@php($record = $record ?? null)
@php($specialties = $specialties ?? collect())
@php($selectedSpecialtyIds = old('specialty_ids', $record?->specialties->pluck('id')->all() ?? []))

<div class="row g-9 mb-7">
    <div class="col-md-6">
        <label class="required form-label">{{ trans('clinic.common.name_ar') }}</label>
        <input type="text" name="name[ar]" class="form-control @error('name.ar') is-invalid @enderror"
               value="{{ old('name.ar', $record?->getTranslation('name', 'ar') ?? '') }}">
        @error('name.ar')<div class="invalid-feedback">{{ $message }}</div>@enderror
    </div>
    <div class="col-md-6">
        <label class="required form-label">{{ trans('clinic.common.name_en') }}</label>
        <input type="text" name="name[en]" class="form-control @error('name.en') is-invalid @enderror"
               value="{{ old('name.en', $record?->getTranslation('name', 'en') ?? '') }}">
        @error('name.en')<div class="invalid-feedback">{{ $message }}</div>@enderror
    </div>
</div>

<div class="row g-9 mb-7">
    <div class="col-md-8">
        <label class="form-label">{{ trans('clinic.clinics.description') }}</label>
        <textarea name="clinic_description" rows="3" class="form-control @error('clinic_description') is-invalid @enderror">{{ old('clinic_description', $record->description ?? '') }}</textarea>
        @error('clinic_description')<div class="invalid-feedback">{{ $message }}</div>@enderror
    </div>
    <div class="col-md-4">
        <label class="form-label">{{ trans('clinic.clinics.whatsapp') }}</label>
        <input type="text" name="whatsapp" class="form-control @error('whatsapp') is-invalid @enderror"
               value="{{ old('whatsapp', $record->whatsapp ?? '') }}">
        @error('whatsapp')<div class="invalid-feedback">{{ $message }}</div>@enderror
        <label class="form-label mt-4">{{ trans('clinic.clinics.commission_percentage') }}</label>
        <input type="number" step="0.01" min="0" max="100" name="commission_percentage"
               class="form-control @error('commission_percentage') is-invalid @enderror"
               value="{{ old('commission_percentage', $record->commission_percentage ?? 0) }}">
        @error('commission_percentage')<div class="invalid-feedback">{{ $message }}</div>@enderror
    </div>
</div>

<div class="row g-9 mb-7">
    <div class="col-md-12">
        <label class="form-label">{{ trans('clinic.clinics.specialties') }}</label>
        <select name="specialty_ids[]" multiple class="form-select @error('specialty_ids') is-invalid @enderror" data-control="select2">
            @foreach($specialties as $specialty)
                <option value="{{ $specialty->id }}" {{ in_array($specialty->id, $selectedSpecialtyIds) ? 'selected' : '' }}>{{ $specialty->name }}</option>
            @endforeach
        </select>
        @error('specialty_ids')<div class="invalid-feedback">{{ $message }}</div>@enderror
    </div>
</div>

<div class="mb-7">
    <div class="form-check form-check-custom form-check-solid">
        <input type="hidden" name="is_active" value="0">
        <input class="form-check-input" type="checkbox" name="is_active" value="1" id="is_active"
               {{ old('is_active', $record->is_active ?? true) ? 'checked' : '' }}>
        <label class="form-check-label" for="is_active">{{ trans('clinic.common.active') }}</label>
    </div>
</div>