{% extends "hostis-main.html" %}


{% block head %}
    {{ block.super }}
    <script>

        $(function () {
            $(document).tooltip();

            $("#edit-example-rx-info").dialog({
                {% if show_add_edit == 'Y' %}
                    autoOpen: true,
                {% else %}
                    autoOpen: false,
                {% endif %}
                closeOnEscape: false,
                modal: true,
                draggable: false,
                width: 1300,
                buttons: [
                    {
                        text: "Close",
                        "class": 'modal-dialog-button-right',
                        click: function () {
                            $(this).dialog("close");
                        }
                    },
                    {
                        text: "Save",
                        "class": 'modal-dialog-button-left',
                        click: function () {
                            $("#editExampleRxForm").validate();
                            if ($("#editExampleRxForm").valid()) {
                                document.editExampleRxForm.submit();
                                $(this).dialog("close");
                            }
                        }
                    }
                ]
            });

             {% if show_add_edit == 'Y' %}
                $("#editExampleRxForm").validate({
                    onkeyup: false,
                    errorContainer: $("#edit-example-rx-info-validation-alert"),
                    errorLabelContainer: $("ul", $("#edit-example-rx-info-validation-alert")),
                    wrapper: 'li'
                });

                $("#add-sig").click(function() {
                    var form_idx = $("#id_sig-TOTAL_FORMS").val();
                    $("#sig-form").append($("#empty_form").html().replace(/__prefix__/g, form_idx));
                    $("#id_sig-" + form_idx + "-sig-num-val").html(parseInt(form_idx) + 1);
                    $("#id_sig-" + form_idx + "-sig_number").val(parseInt(form_idx) + 1);

                    $("#id_sig-TOTAL_FORMS").val(parseInt(form_idx) + 1);
                });

                $("#editExampleRxForm").on("click", "button[name^='del-sig-btn-']", function () {
                    var form_idx = $("#id_sig-TOTAL_FORMS").val();
                    $(this).closest('table').remove();
                    $("#id_sig-TOTAL_FORMS").val(parseInt(form_idx) - 1);
                });

