{{ form_start(form, {'attr': {'class': 'needs-validation', 'novalidate': true}}) }}

<div class="row g-4">
    <!-- INFORMATIONS PERSONNELLES -->
    <div class="col-xl-6 col-lg-12">
        <div class="card border-0 shadow-sm h-100">
            <div class="card-header text-white purple">
                <h5 class="mb-0">Informations personnelles</h5>
                <i class="fa-solid fa-circle-info"></i>
            </div>
            <div class="card-body">
                <table class="table table-borderless mb-0">
                    <tbody>
                    <tr>
                        <td class="fw-bold text-muted" style="width: 40%;">
                            Nom <span class="text-danger">*</span> :
                        </td>
                        <td>
                            {{ form_widget(form.nom, {'attr': {'class': 'form-control', 'required': true}}) }}
                            {{ form_errors(form.nom) }}
                        </td>
                    </tr>
                    <tr>
                        <td class="fw-bold text-muted">
                            Prénom <span class="text-danger">*</span> :
                        </td>
                        <td>
                            {{ form_widget(form.prenom, {'attr': {'class': 'form-control', 'required': true}}) }}
                            {{ form_errors(form.prenom) }}
                        </td>
                    </tr>
                    <tr>
                        <td class="fw-bold text-muted">Civilité :</td>
                        <td>
                            {{ form_widget(form.civilite, {'attr': {'class': 'form-select'}}) }}
                            {{ form_errors(form.civilite) }}
                        </td>
                    </tr>
                    <tr>
                        <td class="fw-bold text-muted">Nom de jeune fille :</td>
                        <td>
                            {{ form_widget(form.nomJeuneFille, {'attr': {'class': 'form-control'}}) }}
                            {{ form_errors(form.nomJeuneFille) }}
                        </td>
                    </tr>
                    <tr>
                        <td class="fw-bold text-muted">Date de naissance :</td>
                        <td>
                            {{ form_widget(form.dateNaissance, {'attr': {'class': 'form-control', 'max': 'now'|date('Y-m-d')}}) }}
                            {{ form_errors(form.dateNaissance) }}
                            <small class="form-text text-muted">Format: JJ/MM/AAAA</small>
                        </td>
                    </tr>
                    <tr>
                        <td class="fw-bold text-muted">Lieu de naissance :</td>
                        <td>
                            {{ form_widget(form.lieuNaissance, {'attr': {'class': 'form-control'}}) }}
                            {{ form_errors(form.lieuNaissance) }}
                        </td>
                    </tr>
                    <tr>
                        <td class="fw-bold text-muted">Pays de naissance :</td>
                        <td>
                            {{ form_widget(form.paysNaissance, {'attr': {'class': 'form-control', 'placeholder': 'Ex: France'}}) }}
                            {{ form_errors(form.paysNaissance) }}
                        </td>
                    </tr>
                    <tr>
                        <td class="fw-bold text-muted">Date d'accueil :</td>
                        <td>
                            {{ form_widget(form.dateAccueil, {'attr': {'class': 'form-control'}}) }}
                            {{ form_errors(form.dateAccueil) }}
                            <small class="form-text text-muted">Date de première prise en charge</small>
                        </td>
                    </tr>
                    </tbody>
                </table>
            </div>
        </div>
    </div>

    <!-- CONTACT ET ADRESSE -->
    <div class="col-xl-6 col-lg-12">
        <div class="card border-0 shadow-sm h-100">
            <div class="card-header purple text-white">
                <h5 class="mb-0">Contact et adresse</h5>
                <i class="fa-solid fa-address-card"></i>
            </div>
            <div class="card-body">
                <table class="table table-borderless mb-0">
                    <tbody>
                    <tr>
                        <td class="fw-bold text-muted" style="width: 40%;">Adresse :</td>
                        <td>
                            {{ form_widget(form.adresse, {'attr': {'class': 'form-control', 'placeholder': 'Numéro et nom de rue'}}) }}
                            {{ form_errors(form.adresse) }}
                        </td>
                    </tr>
                    <tr>
                        <td class="fw-bold text-muted">Code postal :</td>
                        <td>
                            {{ form_widget(form.codePostal, {'attr': {'class': 'form-control', 'placeholder': 'Ex: 75001', 'maxlength': 5, 'pattern': '[0-9]{5}'}}) }}
                            {{ form_errors(form.codePostal) }}
                        </td>
                    </tr>
                    <tr>
                        <td class="fw-bold text-muted">Ville :</td>
                        <td>
                            {{ form_widget(form.ville, {'attr': {'class': 'form-control'}}) }}
                            {{ form_errors(form.ville) }}
                        </td>
                    </tr>
                    <tr>
                        <td class="fw-bold text-muted">Téléphone :</td>
                        <td>
                            {{ form_widget(form.tel, {'attr': {'class': 'form-control', 'type': 'tel', 'placeholder': '06 12 34 56 78'}}) }}
                            {{ form_errors(form.tel) }}
                        </td>
                    </tr>
                    <tr>
                        <td class="fw-bold text-muted">Email :</td>
                        <td>
                            {{ form_widget(form.mail, {'attr': {'class': 'form-control', 'type': 'email', 'placeholder': 'exemple@email.fr'}}) }}
                            {{ form_errors(form.mail) }}
                        </td>
                    </tr>
                    </tbody>
                </table>
            </div>
        </div>
    </div>

