@include('layouts.header', ['title' => 'Add Survey Details'])
    <div class="wrapper">
    @include('layouts.agency-user-navbar')
    @include('layouts.agency-user-sidebar')
    @php
        $surveyScreen5Data = isset($surveyData['survey_user_residential_socio_economic_indicator'][0]) ? $surveyData['survey_user_residential_socio_economic_indicator'][0] : [];
    @endphp

        <div class="content-page">
            <div class="content">
                <div class="container-fluid">
                    <div class="row">
                        <div class="col-12">
                            <div class="page-title-box">
                                <div class="page-title-right"></div>
                            </div>
                        </div>
                    </div>

                    <div class="row">
                        <div class="col-lg-12">
                            <div class="card">
                                <div class="card-header">
                                <h4 class="page-title">Name Of The Project: {{ $project['name'] ?? 'N/A' }}</h4>
                                <h4 class="page-title">Structure</h4>
                                <h4 class="page-title">
                                {{ isset($surveyData['structure_use'])
                                    ? ($surveyData['structure_use'] == 1
                                        ? 'Residential'
                                        : ($surveyData['structure_use'] == 3
                                            ? 'Residential + Commercial'
                                            : 'N/A'))
                                    : 'N/A'
                                }}
                                </h4>
                                </div>
                            </div>
                        </div>
                    </div>

                    <div class="row">
                        <div class="col-lg-12">
                            <div class="card">
                                <div class="card-header">
                                <h4 class="page-title">Socio-economic Indicators</h4>
                                </div>
                                <form id="userForm"
                                    action="{{ route('agencyUser.saveFormScreen5.serveyDetails', ['project_id' => encrypt($projectId), 'survey_id' => encrypt($surveyId)]) }}"
                                    method="POST" enctype="multipart/form-data" autocomplete="off">
                                    @csrf

                                    <input type="hidden" name="structure_use" value="{{ $surveyData['structure_use'] ?? null }}">
                                    <div class="card-body">
                                        <div class="row">
                                            <div class="col-lg-6">
                                                <div class="mb-3">
                                                    <label for="name" class="form-label">Type of Structure<span class="text-danger">*</span></label>
                                                    <select class="form-select form-select-sm @error('types_of_structure_id') is-invalid @enderror" name="types_of_structure_id" id="types_of_structure_id">
                                                        <option value="">Select Type of Structure</option>
                                                        @foreach ($typesOfStructures as $structure)
                                                            <option value="{{ $structure->id }}" {{ old('types_of_structure_id', $surveyScreen5Data['types_of_structure_id'] ?? '') == $structure->id ? 'selected' : '' }}>
                                                                {{ $structure->name }}
                                                            </option>
                                                        @endforeach
                                                    </select>
                                                    @error('types_of_structure_id')
                                                        <div class="invalid-feedback">
                                                            {{ $message }}
                                                        </div>
                                                    @enderror
                                                </div>
                                            </div>
                                            <div class="col-lg-6">
                                                <div class="mb-3">
                                                    <label for="area" class="form-label">Area (sq ft)<span class="text-danger">*</span></label>
                                                    <input type="text" id="area" name="area" class="form-control @error('area') is-invalid @enderror" placeholder="Enter Area (sq ft)" value="{{ old('area', $surveyScreen5Data['area'] ?? '') }}">
                                                    @error('area')
                                                        <div class="invalid-feedback">
                                                            {{ $message }}
                                                        </div>
                                                    @enderror
                                                </div>
                                            </div>
                                        </div>

                                        <div class="row">
                                            <div class="col-lg-6">
                                                <div class="mb-3">
                                                    <label for="floors_id" class="form-label">No. of Floors<span class="text-danger">*</span></label>
                                                    <select class="form-select form-select-sm @error('floors_id') is-invalid @enderror" name="floors_id" id="floors_id">
                                                        <option value="">Select No. of Floors</option>
                                                        @foreach ($floors as $floor)
                                                            <option value="{{ $floor->id }}" {{ old('floors_id', $surveyScreen5Data['floors_id'] ?? '') == $floor->id ? 'selected' : '' }}>
                                                                {{ $floor->number }}
                                                            </option>
                                                        @endforeach
                                                    </select>
                                                    @error('floors_id')
                                                        <div class="invalid-feedback">
                                                            {{ $message }}
                                                        </div>
                                                    @enderror
                                                </div>
                                            </div>
                                            <div class="col-lg-6">
                                                <div class="mb-3">
                                                    <label for="rooms_id" class="form-label">No. of Rooms<span class="text-danger">*</span></label>
                                                    <select class="form-select form-select-sm @error('rooms_id') is-invalid @enderror" name="rooms_id" id="rooms_id">
                                                        <option value="">Select No. of Rooms</option>
                                                        @foreach ($rooms as $room)
                                                            <option value="{{ $room->id }}" {{ old('rooms_id', $surveyScreen5Data['rooms_id'] ?? '') == $room->id ? 'selected' : '' }}>
                                                                {{ $room->number }}
                                                            </option>
                                                        @endforeach
                                                    </select>
                                                    @error('rooms_id')
                                                        <div class="invalid-feedback">
                                                            {{ $message }}
                                                        </div>
                                                    @enderror
                                                </div>
                                            </div>
                                        </div>

