224 lines
7.8 KiB
PHP
224 lines
7.8 KiB
PHP
<!doctype html>
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<html lang="id">
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<head>
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<meta charset="UTF-8" />
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<meta name="viewport" content="width=device-width, initial-scale=1.0" />
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<title>Edit Pengajuan TEST - E-Lades</title>
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<link href="https://cdn.jsdelivr.net/npm/bootstrap@5.3.0/dist/css/bootstrap.min.css" rel="stylesheet" />
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<link rel="stylesheet" href="https://cdn.jsdelivr.net/npm/bootstrap-icons@1.11.1/font/bootstrap-icons.css" />
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<style>
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body {
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background-color: #f0f5ff; /* Background biru sangat muda sesuai gambar */
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font-family: "Segoe UI", Roboto, Helvetica, Arial, sans-serif;
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color: #334155;
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}
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/* Header Biru Tua Solid */
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.header-government {
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background-color: #2c4e8a;
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color: white;
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border-radius: 12px;
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padding: 20px 30px;
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box-shadow: 0 4px 6px -1px rgba(0, 0, 0, 0.1);
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}
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.btn-back {
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background-color: white;
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color: #334155;
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font-weight: 600;
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border-radius: 8px;
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padding: 8px 18px;
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border: 1px solid #e2e8f0;
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font-size: 0.85rem;
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text-decoration: none;
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}
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/* Container Putih Utama */
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.form-container-main {
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background-color: white;
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border-radius: 20px;
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padding: 40px;
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box-shadow: 0 10px 25px rgba(0, 0, 0, 0.02);
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margin-top: 25px;
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margin-bottom: 50px;
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}
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/* Box Section (Informasi Pemohon & Formulir) */
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.section-box {
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background-color: #f8fbff; /* Biru transparan tipis */
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border-radius: 15px;
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padding: 25px;
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margin-bottom: 30px;
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border: 1px solid #eef2f7;
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}
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.section-title {
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color: #2c4e8a;
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font-weight: 600;
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font-size: 1.1rem;
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text-align: center;
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margin-bottom: 25px;
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letter-spacing: 0.5px;
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}
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/* Style Input & Label */
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.form-label {
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font-weight: 600;
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font-size: 0.9rem;
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color: #1e293b;
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margin-bottom: 8px;
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display: flex;
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align-items: center;
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}
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.form-label i {
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margin-right: 8px;
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color: #64748b;
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font-size: 1rem;
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}
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.text-danger {
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color: #ef4444 !important;
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margin-left: 4px;
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}
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.form-control,
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.form-select {
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border: 1px solid #e2e8f0;
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border-radius: 10px;
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padding: 12px 15px;
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font-size: 0.95rem;
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color: #475569;
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background-color: white;
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}
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.form-control:focus {
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border-color: #2c4e8a;
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box-shadow: 0 0 0 4px rgba(44, 78, 138, 0.1);
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}
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/* Helper Text di bawah input */
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.form-text {
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font-size: 0.8rem;
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color: #94a3b8;
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margin-top: 6px;
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display: flex;
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align-items: center;
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}
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.form-text i {
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margin-right: 5px;
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}
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/* Tombol Perbarui (Biru Tua) */
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.btn-update-government {
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background-color: #2c4e8a;
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color: white;
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padding: 14px 40px;
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border-radius: 10px;
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font-weight: 600;
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border: none;
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display: inline-flex;
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align-items: center;
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justify-content: center;
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gap: 10px;
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transition: all 0.3s;
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text-transform: uppercase;
