@extends('frontend.master')
@section('right')
    <div class="card right_side">
        <div class="card-header text-center right_side-header">
            নাগরিক আবেদন
        </div>
        <div class="card-body" style="background: #f5ffdf; min-height: 75rem;">
            <div class="page_nagorik_abedon_body table-responsive table-responsive-sm">
                <div class="card" style="width: 70%;">
                    <div class="card-header">
                        <div class="btn-group btn-group-lg" role="group" aria-label="Large button group">
                            <button type="button" class="btn actives btn-outline-success" id="nibondhon-btn">নাগরিক নিবন্ধন</button>
{{--                            <button type="button" class="btn btn-outline-success" id="nagorig-log">নাগরিক লগইন</button>--}}
{{--                            <button type="button" class="btn btn-outline-success" id="sngostha-log">সংস্থা লগইন</button>--}}
                        </div>
                    </div>
                    <div class="card-body" style="height: auto;">
                        @if(env('CITIZEN_APP_BY_FRONTEDN', true))
                            <div class="nibondhon">
                                {{ Form::open(['route'=>'citizen_apps.store','method'=>'POST', 'class'=>'needs-validation', 'enctype'=>'multipart/form-data', 'novalidate']) }}
                                <div class="" id="form_1">
                                    <div class="mb-3">
                                        <label for="pictures" class="form-label">ছবি<span class="required">* (পাসপোর্ট সাইজ অফিসিয়াল ছবি)</span></label>
                                        <div class="custom-file">
                                            <div class="input-group inputs">
                                                <span class="input-group-text icons"><i class="fa-solid fa-photo-video"></i></span>
                                                <input type="file" accept="image/*" name="pictures" class="custom-file-input form-control" required id="pictures">
                                                <div class="invalid-feedback">ছবি দিন</div>
                                            </div>
                                        </div>
                                        <span class="text-danger">{{ $errors->has('pictures') ? $errors->first('pictures') : ' ' }}</span>
                                    </div>
                                    <div class="mb-3 formControl">
                                        <label for="holding_no" class="form-label">হোল্ডিং নং<span class="required">*</span></label>
                                        <div class="input-group inputs">
                                            <span class="input-group-text icons"><i class="fa-solid fa-home"></i></span>
                                            @if(env('HOLDING_TAX_EXT', false))
                                                <select name="holding_name_type" required class="form-control select2" id="holding_name_type">
                                                    <option style="color: red" selected disabled value="">&mdash; চিহ্নিত করুন &mdash;</option>
                                                    @foreach($holding_name as $item)
                                                        <option value="{{ $item->holding_name }}">{{ $item->holding_name }}</option>
                                                    @endforeach
                                                </select>
                                                <input class="form-control DisableSpace" type="text" autocomplete="off" id="holding_number" required>
                                                <input class="form-control DisableSpace" name="holding_no" type="text" autocomplete="off" id="holding_no" required readonly>
                                            @else
                                                <input class="form-control DisableSpace" name="holding_no" type="text" autocomplete="off" id="holding_no" required>
                                            @endif
                                            <div class="invalid-feedback">হোল্ডিং নং দিন</div>
                                        </div>
                                        <span class="text-danger">{{ $errors->has('holding_no') ? $errors->first('holding_no') : ' ' }}</span>
                                    </div>
                                    <div class="mb-3">
                                        <label for="birth_registration" class="form-label">জন্ম নিবন্ধন নং ( ইংরেজিতে )<span class="required">*</span></label>
                                        <div class="input-group inputs">
                                            <span class="input-group-text icons"><i class="fa-solid fa-cake-candles"></i></span>
                                            <input required class="form-control DisableSpace" name="birth_registration" id="birth_registration" type="text" placeholder="জন্ম নিবন্ধন নং...">
                                            <div class="invalid-feedback">জন্ম নিবন্ধন নং দিন</div>
                                        </div>
                                        <span class="text-danger" id="birthNumberAlert">{{ $errors->has('birth_registration') ? $errors->first('birth_registration') : ' ' }}</span>
                                    </div>
                                    <div class="mb-3">
                                        <label for="nid_number" class="form-label">ন্যাশনাল আইডি (ইংরেজিতে)</label>
                                        <div class="input-group inputs">
                                            <span class="input-group-text icons"><i class="fa-solid fa-id-card"></i></span>
                                            <input class="form-control DisableSpace" name="national_id" type="text" id="nid_number" placeholder="NID Number...">
                                            <div class="invalid-feedback">ন্যাশনাল আইডি নং দিন</div>
                                        </div>
                                        <span class="text-danger" id="nidNumberAlert">{{ $errors->has('national_id') ? $errors->first('national_id') : ' ' }}</span>
                                    </div>
                                    <div class="form-group row mb-4">
                                        <label for="date_of_birth" class="form-label">জম্ম তারিখ<span class="required">*</span></label>
                                        <div class="input-group inputs">
                                            <span class="input-group-text icons"><i class="fa-solid fa-cake-candles"></i></span>
                                            <select required class="form-select" name="day" aria-label="Default select example">
                                                <option value="" selected="" disabled="">দিন</option>
                                                <option value="01">01</option>
                                                <option value="02">02</option>
                                                <option value="03">03</option>
                                                <option value="04">04</option>
                                                <option value="05">05</option>
                                                <option value="06">06</option>
                                                <option value="07">07</option>
                                                <option value="08">08</option>
                                                <option value="09">09</option>
                                                <option value="10">10</option>
                                                <option value="11">11</option>
                                                <option value="12">12</option>
                                                <option value="13">13</option>
                                                <option value="14">14</option>
                                                <option value="15">15</option>
                                                <option value="16">16</option>
                                                <option value="17">17</option>
                                                <option value="18">18</option>
                                                <option value="19">19</option>
                                                <option value="20">20</option>
                                                <option value="21">21</option>
                                                <option value="22">22</option>
                                                <option value="23">23</option>
                                                <option value="24">24</option>