                                        <div class="row">
                                                <div class="col-lg-6">
                                                    <div class="mb-3">
                                                        <label for="kitchen" class="form-label">Kitchen<span class="text-danger">*</span></label>
                                                        <div>
                                                            <div class="form-check form-check-inline">
                                                                <input class="form-check-input" type="radio" name="kitchen" id="kitchen_yes" value="Yes"
                                                                    {{ old('kitchen', $surveyScreen5Data['kitchen'] ?? '') == 'Yes' ? 'checked' : '' }}>
                                                                <label class="form-check-label" for="kitchen_yes">Yes</label>
                                                            </div>
                                                            <div class="form-check form-check-inline">
                                                                <input class="form-check-input" type="radio" name="kitchen" id="kitchen_no" value="No"
                                                                    {{ old('kitchen', $surveyScreen5Data['kitchen'] ?? '') == 'No' ? 'checked' : '' }}>
                                                                <label class="form-check-label" for="kitchen_no">No</label>
                                                            </div>
                                                            @if ($errors->has('kitchen'))
                                                                <div class="text-danger">{{ $errors->first('kitchen') }}</div>
                                                            @endif
                                                        </div>
                                                    </div>
                                                </div>

                                                <div class="col-lg-6">
                                                <div class="mb-3">
                                                    <label for="structure_roof_id" class="form-label">Structure Roof<span class="text-danger">*</span></label>
                                                        <select class="form-select form-select-sm @error('structure_roof_id') is-invalid @enderror" name="structure_roof_id" id="structure_roof_id">
                                                            <option value="">Select Structure Roof</option>
                                                            @foreach ($structureRoofs as $roof)
                                                            <option value="{{ $roof->id }}" {{ old('structure_roof_id', $surveyScreen5Data['structure_roof_id'] ?? '') == $roof->id ? 'selected' : '' }}>
                                                                {{ $roof->name }}
                                                            </option>
                                                            @endforeach
                                                        </select>

                                                    @error('structure_roof_id')
                                                        <div class="invalid-feedback">
                                                            {{ $message }}
                                                        </div>
                                                    @enderror
                                                </div>
                                            </div>

                                        </div>

                                        <div class="row">
                                                <div class="col-lg-6">
                                                    <div class="mb-3">
                                                        <label for="structure_wall_id" class="form-label">Structure Wall<span class="text-danger">*</span></label>
                                                        <select class="form-select form-select-sm @error('structure_wall_id') is-invalid @enderror" name="structure_wall_id" id="structure_wall_id">
                                                            <option value="">Select Structure Wall</option>
                                                            @foreach ($structureRoofs as $roof)
                                                            <option value="{{ $roof->id }}" {{ old('structure_wall_id', $surveyScreen5Data['structure_wall_id'] ?? '') == $roof->id ? 'selected' : '' }}>
                                                                {{ $roof->name }}
                                                            </option>
                                                            @endforeach
                                                        </select>

                                                        @error('structure_wall_id')
                                                            <div class="invalid-feedback">
                                                                {{ $message }}
                                                            </div>
                                                        @enderror
                                                    </div>
                                                </div>

                                                <div class="col-lg-6">
                                                    <div class="mb-3">
                                                        <label for="structure_floor_id" class="form-label">Structure Floor<span class="text-danger">*</span></label>
                                                        <select class="form-select form-select-sm @error('structure_floor_id') is-invalid @enderror" name="structure_floor_id" id="structure_floor_id">
                                                            <option value="">Select Structure Floor</option>
                                                            @foreach ($structureRoofs as $roof)
                                                            <option value="{{ $roof->id }}" {{ old('structure_floor_id', $surveyScreen5Data['structure_floor_id'] ?? '') == $roof->id ? 'selected' : '' }}>
                                                                {{ $roof->name }}
                                                            </option>
                                                            @endforeach
                                                        </select>

                                                        @error('structure_floor_id')
                                                            <div class="invalid-feedback">
                                                                {{ $message }}
                                                            </div>
                                                        @enderror
                                                    </div>
                                                </div>

                                        </div>

                                        <div class="row">
                                                <div class="col-lg-6">
                                                    <div class="mb-3">
                                                        <label for="construction_year" class="form-label">Year of construction of the structure</label>
                                                        @php
                                                        $selectedYear = old('construction_year', $surveyScreen5Data['construction_year'] ?? '');
                                                    @endphp
                                                    <select class="form-select form-select-sm @error('bpl_card') is-invalid @enderror" name="construction_year" id="construction_year">
                                                        <option value="">Year of construction of the structure</option>
                                                        @for ($year = 1950; $year <= 2025; $year++)
                                                            <option value="{{ $year }}" {{ $selectedYear == $year ? 'selected' : '' }}>{{ $year }}</option>
                                                        @endfor
                                                    </select>

                                                        @error('construction_year')
                                                            <div class="invalid-feedback">
                                                                {{ $message }}
                                                            </div>
                                                        @enderror
                                                    </div>
                                                </div>

