@extends('layouts.app')

@section('content')
    <div class="container mt-5">
        <div class="col-md-6 offset-md-3">
            <div class="card">
                <div class="card-body">
                    <h2 class="card-title text-center mb-4">User Registration</h2>
                    <form method="POST" action="{{ route('register') }}">
                        @csrf

                        <div class="form-group">
                            <label for="name">IC Number:</label>
                            <input type="text" class="form-control" name="id_no" required>
                            @error('id_no')
                                <small class="text-danger">{{ $message }}</small>
                            @enderror
                        </div>

                        <div class="form-group">
                            <label for="name">Name:</label>
                            <input type="text" class="form-control" name="name" value="{{ old('name') }}" required>
                            @error('name')
                                <small class="text-danger">{{ $message }}</small>
                            @enderror
                        </div>

                        <div class="form-group">
                            <label for="email">Email:</label>
                            <input type="email" class="form-control" name="email" value="{{ old('email') }}" required>
                            @error('email')
                                <small class="text-danger">{{ $message }}</small>
                            @enderror
                        </div>

                        <div class="form-group">
                            <label for="password">Password:</label>
                            <input type="password" class="form-control" name="password" required>
                            @error('password')
                                <small class="text-danger">{{ $message }}</small>
                            @enderror
                        </div>

                        <div class="form-group">
                            <label for="password_confirmation">Confirm Password:</label>
                            <input type="password" class="form-control" name="password_confirmation" required>
                        </div>

                        <div class="form-group">
                            <label for="address1">Address - Line 1:</label>
                            <input type="text" class="form-control" name="address1" required>
                            @error('address1')
                                <small class="text-danger">{{ $message }}</small>
                            @enderror
                        </div>

                        <div class="form-group">
                            <label for="address2">Address - Line 2:</label>
                            <input type="text" class="form-control" name="address2" required>
                            @error('address2')
                                <small class="text-danger">{{ $message }}</small>
                            @enderror
                        </div>

                        <div class="form-group">
                            <label for="city">City:</label>
                            <input type="text" class="form-control" name="city" required>
                            @error('city')
                                <small class="text-danger">{{ $message }}</small>
                            @enderror
                        </div>

                        <div class="form-group">
                            <label for="postcode">Postcode:</label>
                            <input type="text" class="form-control" name="postcode" required>
                            @error('postcode')
                                <small class="text-danger">{{ $message }}</small>
                            @enderror
                        </div>

                        <div class="form-group">
                            <label for="state">State:</label>
                            <select class="form-control" name="state" required>
                                <option value="" disabled selected>Select State</option>
                                @foreach ($states as $state)
                                    <option value="{{ $state->id }}">{{ $state->shortname }}</option>
                                @endforeach
                            </select>
                            @error('state')
                                <small class="text-danger">{{ $message }}</small>
                            @enderror
                        </div>

                        <div class="form-group">
                            <label for="mobile_no">Mobile No:</label>
                            <input type="text" class="form-control" name="mobile_no" required>
                            @error('mobile_no')
                                <small class="text-danger">{{ $message }}</small>
                            @enderror
                        </div>

                        <div class="form-group">
                            <button type="submit" class="btn btn-primary">Register</button>
                        </div>
                    </form>
                </div>
            </div>
        </div>
    </div>
@endsection