                                                <option value="25">25</option>
                                                <option value="26">26</option>
                                                <option value="27">27</option>
                                                <option value="28">28</option>
                                                <option value="29">29</option>
                                                <option value="30">30</option>
                                                <option value="31">31</option>
                                            </select>
                                            <span class="text-danger">{{ $errors->has('day') ? $errors->first('day') : ' ' }}</span>
                                            <select required class="form-select" name="month" style="margin: 0 1rem;" aria-label="Default select example">
                                                <option value="" selected="" disabled="">মাস</option>
                                                <option class="" value="01">জানুয়ারী</option>
                                                <option class="" value="02">ফেব্রুয়ারী</option>
                                                <option class="" value="03">মার্চ</option>
                                                <option class="" value="04">এপ্রিল</option>
                                                <option class="" value="05">মে</option>
                                                <option class="" value="06">জুন</option>
                                                <option class="" value="07">জুলাই</option>
                                                <option class="" value="08">আগস্ট</option>
                                                <option class="" value="09">সেপ্টেম্বর</option>
                                                <option class="" value="10">অক্টোবর</option>
                                                <option class="" value="11">নভেম্বর</option>
                                                <option class="" value="12">ডিসেম্বর</option>
                                            </select>
                                            <span class="text-danger">{{ $errors->has('month') ? $errors->first('month') : ' ' }}</span>
                                            <select required class="form-select" name="year" aria-label="Default select example">
                                                <option value="" selected="" disabled="">বছর</option>
                                                    <option value='1900' >1900</option><option value='1901' >1901</option><option value='1902' >1902</option><option value='1903' >1903</option><option value='1904' >1904</option><option value='1905' >1905</option><option value='1906' >1906</option><option value='1907' >1907</option><option value='1908' >1908</option><option value='1909' >1909</option><option value='1910' >1910</option><option value='1911' >1911</option><option value='1912' >1912</option><option value='1913' >1913</option><option value='1914' >1914</option><option value='1915' >1915</option><option value='1916' >1916</option><option value='1917' >1917</option><option value='1918' >1918</option><option value='1919' >1919</option><option value='1920' >1920</option><option value='1921' >1921</option><option value='1922' >1922</option><option value='1923' >1923</option><option value='1924' >1924</option><option value='1925' >1925</option><option value='1926' >1926</option><option value='1927' >1927</option><option value='1928' >1928</option><option value='1929' >1929</option><option value='1930' >1930</option><option value='1931' >1931</option><option value='1932' >1932</option><option value='1933' >1933</option><option value='1934' >1934</option><option value='1935' >1935</option><option value='1936' >1936</option><option value='1937' >1937</option><option value='1938' >1938</option><option value='1939' >1939</option><option value='1940' >1940</option><option value='1941' >1941</option><option value='1942' >1942</option><option value='1943' >1943</option><option value='1944' >1944</option><option value='1945' >1945</option><option value='1946' >1946</option><option value='1947' >1947</option><option value='1948' >1948</option><option value='1949' >1949</option><option value='1950' >1950</option><option value='1951' >1951</option><option value='1952' >1952</option><option value='1953' >1953</option><option value='1954' >1954</option><option value='1955' >1955</option><option value='1956' >1956</option><option value='1957' >1957</option><option value='1958' >1958</option><option value='1959' >1959</option><option value='1960' >1960</option><option value='1961' >1961</option><option value='1962' >1962</option><option value='1963' >1963</option><option value='1964' >1964</option><option value='1965' >1965</option><option value='1966' >1966</option><option value='1967' >1967</option><option value='1968' >1968</option><option value='1969' >1969</option><option value='1970' >1970</option><option value='1971' >1971</option><option value='1972' >1972</option><option value='1973' >1973</option><option value='1974' >1974</option><option value='1975' >1975</option><option value='1976' >1976</option><option value='1977' >1977</option><option value='1978' >1978</option><option value='1979' >1979</option><option value='1980' >1980</option><option value='1981' >1981</option><option value='1982' >1982</option><option value='1983' >1983</option><option value='1984' >1984</option><option value='1985' >1985</option><option value='1986' >1986</option><option value='1987' >1987</option><option value='1988' >1988</option><option value='1989' >1989</option><option value='1990' >1990</option><option value='1991' >1991</option><option value='1992' >1992</option><option value='1993' >1993</option><option value='1994' >1994</option><option value='1995' >1995</option><option value='1996' >1996</option><option value='1997' >1997</option><option value='1998' >1998</option><option value='1999' >1999</option><option value='2000' >2000</option><option value='2001' >2001</option><option value='2002' >2002</option><option value='2003' >2003</option><option value='2004' >2004</option><option value='2005' >2005</option><option value='2006' >2006</option><option value='2007' >2007</option><option value='2008' >2008</option><option value='2009' >2009</option><option value='2010' >2010</option><option value='2011' >2011</option><option value='2012' >2012</option><option value='2013' >2013</option><option value='2014' >2014</option><option value='2015' >2015</option><option value='2016' >2016</option><option value='2017' >2017</option><option value='2018' >2018</option><option value='2019' >2019</option><option value='2020' >2020</option><option value='2021' >2021</option><option value='2022' >2022</option><option value='2023' >2023</option><option value='2024' >2024</option><option value='2025' >2025</option><option value='2026' selected="selected">2026</option>                                            </select>
                                            <span class="text-danger">{{ $errors->has('year') ? $errors->first('year') : ' ' }}</span>
                                            <div class="invalid-feedback">
                                                জম্ম তারিখ দিন
                                            </div>
                                        </div>
                                        <span class="text-danger"> </span>
                                    </div>
                                    <div class="mb-3">
                                        <label for="bangla_name" class="form-label">নাম ( বাংলায় )<span class="required">*</span></label>
                                        <div class="input-group inputs">
                                            <span class="input-group-text icons"><i class="fa-solid fa-file-signature"></i></span>
                                            <input required class="form-control" name="bangla_name" type="text" id="bangla_name" placeholder="বাংলায় নাম...">
                                            <div class="invalid-feedback">বাংলায় নাম দিন</div>
                                        </div>
                                        <span class="text-danger">{{ $errors->has('bangla_name') ? $errors->first('bangla_name') : ' ' }}</span>
                                    </div>
                                    <div class="form-group mb-4">
                                        <label class="form-label">পিতা/স্বামী <span class="required">*</span></label>
                                        <div class="input-group inputs">