                                                <div class="col-lg-6">
                                                <div class="mb-3">
                                                    <label for="name" class="form-label">Type of Toilet</label>
                                                    <select class="form-select form-select-sm @error('toilet_type_id') is-invalid @enderror" name="toilet_type_id" id="toilet_type_id">
                                                        <option value="">Select Type of Toilet</option>
                                                        @foreach ($typesOfToilets as $toilet)
                                                            <option value="{{ $toilet->id }}" {{ old('toilet_type_id', $surveyScreen5Data['toilet_type_id'] ?? '') == $toilet->id ? 'selected' : '' }}>
                                                                {{ $toilet->name }}
                                                            </option>
                                                        @endforeach
                                                    </select>
                                                    @error('toilet_type_id')
                                                        <div class="invalid-feedback">
                                                            {{ $message }}
                                                        </div>
                                                    @enderror
                                                </div>
                                            </div>



                                        </div>

                                        <div class="row">
                                            <div class="col-lg-6">
                                                <div class="mb-3">
                                                    <label for="nearest_hospital" class="form-label">Nearest Hospital (Km)</label>
                                                    <input type="text" id="nearest_hospital" name="nearest_hospital" class="form-control @error('nearest_hospital') is-invalid @enderror" placeholder="Enter nearest hospital (sq ft)" value="{{ old('nearest_hospital', $surveyScreen5Data['nearest_hospital'] ?? '') }}">
                                                    @error('nearest_hospital')
                                                        <div class="invalid-feedback">
                                                            {{ $message }}
                                                        </div>
                                                    @enderror
                                                </div>
                                            </div>

                                            <div class="col-lg-6">
                                                <div class="mb-3">
                                                    <label for="electricity" class="form-label">Electricity<span class="text-danger">*</span></label>
                                                    <div>
                                                        <div class="form-check form-check-inline">
                                                            <input class="form-check-input" type="radio" name="electricity" id="electricity_yes" value="Yes"
                                                                {{ old('electricity', $surveyScreen5Data['electricity'] ?? '') == 'Yes' ? 'checked' : '' }}>
                                                            <label class="form-check-label" for="electricity_yes">Yes</label>
                                                        </div>
                                                        <div class="form-check form-check-inline">
                                                            <input class="form-check-input" type="radio" name="electricity" id="electricity_no" value="No"
                                                                {{ old('electricity', $surveyScreen5Data['electricity'] ?? '') == 'No' ? 'checked' : '' }}>
                                                            <label class="form-check-label" for="electricity_no">No</label>
                                                        </div>
                                                        @if ($errors->has('electricity'))
                                                            <div class="text-danger">{{ $errors->first('electricity') }}</div>
                                                        @endif
                                                    </div>
                                                </div>
                                            </div>

                                        </div>

                                        <div class="row">
                                            <div class="col-lg-6">
                                                <div class="mb-3">
                                                    <label for="consumer_no" class="form-label">Consumer No</label>
                                                    <input type="text" id="consumer_no" name="consumer_no" class="form-control @error('consumer_no') is-invalid @enderror" placeholder="Enter consumer no" value="{{ old('consumer_no', $surveyScreen5Data['consumer_no'] ?? '') }}">

                                                    @error('consumer_no')
                                                        <div class="invalid-feedback">
                                                            {{ $message }}
                                                        </div>
                                                    @enderror
                                                </div>
                                            </div>

                                            <div class="col-lg-6">
                                                    <div class="mb-3">
                                                        <label for="water_type_id" class="form-label">Water</label>
                                                        <select class="form-select form-select-sm @error('water_type_id') is-invalid @enderror" name="water_type_id" id="water_type_id">
                                                            <option value="">Select Water</option>
                                                            @foreach ($waterTypes as $water)
                                                            <option value="{{ $water->id }}" {{ old('water_type_id', $surveyScreen5Data['water_type_id'] ?? '') == $water->id ? 'selected' : '' }}>
                                                                {{ $water->name }}
                                                            </option>
                                                            @endforeach
                                                        </select>
                                                        @error('water_type_id')
                                                            <div class="invalid-feedback">
                                                                {{ $message }}
                                                            </div>
                                                        @enderror
                                                    </div>
                                            </div>

                                        </div>

                                        <div class="row">
                                            <div class="col-lg-6">
                                                <div class="mb-3">
                                                    <label for="distance_local_train" class="form-label">Distance from local train(Km)</label>
                                                    <input type="text" id="distance_local_train" name="distance_local_train" class="form-control @error('distance_local_train') is-invalid @enderror" placeholder="Enter Distance from local train(Km)" value="{{ old('distance_local_train', $surveyScreen5Data['distance_local_train'] ?? '') }}">
                                                    @error('distance_local_train')
                                                        <div class="invalid-feedback">
                                                            {{ $message }}
                                                        </div>
                                                    @enderror
                                                </div>
                                            </div>

