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Edit File Name : BloodDonation.cshtml

@model bnb.Models.BloodDonationViewModel

@{
    ViewBag.Title = "BloodDonation";
    Layout = "~/Views/Shared/_Navbar.cshtml";
}

h2, h3, h4 {
        font-weight: 700;
        color: #f47c2c;
        margin-bottom: 15px;
    }

label.control-label {
        font-weight: 600;
        color: #333;
    }

.btn-primary {
        background-color: #f47c2c;
        border-color: #f47c2c;
        font-weight: 600;
        padding: 10px 30px;
        border-radius: 4px;
        transition: background-color 0.3s ease;
    }

.btn-primary:hover {
            background-color: #d0631e;
            border-color: #d0631e;
        }

.btn-info {
        background-color: #5bc0de;
        border-color: #46b8da;
        font-weight: 600;
        padding: 10px 25px;
        border-radius: 4px;
    }

.btn-info:hover {
            background-color: #31b0d5;
            border-color: #269abc;
        }

.validation-summary-errors, .text-danger {
        color: #d9534f;
        font-weight: 600;
        margin-top: 5px;
    }

.breadcrumb a {
        color: #f47c2c;
        font-weight: 600;
        text-decoration: none;
    }

.breadcrumb a:hover {
            text-decoration: underline;
        }
</style>

<div class="l-breadcrumb pt-2 pb-2">
    <div class="container">
        <nav aria-label="breadcrumb" class="d-flex py-3">
            <ol class="breadcrumb mb-0">
                <li class="breadcrumb-item"><a href="@Url.Action("Index", "HomeUI")">Home</a></li>
                <li class="breadcrumb-item active" aria-current="page">Donate Blood</li>
            </ol>
        </nav>
    </div>
</div>

<div class="text-center mt-4 mb-4 px-3">
    <h2>B&amp;B Hospital Donor Registration Online Form</h2>
    <p>
        Your single act of kindness can give someone a second chance at life.<br />
        Together, let’s spread hope. Donate blood, save lives.
    </p>

<h2 style="color: red;">
        DONATE BLOOD <i class="fa-solid fa-droplet" style="color: red;"></i>
    </h2>
    <p style="margin-bottom:0rem"><strong>AT</strong></p>
    <h3>B&amp;B HOSPITAL</h3>
    <p style="font-weight: bold; color: #f47c2c;">
        BLOOD BANK &amp; TRANSFUSION MEDICINE
    </p>
    <p style="font-weight:bold">
        6th Floor, New Building <br />
        Everyday 9am - 4pm
    </p>

<div style="background-color: #fde3cf; border: 1px solid #f47c2c; padding: 20px; margin-top: 20px; border-radius: 6px; max-width: 600px; margin-left: auto; margin-right: auto; font-weight: bold; color: #000;">
        <h4 class="text-center">Eligibility for Blood Donation</h4>
        <ul style="list-style: none; margin: 0; padding: 0; font-size: 16px;">
            <li style="margin-bottom: 10px; display: flex; align-items: flex-start;">
                <span style="margin-right: 8px;">✔</span>
                <span>Age: Between 18 to 65 years</span>
            </li>
            <li style="margin-bottom: 10px; display: flex; align-items: flex-start;">
                <span style="margin-right: 8px;">✔</span>
                <span>Weight: Above 45 kg</span>
            </li>
            <li style="margin-bottom: 10px; display: flex; align-items: flex-start;">
                <span style="margin-right: 8px;">✔</span>
                <span>Hemoglobin (HB): More than 12 gm/dl</span>
            </li>
            <li style="margin-bottom: 10px; display: flex; align-items: flex-start; flex-direction: column;">
                <span style="margin-bottom: 4px; display: inline-block;">✔ Blood Pressure:</span>
                <ul style="list-style: disc; padding-left: 25px; margin: 4px 0 0 25px;">
                    <li>Systolic: 100 – 160 mmHg</li>
                    <li>Diastolic: 60 – 100 mmHg</li>
                </ul>
            </li>

</ul>
    </div>

<p style="text-align: center; font-weight: bold; color: #000; margin-top: 20px; font-size:20px">
        If you are interested and eligible, please fill in the form below.<br /> We will contact you shortly.
    </p>
</div>

<div class="form-container">
    @using (Html.BeginForm("BloodDonation", "HomeUI", FormMethod.Post, new { enctype = "multipart/form-data", id = "bloodDonationForm" }))

{
        @Html.AntiForgeryToken()

@Html.ValidationSummary(true, "", new { @class = "text-danger" })

