Form - LARAVEL

@extends('layouts.master')

@section('content')

<!-- Content Wrapper. Contains page content -->

<div class="content-wrapper">

<!-- Content Header (Page header) -->

<!-- Content Wrapper. Contains page content -->

<!-- Content Header (Page header) -->

<div class="content-header">

<div class="container-fluid">

<div class="row mb-2">

<div class="col-sm-6">

<h1>Form Lap. Pertanggung Jawaban Keuangan</h1>

</div>

<div class="col-sm-6">

<ol class="breadcrumb float-sm-right">

<li class="breadcrumb-item"><a href="{{ route('inputdata') }}">Input Data</a></li>

<li class="breadcrumb-item active">Input Form LPJ</li>

</ol>

</div>

</div>

<div class="row">

<div class="col-12">

<!-- Custom Tabs -->

<div class="card">

<div class="card-header d-flex p-0">

<h3 class="card-title p-3">Mohon Untuk Mengisi Form Dengan Benar</h3>

<ul class="nav nav-pills ml-auto p-2">

<li class="nav-item"><a class="nav-link active" href="#tab_1" data-toggle="tab">Form 01</a></li>

<li class="nav-item"><a class="nav-link" href="#tab_2" data-toggle="tab">Form 02</a></li>

<li class="nav-item"><a class="nav-link" href="#tab_3" data-toggle="tab">Form 03</a></li>

<li class="nav-item"><a class="nav-link" href="#tab_4" data-toggle="tab">Form 04</a></li>

<li class="nav-item"><a class="nav-link" href="#tab_5" data-toggle="tab">Form 05</a></li>

<li class="nav-item dropdown">

<a class="nav-link dropdown-toggle" data-toggle="dropdown" href="#">

Dropdown <span class="caret"></span>

</a>

<div class="dropdown-menu">

<a class="dropdown-item" tabindex="-1" href="#">Action</a>

<a class="dropdown-item" tabindex="-1" href="#">Another action</a>

<a class="dropdown-item" tabindex="-1" href="#">Something else here</a>

<div class="divider"></div>

<a class="dropdown-item" tabindex="-1" href="#">Separated link</a>

</div>

</li>

</ul>

</div><!-- /.card-header -->

<div class="card-body">

<div class="tab-content">

<div class="tab-pane active" id="tab_1">

<!-- Main content -->

<!-- general form elements disabled -->

<div class="card card-warning">

<div class="card-header">

<h3 class="card-title">Surat Pengajuan Ke Bendahara</h3>

</div>

<!-- /.card-header -->

<div class="card-body">

<form role="form">

<!-- text input -->

<div class="form-group">

<label>Nama Kegiatan</label>

<input type="text" class="form-control" placeholder="Masukkan Nama Kegiatan">

</div>

<!-- select -->

<div class="form-group">

<label>Instansi</label>

<select class="form-control">

<option>Dinas Kesehatan</option>

<option>Upt Puskesmas Kebonsari</option>

<option>Upt Puskesmas Kandangsapi</option>

<option>Upt Puskesmas Sekargadung</option>

<option>Upt Puskesmas Gadingrejo</option>

<option>Upt Puskesmas Trajeng</option>

<option>Upt Puskesmas Kebonagung</option>

<option>Upt Puskesmas Karangketug</option>

<option>Upt Kefarmasian</option>

</select>

</div>

<div class="form-group">

<label>Jenis Kegiatan</label>

<select class="form-control select2" style="width: 100%;">

<option selected="selected">Honorarium Tenaga Ahli/Narasumber/Instruktur</option>

<option>Honorarium Pegawai</option>

<option>Pengadaan Barang dan Jasa</option>

<option>Jasa Pelayanan / Retribusi</option>

<option>Pembayaran Tagihan Telepon & Listrik</option>

<option>Pembayaran lain-lain</option>

</select>

</div>

<div class="row no-print">

<div class="col-12">

<a href="{{ route('lapform01') }}" target="_blank" class="btn btn-default"><i class="fa fa-print"></i> Print</a>

<button type="button" class="btn btn-success float-right" ><i data-toggle="modal" data-target="#myModal">Proses</i></button>

