<!DOCTYPE html>
<html lang="<?php echo e(str_replace('_', '-', app()->getLocale())); ?>">
<head>
    <meta charset="utf-8">
    <meta name="viewport" content="width=device-width, initial-scale=1">
    <title>LPKA Kelas II Jakarta - Tambah Laporan Anak Binaan</title>
    <link rel="icon" href="<?php echo e(asset('picture/favicon.ico')); ?>" type="image/x-icon">
    <link rel="shortcut icon" href="<?php echo e(asset('picture/favicon.ico')); ?>" type="image/x-icon">
    <?php echo app('Illuminate\Foundation\Vite')(['resources/css/app.css', 'resources/js/app.js']); ?>
    <style>
        body { font-family: Arial, sans-serif; background: #fff; color: #000; margin:0; padding:0; }
        .container { max-width: 1000px; margin: 20px auto; padding: 0 20px; }
        header h1 { margin:0 0 20px 0; font-size:22px; color:#1e40af; text-align:center; }
        h2 { color: #1e40af; font-weight: bold; margin-bottom: 20px; text-align:center; }
        .form-section { margin-bottom: 25px; }
        .form-section h3 { color: #1e40af; margin-bottom:10px; }
        label { display:block; font-weight:bold; margin-bottom:4px; }
        input, select, textarea { width:100%; padding:6px 8px; margin-bottom:8px; box-sizing:border-box; }
        textarea { min-height:50px; }
        .btn-submit { background:black; color:white; padding:8px 16px; border:none; cursor:pointer; margin-top:10px; }
        .btn-back { display:inline-block; margin-top:10px; text-decoration:none; color:black; background:#ddd; padding:8px 16px; }
        /* Grid dua kolom untuk form */
        .grid-two { display:grid; grid-template-columns: repeat(auto-fit, minmax(200px, 1fr)); gap:15px; }
        .grid-two > div { display:flex; flex-direction:column; }
        footer { text-align:center; font-size:12px; color:#555; margin-top:30px; }
    </style>
</head>
<body>

<div class="container">
    <header>
        <h1>LPKA Kelas II Jakarta - Tambah Laporan Anak Binaan</h1>
    </header>

    <form action="<?php echo e(route('laporan.store')); ?>" method="POST">
        <?php echo csrf_field(); ?>

        
        <div class="form-section">
            <label for="anak_id">Pilih Anak Binaan:</label>
            <select name="anak_id" id="anak_id" required>
                <option value="">-- Pilih Anak --</option>
                <?php $__currentLoopData = $anak; $__env->addLoop($__currentLoopData); foreach($__currentLoopData as $a): $__env->incrementLoopIndices(); $loop = $__env->getLastLoop(); ?>
                    <option value="<?php echo e($a->id); ?>"><?php echo e($a->nama); ?> - <?php echo e($a->alamat); ?></option>
                <?php endforeach; $__env->popLoop(); $loop = $__env->getLastLoop(); ?>
            </select>
        </div>

        
        <div class="grid-two form-section">
            <div>
                <label for="bulan">Bulan:</label>
                <input type="text" name="bulan" id="bulan" required>
            </div>
            <div>
                <label for="tahun">Tahun:</label>
                <input type="text" name="tahun" id="tahun" required>
            </div>
        </div>

        
        <div class="form-section">
            <h3>Pembinaan</h3>
            <div class="grid-two">
                <div>
                    <label>Disiplin:</label>
                    <input type="number" name="pembinaan[disiplin]" min="1" max="5">
                </div>
                <div>
                    <label>Partisipasi:</label>
                    <input type="number" name="pembinaan[partisipasi]" min="1" max="5">
                </div>
                <div>
                    <label>Tanggung Jawab:</label>
                    <input type="number" name="pembinaan[tanggung_jawab]" min="1" max="5">
                </div>
                <div>
                    <label>Catatan:</label>
                    <textarea name="pembinaan[catatan]"></textarea>
                </div>
            </div>
        </div>

        
        <div class="form-section">
            <h3>Kesehatan</h3>
            <div class="grid-two">
                <div><label>Tekanan Darah:</label><input type="text" name="kesehatan[tekanan_darah]"></div>
                <div><label>Nadi:</label><input type="number" name="kesehatan[nadi]"></div>
                <div><label>Suhu:</label><input type="number" step="0.1" name="kesehatan[suhu]"></div>
                <div><label>Berat Badan:</label><input type="number" step="0.1" name="kesehatan[berat_badan]"></div>
                <div><label>Tinggi Badan:</label><input type="number" step="0.1" name="kesehatan[tinggi_badan]"></div>
                <div><label>Diagnosa:</label><input type="text" name="kesehatan[diagnosa]"></div>
                <div><label>Tindakan:</label><input type="text" name="kesehatan[tindakan]"></div>
            </div>
        </div>

        
        <div class="form-section">
            <h3>Psikologi</h3>
            <div class="grid-two">
                <div><label>Kontrol Emosi:</label><input type="text" name="psikologi[kontrol_emosi]"></div>
                <div><label>Motivasi:</label><input type="text" name="psikologi[motivasi]"></div>
                <div><label>Interaksi Sosial:</label><input type="text" name="psikologi[interaksi_sosial]"></div>
                <div><label>Tingkat Risiko:</label><input type="text" name="psikologi[tingkat_risiko]"></div>
                <div><label>Kondisi Emosional:</label><input type="text" name="psikologi[kondisi_emosional]"></div>
                <div><label>Rekomendasi:</label><input type="text" name="psikologi[rekomendasi]"></div>
            </div>
        </div>

        
        <div class="form-section">
            <h3>Pengajian</h3>
            <div class="grid-two">
                <div><label>Program:</label><input type="text" name="pengajian[program]"></div>
                <div><label>Halaman:</label><input type="text" name="pengajian[halaman]"></div>
                <div><label>Target:</label><input type="text" name="pengajian[target]"></div>
            </div>
        </div>

        <button type="submit" class="btn-submit">Simpan Laporan</button>
    </form>

    <a href="<?php echo e(route('laporan.index')); ?>" class="btn-back">Kembali ke Daftar Laporan</a>

    <footer>
        &copy; <?php echo e(now()->year); ?> LPKA Kelas II Jakarta | <a href="<?php echo e(url('/')); ?>">Menu Utama</a>
    </footer>
</div>

</body>
</html><?php /**PATH /home/lpkaberk/public_html/resources/views/laporan/create.blade.php ENDPATH**/ ?>