                                            <div class="col-lg-6">
                                                    <div class="mb-3">
                                                        <label for="distance_school" class="form-label">Distance of School(Km)</label>
                                                        <input type="text" id="distance_school" name="distance_school" class="form-control @error('distance_school') is-invalid @enderror" placeholder="Enter Distance of School(Km)" value="{{ old('distance_school', $surveyScreen5Data['distance_school'] ?? '') }}">
                                                        @error('distance_school')
                                                            <div class="invalid-feedback">
                                                                {{ $message }}
                                                            </div>
                                                        @enderror
                                                    </div>
                                            </div>

                                        </div>

                                        <div class="row">
                                            <div class="col-lg-6">
                                                <div class="mb-3">
                                                    <label for="total_monthly_income" class="form-label">Total Monthly Income<span class="text-danger">*</span></label>
                                                    <input type="text" id="total_monthly_income" name="total_monthly_income" class="form-control @error('total_monthly_income') is-invalid @enderror" placeholder="Enter Total Monthly Income" value="{{ old('total_monthly_income', $surveyScreen5Data['total_monthly_income'] ?? '') }}">
                                                    @error('total_monthly_income')
                                                        <div class="invalid-feedback">
                                                            {{ $message }}
                                                        </div>
                                                    @enderror
                                                </div>
                                            </div>

                                            <div class="col-lg-6">
                                                    <div class="mb-3">
                                                        <label for="secondary_income_source" class="form-label">Income from other source(Secondary)<span class="text-danger">*</span></label>
                                                        <input type="text" id="secondary_income_source" name="secondary_income_source" class="form-control @error('secondary_income_source') is-invalid @enderror" placeholder="Enter Income from other source(Secondary)" value="{{ old('secondary_income_source', $surveyScreen5Data['secondary_income_source'] ?? '') }}">
                                                        @error('secondary_income_source')
                                                            <div class="invalid-feedback">
                                                                {{ $message }}
                                                            </div>
                                                        @enderror
                                                    </div>
                                            </div>

                                        </div>

                                        <div class="row">
                                            <div class="col-lg-6">
                                                <div class="mb-3">
                                                    <label for="annual_expenditure_id" class="form-label">Estimate of Annual Expenditure(INR)<span class="text-danger">*</span></label>
                                                    <select class="form-select form-select-sm @error('annual_expenditure_id') is-invalid @enderror" name="annual_expenditure_id" id="annual_expenditure_id">
                                                            <option value="">Select Annual Expenditure(INR)</option>
                                                            @foreach ($estimateAnnualExpenditures as $expenditure)
                                                            <option value="{{ $expenditure->id }}" {{ old('annual_expenditure_id', $surveyScreen5Data['annual_expenditure_id'] ?? '') == $expenditure->id ? 'selected' : '' }}>
                                                                {{ $expenditure->number }}
                                                            </option>
                                                            @endforeach
                                                    </select>
                                                    @error('annual_expenditure_id')
                                                        <div class="invalid-feedback">
                                                            {{ $message }}
                                                        </div>
                                                    @enderror
                                                </div>
                                            </div>

                                            <div class="col-lg-6">
                                                    <div class="mb-3">
                                                        <label for="bank_account_number" class="form-label">Bank Account No.</label>
                                                        <input type="text" id="bank_account_number" name="bank_account_number" class="form-control @error('bank_account_number') is-invalid @enderror" placeholder="Enter Bank Account No." value="{{ old('bank_account_number', $surveyScreen5Data['bank_account_number'] ?? '') }}">
                                                        @error('bank_account_number')
                                                            <div class="invalid-feedback">
                                                                {{ $message }}
                                                            </div>
                                                        @enderror
                                                    </div>
                                            </div>

                                        </div>

                                        <div class="row">
                                            <div class="col-lg-6">
                                                <div class="mb-3">
                                                    <label for="bank_name" class="form-label">Bank Name</label>
                                                    <input type="text" id="bank_name" name="bank_name" class="form-control @error('bank_name') is-invalid @enderror" placeholder="Enter Bank Name" value="{{ old('bank_name', $surveyScreen5Data['bank_name'] ?? '') }}">

                                                    @error('bank_name')
                                                        <div class="invalid-feedback">
                                                            {{ $message }}
                                                        </div>
                                                    @enderror
                                                </div>
                                            </div>

                                            <div class="col-lg-6">
                                                    <div class="mb-3">
                                                        <label for="bank_ifsc" class="form-label">IFSC Code</label>
                                                        <input type="text" id="bank_ifsc" name="bank_ifsc" class="form-control @error('bank_ifsc') is-invalid @enderror" placeholder="Enter IFSC Code" value="{{ old('bank_ifsc', $surveyScreen5Data['bank_ifsc'] ?? '') }}">
                                                        @error('bank_ifsc')
                                                            <div class="invalid-feedback">
                                                                {{ $message }}
                                                            </div>
                                                        @enderror
                                                    </div>
                                            </div>

