@php
$categories = ['Travel' => 'Travel', 'Meal' => 'Meal', 'Accommodation' => 'Accommodation', 'Office Supplies' => 'Office Supplies', 'Other' => 'Other'];
$paymentMethods = ['Cash' => 'Cash', 'Credit Card' => 'Credit Card', 'Bank Transfer' => 'Bank Transfer','UPI' => 'UPI', 'Other' => 'Other'];
@endphp

<div class="modal fade" id="ajaxModel" aria-hidden="true">
    <div class="modal-dialog modal-lg">
        <div class="modal-content">
            <div class="card card-signup card-plain">
                {!! Form::open(['id' => 'dataForm', 'name' => 'dataForm', 'class' => 'form-horizontal', 'enctype' => 'multipart/form-data']) !!}
                {!! Form::hidden('reimbursement_id', '', ['id' => 'reimbursement_id']) !!}
                {{ csrf_field() }}

                <div class="modal-header">
                    <div class="card-header card-header-primary text-center" style="margin-top: -30px;">
                        <button type="button" class="close" data-bs-dismiss="modal" aria-hidden="true">
                            <i class="fa fa-times"></i>
                        </button>
                        <h4 class="card-title" id="modelHeading">Add Reimbursement</h4>
                    </div>
                </div>

                <div class="modal-body">

                    <div class="row mb-3">
                        <div class="col-md-6">
                            <label for="site_id" class="col-form-label">Site Name <k>*</k></label>
                            {!! Form::select('site_id', $sites, null, ['class' => 'form-control', 'placeholder' => 'Select Site', 'id' => 'site_id', 'required']) !!}
                            <span class="text-danger" id="site_id-error"></span>
                        </div>
                        <div class="col-md-6">
                            <label for="category" class="col-form-label">Category <k>*</k></label>
                            {!! Form::select('category[]', $categories, null, [
                            'class' => 'form-control standardSelect',
                            'placeholder' => 'Select Category',
                            'id' => 'category',
                            'multiple' => 'multiple'
                            ]) !!}
                            <span class="text-danger" id="category-error"></span>
                        </div>

                    </div>

                    <div class="row mb-3">
                        <div class="col-md-6">
                            <label for="amount" class="col-form-label">Amount <k>*</k></label>
                            {!! Form::number('amount', '', ['class' => 'form-control', 'id' => 'amount', 'placeholder' => 'Enter amount', 'step' => '0.01']) !!}
                            <span class="text-danger" id="amount-error"></span>
                        </div>

                        <div class="col-md-6">
                            <label for="payment_method" class="col-form-label">Payment Method <k>*</k></label>
                            {!! Form::select('payment_method', $paymentMethods, null, ['class' => 'form-control', 'placeholder' => 'Select Payment Method', 'id' => 'payment_method']) !!}
                            <span class="text-danger" id="payment_method-error"></span>
                        </div>
                    </div>


                    <div class="row mb-3">
                        <div class="col-md-12">
                            <label for="description" class="col-form-label">Description</label>
                            {!! Form::textarea('description', '', ['class' => 'form-control', 'id' => 'description', 'placeholder' => 'Optional description...', 'rows' => 2]) !!}
                            <span class="text-danger" id="description-error"></span>
                        </div>
                    </div>




                    <div class="row mb-3">
                        <div class="col-md-12">
                            <label for="receipt_attachment" class="col-form-label">Receipt Attachment</label>
                            {!! Form::file('receipt_attachment[]', ['class' => 'form-control', 'id' => 'receipt_attachment', 'multiple' => 'multiple']) !!}
                            <span class="text-danger" id="receipt_attachment-error"></span>
                        </div>
                    </div>
                    <div class="row mb-3">
                        <div class="col-md-12">
                            <label for="date_of_expense" class="col-form-label">Date of Expense <k>*</k></label>
                            {!! Form::date('date_of_expense', null, ['class' => 'form-control', 'id' => 'date_of_expense']) !!}
                            <span class="text-danger" id="date_of_expense-error"></span>
                        </div>
                    </div>



                </div>

                <div class="modal-footer justify-content-center" style="border-top: 1px solid #e9ecef;">
                    <button type="button" class="btn btn-secondary" data-bs-dismiss="modal">Close</button>
                    {!! Form::submit('Save Changes', ['class' => 'btn btn-primary', 'id' => 'saveBtn']) !!}
                </div>

                {!! Form::close() !!}
            </div>
        </div>
    </div>
</div>