TKK_E32220316/resources/views/pendaftaran_balita.blade.php

203 lines
8.1 KiB
PHP

<!DOCTYPE html>
<html>
<head>
<!-- Basic -->
<meta charset="utf-8" />
<meta http-equiv="X-UA-Compatible" content="IE=edge" />
<!-- Mobile Metas -->
<meta name="viewport" content="width=device-width, initial-scale=1, shrink-to-fit=no" />
<!-- Site Metas -->
<meta name="keywords" content="" />
<meta name="description" content="" />
<meta name="author" content="" />
<title>NutriPosy</title>
<link rel="icon" type="image/png" href="images/nutriposy.png">
<!-- bootstrap core css -->
<link rel="stylesheet" type="text/css" href="css/bootstrap.css" />
<!-- fonts style -->
<link href="https://fonts.googleapis.com/css2?family=Roboto:wght@400;500;700;900&display=swap" rel="stylesheet">
<!-- owl slider stylesheet -->
<link rel="stylesheet" type="text/css"
href="https://cdnjs.cloudflare.com/ajax/libs/OwlCarousel2/2.3.4/assets/owl.carousel.min.css" />
<!-- font awesome style -->
<link href="css/font-awesome.min.css" rel="stylesheet" />
<!-- nice select -->
<link rel="stylesheet"
href="https://cdnjs.cloudflare.com/ajax/libs/jquery-nice-select/1.1.0/css/nice-select.min.css"
integrity="sha256-mLBIhmBvigTFWPSCtvdu6a76T+3Xyt+K571hupeFLg4=" crossorigin="anonymous" />
<!-- datepicker -->
<link rel="stylesheet"
href="https://cdnjs.cloudflare.com/ajax/libs/bootstrap-datepicker/1.3.0/css/datepicker.css">
<!-- Custom styles for this template -->
<link href="css/style.css" rel="stylesheet" />
<!-- responsive style -->
<link href="css/responsive.css" rel="stylesheet" />
</head>
<body>
<div class="hero_area">
<!-- header section starts -->
<header class="header_section">
<div class="header_bottom">
<div class="container-fluid">
<nav class="navbar navbar-expand-lg custom_nav-container">
<a class="navbar-brand" href="#">
<img src="images/nutriposy.png" alt="">
</a>
<!-- PERBAIKAN tombol hamburger -->
<button class="navbar-toggler" type="button" data-toggle="collapse"
data-target="#navbarSupportedContent" aria-controls="navbarSupportedContent" aria-expanded="false"
aria-label="Toggle navigation">
<span class="navbar-toggler-icon"></span>
</button>
<div class="collapse navbar-collapse" id="navbarSupportedContent">
<div class="d-flex mr-auto flex-column flex-lg-row align-items-center">
<ul class="navbar-nav">
<li class="nav-item active">
<a class="nav-link" href="{{ route('dashboard') }}">Beranda</a>
</li>
</ul>
</div>
</div>
</nav>
</div>
</div>
</header>
<!-- end header section -->
<section class="book_section layout_padding">
<div class="container">
<h4>Pendaftaran <span>Balita</span></h4>
<!-- ALERT BERHASIL -->
@if(session('success'))
<div class="alert alert-success alert-dismissible fade show" role="alert">
{{ session('success') }}
<button type="button" class="close" data-dismiss="alert" aria-label="Close">
<span aria-hidden="true">&times;</span>
</button>
</div>
@endif
<form action="{{ route('balita.store') }}" method="POST">
@csrf
<div class="form-row">
<div class="form-group col-lg-4">
<label for="nik">NIK</label>
<input type="text" name="nik" class="form-control @error('nik') is-invalid @enderror" id="nik"
value="{{ old('nik') }}" placeholder="Masukkan NIK">
@error('nik')
<div class="invalid-feedback">{{ $message }}</div>
@enderror
</div>
<div class="form-group col-lg-4">
<label for="nama_anak">Nama Anak</label>