                                        </div>

                                        <div class="row">
                                            <div class="col-lg-6">
                                                <div class="mb-3">
                                                    <label for="pan_card" class="form-label">Pan Card<span class="text-danger">*</span></label>
                                                    <div>
                                                        <div class="form-check form-check-inline">
                                                            <input class="form-check-input" type="radio" name="pan_card" id="pan_card_yes" value="Yes"
                                                                {{ old('pan_card', $surveyScreen5Data['pan_card'] ?? '') == 'Yes' ? 'checked' : '' }}>
                                                            <label class="form-check-label" for="pan_card_yes">Yes</label>
                                                        </div>
                                                        <div class="form-check form-check-inline">
                                                            <input class="form-check-input" type="radio" name="pan_card" id="pan_card_no" value="No"
                                                                {{ old('pan_card', $surveyScreen5Data['pan_card'] ?? '') == 'No' ? 'checked' : '' }}>
                                                            <label class="form-check-label" for="pan_card_no">No</label>
                                                        </div>
                                                        @if ($errors->has('pan_card'))
                                                            <div class="text-danger">{{ $errors->first('pan_card') }}</div>
                                                        @endif
                                                    </div>
                                                </div>
                                            </div>

                                            <div class="col-lg-6">
                                                    <div class="mb-3">
                                                        <label for="aadhaar_status" class="form-label">Aadhar No.<span class="text-danger">*</span></label>
                                                        <div>
                                                            <div class="form-check form-check-inline">
                                                                <input class="form-check-input" type="radio" name="aadhaar_status" id="aadhaar_status_yes" value="Yes"
                                                                    {{ old('aadhaar_status', $surveyScreen5Data['aadhaar_status'] ?? '') == 'Yes' ? 'checked' : '' }}>
                                                                <label class="form-check-label" for="aadhaar_status_yes">Yes</label>
                                                            </div>
                                                            <div class="form-check form-check-inline">
                                                                <input class="form-check-input" type="radio" name="aadhaar_status" id="aadhaar_status_no" value="No"
                                                                    {{ old('aadhaar_status', $surveyScreen5Data['aadhaar_status'] ?? '') == 'No' ? 'checked' : '' }}>
                                                                <label class="form-check-label" for="aadhaar_status_no">No</label>
                                                            </div>
                                                            @if ($errors->has('aadhaar_status'))
                                                                <div class="text-danger">{{ $errors->first('aadhaar_status') }}</div>
                                                            @endif
                                                        </div>
                                                    </div>
                                            </div>

                                        </div>

                                        <div class="row">
                                            <div class="col-lg-6">
                                                <div class="mb-3">
                                                    <label for="loan_status" class="form-label">Have you taken loan</label>
                                                    <div>
                                                        <div class="form-check form-check-inline">
                                                            <input class="form-check-input" type="radio" name="loan_status" id="loan_status_yes" value="Yes"
                                                                {{ old('loan_status', $surveyScreen5Data['loan_status'] ?? '') == 'Yes' ? 'checked' : '' }}>
                                                            <label class="form-check-label" for="loan_status_yes">Yes</label>
                                                        </div>
                                                        <div class="form-check form-check-inline">
                                                            <input class="form-check-input" type="radio" name="loan_status" id="loan_status_no" value="No"
                                                                {{ old('loan_status', $surveyScreen5Data['loan_status'] ?? '') == 'No' ? 'checked' : '' }}>
                                                            <label class="form-check-label" for="loan_status_no">No</label>
                                                        </div>
                                                        @if ($errors->has('loan_status'))
                                                            <div class="text-danger">{{ $errors->first('loan_status') }}</div>
                                                        @endif
                                                    </div>
                                                </div>
                                            </div>

                                            <div class="col-lg-6">
                                                    <div class="mb-3">
                                                        <label for="loan_source" class="form-label">Source of Loan</label>
                                                        <input type="text" id="loan_source" name="loan_source" class="form-control @error('loan_source') is-invalid @enderror" placeholder="Enter Loan source" value="{{ old('loan_source', $surveyScreen5Data['loan_source'] ?? '') }}">

                                                        @error('loan_source')
                                                            <div class="invalid-feedback">
                                                                {{ $message }}
                                                            </div>
                                                        @enderror
                                                    </div>
                                            </div>

                                        </div>

                                        <div class="row">
                                            <div class="col-lg-6">
                                                <div class="mb-3">
                                                    <label for="loan_repayment" class="form-label">Purpose</label>
                                                    <input type="text" id="loan_prupose" name="loan_prupose" class="form-control @error('loan_prupose') is-invalid @enderror" placeholder="Enter Loan purpose" value="{{ old('loan_prupose', $surveyScreen5Data['loan_prupose'] ?? '') }}">

                                                    @error('loan_prupose')
                                                        <div class="invalid-feedback">
                                                            {{ $message }}
                                                        </div>
                                                    @enderror
                                                </div>
                                            </div>

                                            <div class="col-lg-6">
                                                    <div class="mb-3">
                                                        <label for="loan_amount" class="form-label">Amount of Loan</label>
                                                        <input type="text" id="loan_amount" name="loan_amount" class="form-control @error('loan_amount') is-invalid @enderror" placeholder="Enter Loan amount" value="{{ old('loan_amount', $surveyScreen5Data['loan_amount'] ?? '') }}">