<!-- Modal -->

<div id="myModal" class="modal fade" role="dialog">

<div class="modal-dialog">

<!-- konten modal-->

<div class="modal-content">

<!-- heading modal -->

<!-- body modal -->

<div class="modal-body">

<p>Data Berhasil Di SIMPAN</p>

</div>

<!-- footer modal -->

<div class="modal-footer">

<button type="button" class="btn btn-default" data-dismiss="modal">Keluar dan Lanjutkan Ke Print</button>

</div>

</div>

</div>

</div>

</button>

<button type="button" class="btn btn-primary float-right" style="margin-right: 5px;">

<i class="fa fa-download"></i> Download PDF

</button>

</div>

</div>

</form>

</div>

</div>

</div>

<!-- /.tab-pane -->

<div class="tab-pane" id="tab_2">

<!-- Main content -->

<!-- general form elements disabled -->

<div class="card card-success">

<div class="card-header">

<h3 class="card-title">Daftar Rekapitulasi Pemindah Bukuan Non Tunai</h3>

</div>

<!-- /.card-header -->

<div class="card-body">

<form role="form">

<!-- text input -->

<div class="form-group">

<label>Rekening Belanja</label>

<input type="text" class="form-control" placeholder="Masukkan Rekening Kegiatan">

</div>

<div class="form-group">

<label>Uraian Belanja</label>

<textarea class="form-control" rows="3" placeholder="Enter ..."></textarea>

</div>

<div class="form-group has-success">

<label class="control-label" for="inputSuccess"><i class="fa fa-check"></i> Nama Penerima</label>

<input type="text" class="form-control" id="inputSuccess" placeholder="Enter ...">

</div>

<div class="form-group has-warning">

<label class="control-label" for="inputWarning"><i class="fa fa-bell-o"></i> Rekening Bank

</label>

<input type="text" class="form-control" id="inputWarning" placeholder="Enter ...">

</div>

<div class="form-group has-success">

<label class="control-label" for="inputError"><i class="fa fa-check"></i> Jumlah Kotor

</label>

<input type="text" class="form-control" id="inputError" placeholder="Enter ...">

</div>

<div class="form-group has-success">

<label class="control-label" for="inputError"><i class="fa fa-check"></i> Jumlah Bersih

</label>

<input type="text" class="form-control" id="inputError" placeholder="Enter ...">

</div>

<!-- checkbox

<div class="form-group">

<div class="form-check">

<input class="form-check-input" type="checkbox" value="option1">

<label class="form-check-label">Checkbox</label>

</div>

<div class="form-check">

<input class="form-check-input" type="checkbox" value="option1" disabled>

<label class="form-check-label">Checkbox disabled</label>

</div>

</div>-->

<!-- radio

<div class="form-group">

<div class="form-check">

<input class="form-check-input" type="radio" value="option1">

<label class="form-check-label">Radio</label>

</div>

<div class="form-check">

<input class="form-check-input" type="radio" value="option1" disabled>

<label class="form-check-label">Radio disabled</label>

</div>

</div>-->

<!-- select -->

<!--<div class="form-group">

<label>Instansi</label>

<select class="form-control">

<option>Dinas Kesehatan</option>

<option>Upt Puskesmas Kebonsari</option>

<option>Upt Puskesmas Kandangsapi</option>

<option>Upt Puskesmas Sekargadung</option>

<option>Upt Puskesmas Gadingrejo</option>

<option>Upt Puskesmas Trajeng</option>

<option>Upt Puskesmas Kebonagung</option>

<option>Upt Puskesmas Karangketug</option>

<option>Upt Kefarmasian</option>

</select>

</div>-->

<!--<div class="form-group">

<label>Select Disabled</label>

<select class="form-control" disabled>

<option>option 1</option>

<option>option 2</option>

<option>option 3</option>

<option>option 4</option>

<option>option 5</option>

</select>

</div>-->

<!--<div class="form-group">

<label>Jenis Kegiatan</label>

<select class="form-control select2" style="width: 100%;">

<option selected="selected">Honorarium Tenaga Ahli/Narasumber/Instruktur</option>