<input type="text" name="nama_anak" class="form-control @error('nama_anak') is-invalid @enderror"
id="nama_anak" value="{{ old('nama_anak') }}" placeholder="Masukkan nama anak">
@error('nama_anak')
<div class="invalid-feedback">{{ $message }}</div>
@enderror
</div>
<div class="form-group col-lg-4">
<label for="jenis_kelamin">Jenis Kelamin</label>
<select name="jenis_kelamin" class="form-control @error('jenis_kelamin') is-invalid @enderror"
id="jenis_kelamin">
<option value="">-- Pilih Jenis Kelamin --</option>
<option value="Laki-laki" {{ old('jenis_kelamin') == 'Laki-laki' ? 'selected' : '' }}>Laki-laki</option>
<option value="Perempuan" {{ old('jenis_kelamin') == 'Perempuan' ? 'selected' : '' }}>Perempuan</option>
</select>
@error('jenis_kelamin')
<div class="invalid-feedback">{{ $message }}</div>
@enderror
</div>
</div>
<div class="form-row">
<div class="form-group col-lg-4">
<label for="tanggal_lahir">Tanggal Lahir</label>
<input type="date" name="tanggal_lahir"
class="form-control @error('tanggal_lahir') is-invalid @enderror" id="tanggal_lahir"
value="{{ old('tanggal_lahir') }}">
@error('tanggal_lahir')
<div class="invalid-feedback">{{ $message }}</div>
@enderror
</div>
<div class="form-group col-lg-4">
<label for="tempat_lahir">Tempat Lahir</label>
<input type="text" name="tempat_lahir"
class="form-control @error('tempat_lahir') is-invalid @enderror" id="tempat_lahir"
value="{{ old('tempat_lahir') }}" placeholder="Masukkan tempat lahir">
@error('tempat_lahir')
<div class="invalid-feedback">{{ $message }}</div>
@enderror
</div>
<div class="form-group col-lg-4">
<label for="ibu_kandung">Nama Ibu Kandung</label>
<input type="text" name="ibu_kandung"
class="form-control @error('ibu_kandung') is-invalid @enderror" id="ibu_kandung"
value="{{ old('ibu_kandung') }}" placeholder="Masukkan nama ibu">
@error('ibu_kandung')
<div class="invalid-feedback">{{ $message }}</div>
@enderror
</div>
</div>
<div class="form-row">
<div class="form-group col-lg-4">
<label for="nama_ayah">Nama Ayah</label>
<input type="text" name="nama_ayah" class="form-control @error('nama_ayah') is-invalid @enderror"
id="nama_ayah" value="{{ old('nama_ayah') }}" placeholder="Masukkan nama ayah">
@error('nama_ayah')
<div class="invalid-feedback">{{ $message }}</div>
@enderror
</div>
<div class="form-group col-lg-8">
<label for="alamat">Alamat</label>
<textarea name="alamat" class="form-control @error('alamat') is-invalid @enderror" id="alamat" rows="2"
placeholder="Masukkan alamat lengkap">{{ old('alamat') }}</textarea>
@error('alamat')
<div class="invalid-feedback">{{ $message }}</div>
@enderror
</div>
</div>
<div class="btn-box">
<button type="submit" class="btn btn-primary">Simpan Data</button>
</div>
</form>
</div>
</section>
<!-- footer section -->
<footer class="footer_section">
<div class="container">
<p>
&copy; <span id="displayYear"></span> All Rights Reserved By
<a href="#">NutriPosy</a>
</p>
</div>
</footer>
</div>
<!-- Tambahkan jQuery & Bootstrap JS sebelum </body> -->
<script src="https://code.jquery.com/jquery-3.6.0.min.js"></script>
<script src="https://cdn.jsdelivr.net/npm/bootstrap@4.6.2/dist/js/bootstrap.bundle.min.js"></script>
<!-- Script untuk auto-close alert -->
<script>
setTimeout(function () {
$('.alert').alert('close');
}, 3000); // hilang setelah 3 detik
</script>
</body>
</html>