    <!-- SITUATION FAMILIALE -->
    <div class="col-xl-6 col-lg-12">
        <div class="card border-0 shadow-sm h-100">
            <div class="card-header purple text-white">
                <h5 class="mb-0">Situation familiale</h5>
                <i class="fa-solid fa-people-roof"></i>
            </div>
            <div class="card-body">
                <table class="table table-borderless mb-0">
                    <tbody>
                    <tr>
                        <td class="fw-bold text-muted" style="width: 40%;">Situation :</td>
                        <td>
                            {{ form_widget(form.situationFamille, {'attr': {'class': 'form-control'}}) }}
                            {{ form_errors(form.situationFamille) }}
                        </td>
                    </tr>
                    <tr>
                        <td class="fw-bold text-muted">Nombre d'enfants :</td>
                        <td>
                            {{ form_widget(form.nbEnfants, {'attr': {'class': 'form-control', 'type': 'number', 'min': 0}}) }}
                            {{ form_errors(form.nbEnfants) }}
                        </td>
                    </tr>
                    <tr>
                        <td class="fw-bold text-muted">Enfants à charge :</td>
                        <td>
                            {{ form_widget(form.nbEnfantsACharge, {'attr': {'class': 'form-control', 'type': 'number', 'min': 0}}) }}
                            {{ form_errors(form.nbEnfantsACharge) }}
                        </td>
                    </tr>
                    <tr>
                        <td class="fw-bold text-muted">Si en couple : Nb de personne dans le foyer en emploi :</td>
                        <td>
                            {{ form_widget(form.nbPersonnesEmploiFoyer, {'attr': {'class': 'form-control', 'type': 'number', 'min': 0, 'max': 2}}) }}
                            {{ form_errors(form.nbPersonnesEmploiFoyer) }}
                        </td>
                    </tr>
                    <tr>
                        <td class="fw-bold text-muted">Parents nés en France :</td>
                        <td>
                            {{ form_widget(form.parentsNesEnFrance, {'attr': {'class': 'form-select'}}) }}
                            {{ form_errors(form.parentsNesEnFrance) }}
                        </td>
                    </tr>
                    </tbody>
                </table>
            </div>
        </div>
    </div>

    <!-- EMPLOI ET FORMATION -->
    <div class="col-xl-6 col-lg-12">
        <div class="card border-0 shadow-sm h-100">
            <div class="card-header purple text-white">
                <h5 class="mb-0">Emploi et formation</h5>
                <i class="fa-solid fa-briefcase"></i>
            </div>
            <div class="card-body">
                <table class="table table-borderless mb-0">
                    <tbody>
                    <tr>
                        <td class="fw-bold text-muted" style="width: 40%;">Dernier emploi :</td>
                        <td>
                            {{ form_widget(form.dateDernierEmploi, {'attr': {'class': 'form-control', 'max': 'now'|date('Y-m-d')}}) }}
                            {{ form_errors(form.dateDernierEmploi) }}
                            <small class="form-text text-muted">Date du dernier emploi occupé</small>
                        </td>
                    </tr>
                    <tr>
                        <td class="fw-bold text-muted">Niveau scolaire :</td>
                        <td>
                            {{ form_widget(form.niveauScolaire, {'attr': {'class': 'form-select'}}) }}
                            {{ form_errors(form.niveauScolaire) }}
                        </td>
                    </tr>
                    <tr>
                        <td class="fw-bold text-muted">RQTH :</td>
                        <td>
                            {{ form_widget(form.rqth, {'attr': {'class': 'form-select'}}) }}
                            {{ form_errors(form.rqth) }}
                            <small class="form-text text-muted">Reconnaissance Qualité Travailleur Handicapé</small>
                        </td>
                    </tr>
                    </tbody>
                </table>
            </div>
        </div>
    </div>