                                            <span class="input-group-text icons"><i class="fa-solid fa-file-signature"></i></span>
                                            <select required class="form-select husband_or_father" name="husband_or_father" aria-label="Default select example">
                                                <option style="color: red" value="">— চিহ্নিত করুন —</option>
                                                <option value="1" selected>পিতা</option>
                                                <option value="2">স্বামী</option>
                                            </select>
                                            <span class="text-danger">{{ $errors->has('husband_or_father') ? $errors->first('husband_or_father') : ' ' }}</span>
                                            <div class="invalid-feedback">
                                                পিতা/স্বামী
                                            </div>
                                        </div>
                                    </div>
                                    <div class="father_name">
                                        <div class="mb-3">
                                            <label for="bn_father_name" class="form-label">পিতার নাম (বাংলায়) <span class="required">*</span></label>
                                            <div class="input-group inputs">
                                                <span class="input-group-text icons"><i class="fa-solid fa-file-signature"></i></span>
                                                <input required class="form-control" name="bn_father_name" type="text" id="bn_father_name" placeholder="বাংলায় নাম...">
                                                <div class="invalid-feedback">পিতার নাম দিন</div>
                                            </div>
                                            <span class="text-danger">{{ $errors->has('bn_father_name') ? $errors->first('bn_father_name') : ' ' }}</span>
                                        </div>
                                    </div>
                                    <div class="Husband_name"  style="display:none;">
                                        <div class="mb-3">
                                            <label for="bn_Husband_name" class="form-label">স্বামীর নাম (বাংলায়) <span class="required">*</span></label>
                                            <div class="input-group inputs">
                                                <span class="input-group-text icons"><i class="fa-solid fa-file-signature"></i></span>
                                                <input required class="form-control" name="bn_Husband_name" type="text" id="bn_Husband_name" disabled placeholder="বাংলায় নাম...">
                                                <div class="invalid-feedback">স্বামীর নাম দিন</div>
                                            </div>
                                            <span class="text-danger">{{ $errors->has('bn_Husband_name') ? $errors->first('bn_Husband_name') : ' ' }}</span>
                                        </div>
                                    </div>
                                    <div class="mb-3">
                                        <label for="bn_mother_name" class="form-label">মাতার নাম (বাংলায়) <span class="required">*</span></label>
                                        <div class="input-group inputs">
                                            <span class="input-group-text icons"><i class="fa-solid fa-file-signature"></i></span>
                                            <input required class="form-control" name="bn_mother_name" type="text" id="bn_mother_name" placeholder="বাংলায় নাম...">
                                            <div class="invalid-feedback">মাতার নাম দিন</div>
                                        </div>
                                        <span class="text-danger">{{ $errors->has('bn_mother_name') ? $errors->first('bn_mother_name') : ' ' }}</span>
                                    </div>
                                    <div class="mb-3">
                                        <label for="english_name" class="form-label">নাম ( ইংরেজিতে )</label>
                                        <div class="input-group inputs">
                                            <span class="input-group-text icons"><i class="fa-solid fa-file-signature"></i></span>
                                            <input class="form-control" name="english_name" type="text" id="english_name" placeholder="English name...">
                                            <div class="invalid-feedback">ইংরেজিতে নাম দিন</div>
                                        </div>
                                        <span class="text-danger">{{ $errors->has('english_name') ? $errors->first('english_name') : ' ' }}</span>
                                    </div>
                                    <div class="father_name">
                                        <div class="mb-3">
                                            <label for="en_father_name" class="form-label">পিতার নাম (ইংরেজিতে)</label>
                                            <div class="input-group inputs">
                                                <span class="input-group-text icons"><i class="fa-solid fa-file-signature"></i></span>
                                                <input class="form-control" name="en_father_name" type="text" id="en_father_name" placeholder="English name...">
                                                <div class="invalid-feedback">পিতার নাম দিন</div>
                                            </div>
                                            <span class="text-danger">{{ $errors->has('en_father_name') ? $errors->first('en_father_name') : ' ' }}</span>
                                        </div>
                                    </div>
                                    <div class="Husband_name"  style="display:none;">
                                        <div class="mb-3">
                                            <label for="en_Husband_name" class="form-label">স্বামীর নাম (ইংরেজিতে)</label>
                                            <div class="input-group inputs">
                                                <span class="input-group-text icons"><i class="fa-solid fa-file-signature"></i></span>
                                                <input class="form-control" name="en_Husband_name" type="text" id="en_Husband_name" disabled placeholder="English name...">
                                                <div class="invalid-feedback">স্বামীর নাম দিন</div>
                                            </div>
                                            <span class="text-danger">{{ $errors->has('en_Husband_name') ? $errors->first('en_Husband_name') : ' ' }}</span>
                                        </div>
                                    </div>
                                    <div class="mb-3">
                                        <label for="en_mother_name" class="form-label">মাতার নাম (ইংরেজিতে)</label>
                                        <div class="input-group inputs">
                                            <span class="input-group-text icons"><i class="fa-solid fa-file-signature"></i></span>
                                            <input class="form-control" name="en_mother_name" type="text" id="en_mother_name" placeholder="English name...">
                                            <div class="invalid-feedback">মাতার নাম দিন</div>
                                        </div>
                                        <span class="text-danger">{{ $errors->has('en_mother_name') ? $errors->first('en_mother_name') : ' ' }}</span>
                                    </div>
                                    <div class="form-group mb-4">
                                        <label class="form-label">লিঙ্গ <span class="required">*</span></label>
                                        <div class="input-group inputs">
                                            <span class="input-group-text icons"><i class="fa-solid fa-file-signature"></i></span>
                                            <select required class="form-select" name="gender" aria-label="Default select example">
                                                <option style="color: red" value="">— চিহ্নিত করুন —</option>
                                                <option value="1">পুরুষ</option>
                                                <option value="2">মহিলা</option>
                                                <option value="3">তৃতীয় লিঙ্গ</option>
                                            </select>
                                            <span class="text-danger">{{ $errors->has('gender') ? $errors->first('gender') : ' ' }}</span>
