@extends('layouts.backend')

@section('content')
<div class="container">
    <div class="row">
        <div class="col-sm-12">
            <h4 class="page-title">Surat</h4>
            <ol class="breadcrumb">
                <li>
                    <a href="{{route('home')}}">Home</a>
                </li>
                <li>
                    <a href="{{route('daftar-surat')}}">Daftar Surat</a>
                </li>
                <li>
                    <a href="{{ route('surat-pengantar-akta-lahir') }}">Pengantar Akta Lahir</a>
                </li>
                <li class="active">
                    Form Surat
                </li>
            </ol>
        </div>
    </div>
    <div class="row">
        <div class="col-sm-12">
            <div class="card-box">
                <h4 class="m-t-0 m-b-20 header-title"><b>Form Surat Pengantar Akta Lahir</b></h4>
                <div class="row">
                    <form method="POST" class="form-horizontal" action="{{ route('surat-pengantar-akta-lahir-simpan') }}">
                        {{@csrf_field()}}
                        <input type="hidden" name="no_kk">
                        <div class="form-group">
                            <label class="col-sm-2 control-label" for="noInduk">Pimpinan : </label>
                            <div class="col-md-7">
                                <ul class="list-group">
                                    <select name="pimpinan" class="nik form-control form-control @error('pimpinan') parsley-error @enderror">
                                    </select>
                                    @error('pimpinan')
                                        <ul class="parsley-errors-list filled" id="parsley-id-7"><li class="parsley-required">{{ $message }}</li></ul>
                                    @enderror
                                </ul>
                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-sm-2 control-label"> Nomor Surat : </label>
                            <div class="col-sm-4">
                                <input type="text" class="form-control" name="nomorsurat" placeholder="Nomor Surat">
                                @error('nomorsurat')
                                    <ul class="parsley-errors-list filled" id="parsley-id-7"><li class="parsley-required">{{ $message }}</li></ul>
                                @enderror
                            </div>
                        </div>
                        <ul class="nav nav-tabs tabs">
                            <li class="active tab">
                                <a href="#tabAyah" data-toggle="tab" aria-expanded="false"> 
                                    <span class="visible-xs"><i class="fa fa-home"></i></span> 
                                    <span class="hidden-xs">Data Ayah</span> 
                                </a> 
                            </li> 
                            <li class="tab"> 
                                <a href="#tabIbu" data-toggle="tab" aria-expanded="false"> 
                                    <span class="visible-xs"><i class="fa fa-user"></i></span> 
                                    <span class="hidden-xs">Data Ibu</span> 
                                </a> 
                            </li>
                            <li class="tab"> 
                                <a href="#tabAnak" data-toggle="tab" aria-expanded="false"> 
                                    <span class="visible-xs"><i class="fa fa-user"></i></span> 
                                    <span class="hidden-xs">Data Anak</span> 
                                </a> 
                            </li> 
                        </ul> 
                        <div class="tab-content"> 
                            <div class="tab-pane active" id="tabAyah"> 
                                <div class="form-group">
                                    <ul class="list-group">
                                        <label class="col-sm-2 control-label" for="noInduk">N I K : </label>
                                        <div class="col-md-5">
                                       
                                            <select name="ktpAyah" class="nik form-control form-control @error('ktpAyah') parsley-error @enderror">
                                            </select>
                                            @error('ktpAyah')
                                                <ul class="parsley-errors-list filled" id="parsley-id-7"><li class="parsley-required">{{ $message }}</li></ul>
                                            @enderror
                                        </div>
                                        <button type="button" id="cari1" class="ladda-button btn btn-primary" data-style="expand-left">
                                            Cari
                                        </button>
                                    </ul>
                                </div>
                                <div class="form-group">
                                    <label class="col-sm-2 control-label">Nama : </label>
                                    <div class="col-sm-6">
                                        <ul class="list-group">
                                            <li class="list-group-item nama1">
                                                . . . . . .
                                            </li>
                                        </ul>
                                    </div>

                                </div>
                                <div class="form-group">
                                    <label class="col-sm-2 control-label">Tempat Tgl Lahir : </label>
                                    <div class="col-sm-6">
                                        <ul class="list-group">
                                            <li class="list-group-item ttl1">
                                                . . . . . .
                                            </li>
                                        </ul>
                                    </div>
                                </div>
                                <div class="form-group">
                                    <label class="col-sm-2 control-label">Pekerjaan : </label>
                                    <div class="col-sm-5">
                                        <ul class="list-group">
                                            <li class="list-group-item job1">
                                                 . . . . . .
                                            </li>
                                        </ul>
                                    </div>
                                    <label class="col-sm-2 control-label">Agama : </label>
                                    <div class="col-sm-2">
                                        <ul class="list-group">
                                            <li class="list-group-item agama1">
                                                . . . . . .
                                            </li>
                                        </ul>
                                    </div>
                                </div>
                                <div class="form-group">
                                    <label class="col-sm-2 control-label">Alamat KTP : </label>
                                    <div class="col-sm-7">
                                        <ul class="list-group">
                                            <li class="list-group-item alamat1">
                                                . . . . . .
                                            </li>
                                        </ul>
                                    </div>
                                </div>
                                <div class="form-group">
                                    <label class="col-sm-2 control-label">Alamat Ayah Sekarang : </label>
                                    <div class="col-sm-7">
                                        <ul class="list-group">
                                            <input type="text" name="alamatAyahSekarang" class="form-control @error('alamatAyahSekarang') parsley-error @enderror" value="