polizia_frascati/resources/views/components/report/protocollo/generale.blade.php

<div class="card card-primary">
    <div class="card-header">
        <h3 class="card-title">Generale</h3>
    </div>
    <div class="card-body">
        <div class="row">
            <div class="col-sm-6">
                <div class="form-group">
                    <div class="custom-control custom-switch custom-switch-md">
                        <input type="checkbox" class="custom-control-input" id="necessita_nulla_osta"
                            wire:model="necessita_nulla_osta">
                        <label class="custom-control-label" for="necessita_nulla_osta">Necessità nulla
                            osta</label>
                    </div>

                </div>
            </div>
            <div class="col-sm-2">
            </div>
            <div class="col-sm-4">
                <div class="form-group">
                    <label>Data nulla osta</label>

                    <input class="form-control" type="date" wire:model="data_nulla_osta">
                </div>
            </div>
        </div>
        <div class="row">
            <div class="col-sm-4">
                <div class="form-group">
                    <label>Numero protocollo</label>
                    <input class="form-control" type="text" wire:model="protocollo_num">
                </div>
            </div>
            <div class="col-sm-4">
                <div class="form-group">
                    <label>Anno protocollo</label>
                    <select class="form-control" wire:model="protocollo_anno">
                        @for ($year = date('Y'); $year > 1970; $year--)
                            <option value="{{ $year }}">
                                {{ $year }}
                        @endfor
                    </select>
                </div>
            </div>
            <div class="col-sm-4">
                <div class="form-group">
                    <label>Numerazione secondaria</label>
                    <select class="form-control" style="width:100%" wire:model="protocollo_ord">
                        <option value=""></option>
                        <option value="1">---</option>
                        <option value="2">Bis</option>
                        <option value="3">Ter</option>
                        <option value="4">Quater</option>
                        <option value="5">Quinquies</option>
                        <option value="6">Sexies</option>
                        <option value="7">Septies</option>
                        <option value="8">Octies</option>
                        <option value="9">Novies</option>
                        <option value="10">Decies</option>
                    </select>
                </div>
            </div>
        </div>
        <div class="row">
            <div class="col-sm-4">
                <div class="form-group">
                    <label>Verificatosi in data</label>
                    <input class="form-control" type="date" wire:model="verificatosi_in_data">
                </div>
            </div>
            <div class="col-sm-4">
                <div class="form-group">
                    <label>Seleziona ora</label>
                    <select class="form-control" wire:model="verificatosi_in_data_ora">
                        <option value="">-- Seleziona ora --
                        </option>
                        @for ($hour = 0; $hour <= 23; $hour++)
                            <option value="{{ str_pad($hour, 2, '0', STR_PAD_LEFT) }}">
                                {{ str_pad($hour, 2, '0', STR_PAD_LEFT) }}
                            </option>
                        @endfor
                    </select>
                </div>
            </div>
            <div class="col-sm-4">
                <div class="form-group">
                    <label>Seleziona minuti</label>
                    <select class="form-control" wire:model="verificatosi_in_data_minuti">
                        <option value="">-- Seleziona minuti --
                        </option>
                        @for ($minute = 0; $minute <= 59; $minute++)
                            <option value="{{ str_pad($minute, 2, '0', STR_PAD_LEFT) }}">
                                {{ str_pad($minute, 2, '0', STR_PAD_LEFT) }}
                            </option>
                        @endfor
                    </select>
                </div>
            </div>
        </div>
        <div class="row">
            <div class="col-sm-2">
                <div class="form-group">
                    <div class="custom-control custom-switch custom-switch-md">
                        <input type="checkbox" class="custom-control-input" id="utg" wire:model="utg">
                        <label class="custom-control-label" for="utg">UTG</label>
                    </div>
                </div>
            </div>
            @if ($utg)
                <div class="col-sm-5">
                    <div class="form-group">
                        <label>UTG data</label>
                        <input class="form-control" type="date" wire:model="utg_data">
                    </div>
                </div>
                <div class="col-sm-5">
                    <div class="form-group">
                        <label>UTG protocollo</label>
                        <input class="form-control" type="text" wire:model="utg_protocollo">
                    </div>
                </div>
            @endif
        </div>
        <div class="row">
            <div class="col-sm-2">
                <div class="form-group">
                    <div class="custom-control custom-switch custom-switch-md">
                        <input type="checkbox" class="custom-control-input" id="ag" wire:model="ag">
                        <label class="custom-control-label" for="ag">AG</label>
                    </div>
                </div>
            </div>
            @if ($ag)
                <div class="col-sm-5">
                    <div class="form-group">
                        <label>AG data</label>
                        <input class="form-control" type="date" wire:model="ag_data">
                    </div>
                </div>
                <div class="col-sm-5">
                    <div class="form-group">
                        <label>AG protocollo</label>
                        <input class="form-control" type="text" wire:model="ag_protocollo">
                    </div>
                </div>
            @endif
        </div>

        <div class="row">
            <div class="col-sm-4">
                <div class="form-group">
                    <div class="custom-control custom-switch custom-switch-md">
                        <input type="checkbox" class="custom-control-input" id="incidente_con_danni_a_cose"
                            wire:model="incidente_con_danni_a_cose">
                        <label class="custom-control-label" for="incidente_con_danni_a_cose">Danni a
                            cose</label>
                    </div>
                </div>
            </div>
        </div>
        <div class="row">
            <div class="col-sm-4">
                <div class="form-group">
                    <div class="custom-control custom-switch custom-switch-md">
                        <input type="checkbox" class="custom-control-input" id="incidente_con_feriti"
                            wire:model="incidente_con_feriti">
                        <label class="custom-control-label" for="incidente_con_feriti">Feriti</label>
                    </div>
                </div>
            </div>
            @if ($incidente_con_feriti)
                <div class="col-sm-4">
                    <div class="form-group">
                        <div class="custom-control custom-switch custom-switch-md">
                            <input type="checkbox" class="custom-control-input"
                                id="incidente_con_feriti_lesioni_lievi"
                                wire:model="incidente_con_feriti_lesioni_lievi">
                            <label class="custom-control-label" for="incidente_con_feriti_lesioni_lievi">Lesioni
                                lievi</label>
                        </div>
                    </div>
                </div>
                <div class="col-sm-4">
                    <div class="form-group">
                        <div class="custom-control custom-switch custom-switch-md">
                            <input type="checkbox" class="custom-control-input"
                                id="incidente_con_feriti_lesioni_gravi"
                                wire:model="incidente_con_feriti_lesioni_gravi">
                            <label class="custom-control-label" for="incidente_con_feriti_lesioni_gravi">Lesioni
                                gravi</label>
                        </div>
                    </div>
                </div>
            @endif
        </div>

        <div class="row">
            <div class="col-sm-4">
                <div class="form-group">
                    <div class="custom-control custom-switch custom-switch-md">
                        <input type="checkbox" class="custom-control-input" id="incidente_mortale"
                            wire:model="incidente_mortale">
                        <label class="custom-control-label" for="incidente_mortale">Mortale</label>
                    </div>
                </div>
            </div>
        </div>
    </div>
</div>