<option>Honorarium Pegawai</option>

<option>Pengadaan Barang dan Jasa</option>

<option>Jasa Pelayanan / Retribusi</option>

<option>Pembayaran Tagihan Telepon & Listrik</option>

<option>Pembayaran lain-lain</option>

</select>

</div>-->

<!-- Select multiple

<div class="form-group">

<label>Select Multiple</label>

<select multiple class="form-control">

<option>option 1</option>

<option>option 2</option>

<option>option 3</option>

<option>option 4</option>

<option>option 5</option>

</select>

</div>-->

<!--<div class="form-group">

<label>Disabled Result</label>

<select class="form-control select2" style="width: 100%;">

<option selected="selected">Alabama</option>

<option>Alaska</option>

<option disabled="disabled">California (disabled)</option>

<option>Delaware</option>

<option>Tennessee</option>

<option>Texas</option>

<option>Washington</option>

</select>

</div>-->

<!--<div class="form-group">

<label>Select Multiple Disabled</label>

<select multiple class="form-control" disabled>

<option>option 1</option>

<option>option 2</option>

<option>option 3</option>

<option>option 4</option>

<option>option 5</option>

</select>

</div>-->

<div class="row no-print">

<div class="col-12">

<a href="{{ route('lapform01') }}" target="_blank" class="btn btn-default"><i class="fa fa-print"></i> Print</a>

<button type="button" class="btn btn-success float-right" ><i data-toggle="modal" data-target="#myModal">Proses</i></button>

<!-- Modal -->

<div id="myModal" class="modal fade" role="dialog">

<div class="modal-dialog">

<!-- konten modal-->

<div class="modal-content">

<!-- heading modal -->

<!-- body modal -->

<div class="modal-body">

<p>Data Berhasil Di SIMPAN</p>

</div>

<!-- footer modal -->

<div class="modal-footer">

<button type="button" class="btn btn-default" data-dismiss="modal">Keluar dan Lanjutkan Ke Print</button>

</div>

</div>

</div>

</div>

</button>

<button type="button" class="btn btn-primary float-right" style="margin-right: 5px;">

<i class="fa fa-download"></i> Download PDF

</button>

</div>

</div>

</form>

</div>

</div>

</div>

<!-- /.tab-pane -->

<!-- /.tab-pane -->

<div class="tab-pane" id="tab_3">

<!-- Main content -->

<!-- general form elements disabled -->

<div class="card card-info">

<div class="card-header">

<h3 class="card-title">Nota Pencairan Dana</h3>

</div>

<!-- /.card-header -->

<div class="card-body">

<form role="form">

<!-- text input -->

<div class="form-group">

<label>Pencairan Saat Ini</label>

<input type="text" class="form-control" placeholder="Masukkan Pencairan Saat Ini">

</div>

<div class="form-group">

<label>Uraian</label>

<textarea class="form-control" rows="3" placeholder="Enter ..."></textarea>

</div>

<!--<div class="form-group has-success">

<label class="control-label" for="inputSuccess"><i class="fa fa-check"></i> Mengetahui 1</label>

<input type="text" class="form-control" id="inputSuccess" placeholder="Enter ...">

</div>

<div class="form-group has-warning">

<label class="control-label" for="inputWarning"><i class="fa fa-bell-o"></i> Input with

warning</label>

<input type="text" class="form-control" id="inputWarning" placeholder="Enter ...">

</div>

<div class="form-group has-error">

<label class="control-label" for="inputError"><i class="fa fa-times-circle-o"></i> Input with