                                                        @error('loan_amount')
                                                            <div class="invalid-feedback">
                                                                {{ $message }}
                                                            </div>
                                                        @enderror
                                                    </div>
                                            </div>

                                        </div>

                                        <div class="row">
                                            <div class="col-lg-6">
                                                <div class="mb-3">
                                                    <label for="loan_repayment" class="form-label">Repayment of Loan</label>
                                                    <input type="text" id="loan_repayment" name="loan_repayment" class="form-control @error('loan_repayment') is-invalid @enderror" placeholder="Enter Loan repayment" value="{{ old('loan_repayment', $surveyScreen5Data['loan_amount'] ?? '') }}">

                                                    @error('loan_repayment')
                                                        <div class="invalid-feedback">
                                                            {{ $message }}
                                                        </div>
                                                    @enderror
                                                </div>
                                            </div>

                                            <div class="col-lg-6">
                                                    <div class="mb-3">
                                                        <label for="tv" class="form-label">TV<span class="text-danger">*</span></label>
                                                        <div>
                                                            <div class="form-check form-check-inline">
                                                                <input class="form-check-input" type="radio" name="tv" id="tv_yes" value="Yes"
                                                                    {{ old('tv', $surveyScreen5Data['tv'] ?? '') == 'Yes' ? 'checked' : '' }}>
                                                                <label class="form-check-label" for="tv_yes">Yes</label>
                                                            </div>
                                                            <div class="form-check form-check-inline">
                                                                <input class="form-check-input" type="radio" name="tv" id="tv_no" value="No"
                                                                    {{ old('tv', $surveyScreen5Data['tv'] ?? '') == 'No' ? 'checked' : '' }}>
                                                                <label class="form-check-label" for="tv_no">No</label>
                                                            </div>
                                                            @if ($errors->has('tv'))
                                                                <div class="text-danger">{{ $errors->first('tv') }}</div>
                                                            @endif
                                                        </div>
                                                    </div>
                                            </div>

                                        </div>

                                        <div class="row">
                                            <div class="col-lg-6">
                                                <div class="mb-3">
                                                    <label for="fridge" class="form-label">fridge<span class="text-danger">*</span></label>
                                                    <div>
                                                        <div class="form-check form-check-inline">
                                                            <input class="form-check-input" type="radio" name="fridge" id="fridge_yes" value="Yes"
                                                                {{ old('fridge', $surveyScreen5Data['fridge'] ?? '') == 'Yes' ? 'checked' : '' }}>
                                                            <label class="form-check-label" for="fridge_yes">Yes</label>
                                                        </div>
                                                        <div class="form-check form-check-inline">
                                                            <input class="form-check-input" type="radio" name="fridge" id="fridge_no" value="No"
                                                                {{ old('fridge', $surveyScreen5Data['fridge'] ?? '') == 'No' ? 'checked' : '' }}>
                                                            <label class="form-check-label" for="fridge_no">No</label>
                                                        </div>
                                                        @if ($errors->has('fridge'))
                                                            <div class="text-danger">{{ $errors->first('fridge') }}</div>
                                                        @endif
                                                    </div>
                                                </div>
                                            </div>

                                            <div class="col-lg-6">
                                                    <div class="mb-3">
                                                        <label for="tv" class="form-label">Vehicle<span class="text-danger">*</span></label>
                                                        <div>
                                                            <div class="form-check form-check-inline">
                                                                <input class="form-check-input" type="radio" name="vehicle" id="vehicle_yes" value="Yes"
                                                                    {{ old('vehicle', $surveyScreen5Data['vehicle'] ?? '') == 'Yes' ? 'checked' : '' }}>
                                                                <label class="form-check-label" for="vehicle_yes">Yes</label>
                                                            </div>
                                                            <div class="form-check form-check-inline">
                                                                <input class="form-check-input" type="radio" name="vehicle" id="vehicle_no" value="No"
                                                                    {{ old('vehicle', $surveyScreen5Data['vehicle'] ?? '') == 'No' ? 'checked' : '' }}>
                                                                <label class="form-check-label" for="vehicle_no">No</label>
                                                            </div>
                                                            @if ($errors->has('vehicle'))
                                                                <div class="text-danger">{{ $errors->first('vehicle') }}</div>
                                                            @endif
                                                        </div>
                                                    </div>
                                            </div>

                                        </div>

                                        <div class="row">
                                            <div class="col-lg-6">
                                                <div class="mb-3">
                                                    <label for="land_city_village" class="form-label">Land (in city or village)<span class="text-danger">*</span></label>
                                                    <div>
                                                        <div class="form-check form-check-inline">
                                                            <input class="form-check-input" type="radio" name="land_city_village" id="land_city_village_yes" value="Yes"
                                                                {{ old('land_city_village', $surveyScreen5Data['land_city_village'] ?? '') == 'Yes' ? 'checked' : '' }}>
                                                            <label class="form-check-label" for="land_city_village_yes">Yes</label>
                                                        </div>
                                                        <div class="form-check form-check-inline">
                                                            <input class="form-check-input" type="radio" name="land_city_village" id="land_city_village_no" value="No"
                                                                {{ old('land_city_village', $surveyScreen5Data['land_city_village'] ?? '') == 'No' ? 'checked' : '' }}>
                                                            <label class="form-check-label" for="land_city_village_no">No</label>
                                                        </div>
                                                        @if ($errors->has('land_city_village'))
                                                            <div class="text-danger">{{ $errors->first('land_city_village') }}</div>
                                                        @endif
                                                    </div>
                                                </div>
                                            </div>