            {% endif %}

        });
    </script>
{% endblock %}

{% block pagehead %}
    {% include 'hostis-pagehead.html' %}
{% endblock %}

{% block content %}
    <form name="exampleRxManageForm" id="exampleRxManageForm" method="POST">
    {% csrf_token %}
    <table id="example-rx-table" class="table table-striped table-bordered table-condensed">
    <thead>
    <tr class="dosis-report-header">
        {% include 'report-table-header.html' %}
        <th><i class="icon-th-list"></i></th>
    </tr>
    </thead>
    <tbody>
    {% for rx in report_list %}
        <tr>
            <td style="padding-bottom: 2px;">{{ rx.comment}}</td>
            <td style="padding-bottom: 2px;">{{ rx.fill_instance }}</td>
            <td style="padding-bottom: 2px;">{{ rx.rx_quantity }}</td>
            <td style="padding-bottom: 2px;">{{ rx.days_supply }}</td>
            <td style="padding-bottom: 2px;">{{ rx.total_refills }}</td>
            <td style="padding-bottom: 2px;">{{ rx.refills_left }}</td>
            <td style="padding-bottom: 2px;">{{ rx.number_of_labels }}</td>
            <td style="padding-bottom: 2px;">{{ rx.multisig }}</td>
            <td style="padding-bottom: 2px;">{{ rx.active }}</td>
            <td style="padding-bottom: 2px;"><a href="{% url 'hostis:edit-example-rx-info' rx.id %}">
                                <i title="Edit Example Rx" class="icon-pencil"></i></a></td>
        </tr>
    {% endfor %}
    </tbody>
    </table>
    <div><a class="btn" href="{% url 'hostis:add-example-rx-info' %}">Add Example Rx</a></div>
    </form>
    <div id="edit-example-rx-info" title="Edit Example Rx Info" style="margin-left: 2px;">
        <form id="editExampleRxForm" name="editExampleRxForm" method="POST">
            {% csrf_token %}
            <div class="alert alert-error" id="edit-example-rx-info-validation-alert" style="display: none;">
                <button type="button" class="close" data-dismiss="alert">&times;</button>
                <ul id="edit-example-rx-info-validation-error-list">
                </ul>
            </div>
             {{ sig_formset.management_form }}
            <div id="rx-form">
            <table id="edit-rx-table" style="width: 90%;">
                <tr>
                    <td class="site-drug-edit-td">{{ edit_rx_form.id }}Description: {{ edit_rx_form.comment }}</td>
                </tr>
                <tr>
                    <td class="site-drug-edit-td">Quantity: {{ edit_rx_form.rx_quantity }}&nbsp;&nbsp;&nbsp;
                        Days: {{ edit_rx_form.days_supply }}&nbsp;&nbsp;&nbsp;
                        Multisig?: {{ edit_rx_form.multisig }}&nbsp;&nbsp;&nbsp;
                        Active?: {{ edit_rx_form.active }}</td>
                </tr>
                <tr>
                    <td class="site-drug-edit-td">
                        Fill Instance: {{ edit_rx_form.fill_instance }}&nbsp;&nbsp;&nbsp;
                        Total Refills: {{ edit_rx_form.total_refills }}&nbsp;&nbsp;&nbsp;
                        Refills Left: {{ edit_rx_form.refills_left }}&nbsp;&nbsp;&nbsp;
                        Number of Labels: {{ edit_rx_form.number_of_labels }}
                    </td>
                </tr>
                <tr>
                    <td class="site-drug-edit-td">
                        <button class="btn" type="button" id="add-sig" name="add-sig">Add Sig</button>
                    </td>
                </tr>
             </table>
            </div>
            <div id="sig-form">
            {% for form in sig_formset %}
                <table id="sig-form-table-{{ form.sig_number.value }}">
                    <tr>
                        <td style="border-top:2pt solid black; padding-left: 15px;">{{ form.id }}{{ form.sig_number }}
                            Sig Number: <b>{{ form.sig_number.value }}</b>&nbsp;&nbsp;&nbsp;
                            Sig Code: {{ form.sig_code }}&nbsp;&nbsp;&nbsp;
                            Number of Labels: {{ form.num_labels }}&nbsp;&nbsp;&nbsp;
                            PRN?: {{ form.is_prn }}
                        </td>{% if not forloop.first %}
                        <td><button id="exist-del-sig-btn-{{ form.id.value }}"
                                            name="exist-del-sig-btn-{{ form.id.value }}" value="{{ form.id.value }}"><i class="icon-minus-sign"></i></button></td>{% endif %}
                    </tr>
                    <tr>
                        <td style="padding-left: 15px;">
                            Sig Text: {{ form.sig_text }}
                        </td>
                    </tr>
                    <tr>
                        <td style="padding-left: 15px;">
                            Qty Per Dose: {{ form.qty_per_dose }}&nbsp;&nbsp;&nbsp;
                            Qty Per Day: {{ form.qty_per_day }}&nbsp;&nbsp;&nbsp;
                            Admin Days: {{ form.admin_schedule }}
                            Admin Times: {{ form.hoa }}
                        </td>
                    </tr>
                </table>
            {% endfor %}
            </div>
                <div id="empty_form" style="display:none">
                        <table>
                            <tr>
                                <td style="border-top:2pt solid black; padding-left: 15px;">{{ sig_formset.empty_form.id }}
                                    {{ sig_formset.empty_form.sig_number }}
                                    Sig Number: <b id="id_sig-__prefix__-sig-num-val">{{ sig_formset.empty_form.sig_number.value }}</b>&nbsp;&nbsp;&nbsp;
                                    Sig Code: {{ sig_formset.empty_form.sig_code }}&nbsp;&nbsp;&nbsp;
                                    Number of Labels: {{ sig_formset.empty_form.num_labels }}&nbsp;&nbsp;&nbsp;
                                    PRN?: {{ sig_formset.empty_form.is_prn }}
                                </td>
                                <td><button type="button" id="del-sig-btn-__prefix__"
                                            name="del-sig-btn-__prefix__" value="__prefix__"><i class="icon-minus-sign"></i></button></td>
                            </tr>
                            <tr>
                                <td style="padding-left: 15px;">
                                    Sig Text: {{ sig_formset.empty_form.sig_text }}
                                </td>
                            </tr>
                            <tr>
                                <td style="padding-left: 15px;">
                                    Qty Per Dose: {{ sig_formset.empty_form.qty_per_dose }}&nbsp;&nbsp;&nbsp;
                                    Qty Per Day: {{ sig_formset.empty_form.qty_per_day }}&nbsp;&nbsp;&nbsp;
                                    Admin Days: {{ sig_formset.empty_form.admin_schedule }}
                                    Admin Times: {{ sig_formset.empty_form.hoa }}
                                </td>
                            </tr>
                        </table>
                </div>

        </form>
    </div>
{% endblock %}