                                            <div class="invalid-feedback">
                                                লিঙ্গ দিন
                                            </div>
                                        </div>
                                    </div>
                                    <div class="form-group mb-4" data-select2-id="48">
                                        <label for="marital_status" class="form-label">বৈবাহিক অবস্থা <span class="required">*</span></label>
                                        <div class="input-group inputs">
                                            <span class="input-group-text icons"><i class="fa-solid fa-file-signature"></i></span>
                                            <select required class="form-select" name="marital_status" aria-label="Default select example">
                                                <option style="color: red" selected="" disabled="" value="">— চিহ্নিত করুন —</option>
                                                <option value="1">বিবাহিত</option>
                                                <option value="2">অবিবাহিত</option>
                                                <option value="3">তালাক প্রাপ্ত</option>
                                                <option value="4">বিধবা</option>
                                                <option value="5">অন্যান্য</option>
                                            </select>
                                            <span class="text-danger">{{ $errors->has('marital_status') ? $errors->first('marital_status') : ' ' }}</span>
                                            <div class="invalid-feedback">
                                                বৈবাহিক অবস্থা দিন
                                            </div>
                                        </div>
                                    </div>
                                    <div class="mb-3">
                                        <label for="pesha" class="form-label">পেশা <span class="required">*</span></label>
                                        <div class="input-group inputs">
                                            <span class="input-group-text icons"><i class="fa-solid fa-user-tie"></i></span>
                                            <select required class="form-select" name="pesha" id="pesha" aria-label="Default select example">
                                                <option style="color: red" selected="" disabled="" value="">— চিহ্নিত করুন —</option>
                                                <option value="কৃষক">কৃষক</option>
                                                <option value="গৃহিণী">গৃহিণী</option>
                                                <option value="ছাত্র">ছাত্র</option>
                                                <option value="ছাত্রী">ছাত্রী</option>
                                                <option value="ব্যাবসা">ব্যাবসা</option>
                                                <option value="চাকুরী">চাকুরী</option>
                                                <option value="দিনমজুরি">দিনমজুরি </option>
                                                <option value="প্রবাসী">প্রবাসী </option>
                                                <option value="অন্যান্য">অন্যান্য </option>
                                                <option value="নাই">নাই </option>
                                            </select>
                                            <div class="invalid-feedback">পেশা দিন</div>
                                        </div>
                                        <span class="text-danger">{{ $errors->has('pesha') ? $errors->first('pesha') : ' ' }}</span>
                                    </div>
                                    <div class="mb-3">
                                        <label for="educational_qualifications" class="form-label">শিক্ষাগত যোগ্যতা <span class="required">*</span></label>
                                        <div class="input-group inputs">
                                            <span class="input-group-text icons"><i class="fa-solid fa-graduation-cap"></i></span>
                                            <select required class="form-select" name="educational_qualifications" id="educational_qualifications" aria-label="Default select example">
                                                <option style="color: red" selected="" disabled="" value="">— চিহ্নিত করুন —</option>
                                                <option value="প্রাথমিক শিক্ষা">প্রাথমিক শিক্ষা</option>
                                                <option value="৮ম শ্রেণি">৮ম শ্রেণি</option>
                                                <option value="এস এস সি">এস এস সি</option>
                                                <option value="এইচ এস সি">এইচ এস সি</option>
                                                <option value="অনার্স">অনার্স </option>
                                                <option value="মাস্টার্স">মাস্টার্স </option>
                                                <option value="গ্রেজুয়েশন">গ্রেজুয়েশন</option>
                                                <option value="এমবিএ">এমবিএ </option>
                                                <option value="বি বি এ">বি বি এ </option>
                                                <option value="অন্যান্য">অন্যান্য </option>
                                                <option value="নাই">নাই </option>
                                            </select>
                                            <div class="invalid-feedback">শিক্ষাগত দিন</div>
                                        </div>
                                        <span class="text-danger">{{ $errors->has('educational_qualifications') ? $errors->first('educational_qualifications') : ' ' }}</span>
                                    </div>
                                    <div class="form-group mb-4">
                                        <label for="religion" class="form-label">ধর্ম <span class="required">*</span></label>
                                        <div class="input-group inputs">
                                            <span class="input-group-text icons"><i class="fa-solid fa-file-signature"></i></span>
                                            <select required class="form-select" name="religion" id="religion" aria-label="Default select example">
                                                <option style="color: red" selected="" disabled="" value="">— চিহ্নিত করুন —</option>
                                                <option value="1">ইসলাম</option>
                                                <option value="2">হিন্দু</option>
                                                <option value="3">বৌদ্ধ</option>
                                                <option value="4">খ্রিস্ট</option>
                                                <option value="5">অন্যান্য</option>
                                            </select>
                                            <span class="text-danger">{{ $errors->has('religion') ? $errors->first('religion') : ' ' }}</span>
                                            <div class="invalid-feedback">
                                                ধর্ম দিন
                                            </div>
                                        </div>
                                    </div>
                                    <div class="form-group mb-4">
                                        <label for="basinda" class="form-label">বাসিন্দা  <span class="required">*</span></label>
                                        <div class="input-group inputs">
                                            <span class="input-group-text icons"><i class="fa-solid fa-file-signature"></i></span>
                                            <select required class="form-select" name="basinda" id="basinda" aria-label="Default select example">
                                                <option style="color: red" disabled="" value="">— চিহ্নিত করুন —</option>
                                                <option value="1" selected>স্থায়ী</option>
                                                <option value="2">অস্থায়ী</option>
                                            </select>
                                            <span class="text-danger">{{ $errors->has('basinda') ? $errors->first('basinda') : ' ' }}</span>
                                            <div class="invalid-feedback">
                                                বাসিন্দা  দিন
                                            </div>
                                        </div>