                                            <div class="col-lg-6">
                                                    <div class="mb-3">
                                                        <label for="tv" class="form-label">Computer/Laptop<span class="text-danger">*</span></label>
                                                        <div>
                                                            <div class="form-check form-check-inline">
                                                                <input class="form-check-input" type="radio" name="computer_laptop" id="computer_laptop_yes" value="Yes"
                                                                    {{ old('computer_laptop', $surveyScreen5Data['computer_laptop'] ?? '') == 'Yes' ? 'checked' : '' }}>
                                                                <label class="form-check-label" for="computer_laptop_yes">Yes</label>
                                                            </div>
                                                            <div class="form-check form-check-inline">
                                                                <input class="form-check-input" type="radio" name="computer_laptop" id="computer_laptop_no" value="No"
                                                                    {{ old('computer_laptop', $surveyScreen5Data['computer_laptop'] ?? '') == 'No' ? 'checked' : '' }}>
                                                                <label class="form-check-label" for="computer_laptop_no">No</label>
                                                            </div>
                                                            @if ($errors->has('computer_laptop'))
                                                                <div class="text-danger">{{ $errors->first('computer_laptop') }}</div>
                                                            @endif
                                                        </div>
                                                    </div>
                                            </div>

                                        </div>

                                        <div class="row">
                                            <div class="col-lg-6">
                                                <div class="mb-3">
                                                    <label for="cooking_fuel_id" class="form-label">Cooking Fuel</label>
                                                    <select class="form-select form-select-sm @error('cooking_fuel_id') is-invalid @enderror" name="cooking_fuel_id" id="cooking_fuel_id">
                                                            <option value="">Select Cooking Fuel</option>
                                                            @foreach ($cookingFuels as $fuel)
                                                            <option value="{{ $fuel->id }}" {{ old('cooking_fuel_id', $surveyScreen5Data['cooking_fuel_id'] ?? '') == $fuel->id ? 'selected' : '' }}>
                                                                {{ $fuel->name }}
                                                            </option>
                                                            @endforeach
                                                    </select>
                                                    @error('cooking_fuel_id')
                                                        <div class="invalid-feedback">
                                                            {{ $message }}
                                                        </div>
                                                    @enderror
                                                </div>
                                            </div>

                                            <div class="col-lg-6">
                                                    <div class="mb-3">
                                                        <label for="tv" class="form-label">Mobile Phone<span class="text-danger">*</span></label>
                                                        <div>
                                                            <div class="form-check form-check-inline">
                                                                <input class="form-check-input" type="radio" name="mobile_phone" id="mobile_phone_yes" value="Yes"
                                                                    {{ old('mobile_phone', $surveyScreen5Data['mobile_phone'] ?? '') == 'Yes' ? 'checked' : '' }}>
                                                                <label class="form-check-label" for="mobile_phone_yes">Yes</label>
                                                            </div>
                                                            <div class="form-check form-check-inline">
                                                                <input class="form-check-input" type="radio" name="mobile_phone" id="mobile_phone_no" value="No"
                                                                    {{ old('mobile_phone', $surveyScreen5Data['mobile_phone'] ?? '') == 'No' ? 'checked' : '' }}>
                                                                <label class="form-check-label" for="mobile_phone_no">No</label>
                                                            </div>
                                                            @if ($errors->has('mobile_phone'))
                                                                <div class="text-danger">{{ $errors->first('mobile_phone') }}</div>
                                                            @endif
                                                        </div>
                                                    </div>
                                            </div>

                                        </div>

                                        <div class="row">
                                            <div class="col-lg-6">
                                                <div class="mb-3">
                                                    <label for="ac" class="form-label">AC<span class="text-danger">*</span></label>
                                                    <div>
                                                        <div class="form-check form-check-inline">
                                                            <input class="form-check-input" type="radio" name="ac" id="ac_yes" value="Yes"
                                                                {{ old('ac', $surveyScreen5Data['ac'] ?? '') == 'Yes' ? 'checked' : '' }}>
                                                            <label class="form-check-label" for="ac_yes">Yes</label>
                                                        </div>
                                                        <div class="form-check form-check-inline">
                                                            <input class="form-check-input" type="radio" name="ac" id="ac_no" value="No"
                                                                {{ old('ac', $surveyScreen5Data['ac'] ?? '') == 'No' ? 'checked' : '' }}>
                                                            <label class="form-check-label" for="ac_no">No</label>
                                                        </div>
                                                        @if ($errors->has('ac'))
                                                            <div class="text-danger">{{ $errors->first('ac') }}</div>
                                                        @endif
                                                    </div>
                                                </div>
                                            </div>

