="control-label" for="txt_identity_proof_doi"><b>Date of Issue</b></label>
  <input type="text" name="txt_identity_proof_doi" id="txt_identity_proof_doi" class="form-control form-control-sm " placeholder="" >
  <span class="text-danger" id="txt_identity_proof_doi_e">
  </span>
  </div>

  <div class="col-sm-3 mb-3">
    <label class="control-label" for="txt_identity_validity"><b>Validity Upto</b></label>
    <input type="text" name="txt_identity_validity" id="txt_identity_validity" class="form-control form-control-sm " placeholder="" >
    <span class="text-danger" id="txt_identity_validity_e">
    </span>
    </div>

    <div class="col-sm-3 mb-3">
      <label class="control-label" for="txt_identity_iauth"><b>Issuing Authority</b></label>
      <input type="text" name="txt_identity_iauth" id="txt_identity_iauth" class="form-control form-control-sm " placeholder="" >
      <span class="text-danger" id="txt_identity_iauth_e">
      </span>
      </div>

      <div class="col-sm-3 mb-3">
        <label class="control-label" for="identity_proof_upload"><b>Upload identity proof<span class="cl_red"> *</span></b></label>
        <input class="form-control form-control-sm" id="identity_proof_upload" type="file">
        <span class="text-danger" id="identity_proof_upload_e">
        </span>
        </div>

        <div class="col-sm-12">
          <label class="control-label text-info" ><h5>Details of residence proof</h5></label>
        </div>    
        <div class="col-sm-3">
          <label class="control-label" for="ddl_residence_proof_id"><b>Residence Proof ID<span class="cl_red"> *</span></b></label>
          <select name="ddl_residence_proof_id" id="ddl_residence_proof_id" class="form-select form-select-sm">
            <option value="">Select</option>
            @foreach($getIdentityProof as $val)
              <option value="{{ $val->id }}">{{ $val->name }}</option>
            @endforeach
          </select>
          <span class="text-danger" id="ddl_residence_proof_id_e">
          </span>
        </div>

        <div class="col-sm-3 mb-3">
          <label class="control-label" for="txt_residence_proof_no"><b>Number</b></label>
          <input type="text" name="txt_residence_proof_no" id="txt_residence_proof_no" class="form-control form-control-sm " placeholder="" >
          <span class="text-danger" id="txt_residence_proof_no_e">
          </span>
          </div>

          <div class="col-sm-3 mb-3">
            <label class="control-label" for="txt_residence_proof_doi"><b>Date of Issue</b></label>
            <input type="text" name="txt_residence_proof_doi" id="txt_residence_proof_doi" class="form-control form-control-sm " placeholder="" >
            <span class="text-danger" id="txt_residence_proof_doi_e">
            </span>
            </div>

            <div class="col-sm-3 mb-3">
              <label class="control-label" for="txt_residence_validity"><b>Validity Upto</b></label>
              <input type="text" name="txt_residence_validity" id="txt_residence_validity" class="form-control form-control-sm " placeholder="" >
              <span class="text-danger" id="txt_residence_validity_e">
              </span>
              </div>

              <div class="col-sm-3 mb-3">
                <label class="control-label" for="txt_residence_iauth"><b>Issuing Authority</b></label>
                <input type="text" name="txt_residence_iauth" id="txt_residence_iauth" class="form-control form-control-sm " placeholder="" >
                <span class="text-danger" id="txt_residence_iauth_e">
                </span>
                </div>

                <div class="col-sm-3 mb-3">
                  <label class="control-label" for="residence_proof_upload"><b>Upload residence proof<span class="cl_red"> *</span></b></label>
                  <input class="form-control form-control-sm" id="residence_proof_upload" type="file">
                  <span class="text-danger" id="residence_proof_upload_e">
                  </span>
                </div>

                <div class="col-sm-12">
                  <label class="control-label text-info" ><h5>Permanent Address</h5></label>
                </div> 

                <div class="col-sm-3">
                  <label class="control-label" for="ddl_p_country"><b>Country<span class="cl_red"> *</span></b></label>
                  <select name="ddl_p_country" id="ddl_p_country" class="form-select form-select-sm">
                    <option value="">Select</option>
                     <option value="1">India</option>
                     <option value="2">Other</option>
                  </select>
                  <span class="text-danger" id="ddl_p_country_e">
                  </span>
                </div>

                <div class="col-sm-3 mb-3">
                  <label class="control-label" for="txt_address"><b>Address</b><span class="cl_red"> *</span></label>
                  <input type="text" name="txt_address" id="txt_address" class="form-control form-control-sm @error('txt_address') border border-danger @enderror" placeholder="Address" value="{{ old('txt_address') }}">
                  <small class="text-danger" id="txt_address_e">
                    @error('txt_address')
                       {{$message}}
                    @enderror
                  </small>
                  </div>
                  
          
                  
                  
                  <div class="col-sm-3 mb-3 cl_add_ind">
                  <label class="control-label" for="ddl_state"><b>State</b><span class="cl_red"> *</span></label>
                 
          
                  <select  name="ddl_state" id="ddl_state" class="form-select form-select-sm cl_ddlstate @error('ddl_state') border border-danger @enderror">
                   <option value="">Select</option>
                   @foreach($getStateDetails as $getStateDetail)
                   <option value="{{$getStateDetail->state_code}}" @if(old('ddl_state')==$getStateDetail->state_code) {{'selected'}} @endif>{{$getStateDetail->state_name_english}}</option>
                   @endforeach
                 </select>
                 <small class="text-danger" id="ddl_state_e">
                    @error('ddl_state')
                       {{$message}}
                    @enderror
                  </small>
                  </div>
                  
                  <div class="col-sm-3 mb-3 cl_add_ind">
                  <label class="control-label" for="ddl_district"><b>District</b><span class="cl_red"> *</span></label>
                  <select name="ddl_district" id="ddl_district" class="form-select form-select-sm @error('ddl_district') border border-danger @enderror cl_ddl_district">
                   <option value="">Select</option>
                   @if($getDistrictDetails && old('dbn_i_o')=='I')
                   @foreach($getDistrictDetails as $getDistrictDetail)
                   <option value="{{$getDistrictDetail->district_code}}" @if(old('ddl_district')==$getDistrictDetail->district_code) {{'selected'}} @endif>{{$getDistrictDetail->district_name_english}}</option>
                   @endforeach
                  @endif
                 </select>
                 <small class="text-danger" id="ddl_district_e">
                    @error('ddl_district')
                       {{$message}}
                    @enderror
                  </small>
                  </div>
                  