error</label>

<input type="text" class="form-control" id="inputError" placeholder="Enter ...">

</div>

checkbox

<div class="form-group">

<div class="form-check">

<input class="form-check-input" type="checkbox" value="option1">

<label class="form-check-label">Checkbox</label>

</div>

<div class="form-check">

<input class="form-check-input" type="checkbox" value="option1" disabled>

<label class="form-check-label">Checkbox disabled</label>

</div>

</div>-->

<!-- radio

<div class="form-group">

<div class="form-check">

<input class="form-check-input" type="radio" value="option1">

<label class="form-check-label">Radio</label>

</div>

<div class="form-check">

<input class="form-check-input" type="radio" value="option1" disabled>

<label class="form-check-label">Radio disabled</label>

</div>

</div>-->

<!-- select -->

<!--<div class="form-group">

<label>Instansi</label>

<select class="form-control">

<option>Dinas Kesehatan</option>

<option>Upt Puskesmas Kebonsari</option>

<option>Upt Puskesmas Kandangsapi</option>

<option>Upt Puskesmas Sekargadung</option>

<option>Upt Puskesmas Gadingrejo</option>

<option>Upt Puskesmas Trajeng</option>

<option>Upt Puskesmas Kebonagung</option>

<option>Upt Puskesmas Karangketug</option>

<option>Upt Kefarmasian</option>

</select>

</div>

<!--<div class="form-group">

<label>Select Disabled</label>

<select class="form-control" disabled>

<option>option 1</option>

<option>option 2</option>

<option>option 3</option>

<option>option 4</option>

<option>option 5</option>

</select>

</div>-->

<!--<div class="form-group">

<label>Jenis Kegiatan</label>

<select class="form-control select2" style="width: 100%;">

<option selected="selected">Honorarium Tenaga Ahli/Narasumber/Instruktur</option>

<option>Honorarium Pegawai</option>

<option>Pengadaan Barang dan Jasa</option>

<option>Jasa Pelayanan / Retribusi</option>

<option>Pembayaran Tagihan Telepon & Listrik</option>

<option>Pembayaran lain-lain</option>

</select>

</div>

<!-- Select multiple

<div class="form-group">

<label>Select Multiple</label>

<select multiple class="form-control">

<option>option 1</option>

<option>option 2</option>

<option>option 3</option>

<option>option 4</option>

<option>option 5</option>

</select>

</div>-->

<!--<div class="form-group">

<label>Disabled Result</label>

<select class="form-control select2" style="width: 100%;">

<option selected="selected">Alabama</option>

<option>Alaska</option>

<option disabled="disabled">California (disabled)</option>

<option>Delaware</option>

<option>Tennessee</option>

<option>Texas</option>

<option>Washington</option>

</select>

</div>-->

<!--<div class="form-group">

<label>Select Multiple Disabled</label>

<select multiple class="form-control" disabled>

<option>option 1</option>

<option>option 2</option>

<option>option 3</option>

<option>option 4</option>

<option>option 5</option>

</select>

</div>-->

<div class="row no-print">

<div class="col-12">

<a href="{{ route('lapform01') }}" target="_blank" class="btn btn-default"><i class="fa fa-print"></i> Print</a>

<button type="button" class="btn btn-success float-right" ><i data-toggle="modal" data-target="#myModal">Proses</i></button>

<!-- Modal -->

<div id="myModal" class="modal fade" role="dialog">

<div class="modal-dialog">

<!-- konten modal-->

<div class="modal-content">

<!-- heading modal -->

<!-- body modal -->

<div class="modal-body">

<p>Data Berhasil Di SIMPAN</p>

</div>

<!-- footer modal -->

<div class="modal-footer">

<button type="button" class="btn btn-default" data-dismiss="modal">Keluar dan Lanjutkan Ke Print</button>

</div>

</div>

</div>

</div>

</button>

<button type="button" class="btn btn-primary float-right" style="margin-right: 5px;">

<i class="fa fa-download"></i> Download PDF

</button>

</div>

</div>

</form>

</div>

</div>

</div>

<!-- /.tab-pane -->

<div class="tab-pane" id="tab_4">

<!-- Main content -->

<!-- general form elements disabled -->

<div class="card card-primary">

<div class="card-header">

<h3 class="card-title">Kartu Kendali Kegiatan</h3>

</div>

<!-- /.card-header -->

<div class="card-body">

<form role="form">

<!-- text input -->

<div class="form-group">

<label>Kredit APBD</label>

<input type="text" class="form-control" placeholder="Masukkan Kredit APBD">

</div>

<div class="form-group">

<label>Nama rekening</label>

<textarea class="form-control" rows="3" placeholder="Masukan Nama Rekening"></textarea>