                                            <div class="col-lg-6">
                                                    <div class="mb-3">
                                                        <label for="fan" class="form-label">Fan<span class="text-danger">*</span></label>
                                                        <div>
                                                            <div class="form-check form-check-inline">
                                                                <input class="form-check-input" type="radio" name="fan" id="fan_yes" value="Yes"
                                                                    {{ old('fan', $surveyScreen5Data['fan'] ?? '') == 'Yes' ? 'checked' : '' }}>
                                                                <label class="form-check-label" for="fan_yes">Yes</label>
                                                            </div>
                                                            <div class="form-check form-check-inline">
                                                                <input class="form-check-input" type="radio" name="fan" id="fan_no" value="No"
                                                                    {{ old('fan', $surveyScreen5Data['fan'] ?? '') == 'No' ? 'checked' : '' }}>
                                                                <label class="form-check-label" for="fan_no">No</label>
                                                            </div>
                                                            @if ($errors->has('fan'))
                                                                <div class="text-danger">{{ $errors->first('fan') }}</div>
                                                            @endif
                                                        </div>
                                                    </div>
                                            </div>

                                        </div>

                                        <div class="row">
                                            <div class="col-lg-6">
                                                <div class="mb-3">
                                                    <label for="digital_payment" class="form-label">Digital payment system<span class="text-danger">*</span></label>
                                                    <div>
                                                        <div class="form-check form-check-inline">
                                                            <input class="form-check-input" type="radio" name="digital_payment" id="digital_payment_yes" value="Yes"
                                                                {{ old('digital_payment', $surveyScreen5Data['digital_payment'] ?? '') == 'Yes' ? 'checked' : '' }}>
                                                            <label class="form-check-label" for="digital_payment_yes">Yes</label>
                                                        </div>
                                                        <div class="form-check form-check-inline">
                                                            <input class="form-check-input" type="radio" name="digital_payment" id="digital_payment_no" value="No"
                                                                {{ old('digital_payment', $surveyScreen5Data['digital_payment'] ?? '') == 'No' ? 'checked' : '' }}>
                                                            <label class="form-check-label" for="digital_payment_no">No</label>
                                                        </div>
                                                        @if ($errors->has('digital_payment'))
                                                            <div class="text-danger">{{ $errors->first('digital_payment') }}</div>
                                                        @endif
                                                    </div>
                                                </div>
                                            </div>

                                            <div class="col-lg-6">
                                                    <div class="mb-3">
                                                        <label for="washing_machine" class="form-label">Washing Machine<span class="text-danger">*</span></label>
                                                        <div>
                                                            <div class="form-check form-check-inline">
                                                                <input class="form-check-input" type="radio" name="washing_machine" id="washing_machine_yes" value="Yes"
                                                                    {{ old('washing_machine', $surveyScreen5Data['washing_machine'] ?? '') == 'Yes' ? 'checked' : '' }}>
                                                                <label class="form-check-label" for="washing_machine_yes">Yes</label>
                                                            </div>
                                                            <div class="form-check form-check-inline">
                                                                <input class="form-check-input" type="radio" name="washing_machine" id="washing_machine_no" value="No"
                                                                    {{ old('washing_machine', $surveyScreen5Data['washing_machine'] ?? '') == 'No' ? 'checked' : '' }}>
                                                                <label class="form-check-label" for="washing_machine_no">No</label>
                                                            </div>
                                                            @if ($errors->has('washing_machine'))
                                                                <div class="text-danger">{{ $errors->first('washing_machine') }}</div>
                                                            @endif
                                                        </div>
                                                    </div>
                                            </div>

                                        </div>

                                    </div>


                                    <div class="card-footer border-top border-light d-flex justify-content-between">
                                        @if(isset($surveyData['structure_use']) && $surveyData['structure_use'] == 3)
                                        <a href="{{ route('agencyUser.add.screen4.serveyDetails', ['project_id' => encrypt($projectId), 'survey_id' => encrypt($surveyId)]) }}" class="btn btn-secondary">Back</a>
                                        <button type="submit" class="btn btn-success" id="submitBtn">Save & Next</button>
                                        @else
                                        <a href="{{ route('agencyUser.add.screen4.serveyDetails', ['project_id' => encrypt($projectId), 'survey_id' => encrypt($surveyId)]) }}" class="btn btn-secondary">Back</a>
                                        <button type="submit" class="btn btn-success" id="submitBtn">Submit</button>
                                        @endif
                                    </div>
                                </form>
                            </div>
                        </div>
                    </div>

                </div>
            </div>

            @include('layouts.footer')
        </div>
    </div>

    <!-- Vendor JS -->
    <script src="{{ asset('assets/js/vendor.min.js') }}"></script>
    <script src="{{ asset('assets/js/app.min.js') }}"></script>
    <!--  Select2 Plugin Js -->
    <script src="{{ asset('assets/vendor/select2/js/select2.min.js') }}"></script>

    <script>
        $(document).ready(function() {


            @if (session('success'))
                toastr.success("{{ session('success') }}");
            @endif

            @if (session('error'))
                toastr.error("{{ session('error') }}");
            @endif


        });
    </script>

</body>

</html>