                                    </div>
                                    <div class="present_text text-center present">
                                        <h2>বর্তমান ঠিকানা </h2>
                                    </div>
                                    <div class="card-header text-center present-head">(ইংরেজিতে)</div>
                                    <div class="form-group mb-4">
                                        <label for="p_en_word" class="form-label">ওয়ার্ড নং <span class="required">*</span></label>
                                        <div class="input-group inputs">
                                            <span class="input-group-text icons"><i class="fa-solid fa-file-signature"></i></span>
                                            <select required class="form-select" name="p_en_word" id="p_en_word" aria-label="Default select example">
                                                <option style="color: red" selected="" disabled="" value="" data-select2-id="16">— চিহ্নিত করুন —</option>
                                                @foreach(words() as $word)
                                                    <option value="{{ $word->number }}">{{ $word->number }}</option>
                                                @endforeach
                                            </select>
                                            <span class="text-danger">{{ $errors->has('p_en_word') ? $errors->first('p_en_word') : ' ' }}</span>
                                            <div class="invalid-feedback">
                                                ওয়ার্ড নং দিন
                                            </div>
                                        </div>
                                    </div>
                                    {{--                                    <div class="form-group mb-3">--}}
                                    {{--                                        <label for="p_en_address" class="form-label">পাড়া/মহল্লা <span class="required">*</span></label>--}}
                                    {{--                                        <div class="input-group inputs">--}}
                                    {{--                                            <span class="input-group-text icons"><i class="fa-sharp fa-solid fa-chart-area"></i></span>--}}
                                    {{--                                            <select required class="form-select" name="p_en_address" id="p_en_address" aria-label="Default select example">--}}
                                    {{--                                                <option style="color: red" selected="" disabled="" value="" data-select2-id="16">— চিহ্নিত করুন —</option>--}}
                                    {{--                                            </select>--}}
                                    {{--                                            <div class="invalid-feedback">পাড়া/মহল্লা দিন</div>--}}
                                    {{--                                        </div>--}}
                                    {{--                                        <span class="text-danger">{{ $errors->has('p_en_address') ? $errors->first('p_en_address') : ' ' }}</span>--}}
                                    {{--                                    </div>--}}
                                    <div class="mb-3">
                                        <label for="p_en_bloc" class="form-label">রোড/ব্লক/সেক্টর</label>
                                        <div class="input-group inputs">
                                            <span class="input-group-text icons"><i class="fa-solid fa-road"></i></span>
                                            <input class="form-control" name="p_en_bloc" type="text" id="p_en_bloc" placeholder="Road/Block/Sector">
                                            <div class="invalid-feedback">রোড/ব্লক/সেক্টর দিন</div>
                                        </div>
                                    </div>
                                    <div class="card-header text-center present-head">(বাংলায়)</div>
                                    <div class="form-group mb-3">
                                        <label for="p_bn_address" class="form-label">পাড়া/মহল্লা <span class="required">*</span></label>
                                        <div class="input-group inputs">
                                            <span class="input-group-text icons"><i class="fa-sharp fa-solid fa-chart-area"></i></span>
                                            <select required class="form-select" name="p_bn_address" id="p_bn_address" aria-label="Default select example">
                                                <option style="color: red" selected="" disabled="" value="" data-select2-id="16">— চিহ্নিত করুন —</option>
                                            </select>
                                            <div class="invalid-feedback">পাড়া/মহল্লা দিন</div>
                                            <span class="text-danger">{{ $errors->has('p_bn_address') ? $errors->first('p_bn_address') : ' ' }}</span>
                                        </div>
                                    </div>
                                    <div class="mb-3">
                                        <label for="p_bn_bloc" class="form-label">রোড/ব্লক/সেক্টর</label>
                                        <div class="input-group inputs">
                                            <span class="input-group-text icons"><i class="fa-solid fa-road"></i></span>
                                            <input class="form-control" name="p_bn_bloc" type="text" id="p_bn_bloc" placeholder="রোড/ব্লক/সেক্টর">
                                            <div class="invalid-feedback">রোড/ব্লক/সেক্টর দিন</div>
                                        </div>
                                    </div>
                                    <div class="mb-3">
                                        <label for="p_bn_post" class="form-label">পোষ্ট অফিস <span class="required">*</span></label>
                                        <div class="input-group inputs">
                                            <span class="input-group-text icons"><i class="fa-solid fa-envelopes-bulk"></i></span>
                                            <select required class="form-select" name="p_bn_post" id="p_bn_post" aria-label="Default select example">
                                                <option style="color: red" selected="" disabled="" value="" data-select2-id="16">— চিহ্নিত করুন —</option>
                                                @foreach($post_offices as $item)
                                                    <option value="{{ $item->id }}">{{ $item->bn_post_office }}</option>
                                                @endforeach
                                            </select>
                                            <div class="invalid-feedback">পোষ্ট অফিস দিন</div>
                                            <span class="text-danger">{{ $errors->has('p_bn_post') ? $errors->first('p_bn_post') : ' ' }}</span>
                                        </div>
                                    </div>

                                    <div class="mb-4 form-check">
                                        <input type="checkbox" class="form-check-input" id="sameaspresentaddress" name="sameaspresentaddress" value="1">
                                        <label class="form-check-label text-primary" for="sameaspresentaddress">স্থায়ী ঠিকানা এবং বর্তমান ঠিকানা একই হলে টিক মার্ক দিন</label>
                                    </div>
                                    <div id="permanent_address" class="permanent_address">
                                        <div class="permanent_text text-center present">
                                            <h2>স্থায়ী ঠিকানা </h2>
                                        </div>
                                        <div class="card-header text-center present-head">(ইংরেজিতে)</div>
                                        <div class="form-group mb-3">
                                            <label for="perma_en_address" class="form-label">পাড়া/মহল্লা <span class="required">*</span></label>
                                            <div class="input-group inputs">
                                                <span class="input-group-text icons"><i class="fa-sharp fa-solid fa-chart-area"></i></span>
                                                <input required class="form-control" name="perma_en_address" id="perma_en_address" type="text" placeholder="Neighbourhood/Mahalla">
