@extends('master')
@section('content')

<style type="text/css">
  
    @font-face {
      font-family: "Code39";
      src: url(/fonts/code39r.ttf ); /* IE */
      src: local("Code 39"), url(/fonts/code39r.ttf format("truetype"); /* non-IE */
      font-style: normal;
      font-weight: 100;
  }

  .off-canvas-wrap {
    min-height: 800px;
  }
  select[multiple] {
    height: 100px;
  }
</style>

<div class="row">
    <div class="large-12 columns">
        <div class="row">
            <div class="small-12 medium-12 large-12 columns">
                <h4>Laboratory Order</h4>
            </div>
        </div>
    </div>
</div>

	<div class="row">
		<div class="small-12 medium-12 large-12 columns">

			<p>
				<p>{{{$greeting}}}</p>
			</p>
			<p>
				Bldg 3792 Rm 129 Old Davis Rd 
Davis, CA 95616<br>
				(530) 752-1340<br>
				Date: {{{date("d, M Y")}}}<br>
				Time: {{{date("h:i:sa")}}}<br>
				Lab: {{{$laboratory->value}}}<br>
				Mr./Ms. {{{$patientData->fname . ' ' . $patientData->lname}}}<br>
				DOB: {{ date("F d Y",strtotime($patientData->DOB)) }}<br>
			</p>
			<p style="font-family: 'Code39'; font-size: 40px">
        {{{date("dnY")}}}-{{{$restriction}}}
      </p>
			<p>
				<strong>Employer:</strong> <br>
              {{{$employer->name}}}<br>
                {{{$employer->street}}}<br>
                {{{$employer->city}}}<br>
                {{{$employer->state}}}<br>
                {{{$employer->postal_code}}}
			</p>
			<p>
				@if($restriction == 1)
           {{$labOrderTextBaseline}}
        @elseif($restriction == 2)
        	{{$labOrderTextInitial}}
        @elseif($restriction == 3)
        	{{$labOrderTextRoutine}}
        @elseif($restriction == 4)
        	{{$labOrderTextEvaluation}}
        @elseif($restriction == 5)
          {{$labOrderTextRecovery}}
        @endif 
			</p>
			<p>
				{{{$sign}}}
			</p>
		</div>
	</div>

	<div class="row">
		<div class="small-12 medium-3 large-3 columns">
			<a href="{{{URL::to('/patients/'. $patientData->pid .'/lab/order/print?restriction='. $restriction)}}}" class="digital-signature button expand">Print</a>
		</div>
		<div class="small-12 medium-3 large-3 end columns">
			<a href="{{{URL::to('/patients/'. $patientData->pid)}}}" class="button expand">Back</a>
		</div>
	</div>

	<div id="myModal" class="reveal-modal" data-reveal aria-labelledby="modalTitle" aria-hidden="true" role="dialog">
        <form id="actionForm" action="" method="POST">
            <input hidden name="pid" value="{{{$patientData->pid}}}" />
            <input hidden name="examType" value="followUp" />
        </form>
        <form id="signForm" action="" method="GET">
            <div class="row">
              <div class="large-6 columns">
                <label for="password">Please type your digital signature password</label>
                <input type="password" name="password">
                <button class="button">Sign</button>
              </div>
            </div>
        </form>
      <a class="close-reveal-modal" aria-label="Close">&#215;</a>
    </div>
	<script>

    $(document).ready(function(){
        $('#signForm').submit(function(e) {
            e.preventDefault();
            var url = '{{ URL::to("sign") }}';
            var passvalue = $("#signForm").find( "input[name='password']" ).val();
            var formData = {};
            $("#signForm").find("input[name='password']").each(function (index, node) {
                formData[node.name] = node.value;
            });
            $.ajax({
              type: "POST",
              url: url,
              contentType: "application/x-www-form-urlencoded; charset=UTF-8",
              data: formData
            }).done(function(response) {
              if(response==='true'){
                  $("#actionForm").attr("action", $('a.digital-signature').attr("href"));
                  $("#actionForm").submit();
              }
            });
        });
        $('a.digital-signature').on('click', function(e) {
            e.preventDefault();
            $('#myModal').foundation('reveal','open');
        });

       $('#close').foundation('reveal', 'close');
    });

    </script>


@stop