          
                 
                 
                  <div class="col-sm-3 mb-3 cl_add_ind">
                  <label class="control-label" for="ddl_tehsil"><b>Tehsil</b><span class="cl_red"> *</span></label>
                  <select name="ddl_tehsil" id="ddl_tehsil" class="form-select form-select-sm cl_ddl_tehsil">
                   <option value="">Select</option>
                   @if($getSubDistrictDetails && old('dbn_i_o')=='I')
                   @foreach($getSubDistrictDetails as $getSubDistrictDetail)
                   <option value="{{$getSubDistrictDetail->subdistrict_code}}" @if(old('ddl_tehsil')==$getSubDistrictDetail->subdistrict_code) {{'selected'}} @endif>{{$getSubDistrictDetail->subdistrict_name_english}}</option>
                   @endforeach
                  @endif
                   
                 </select>
                  <span class="text-danger" id="ddl_tehsil_e"></span>
                  </div>
                  
                  <div class="col-sm-3 mb-3 cl_add_ind">
                  <label class="control-label" for="ddl_village"><b>Village</b></label>
                  <select name="ddl_village" id="ddl_village" class="form-select form-select-sm">
                   <option value="">Select</option>
                   @if($getVillageDetails && old('dbn_i_o')=='I')
                   @foreach($getVillageDetails as $getVillageDetail)
                   <option value="{{$getVillageDetail->village_code}}" @if(old('ddl_village')==$getVillageDetail->village_code) {{'selected'}} @endif>{{$getVillageDetail->village_name_english}}</option>
                   @endforeach
                  @endif
                  
                 </select>
                  <span class="help-block"></span>
                  </div>

                  <div class="col-sm-3 d-none cl_add_others">
                    <label class="control-label" for="txt_country_name"><b>Country name</b><span class="cl_red"> *</span></label>
                    <input type="text" name="txt_country_name" id="txt_country_name" class="form-control form-control-sm " placeholder="Country name" >
                    <small class="text-danger" id="txt_country_name_e">
                   
                    </small>
                    </div>

                    <div class="col-sm-3 d-none cl_add_others">
                      <label class="control-label" for="txt_village"><b>Village / City</b><span class="cl_red"> *</span></label>
                      <input type="text" name="txt_village" id="txt_village" class="form-control form-control-sm" >
                      <small class="text-danger" id="txt_village_e">
                     
                      </small>
                      </div>
           
                  <div class="col-sm-3">
                  <label class="control-label" for="txt_pincode"><b>Pincode</b><span class="cl_red"> *</span></label> 
                  <input type="text" name="txt_pincode" id="txt_pincode" class="form-control form-control-sm @error('txt_pincode') border border-danger  @enderror" placeholder="Pincode" value="{{old('txt_pincode')}}">
                  <small class="text-danger" id="txt_pincode_e">
                 
                  </small>
                  </div>

                  
                  <div class="col-sm-12">
                    <div class="alert alert-info">
                      <div class="form-check">
                        <input type="checkbox" class="form-check-input" id="check1" name="option1" value="something">
                        <label class="form-check-label" for="check1">For same address please check this box.</label>
                      </div>  
                    </div>
                  </div>

                  <div class="col-sm-12">
                    <label class="control-label text-info" ><h5>Address for Correspondence</h5></label>
                  </div> 

                  <div class="col-sm-3">
                    <label class="control-label" for="ddl_c_country"><b>Country<span class="cl_red"> *</span></b></label>
                    <select name="ddl_c_country" id="ddl_c_country" class="form-select form-select-sm">
                      <option value="">Select</option>
                       <option value="1">India</option>
                       <option value="2">Other</option>
                    </select>
                    <span class="text-danger" id="ddl_c_country_e">
                    </span>
                  </div>

                  <div class="col-sm-3 mb-3">
                    <label class="control-label" for="txt_c_address"><b>Address</b><span class="cl_red"> *</span></label>
                    <input type="text" name="txt_c_address" id="txt_c_address" class="form-control form-control-sm @error('txt_c_address') border border-danger @enderror" placeholder="Address">
                    <small class="text-danger" id="txt_c_address_e">
                   
                    </small>
                    </div>
                    
            
                    
                    
                    <div class="col-sm-3 mb-3 cl_c_add_ind">
                    <label class="control-label" for="ddl_c_state"><b>State</b><span class="cl_red"> *</span></label>
                   
            
                    <select  name="ddl_c_state" id="ddl_c_state" class="form-select form-select-sm cl_c_ddlstate">
                     <option value="">Select</option>
                     @foreach($getStateDetails as $getStateDetail)
                     <option value="{{$getStateDetail->state_code}}" @if(old('ddl_state')==$getStateDetail->state_code) {{'selected'}} @endif>{{$getStateDetail->state_name_english}}</option>
                     @endforeach
                   </select>
                   <small class="text-danger" id="ddl_c_state_e">
                   
                    </small>
                    </div>
                    
                    <div class="col-sm-3 mb-3 cl_c_add_ind">
                    <label class="control-label" for="ddl_c_district"><b>District</b><span class="cl_red"> *</span></label>
                    <select name="ddl_c_district" id="ddl_c_district" class="form-select form-select-sm  cl_c_ddl_district">
                     <option value="">Select</option>
                     @if($getDistrictDetails && old('dbn_i_o')=='I')
                     @foreach($getDistrictDetails as $getDistrictDetail)
                     <option value="{{$getDistrictDetail->district_code}}" @if(old('ddl_district')==$getDistrictDetail->district_code) {{'selected'}} @endif>{{$getDistrictDetail->district_name_english}}</option>
                     @endforeach
                    @endif
                   </select>
                   <small class="text-danger" id="ddl_c_district_e">
                   
                    </small>
                    </div>
                    
            
                   