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letter-spacing: 1px;
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}
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.btn-update-government:hover {
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background-color: #1e3a6d;
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transform: translateY(-2px);
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color: white;
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}
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.footer-note {
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font-size: 0.85rem;
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color: #94a3b8;
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margin-top: 15px;
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}
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</style>
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</head>
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<body>
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<div class="container mt-4">
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<div class="header-government d-flex justify-content-between align-items-center">
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<div>
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<h5 class="fw-semibold mb-1"><i class="bi bi-pencil-square me-2"></i>Edit Pengajuan TEST</h5>
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<p class="small mb-0 opacity-75">Perbarui informasi pengajuan TEST</p>
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</div>
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<a href="{{ route('pengajuan.index') }}" class="btn-back"><i class="bi bi-arrow-left me-1"></i> Kembali</a>
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</div>
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<div class="form-container-main">
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<form id="formEdit">
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<div class="section-box">
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<div class="section-title">Informasi Pemohon</div>
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<div class="row g-4">
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<div class="col-md-6">
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<label class="form-label"><i class="bi bi-card-heading"></i>NIK <span class="text-danger">*</span></label>
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<input type="text" class="form-control" value="1111111111111111" />
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<div class="form-text"><i class="bi bi-info-circle"></i> NIK harus sesuai dengan KTP</div>
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</div>
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<div class="col-md-6">
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<label class="form-label"><i class="bi bi-person"></i>Nama Lengkap <span class="text-danger">*</span></label>
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<input type="text" class="form-control" value="Test" />
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<div class="form-text"><i class="bi bi-check2-circle"></i> Nama harus sesuai dengan identitas resmi</div>
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</div>
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<div class="col-md-12">
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<label class="form-label"><i class="bi bi-telephone"></i>Nomor Telepon <span class="text-danger">*</span></label>
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<input type="text" class="form-control" value="085850367053" style="max-width: 100%" />
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<div class="form-text"><i class="bi bi-chat-dots"></i> Nomor ini akan digunakan untuk mengirim notifikasi status pengajuan</div>
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</div>
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</div>
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</div>
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<div class="section-box">
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<div class="section-title">Formulir Surat</div>
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<div class="row g-4">
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<div class="col-md-12">
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<label class="form-label"><i class="bi bi-pencil"></i>Nama <span class="text-danger">*</span></label>
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<input type="text" class="form-control" value="Test" />
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<div class="form-text"><i class="bi bi-info-circle"></i> Isi dengan data yang akurat</div>
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</div>
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<div class="col-md-12">
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<label class="form-label"><i class="bi bi-list-ul"></i>Jenis Kelamin <span class="text-danger">*</span></label>
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<select class="form-select">
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<option>Laki-laki</option>
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<option selected>Perempuan</option>
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</select>
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<div class="form-text"><i class="bi bi-cursor"></i> Pilih salah satu opsi yang tersedia</div>
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</div>
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<div class="col-md-6">
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<label class="form-label"><i class="bi bi-geo-alt"></i>Tempat Lahir <span class="text-danger">*</span></label>
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<input type="text" class="form-control" value="Nganjuk" />
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</div>
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<div class="col-md-6">
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<label class="form-label">Tanggal Lahir <span class="text-danger">*</span></label>
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<input type="date" class="form-control" value="2026-03-25" />
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</div>
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<div class="col-md-12">
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<div class="form-text"><i class="bi bi-calendar-check"></i> Isi tempat dan tanggal lahir sesuai KTP</div>
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</div>
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<div class="col-md-12">
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<label class="form-label"><i class="bi bi-chat-left-text"></i>Alamat <span class="text-danger">*</span></label>
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<textarea class="form-control" rows="4">Nganjuk</textarea>
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<div class="form-text"><i class="bi bi-info-circle"></i> Jelaskan dengan detail dan jelas</div>
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</div>
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</div>
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</div>
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<div class="text-center mt-4">
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<button type="submit" class="btn btn-update-government"><i class="bi bi-check2-circle"></i> Perbarui Pengajuan</button>
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<div class="footer-note"><i class="bi bi-info-circle me-1"></i> Pastikan semua data yang dimasukkan sudah benar sebelum menyimpan</div>
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</div>
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</form>
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</div>
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</div>
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<script src="https://cdn.jsdelivr.net/npm/bootstrap@5.3.0/dist/js/bootstrap.bundle.min.js"></script>
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</body>
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</html>
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