<div class="form-group row mb-3">
                @Html.LabelFor(m => m.Name, htmlAttributes: new { @class = "col-sm-3 col-form-label" })
                <div class="col-sm-9">
                    @Html.EditorFor(m => m.Name, new { htmlAttributes = new { @class = "form-control", placeholder = "Enter your full name" } })
                    @Html.ValidationMessageFor(m => m.Name, "", new { @class = "text-danger" })
                </div>
            </div>

<div class="form-group row mb-3">
                @Html.LabelFor(m => m.Gender, "Gender", htmlAttributes: new { @class = "col-sm-3 col-form-label" })
                <div class="col-sm-9">
                    @Html.DropDownListFor(m => m.Gender, new SelectList(new[] {
                        new { Value = "", Text = "-- Select Gender --" },
                        new { Value = "Male", Text = "Male" },
                        new { Value = "Female", Text = "Female" },
                        new { Value = "Other", Text = "Other" }
                    }, "Value", "Text", Model.Gender), new { @class = "form-select" })
                    @Html.ValidationMessageFor(m => m.Gender, "", new { @class = "text-danger" })
                </div>
            </div>

<div class="form-group row mb-3">
                @Html.LabelFor(m => m.BloodGroup, "BloodGroup", htmlAttributes: new { @class = "col-sm-3 col-form-label" })
                <div class="col-sm-9">
                    @Html.DropDownListFor(m => m.BloodGroup, new SelectList(new[] {
                        new { Value = "", Text = "-- Select BloodGroup --" },
                        new { Value = "A+", Text = "A+" },
                        new { Value = "B+", Text = "B+" },
                        new { Value = "O+", Text = "O+" },
                        new { Value = "A-", Text = "A-" },
                        new { Value = "B-", Text = "B-" },
                        new { Value = "O-", Text = "O-" },
                        new { Value = "AB-", Text = "AB-" },
                        new { Value = "AB+", Text = "AB+" }
                    }, "Value", "Text", Model.BloodGroup), new { @class = "form-select" })
                    @Html.ValidationMessageFor(m => m.BloodGroup, "", new { @class = "text-danger" })
                </div>
            </div>

<div class="form-group row mb-3">
                @Html.LabelFor(m => m.Address, htmlAttributes: new { @class = "col-sm-3 col-form-label" })
                <div class="col-sm-9">
                    @Html.EditorFor(m => m.Address, new { htmlAttributes = new { @class = "form-control", placeholder = "Your address" } })
                    @Html.ValidationMessageFor(m => m.Address, "", new { @class = "text-danger" })
                </div>
            </div>

<div class="form-group row mb-3">
                @Html.LabelFor(m => m.PhoneNumber, "Phone Number", htmlAttributes: new { @class = "col-sm-3 col-form-label" })
                <div class="col-sm-9">
                    @Html.EditorFor(m => m.PhoneNumber, new { htmlAttributes = new { @class = "form-control", placeholder = "Your phone number" } })
                    @Html.ValidationMessageFor(m => m.PhoneNumber, "", new { @class = "text-danger" })
                </div>
            </div>

<div class="form-group row mb-3">
                @Html.LabelFor(m => m.Email, htmlAttributes: new { @class = "col-sm-3 col-form-label" })
                <div class="col-sm-9">
                    @Html.EditorFor(m => m.Email, new { htmlAttributes = new { @class = "form-control", placeholder = "Your email address" } })
                    @Html.ValidationMessageFor(m => m.Email, "", new { @class = "text-danger" })
                </div>
            </div>

<div class="form-group row mb-4">
                @Html.LabelFor(m => m.Remarks, "Messages", htmlAttributes: new { @class = "col-sm-3 col-form-label" })
                <div class="col-sm-9">
                    @Html.TextAreaFor(m => m.Remarks, 4, 0, new { @class = "form-control", placeholder = "Any additional information or message" })
                    @Html.ValidationMessageFor(m => m.Remarks, "", new { @class = "text-danger" })
                </div>
            </div>

@Html.HiddenFor(m => m.CaptchaResponse, new { id = "CaptchaResponse" })
            <div class="form-group row mb-3">
                <div class="offset-sm-3 col-sm-9">
                    <div class="g-recaptcha" data-sitekey=@ViewBag.CaptchaSiteKey></div>
                    @Html.ValidationMessage("Captcha", "", new { @class = "text-danger" })
                </div>
            </div>

<div class="form-group row">
                <div class="offset-sm-3 col-sm-9 d-flex gap-2" style="display: flex; align-items:center; justify-content:center;">
                    @Html.ActionLink("Back", "Index", null, new { @class = "btn btn-primary" })
                    <input type="submit" value="Save" class="btn btn-primary" id="btnSubmit" />
                </div>
            </div>

</div>
    }
    <script src="https://www.google.com/recaptcha/api.js" async defer></script>

document.querySelector('form').addEventListener('submit', function (e) {
            setCaptchaResponse();
        });
    </script>