                   
                    <div class="col-sm-3 mb-3 cl_c_add_ind">
                    <label class="control-label" for="ddl_c_tehsil"><b>Tehsil</b><span class="cl_red"> *</span></label>
                    <select name="ddl_c_tehsil" id="ddl_c_tehsil" class="form-select form-select-sm cl_c_ddl_tehsil">
                     <option value="">Select</option>
                     @if($getSubDistrictDetails && old('dbn_i_o')=='I')
                     @foreach($getSubDistrictDetails as $getSubDistrictDetail)
                     <option value="{{$getSubDistrictDetail->subdistrict_code}}" @if(old('ddl_tehsil')==$getSubDistrictDetail->subdistrict_code) {{'selected'}} @endif>{{$getSubDistrictDetail->subdistrict_name_english}}</option>
                     @endforeach
                    @endif
                     
                   </select>
                    <span class="text-danger" id="ddl_c_tehsil_e"></span>
                    </div>
                    
                    <div class="col-sm-3 mb-3 cl_c_add_ind">
                    <label class="control-label" for="ddl_c_village"><b>Village</b></label>
                    <select name="ddl_c_village" id="ddl_c_village" class="form-select form-select-sm">
                     <option value="">Select</option>
                     @if($getVillageDetails && old('dbn_i_o')=='I')
                     @foreach($getVillageDetails as $getVillageDetail)
                     <option value="{{$getVillageDetail->village_code}}" @if(old('ddl_village')==$getVillageDetail->village_code) {{'selected'}} @endif>{{$getVillageDetail->village_name_english}}</option>
                     @endforeach
                    @endif
                    
                   </select>
                    <span class="help-block"></span>
                    </div>

                    <div class="col-sm-3 d-none cl_c_add_others">
                      <label class="control-label " for="txt_c_country_name"><b>Country name</b><span class="cl_red"> *</span></label>
                      <input type="text" name="txt_c_country_name" id="txt_c_country_name" class="form-control form-control-sm " placeholder="Country name" >
                      <small class="text-danger" id="txt_c_country_name_e">
                     
                      </small>
                      </div>

                      <div class="col-sm-3 d-none cl_c_add_others">
                        <label class="control-label " for="txt_c_village"><b>Village / City</b><span class="cl_red"> *</span></label>
                        <input type="text" name="txt_c_village" id="txt_c_village" class="form-control form-control-sm" >
                        <small class="text-danger" id="txt_c_village_e">
                       
                        </small>
                        </div>
             
                    <div class="col-sm-3">
                    <label class="control-label" for="txt_c_pincode"><b>Pincode</b><span class="cl_red"> *</span></label>
                    <input type="text" name="txt_c_pincode" id="txt_c_pincode" class="form-control form-control-sm " placeholder="Pincode" >
                    <small class="text-danger" id="txt_c_pincode_e">
                    
                    </small>
                    </div>
</div>

</div>
</div>
<!-- </div>
             </div>
</div> -->

<div class="card mt-3 @if(old('dbn_i_o') != '1' && old('dbn_i_o') != '11' && old('dbn_i_o') != '' ) d-none  @endif" id="dv_individual">
           <div class="card-header bg-dark text-white">
             Individual
           </div>
            <div class="card-body">

           
         <div class="row">

          {{-- <div class="col-sm-12">
            <label class="control-label text-info" ><h5>Personal Details</h5></label>
          </div>   --}}

          <div class="col-sm-12 mb-3 text-center">
            <label class="control-label mx-3" for="chk_employee_type"><b>Employee Type</b><span class="cl_red"> *</span></label>
            <div class="form-check form-check-inline">
  <input class="form-check-input" type="radio" name="ddl_employee_type" id="ddl_office_bearer" value="1">
  <label class="form-check-label" for="ddl_office_bearer">Office bearers</label>
</div>
<div class="form-check form-check-inline">
  <input class="form-check-input" type="radio" name="ddl_employee_type" id="ddl_head_organization" value="2">
  <label class="form-check-label" for="ddl_head_organization">Head of organisation</label>
</div>
            <small class="text-danger" id="ddl_title_e">
           
            </small>
            </div>

          <div class="col-sm-3 mb-3">
            <label class="control-label" for="ddl_title"><b>Title</b><span class="cl_red"> *</span></label>
            <select name="ddl_title" id="ddl_title" class="form-select form-select-sm">
              <option value="">Select</option>
             @foreach($getTitle as $title)
             <option value="{{ $title->id }}">{{ $title->title }}</option>
             @endforeach
            </select>
            <small class="text-danger" id="ddl_title_e">
           
            </small>
            </div>
        
        <div class="col-sm-3 mb-3">
        <label class="control-label" for="txt_name"><b>Name</b><span class="cl_red"> *</span></label>
        <input type="text" name="txt_name" id="txt_name" class="form-control form-control-sm" placeholder="Name" value="{{ old('txt_name') }}" >
        <small class="text-danger" id="txt_name_e">
        @error('txt_name')
              {{$message}}
        @enderror
        </small>
        </div>
       
        <div class="col-sm-3 mb-3">
        <label class="control-label" for="ddl_relation"><b>Relation</b></label>
        <select name="ddl_relation" id="ddl_relation" class="form-select form-select-sm">
         <option value="0">Select</option>
        @foreach($getRelationDetails as $getRelationDetail)
        <option value="{{ $getRelationDetail->id }}" @if($getRelationDetail->id==old('ddl_relation')) {{ 'selected' }} @endif>{{ $getRelationDetail->name }}</option>
        @endforeach
       </select>
        <span class="help-block"></span>
        </div>
         
       
        <div class="col-sm-3 mb-3">
        <label class="control-label" for="txt_relpnm"><b>Father/Husband Name</b></label>
        <input type="text" name="txt_relpnm" id="txt_relpnm" class="form-control form-control-sm" placeholder="Name" value="{{ old('txt_relpnm') }}">
        <span class="help-block"></span>
        </div>

        <div class="col-sm-3 mb-3">
          <label class="control-label" for="ddl_gender"><b>Gender</b><span class="cl_red"> *</span></label>
          <select name="ddl_gender" id="ddl_gender" class="form-select form-select-sm @error('ddl_gender') border border-danger  @enderror">
           <option value="">Select</option>
          @foreach($getGenders as $getGender)
          <option value="{{ $getGender->id }}" @if($getGender->id==old('ddl_gender')) {{ 'selected' }} @endif>{{ $getGender->name }}</option>
          @endforeach
         </select>
         <small class="text-danger" id="ddl_gender_e">
            @error('ddl_gender')
            {{$message}}
            @enderror
          </small>
          </div>