                                                <div class="invalid-feedback">পাড়া/মহল্লা দিন</div>
                                            </div>
                                        </div>
                                        <div class="mb-3">
                                            <label for="perma_en_bloc" class="form-label">রোড/ব্লক/সেক্টর</label>
                                            <div class="input-group inputs">
                                                <span class="input-group-text icons"><i class="fa-solid fa-road"></i></span>
                                                <input class="form-control" name="perma_en_bloc" type="text" id="perma_en_bloc" placeholder="Road/Block/Sector">
                                                <div class="invalid-feedback">রোড/ব্লক/সেক্টর দিন</div>
                                            </div>
                                        </div>
                                        <div class="form-group mb-4">
                                            <label for="perma_en_word" class="form-label">ওয়ার্ড নং <span class="required">*</span></label>
                                            <div class="input-group inputs">
                                                <span class="input-group-text icons"><i class="fa-solid fa-file-signature"></i></span>
                                                <select required class="form-select" name="perma_en_word" id="perma_en_word" aria-label="Default select example">
                                                    <option style="color: red" selected="" disabled="" value="">— চিহ্নিত করুন —</option>
                                                    <option value="1">1</option>
                                                    <option value="2">2</option>
                                                    <option value="3">3</option>
                                                    <option value="4">4</option>
                                                    <option value="5">5</option>
                                                    <option value="6">6</option>
                                                    <option value="7">7</option>
                                                    <option value="8">8</option>
                                                    <option value="9">9</option>
                                                    <option value="10">10</option>
                                                    <option value="11">11</option>
                                                    <option value="12">12</option>
                                                </select>
                                                <span class="text-danger"> </span>
                                                <div class="invalid-feedback">
                                                    ওয়ার্ড নং দিন
                                                </div>
                                            </div>
                                        </div>
                                        <div class="mb-3">
                                            <label for="perma_en_post" class="form-label">পোষ্ট অফিস <span class="required">*</span></label>
                                            <div class="input-group inputs">
                                                <span class="input-group-text icons"><i class="fa-solid fa-envelopes-bulk"></i></span>
                                                <input required class="form-control" name="perma_en_post" type="text" id="perma_en_post" placeholder="post office">
                                                <div class="invalid-feedback">পোষ্ট অফিস দিন</div>
                                            </div>
                                        </div>
                                        <div class="mb-3">
                                            <label for="perma_en_code" class="form-label">পোষ্ট কোড <span class="required">*</span></label>
                                            <div class="input-group inputs">
                                                <span class="input-group-text icons"><i class="fa-solid fa-envelopes-bulk"></i></span>
                                                <input required class="form-control" name="perma_en_code" type="text" id="perma_en_code" placeholder="Post Code">
                                                <div class="invalid-feedback">পোষ্ট কোড দিন</div>
                                            </div>
                                        </div>

                                        <div class="form-group mb-4">
                                            <label for="perma_en_division" class="form-label">বিভাগ <span class="required">*</span></label>
                                            <div class="input-group inputs">
                                                <span class="input-group-text icons"><i class="fa-solid fa-building-user"></i></span>
                                                <select name="perma_en_division" required class="form-select" id="perma_en_division">
                                                    <option style="color: red" selected disabled value="">&mdash; চিহ্নিত করুন &mdash;</option>
                                                    @foreach($divisions as $item)
                                                        <option value="{{ $item->id }}">{{ $item->name }}</option>
                                                    @endforeach
                                                </select>
                                                <div class="invalid-feedback">
                                                    বিভাগ দিন
                                                </div>
                                            </div>
                                        </div>
                                        <div class="form-group mb-4">
                                            <label for="perma_en_district" class="form-label">জেলা <span class="required">*</span></label>
                                            <div class="input-group inputs">
                                                <span class="input-group-text icons"><i class="fa-solid fa-building-user"></i></span>
                                                <select name="perma_en_district" required class="form-select" id="perma_en_district">
                                                    <option style="color: red" selected disabled value="">&mdash; চিহ্নিত করুন &mdash;</option>
                                                    @foreach($districts as $item)
                                                        <option value="{{ $item->id }}">{{ $item->name }}</option>
                                                    @endforeach
                                                </select>
                                                <div class="invalid-feedback">
                                                    জেলা দিন
                                                </div>
                                            </div>
                                        </div>
                                        <div class="form-group mb-4">
                                            <label for="perma_en_upazila" class="form-label">উপজেলা <span class="required">*</span></label>
                                            <div class="input-group inputs">
                                                <span class="input-group-text icons"><i class="fa-solid fa-building-user"></i></span>
                                                <select name="perma_en_upazila" required class="form-select" id="perma_en_upazila">
                                                    <option style="color: red" selected disabled value="">&mdash; চিহ্নিত করুন &mdash;</option>
                                                    @foreach($upazilas as $item)
                                                        <option value="{{ $item->id }}">{{ $item->name }}</option>
                                                    @endforeach
                                                </select>
                                                <div class="invalid-feedback">
                                                    উপজেলা দিন
                                                </div>
                                            </div>
                                        </div>
                                        <div class="form-group mb-3">
                                            <label for="perma_en_thana" class="form-label">থানা <span class="required">*</span></label>
                                            <div class="input-group inputs">