</div>

<div class="form-group has-success">

<label class="control-label" for="inputSuccess"><i class="fa fa-check"></i> Kode Rekening</label>

<input type="text" class="form-control" id="inputSuccess" placeholder="Masukan Kode Rekening">

</div>

<div class="row no-print">

<div class="col-12">

<a href="{{ route('lapform01') }}" target="_blank" class="btn btn-default"><i class="fa fa-print"></i> Print</a>

<button type="button" class="btn btn-success float-right" ><i data-toggle="modal" data-target="#myModal">Proses</i></button>

<!-- Modal -->

<div id="myModal" class="modal fade" role="dialog">

<div class="modal-dialog">

<!-- konten modal-->

<div class="modal-content">

<!-- heading modal -->

<!-- body modal -->

<div class="modal-body">

<p>Data Berhasil Di SIMPAN</p>

</div>

<!-- footer modal -->

<div class="modal-footer">

<button type="button" class="btn btn-default" data-dismiss="modal">Keluar dan Lanjutkan Ke Print</button>

</div>

</div>

</div>

</div>

</button>

<button type="button" class="btn btn-primary float-right" style="margin-right: 5px;">

<i class="fa fa-download"></i> Download PDF

</button>

</div>

</div>

</form>

</div>

</div>

</div>

</div>

<!-- /.tab-content -->

</div><!-- /.card-body -->

</div>

<!-- ./card -->

</div>

<!-- /.col -->

</div>

<!-- /.row -->

<!-- END CUSTOM TABS -->

<!-- Control Sidebar -->

<aside class="control-sidebar control-sidebar-dark">

<!-- Control sidebar content goes here -->

</aside>

<!-- /.control-sidebar -->

</div>

<!-- ./wrapper -->

</div>

</div>

@endsection

@section('javascript')

<!-- jQuery -->

<script src="/dist/plugins/jquery/jquery.min.js"></script>

<!-- jQuery UI 1.11.4 -->

<script src="https://code.jquery.com/ui/1.12.1/jquery-ui.min.js"></script>

<!-- Resolve conflict in jQuery UI tooltip with Bootstrap tooltip -->

<script>

$.widget.bridge('uibutton', $.ui.button)

</script>

<!-- Bootstrap 4 -->

<script src="/dist/plugins/bootstrap/js/bootstrap.bundle.min.js"></script>

<!-- Morris.js charts -->

<script src="https://cdnjs.cloudflare.com/ajax/libs/raphael/2.1.0/raphael-min.js"></script>

<script src="/dist/plugins/morris/morris.min.js"></script>

<!-- Sparkline -->

<script src="/dist/plugins/sparkline/jquery.sparkline.min.js"></script>

<!-- jvectormap -->

<script src="/dist/plugins/jvectormap/jquery-jvectormap-1.2.2.min.js"></script>

<script src="/dist/plugins/jvectormap/jquery-jvectormap-world-mill-en.js"></script>

<!-- jQuery Knob Chart -->

<script src="/dist/plugins/knob/jquery.knob.js"></script>

<!-- daterangepicker -->

<script src="https://cdnjs.cloudflare.com/ajax/libs/moment.js/2.10.2/moment.min.js"></script>

<script src="/dist/plugins/daterangepicker/daterangepicker.js"></script>

<!-- datepicker -->

<script src="/dist/plugins/datepicker/bootstrap-datepicker.js"></script>

<!-- Bootstrap WYSIHTML5 -->

<script src="/dist/plugins/bootstrap-wysihtml5/bootstrap3-wysihtml5.all.min.js"></script>

<!-- Slimscroll -->

<script src="/dist/plugins/slimScroll/jquery.slimscroll.min.js"></script>

<!-- FastClick -->

<script src="/dist/plugins/fastclick/fastclick.js"></script>

<!-- AdminLTE App -->

<script src="/dist/js/adminlte.js"></script>

<!-- AdminLTE dashboard demo (This is only for demo purposes) -->

<script src="/dist/js/pages/dashboard.js"></script>

<!-- AdminLTE for demo purposes -->

<script src="/dist/js/demo.js"></script>

@stop