          <div class="col-sm-3 mb-3">
            <label class="control-label" for="txt_age"><b>Age</b><span class="cl_red"> *</span></label>
            <input type="text" name="txt_age" id="txt_age" class="form-control form-control-sm" placeholder="Age"  >
            <small class="text-danger" id="txt_age_e">
           
            </small>
            </div>

            <div class="col-sm-3 mb-3">
              <label class="control-label" for="ddl_nationality"><b>Nationality</b><span class="cl_red"> *</span></label>
              <select name="ddl_nationality" id="ddl_nationality" class="form-select form-select-sm @error('ddl_nationality') border border-danger  @enderror">
                <option value="">Select Nationality</option>
                <option value="1">Citizen of India</option>
                <option value="2">Not Citizen of India (Attach Copy of Passport)</option>
              </select>
              <small class="text-danger" id="ddl_nationality_e">
             
              </small>
              </div>
       
              <div class="col-sm-3">
                <label class="control-label" for="txt_telephoneno"><b>Telephone Number ( with std codes)</b></label>
                <input type="text" name="txt_telephoneno" id="txt_telephoneno" class="form-control form-control-sm " placeholder="Telephone No." >
                <small class="text-danger">
                 
                </small>
                </div>

               
        <div class="col-sm-3">
        <label class="control-label" for="txt_mobileno"><b>Mobile No.</b><span class="cl_red"> *</span></label>
        <input type="text" name="txt_mobileno" id="txt_mobileno" class="form-control form-control-sm @error('txt_mobileno') border border-danger  @enderror" placeholder="Mobile No." value="{{old('txt_mobileno')}}">
        <small class="text-danger" id="txt_mobileno_e">
        
        </small>
        </div>
        

       
        
        <div class="col-sm-3">
        <label class="control-label" for="txt_email"><b>Email Id</b><span class="cl_red"> *</span></label>
        <input type="text" name="txt_email" id="txt_email" class="form-control form-control-sm @error('txt_email') border border-danger  @enderror" placeholder="Email Id" value="{{old('txt_email')}}">
        <small class="text-danger" id="txt_email_e">
      
        </small>
        </div>

       

        

        <div class="col-sm-3 mb-3">
        <label class="control-label" for="ddl_occupation"><b>Occupation</b><span class="cl_red"> *</span></label>
        <select name="ddl_occupation" id="ddl_occupation" class="form-select form-select-sm">
         <option value="">Select</option>
        @foreach($getOccupations as $getOccupation)
        <option value="{{ $getOccupation->id }}" @if($getOccupation->id==old('ddl_occupation')) {{ 'selected' }} @endif>{{ $getOccupation->name }}</option>
        @endforeach
       </select>
       <small class="text-danger" id="ddl_occupation_e">
          @error('ddl_occupation')
          {{$message}}
          @enderror
        </small>
        </div>
 
       

        <div class="col-sm-3 mb-3 d-none">
        <label class="control-label" for="complainant_victim"><b>Whether the complainant is the victim ?</b></label>
        <div class="form-check form-check-inline">
  <input class="form-check-input" type="radio" name="complainant_victim" id="complainant_victim_y">
  <label class="form-check-label" for="complainant_victim_y">
   Yes
  </label>
</div>
<div class="form-check form-check-inline">
  <input class="form-check-input" type="radio" name="complainant_victim" id="complainant_victim_n">
  <label class="form-check-label" for="complainant_victim_n">
   No
  </label>
</div>
       <small class="text-danger" id="complainant_victim_e">  
        </small>
        </div>

         
        <div class="col-sm-12 ">
          <label class="control-label text-info" ><h5>Details of identity proof</h5></label>
        </div>    
        <div class="col-sm-3">
          <label class="control-label" for="ddl_identity_proof_id"><b>Identity Document<span class="cl_red"> *</span></b></label>
          <select name="ddl_identity_proof_id" id="ddl_identity_proof_id" class="form-select form-select-sm">
            <option value="">Select</option>
            @foreach($getIdentityProof as $val)
              <option value="{{ $val->id }}">{{ $val->name }}</option>
            @endforeach
          </select>
          <span class="text-danger" id="ddl_identity_proof_id_e">
          </span>
        </div>

        <div class="col-sm-3 mb-3">
          <label class="control-label" for="txt_identity_proof_no"><b>Number</b></label>
          <input type="text" name="txt_identity_proof_no" id="txt_identity_proof_no" class="form-control form-control-sm " placeholder="" >
          <span class="text-danger" id="txt_identity_proof_no_e">
          </span>
          </div>

          <div class="col-sm-3 mb-3">
            <label class="control-label" for="txt_identity_proof_doi"><b>Date of Issue</b></label>
            <input type="text" name="txt_identity_proof_doi" id="txt_identity_proof_doi" class="form-control form-control-sm " placeholder="" >
            <span class="text-danger" id="txt_identity_proof_doi_e">
            </span>
            </div>

            <div class="col-sm-3 mb-3">
              <label class="control-label" for="txt_identity_validity"><b>Validity Upto</b></label>
              <input type="text" name="txt_identity_validity" id="txt_identity_validity" class="form-control form-control-sm " placeholder="" >
              <span class="text-danger" id="txt_identity_validity_e">
              </span>
              </div>

              <div class="col-sm-3 mb-3">
                <label class="control-label" for="txt_identity_iauth"><b>Issuing Authority</b></label>
                <input type="text" name="txt_identity_iauth" id="txt_identity_iauth" class="form-control form-control-sm " placeholder="" >
                <span class="text-danger" id="txt_identity_iauth_e">
                </span>
                </div>

                <div class="col-sm-3 mb-3">
                  <label class="control-label" for="identity_proof_upload"><b>Upload identity proof<span class="cl_red"> *</span></b></label>
                  <input class="form-control form-control-sm" id="identity_proof_upload" type="file">
                  <span class="text-danger" id="identity_proof_upload_e">
                  </span>
                  </div>

                  <div class="col-sm-12">
                    <label class="control-label text-info" ><h5>Details of residence proof</h5></label>
                  </div>    
                  <div class="col-sm-3">
                    <label class="control-label" for="ddl_residence_proof_id"><b>Residence Proof ID<span class="cl_red"> *</span></b></label>
                    <select name="ddl_residence_proof_id" id="ddl_residence_proof_id" class="form-select form-select-sm">
                      <option value="">Select</option>
                      @foreach($getIdentityProof as $val)
                        <option value="{{ $val->id }}">{{ $val->name }}</option>
                      @endforeach
                    </select>
                    <span class="text-danger" id="ddl_residence_proof_id_e">
                    </span>
                  </div>
          