                                                <span class="input-group-text icons"><i class="fa-sharp fa-solid fa-building-user"></i></span>
                                                <input required class="form-control" name="perma_en_thana" type="text" id="perma_en_thana" placeholder="থানা">
                                                <div class="invalid-feedback">থানা দিন</div>
                                            </div>
                                        </div>

                                        <div class="card-header text-center present-head">(বাংলায়)</div>
                                        <div class="form-group mb-3">
                                            <label for="perma_bn_address" class="form-label">পাড়া/মহল্লা <span class="required">*</span></label>
                                            <div class="input-group inputs">
                                                <span class="input-group-text icons"><i class="fa-sharp fa-solid fa-chart-area"></i></span>
                                                <input required class="form-control" name="perma_bn_address" type="text" id="perma_bn_address" placeholder="পাড়া/মহল্লা">
                                                <div class="invalid-feedback">পাড়া/মহল্লা দিন</div>
                                            </div>
                                        </div>
                                        <div class="mb-3">
                                            <label for="perma_bn_bloc" class="form-label">রোড/ব্লক/সেক্টর <span class="required">*</span></label>
                                            <div class="input-group inputs">
                                                <span class="input-group-text icons"><i class="fa-solid fa-road"></i></span>
                                                <input required class="form-control" name="perma_bn_bloc" type="text" id="perma_bn_bloc" placeholder="রোড/ব্লক/সেক্টর">
                                                <div class="invalid-feedback">রোড/ব্লক/সেক্টর দিন</div>
                                            </div>
                                        </div>
                                        <div class="form-group mb-4">
                                            <label for="perma_bn_word" class="form-label">ওয়ার্ড নং <span class="required">*</span></label>
                                            <div class="input-group inputs">
                                                <span class="input-group-text icons"><i class="fa-solid fa-file-signature"></i></span>
                                                <select required class="form-select" name="perma_bn_word" id="perma_bn_word" aria-label="Default select example">
                                                    <option style="color: red" selected="" disabled="" value="" data-select2-id="16">— চিহ্নিত করুন —</option>
                                                    <option value="১">১</option>
                                                    <option value="২">২</option>
                                                    <option value="৩">৩</option>
                                                    <option value="৪">৪</option>
                                                    <option value="৫">৫</option>
                                                    <option value="৬">৬</option>
                                                    <option value="৭">৭</option>
                                                    <option value="৮">৮</option>
                                                    <option value="৯">৯</option>
                                                    <option value="১০">১০</option>
                                                    <option value="১১">১১</option>
                                                    <option value="১২">১২</option>
                                                </select>
                                                <span class="text-danger"> </span>
                                                <div class="invalid-feedback">
                                                    ওয়ার্ড নং দিন
                                                </div>
                                            </div>
                                        </div>
                                        <div class="mb-3">
                                            <label for="perma_bn_post" class="form-label">পোষ্ট অফিস <span class="required">*</span></label>
                                            <div class="input-group inputs">
                                                <span class="input-group-text icons"><i class="fa-solid fa-envelopes-bulk"></i></span>
                                                <input required class="form-control" name="perma_bn_post" type="text" id="perma_bn_post" placeholder="পোষ্ট অফিস">
                                                <div class="invalid-feedback">পোষ্ট অফিস দিন</div>
                                            </div>
                                        </div>
                                        <div class="mb-3">
                                            <label for="perma_bn_code" class="form-label">পোষ্ট কোড <span class="required">*</span></label>
                                            <div class="input-group inputs">
                                                <span class="input-group-text icons"><i class="fa-solid fa-envelopes-bulk"></i></span>
                                                <input required class="form-control" name="perma_bn_code" type="text" id="perma_bn_code" placeholder="পোষ্ট কোড">
                                                <div class="invalid-feedback">পোষ্ট কোড দিন</div>
                                            </div>
                                        </div>
                                        <div class="form-group mb-4">
                                            <label for="perma_bn_division" class="form-label">বিভাগ <span class="required">*</span></label>
                                            <div class="input-group inputs">
                                                <span class="input-group-text icons"><i class="fa-solid fa-building-user"></i></span>
                                                <select name="perma_bn_division" required class="form-select" id="perma_bn_division">
                                                    <option style="color: red" selected disabled value="">&mdash; চিহ্নিত করুন &mdash;</option>
                                                    @foreach($divisions as $item)
                                                        <option value="{{ $item->id }}">{{ $item->bn_name }}</option>
                                                    @endforeach
                                                </select>
                                                <div class="invalid-feedback">
                                                    বিভাগ দিন
                                                </div>
                                            </div>
                                        </div>
                                        <div class="form-group mb-4">
                                            <label for="perma_bn_district" class="form-label">জেলা <span class="required">*</span></label>
                                            <div class="input-group inputs">
                                                <span class="input-group-text icons"><i class="fa-solid fa-building-user"></i></span>
                                                <select name="perma_bn_district" required class="form-select" id="perma_bn_district">
                                                    <option style="color: red" selected disabled value="">&mdash; চিহ্নিত করুন &mdash;</option>
                                                    @foreach($districts as $item)
                                                        <option value="{{ $item->id }}">{{ $item->bn_name }}</option>
                                                    @endforeach
                                                </select>
                                                <div class="invalid-feedback">
                                                    জেলা দিন
                                                </div>
                                            </div>
                                        </div>
                                        <div class="form-group mb-4">
                                            <label for="perma_bn_upazila" class="form-label">উপজেলা <span class="required">*</span></label>
                                            <div class="input-group inputs">