                  <div class="col-sm-3 mb-3">
                    <label class="control-label" for="txt_residence_proof_no"><b>Number</b></label>
                    <input type="text" name="txt_residence_proof_no" id="txt_residence_proof_no" class="form-control form-control-sm " placeholder="" >
                    <span class="text-danger" id="txt_residence_proof_no_e">
                    </span>
                    </div>
          
                    <div class="col-sm-3 mb-3">
                      <label class="control-label" for="txt_residence_proof_doi"><b>Date of Issue</b></label>
                      <input type="text" name="txt_residence_proof_doi" id="txt_residence_proof_doi" class="form-control form-control-sm " placeholder="" >
                      <span class="text-danger" id="txt_residence_proof_doi_e">
                      </span>
                      </div>
          
                      <div class="col-sm-3 mb-3">
                        <label class="control-label" for="txt_residence_validity"><b>Validity Upto</b></label>
                        <input type="text" name="txt_residence_validity" id="txt_residence_validity" class="form-control form-control-sm " placeholder="" >
                        <span class="text-danger" id="txt_residence_validity_e">
                        </span>
                        </div>
          
                        <div class="col-sm-3 mb-3">
                          <label class="control-label" for="txt_residence_iauth"><b>Issuing Authority</b></label>
                          <input type="text" name="txt_residence_iauth" id="txt_residence_iauth" class="form-control form-control-sm " placeholder="" >
                          <span class="text-danger" id="txt_residence_iauth_e">
                          </span>
                          </div>
          
                          <div class="col-sm-3 mb-3">
                            <label class="control-label" for="residence_proof_upload"><b>Upload residence proof<span class="cl_red"> *</span></b></label>
                            <input class="form-control form-control-sm" id="residence_proof_upload" type="file">
                            <span class="text-danger" id="residence_proof_upload_e">
                            </span>
                          </div>

                          <div class="col-sm-12">
                            <label class="control-label text-info" ><h5>Permanent Address</h5></label>
                          </div> 

                          <div class="col-sm-3">
                            <label class="control-label" for="ddl_p_country"><b>Country<span class="cl_red"> *</span></b></label>
                            <select name="ddl_p_country" id="ddl_p_country" class="form-select form-select-sm">
                              <option value="">Select</option>
                               <option value="1">India</option>
                               <option value="2">Other</option>
                            </select>
                            <span class="text-danger" id="ddl_p_country_e">
                            </span>
                          </div>

                          <div class="col-sm-3 mb-3">
                            <label class="control-label" for="txt_address"><b>Address</b><span class="cl_red"> *</span></label>
                            <input type="text" name="txt_address" id="txt_address" class="form-control form-control-sm @error('txt_address') border border-danger @enderror" placeholder="Address" value="{{ old('txt_address') }}">
                            <small class="text-danger" id="txt_address_e">
                              @error('txt_address')
                                 {{$message}}
                              @enderror
                            </small>
                            </div>
                            
                    
                            
                            
                            <div class="col-sm-3 mb-3 cl_add_ind">
                            <label class="control-label" for="ddl_state"><b>State</b><span class="cl_red"> *</span></label>
                           
                    
                            <select  name="ddl_state" id="ddl_state" class="form-select form-select-sm cl_ddlstate @error('ddl_state') border border-danger @enderror">
                             <option value="">Select</option>
                             @foreach($getStateDetails as $getStateDetail)
                             <option value="{{$getStateDetail->state_code}}" @if(old('ddl_state')==$getStateDetail->state_code) {{'selected'}} @endif>{{$getStateDetail->state_name_english}}</option>
                             @endforeach
                           </select>
                           <small class="text-danger" id="ddl_state_e">
                              @error('ddl_state')
                                 {{$message}}
                              @enderror
                            </small>
                            </div>
                            
                            <div class="col-sm-3 mb-3 cl_add_ind">
                            <label class="control-label" for="ddl_district"><b>District</b><span class="cl_red"> *</span></label>
                            <select name="ddl_district" id="ddl_district" class="form-select form-select-sm @error('ddl_district') border border-danger @enderror cl_ddl_district">
                             <option value="">Select</option>
                             @if($getDistrictDetails && old('dbn_i_o')=='I')
                             @foreach($getDistrictDetails as $getDistrictDetail)
                             <option value="{{$getDistrictDetail->district_code}}" @if(old('ddl_district')==$getDistrictDetail->district_code) {{'selected'}} @endif>{{$getDistrictDetail->district_name_english}}</option>
                             @endforeach
                            @endif
                           </select>
                           <small class="text-danger" id="ddl_district_e">
                              @error('ddl_district')
                                 {{$message}}
                              @enderror
                            </small>
                            </div>
                            
                    
                           
                           
                            <div class="col-sm-3 mb-3 cl_add_ind">
                            <label class="control-label" for="ddl_tehsil"><b>Tehsil</b><span class="cl_red"> *</span></label>
                            <select name="ddl_tehsil" id="ddl_tehsil" class="form-select form-select-sm cl_ddl_tehsil">
                             <option value="">Select</option>
                             @if($getSubDistrictDetails && old('dbn_i_o')=='I')
                             @foreach($getSubDistrictDetails as $getSubDistrictDetail)
                             <option value="{{$getSubDistrictDetail->subdistrict_code}}" @if(old('ddl_tehsil')==$getSubDistrictDetail->subdistrict_code) {{'selected'}} @endif>{{$getSubDistrictDetail->subdistrict_name_english}}</option>
                             @endforeach
                            @endif
                             
                           </select>
                            <span class="text-danger" id="ddl_tehsil_e"></span>
                            </div>
                            
                            <div class="col-sm-3 mb-3 cl_add_ind">
                            <label class="control-label" for="ddl_village"><b>Village</b></label>
                            <select name="ddl_village" id="ddl_village" class="form-select form-select-sm">
                             <option value="">Select</option>
                             @if($getVillageDetails && old('dbn_i_o')=='I')
                             @foreach($getVillageDetails as $getVillageDetail)
                             <option value="{{$getVillageDetail->village_code}}" @if(old('ddl_village')==$getVillageDetail->village_code) {{'selected'}} @endif>{{$getVillageDetail->village_name_english}}</option>
                             @endforeach
                            @endif
                            
                           </select>
                            <span class="help-block"></span>
                            </div>

                            <div class="col-sm-3 d-none cl_add_others">
                              <label class="control-label" for="txt_country_name"><b>Country name</b><span class="cl_red"> *</span></label>
                              <input type="text" name="txt_country_name" id="txt_country_name" class="form-control form-control-sm " placeholder="Country name" >
                              <small class="text-danger" id="txt_country_name_e">
                             
                              </small>
                              </div>

                              <div class="col-sm-3 d-none cl_add_others">
                                <label class="control-label" for="txt_village"><b>Village / City</b><span class="cl_red"> *</span></label>
                                <input type="text" name="txt_village" id="txt_village" class="form-control form-control-sm" >
                                <small class="text-danger" id="txt_village_e">
                               
                                </small>
                                </div>
                     
                            <div class="col-sm-3">
                            <label class="control-label" for="txt_pincode"><b>Pincode</b><span class="cl_red"> *</span></label> 
                            <input type="text" name="txt_pincode" id="txt_pincode" class="form-control form-control-sm @error('txt_pincode') border border-danger  @enderror" placeholder="Pincode" value="{{old('txt_pincode')}}">
                            <small class="text-danger" id="txt_pincode_e">
                           
                            </small>
                            </div>

                            
                            <div class="col-sm-12">
                              <div class="alert alert-info">
                                <div class="form-check">
                                  <input type="checkbox" class="form-check-input" id="check1" name="option1" value="something">
                                  <label class="form-check-label" for="check1">For same address please check this box.</label>
                                </div>  
                              </div>
                            </div>

                            <div class="col-sm-12">
                              <label class="control-label text-info" ><h5>Address for Correspondence</h5></label>
                            </div> 
  
                            <div class="col-sm-3">
                              <label class="control-label" for="ddl_c_country"><b>Country<span class="cl_red"> *</span></b></label>
                              <select name="ddl_c_country" id="ddl_c_country" class="form-select form-select-sm">
                                <option value="">Select</option>
                                 <option value="1">India</option>
                                 <option value="2">Other</option>
                              </select>
                              <span class="text-danger" id="ddl_c_country_e">
                              </span>
                            </div>
  
                            <div class="col-sm-3 mb-3">
                              <label class="control-label" for="txt_c_address"><b>Address</b><span class="cl_red"> *</span></label>
                              <input type="text" name="txt_c_address" id="txt_c_address" class="form-control form-control-sm @error('txt_c_address') border border-danger @enderror" placeholder="Address">
                              <small class="text-danger" id="txt_c_address_e">
                             
                              </small>
                              </div>
                              
                      
                              
                              
                              <div class="col-sm-3 mb-3 cl_c_add_ind">
                              <label class="control-label" for="ddl_c_state"><b>State</b><span class="cl_red"> *</span></label>
                             
                      
                              <select  name="ddl_c_state" id="ddl_c_state" class="form-select form-select-sm cl_c_ddlstate">
                               <option value="">Select</option>
                               @foreach($getStateDetails as $getStateDetail)
                               <option value="{{$getStateDetail->state_code}}" @if(old('ddl_state')==$getStateDetail->state_code) {{'selected'}} @endif>{{$getStateDetail->state_name_english}}</option>
                               @endforeach
                             </select>
                             <small class="text-danger" id="ddl_c_state_e">
                             
                              </small>
                              </div>
                              
                              <div class="col-sm-3 mb-3 cl_c_add_ind">
                              <label class="control-label" for="ddl_c_district"><b>District</b><span class="cl_red"> *</span></label>
                              <select name="ddl_c_district" id="ddl_c_district" class="form-select form-select-sm  cl_c_ddl_district">
                               <option value="">Select</option>
                               @if($getDistrictDetails && old('dbn_i_o')=='I')
                               @foreach($getDistrictDetails as $getDistrictDetail)
                               <option value="{{$getDistrictDetail->district_code}}" @if(old('ddl_district')==$getDistrictDetail->district_code) {{'selected'}} @endif>{{$getDistrictDetail->district_name_english}}</option>
                               @endforeach
                              @endif
                             </select>
                             <small class="text-danger" id="ddl_c_district_e">
                             
                              </small>
                              </div>
                              
                      
                             
                             
                              <div class="col-sm-3 mb-3 cl_c_add_ind">
                              <label class="control-label" for="ddl_c_tehsil"><b>Tehsil</b><span class="cl_red"> *</span></label>
                              <select name="ddl_c_tehsil" id="ddl_c_tehsil" class="form-select form-select-sm cl_c_ddl_tehsil">
                               <option value="">Select</option>
                               @if($getSubDistrictDetails && old('dbn_i_o')=='I')
                               @foreach($getSubDistrictDetails as $getSubDistrictDetail)
                               <option value="{{$getSubDistrictDetail->subdistrict_code}}" @if(old('ddl_tehsil')==$getSubDistrictDetail->subdistrict_code) {{'selected'}} @endif>{{$getSubDistrictDetail->subdistrict_name_english}}</option>
                               @endforeach
                              @endif
                               
                             </select>
                              <span class="text-danger" id="ddl_c_tehsil_e"></span>
                              </div>
                              
                              <div class="col-sm-3 mb-3 cl_c_add_ind">
                              <label class="control-label" for="ddl_c_village"><b>Village</b></label>
                              <select name="ddl_c_village" id="ddl_c_village" class="form-select form-select-sm">
                               <option value="">Select</option>
                               @if($getVillageDetails && old('dbn_i_o')=='I')
                               @foreach($getVillageDetails as $getVillageDetail)
                               <option value="{{$getVillageDetail->village_code}}" @if(old('ddl_village')==$getVillageDetail->village_code) {{'selected'}} @endif>{{$getVillageDetail->village_name_english}}</option>
                               @endforeach
                              @endif
                              
                             </select>
                              <span class="help-block"></span>
                              </div>

                              <div class="col-sm-3 d-none cl_c_add_others">
                                <label class="control-label " for="txt_c_country_name"><b>Country name</b><span class="cl_red"> *</span></label>
                                <input type="text" name="txt_c_country_name" id="txt_c_country_name" class="form-control form-control-sm " placeholder="Country name" >
                                <small class="text-danger" id="txt_c_country_name_e">
                               