                                                <span class="input-group-text icons"><i class="fa-solid fa-building-user"></i></span>
                                                <select name="perma_bn_upazila" required class="form-select" id="perma_bn_upazila">
                                                    <option style="color: red" selected disabled value="">&mdash; চিহ্নিত করুন &mdash;</option>
                                                    @foreach($upazilas as $item)
                                                        <option value="{{ $item->id }}">{{ $item->bn_name }}</option>
                                                    @endforeach
                                                </select>
                                                <div class="invalid-feedback">
                                                    উপজেলা দিন
                                                </div>
                                            </div>
                                        </div>
                                        <div class="form-group mb-3">
                                            <label for="perma_bn_thana" class="form-label">থানা <span class="required">*</span></label>
                                            <div class="input-group inputs">
                                                <span class="input-group-text icons"><i class="fa-sharp fa-solid fa-building-user"></i></span>
                                                <input required class="form-control" name="perma_bn_thana" type="text" id="perma_bn_thana" placeholder="থানা">
                                                <div class="invalid-feedback">থানা দিন</div>
                                            </div>
                                            <div class="invalid-feedback">
                                                থানা দিন
                                            </div>
                                        </div>
                                    </div>
                                    <div class="text-center present">
                                        <h2>যোগাযোগের মাধ্যম </h2>
                                    </div>
                                    <div class="mb-3">
                                        <label for="phone" class="form-label">মোবাইল <span class="required">*</span></label>
                                        <div class="input-group inputs">
                                            <span class="input-group-text icons"><i class="fa-solid fa-phone"></i></span>
                                            <input required class="form-control DisableSpace isNaN" name="phone" type="tel" minlength="11" maxlength="11" id="phone" placeholder="Type English">
                                            <div class="invalid-feedback">মোবাইল দিন</div>
                                        </div>
                                        <span class="text-danger invalidNumber"></span>
                                        <br/>
                                        <span class="text-danger" id="phoneNumberAlert"></span>
                                    </div>
                                    {{--                                    <div class="mb-3">--}}
                                    {{--                                        <label for="exampleInputEmail1" class="form-label">ই-মেইল <span class="required">*</span></label>--}}
                                    {{--                                        <div class="input-group inputs">--}}
                                    {{--                                            <span class="input-group-text icons"><i class="fa-solid fa-user-tie"></i></span>--}}
                                    {{--                                            <input required class="form-control" name="holding_no" type="email" id="holding_no" placeholder="your email">--}}
                                    {{--                                            <div class="invalid-feedback">ই-মেইল দিন</div>--}}
                                    {{--                                        </div>--}}
                                    {{--                                    </div>--}}
                                    {{--                                    <div class="mb-3">--}}
                                    {{--                                        <label for="en_attachment" class="form-label">সংযুক্তি যদি থাকে ( ইংরেজিতে ) </label>--}}
                                    {{--                                        <div class="inputs">--}}
                                    {{--                                            <textarea class="form-control" name="en_attachment" id="en_attachment" rows="4" placeholder="Examples: Freedom fighter children, widows, tribals ..... etc."></textarea>--}}
                                    {{--                                        </div>--}}
                                    {{--                                    </div>--}}
                                    {{--                                    <div class="mb-3">--}}
                                    {{--                                        <label for="bn_attachment" class="form-label">সংযুক্তি যদি থাকে ( বাংলায় )</label>--}}
                                    {{--                                        <div class="inputs">--}}
                                    {{--                                            <textarea class="form-control" name="bn_attachment" id="bn_attachment" rows="4" placeholder="উদাহরন: মুক্তিযোদ্ধা সন্তান, বিধবা, উপজাতি .....ইত্যাদি"></textarea>--}}
                                    {{--                                        </div>--}}
                                    {{--                                    </div>--}}
                                    <div class="text-center present">
                                        <h2>আবেদনের সংযুক্তি</h2>
                                    </div>
                                    <div class="mb-3">
                                        <label for="tax_copy" class="form-label">হোল্ডিং  ট্যাক্সের কপি<span class="required">*</span></label>
                                        <div class="custom-file">
                                            <div class="input-group inputs">
                                                <span class="input-group-text icons"><i class="fa-solid fa-home"></i></span>
                                                <input type="file" accept="image/*" name="tax_copy" class="custom-file-input form-control" required id="tax_copy">
                                                <div class="invalid-feedback">হোল্ডিং  ট্যাক্সের কপি দিন</div>
                                            </div>
                                        </div>
                                        <span class="text-danger">{{ $errors->has('tax_copy') ? $errors->first('tax_copy') : ' ' }}</span>
                                    </div>
                                    <div class="mb-3">
                                        <label for="birth_nid_copy" class="form-label">জন্ম নিবন্ধন / ন্যাশনাল আইডি কার্ড কপি<span class="required">*</span></label>
                                        <div class="custom-file">
                                            <div class="input-group inputs">
                                                <span class="input-group-text icons"><i class="fa-solid fa-id-card"></i></span>
                                                <input type="file" accept="image/*" name="birth_nid_copy" class="custom-file-input form-control" required id="birth_nid_copy">
                                                <div class="invalid-feedback">জন্ম নিবন্ধন / ন্যাশনাল আইডি কার্ড কপি দিন</div>
                                            </div>
                                        </div>
                                        <span class="text-danger">{{ $errors->has('birth_nid_copy') ? $errors->first('birth_nid_copy') : ' ' }}</span>
                                    </div>
                                    <div class="card-footer text-end text-muted">
                                        <button type="submit" id="next_btn_7" class="btn btn-primary disabled_button">Submit</button>
                                    </div>
                                </div>
                                {{ Form::close() }}
                            </div>
                        @else
                            <p class="text-center text-danger">কারিগরি মান উন্নয়নের জন্য সাময়িকভাবে এই সেবাটি বন্ধ রয়েছে। অনুগ্রহ করে পৌরসভায় যোগাযোগ করুন। ধন্যবাদ</p>
                        @endif

                    </div>
                </div>
            </div>
        </div>
    </div>
@endsection