                                </small>
                                </div>
  
                                <div class="col-sm-3 d-none cl_c_add_others">
                                  <label class="control-label " for="txt_c_village"><b>Village / City</b><span class="cl_red"> *</span></label>
                                  <input type="text" name="txt_c_village" id="txt_c_village" class="form-control form-control-sm" >
                                  <small class="text-danger" id="txt_c_village_e">
                                 
                                  </small>
                                  </div>
                       
                              <div class="col-sm-3">
                              <label class="control-label" for="txt_c_pincode"><b>Pincode</b><span class="cl_red"> *</span></label>
                              <input type="text" name="txt_c_pincode" id="txt_c_pincode" class="form-control form-control-sm " placeholder="Pincode" >
                              <small class="text-danger" id="txt_c_pincode_e">
                              
                              </small>
                              </div>

                    
        
        </div>

       </div>
        </div>
         </div>

        
     </div>


 <div class="card mb-3 cl_upd_hds">
     <div class="card-header bg-dark text-white">
      Defendant 

    </div>
     <div class="card-body" id="dv_respondent">
    
      <div class="row mb-3">
        <label class="col-sm-2 col-form-label d-inline" ><b>Individual/Organization</b></label>
        <div class="col-sm-3">
          <select name="dbn_o_i_o" id="dbn_o_i_o" class="form-select form-select-sm cl_o_i_o @error('dbn_o_i_o') is-invalid @enderror">
            <option value="">Select</option>
            @foreach($getIndividualOrganization as $val) 
            <option value="{{ $val->id }}" @if( old('dbn_o_i_o') == $val->id ) selected @elseif(old('dbn_o_i_o') == '' && $val->id=='1') selected @endif>{{ $val->name }}</option>
            @endforeach
          </select>
        <small class="text-danger" id="ddl_o_i_o_e">
          @error('ddl_i_o')
          {{$message}}
    @enderror
        </small>
        </div>
      </div>
       


<div class="card mb-3 mt-3 @if(old('dbn_o_i_o') != '1' && old('dbn_o_i_o') != '11' && old('dbn_o_i_o') != '' ) d-none  @endif" id="dv_o_individual">
           <div class="card-header bg-dark text-white">
             Individual
           </div>
            <div class="card-body">

           
         <div class="row mb-3">

         
          <div class="col-sm-3 mb-3">
            <label class="control-label" for="ddl_io_title"><b>Title</b><span class="cl_red"> *</span></label>
            <select name="ddl_io_title" id="ddl_io_title" class="form-select form-select-sm">
              <option value="">Select</option>
             @foreach($getTitle as $title)
             <option value="{{ $title->id }}">{{ $title->title }}</option>
             @endforeach
            </select>
            <small class="text-danger" id="ddl_io_title_e">
           
            </small>
            </div>

        <div class="col-sm-3 mb-3">
        <label class="control-label" for="txt_ioname"><b>Name</b><span class="cl_red"> *</span></label>
        <input type="text" name="txt_ioname" id="txt_ioname" class="form-control form-control-sm" placeholder="Name" value="{{ old('txt_ioname') }}" >
        <small class="text-danger" id="txt_ioname_e">
        @error('txt_ioname')
              {{$message}}
        @enderror
</small>
        </div>

        
  
          <div class="col-sm-3 mb-3">
          <label class="control-label" for="txt_iopost"><b>Present designation</b><span class="cl_red"> *</span></label>
          <input type="text" name="txt_iopost" id="txt_iopost" class="form-control form-control-sm " placeholder="Name" >
          <input type="hidden" name="hd_idd_post_o" id="hd_idd_post_o">
          <span class="text-danger" id="txt_iopost_e">
           
          </span>
          </div>

          <div class="col-sm-3 mb-3">
            <label class="control-label" for="txt_oname"><b>Organization Name</b><span class="cl_red"> *</span></label>
            <input type="text" name="txt_io_orgname" id="txt_io_orgname" class="form-control form-control-sm @error('txt_ioname') border border-danger @enderror" placeholder="Name" >
            <input type="hidden" name="hd_idd_o" id="hd_idd_o" >
            <small class="text-danger" id="txt_io_orgname_e">
            
            </small>
            </div>
       
        <div class="col-sm-3 mb-3">
        <label class="control-label" for="ddl_iorelation"><b>Relation</b></label>
        <select name="ddl_orelation" id="ddl_iorelation" class="form-select form-select-sm">
         <option value="">Select</option>
        @foreach($getRelationDetails as $getRelationDetail)
        <option value="{{ $getRelationDetail->id }}" @if($getRelationDetail->id==old('ddl_iorelation')) {{ 'selected' }} @endif>{{ $getRelationDetail->name }}</option>
        @endforeach
       </select>
        <span class="help-block"></span>
        </div>
         
       
        <div class="col-sm-3 mb-3">
        <label class="control-label" for="txt_iorelpnm"><b>Father/Husband Name</b></label>
        <input type="text" name="txt_iorelpnm" id="txt_iorelpnm" class="form-control form-control-sm" placeholder="Name" value="{{ old('txt_iorelpnm') }}">
        <span class="help-block"></span>
        </div>
       
        <div class="col-sm-3 mb-3">
        <label class="control-label" for="txt_ioaddress"><b>Address</b></label>
        <input type="text" name="txt_ioaddress" id="txt_ioaddress" class="form-control form-control-sm @error('txt_ioaddress') border border-danger @enderror" placeholder="Address" value="{{ old('txt_ioaddress') }}">
        <small class="text-danger" id="txt_ioaddress_e">
          @error('txt_ioaddress')
             {{$message}}
          @enderror
</small>
        </div>
        
        <div class="col-sm-3">
          <label class="control-label" for="ddl_io_country"><b>Country<span class="cl_red"> *</span></b></label>
          <select name="ddl_io_country" id="ddl_io_country" class="form-select form-select-sm">
            <option value="">Select</option>
             <option value="1">India</option>
             <option value="2">Other</option>
          </select>
          <span class="text-danger" id="ddl_io_country">
          </span>
        </div>
        
        
        <div class="col-sm-3 mb-3">
        <label class="control-label" for="ddl_iostate"><b>State</b></label>
        <select name="ddl_iostate" id="ddl_iostate" class="form-select form-select-sm @error('ddl_iostate') border border-danger @enderror cl_ioddlstate">
         <option value="">Select</option>
         @foreach($getStateDetails as $getStateDetail)
         <option value="{{$getStateDetail->state_code}}" @if(old('ddl_iostate')==$getStateDetail->state_code) {{'selected'}} @endif>{{$getStateDetail->state_name_english}}</option>
         @endforeach
       </select>
       <small class="text-danger" id="ddl_iostate_e">
          @error('ddl_iostate')
             {{$message}}
          @enderror
</small>
        </div>
        
        <div class="col-sm-3 mb-3">
        <label class="control-label" for="ddl_iodistrict"><b>District</b></label>
        <select name="ddl_iodistrict" id="ddl_iodistrict" class="form-select form-select-sm @error('ddl_iodistrict') border border-danger @enderror cl_ioddl_district">
         <option value="">Select</option>
         @if($getDistrictDetails && old('dbn_o_i_o')=='I')
         @foreach($getDistrictDetails as $getDistrictDetail)
         <option value="{{$getDistrictDetail->district_code}}" @if(old('ddl_iodistrict')==$getDistrictDetail->district_code) {{'selected'}} @endif>{{$getDistrictDetail->district_name_english}}</option>
         @endforeach
        @endif
       </select>
       <small class="text-danger" id="ddl_iodistrict_e">
          @error('ddl_iodistrict')
             {{$message}}
          @enderror
</small>
        </div>
        

       
       
        <div class="col-sm-3 mb-3">
        <label class="control-label" for="ddl_iotehsil"><b>Tehsil</b></label>
        <select name="ddl_iotehsil" id="ddl_iotehsil" class="form-select form-select-sm cl_ioddl_tehsil">
         <option value="">Select</option>
         @if($getSubDistrictDetails && old('dbn_o_i_o')=='I')
         @foreach($getSubDistrictDetails as $getSubDistrictDetail)
         <option value="{{$getSubDistrictDetail->subdistrict_code}}" @if(old('ddl_iotehsil')==$getSubDistrictDetail->subdistrict_code) {{'selected'}} @endif>{{$getSubDistrictDetail->subdistrict_name_english}}</option>
         @endforeach
        @endif
         
       </select>
        <span class="help-block"></span>
        </div>
        
        <div class="col-sm-3 mb-3">
        <label class="control-label" for="ddl_iovillage"><b>Village</b></label>
        <select name="ddl_iovillage" id="ddl_iovillage" class="form-select form-select-sm">
         <option value="">Select</option>
         @if($getVillageDetails && old('dbn_o_i_o')=='I')
         @foreach($getVillageDetails as $getVillageDetail)
         <option value="{{$getVillageDetail->village_code}}" @if(old('ddl_iovillage')==$getVillageDetail->village_code) {{'selected'}} @endif>{{$getVillageDetail->village_name_english}}</option>
         @endforeach
        @endif
        
       </select>
        <span class="help-block"></span>
        </div>
        

         
        
        <div class="col-sm-3">
        <label class="control-label" for="txt_iopincode"><b>Pincode</b></label>
        <input type="text" name="txt_iopincode" id="txt_iopincode" class="form-control form-control-sm @error('txt_iopincode') border border-danger  @enderror" placeholder="Pincode" value="{{old('txt_iopincode')}}">
        <small class="text-danger">
          @error('txt_iopincode')
          {{$message}}
          @enderror
</small>
        </div>
        
        <div class="col-sm-3">
        <label class="control-label" for="txt_iomobileno"><b>Mobile No.</b></label>
        <input type="text" name="txt_iomobileno" id="txt_iomobileno" class="form-control form-control-sm @error('txt_iomobileno') border border-danger  @enderror" placeholder="Mobile No." value="{{old('txt_iomobileno')}}">
        <span class="text-danger">
          @error('txt_iomobileno')
          {{$message}}
          @enderror
        </span>
        </div>
        

       
        
        <div class="col-sm-3">
        <label class="control-label" for="txt_ioemail"><b>Email Id</b></label>
        <input type="text" name="txt_ioemail" id="txt_ioemail" class="form-control form-control-sm @error('txt_ioemail') border border-danger  @enderror" placeholder="Email Id" value="{{old('txt_ioemail')}}">
        <span class="text-danger">
          @error('txt_ioemail')
          {{$message}}
          @enderror
        </span>
        </div>

        <div class="col-sm-9 d-none">
          <label class="control-label"><b> Whether the complaint is against any officer or employee or agency (including the Delhi Special Police Establishment), under or associated with the Lokpal ?</b><span class="cl_red"> *</span></label>
          <div class="form-check form-check-inline">
            <input class="form-check-input" type="radio" name="ddl_lokpal_associate" id="ddl_lokpal_associate_y">
            <label class="form-check-label" for="ddl_lokpal_associate_y">
             Yes
            </label>
          </div>
          <div class="form-check form-check-inline">
            <input class="form-check-input" type="radio" name="ddl_lokpal_associate" id="ddl_lokpal_associate_n">
            <label class="form-check-label" for="ddl_lokpal_associate_n">
             No
            </label>
          </div>
          <span class="text-danger">
          
          </span>
          </div>


        </div>
        </div>
         </div>

       
     </div>
 </div>

 
 
 <div class="row mt-3 cl_upd_hds">
       
        <div class="col-sm-12 text-center">
        
        <button type="button" class="btn btn-primary btn-sm" name="btn_submit" id="btn_submit">Submit</button>
        
        </div>
        </div>

   


 </form>

 <!-- The Modal -->
<!-- <button type="button" class="btn btn-primary" data-bs-toggle="modal" data-bs-target="#myModal">
  Open modal
</button> -->
<div class="modal" id="myModal">
  <div class="modal-dialog modal-xl modal-dialog-scrollable">
    <div class="modal-content">

      <!-- Modal Header -->
      <div class="modal-header">
      <b><small class="modal-title" id="modal_heading"></small></b>
        <button type="button" class="btn-close" data-bs-dismiss="modal"></button>
      
      </div>

      <!-- Modal body -->
      <div class="modal-body" id="dv_shw_pdf">
        Modal body..
      </div>

      <!-- Modal footer -->
      <div class="modal-footer">
        <button type="button" class="btn btn-danger" data-bs-dismiss="modal">Close</button>
      </div>

    </div>
  </div>
</div>
@endif
</div>
@endsection