    <!-- LOGEMENT -->
    <div class="col-xl-6 col-lg-12">
        <div class="card border-0 shadow-sm h-100">
            <div class="card-header purple text-white">
                <h5 class="mb-0">Logement</h5>
                <i class="fa-regular fa-building"></i>
            </div>
            <div class="card-body">
                <table class="table table-borderless mb-0">
                    <tbody>
                    <tr>
                        <td class="fw-bold text-muted" style="width: 40%;">Type :</td>
                        <td>
                            {{ form_widget(form.logement, {'attr': {'class': 'form-select'}}) }}
                            {{ form_errors(form.logement) }}
                        </td>
                    </tr>
                    <tr>
                        <td class="fw-bold text-muted">Risque de perte :</td>
                        <td>
                            {{ form_widget(form.risquePerteLogement, {'attr': {'class': 'form-select'}}) }}
                            {{ form_errors(form.risquePerteLogement) }}
                        </td>
                    </tr>
                    </tbody>
                </table>
            </div>
        </div>
    </div>

    <!-- DOCUMENTS D'IDENTITÉ -->
    <div class="col-xl-6 col-lg-12">
        <div class="card border-0 shadow-sm h-100">
            <div class="card-header purple text-white">
                <h5 class="mb-0">Documents d'identité</h5>
                <i class="fa-solid fa-id-card"></i>
            </div>
            <div class="card-body">
                <table class="table table-borderless mb-0">
                    <tbody>
                    <tr>
                        <td class="fw-bold text-muted" style="width: 40%;">Validité CNI :</td>
                        <td>
                            {{ form_widget(form.dateFinValiditeCNI, {'attr': {'class': 'form-control'}}) }}
                            {{ form_errors(form.dateFinValiditeCNI) }}
                            <small class="form-text text-muted">Date de fin de validité</small>
                        </td>
                    </tr>
                    <tr>
                        <td class="fw-bold text-muted">N° Sécurité Sociale :</td>
                        <td>
                            {{ form_widget(form.numeroSecuriteSociale, {'attr': {'class': 'form-control', 'placeholder': '1 23 45 67 890 123 45', 'maxlength': 15}}) }}
                            {{ form_errors(form.numeroSecuriteSociale) }}
                        </td>
                    </tr>
                    </tbody>
                </table>
            </div>
        </div>
    </div>

    <!-- PRESCRIPTEUR -->
    <div class="col-xl-6 col-lg-12">
        <div class="card border-0 shadow-sm h-100">
            <div class="card-header purple text-white">
                <h5 class="mb-0">Prescripteur</h5>
                <i class="fa-solid fa-user-doctor"></i>
            </div>
            <div class="card-body">
                <table class="table table-borderless mb-0">
                    <tbody>
                    <tr>
                        <td class="fw-bold text-muted" style="width: 40%;">Nom :</td>
                        <td>
                            {{ form_widget(form.prescripteurNom, {'attr': {'class': 'form-control'}}) }}
                            {{ form_errors(form.prescripteurNom) }}
                        </td>
                    </tr>
                    <tr>
                        <td class="fw-bold text-muted">Prénom :</td>
                        <td>
                            {{ form_widget(form.prescripteurPrenom, {'attr': {'class': 'form-control'}}) }}
                            {{ form_errors(form.prescripteurPrenom) }}
                        </td>
                    </tr>
                    <tr>
                        <td class="fw-bold text-muted">Téléphone :</td>
                        <td>
                            {{ form_widget(form.prescripteurTel, {'attr': {'class': 'form-control', 'type': 'tel', 'placeholder': '06 12 34 56 78'}}) }}
                            {{ form_errors(form.prescripteurTel) }}
                        </td>
                    </tr>
                    <tr>
                        <td class="fw-bold text-muted">Email :</td>
                        <td>
                            {{ form_widget(form.prescripteurMail, {'attr': {'class': 'form-control', 'type': 'email', 'placeholder': 'prescripteur@exemple.fr'}}) }}
                            {{ form_errors(form.prescripteurMail) }}
                        </td>
                    </tr>
                    <tr>
                        <td class="fw-bold text-muted">Structure :</td>
                        <td>
                            {{ form_widget(form.prescripteurStructure, {'attr': {'class': 'form-control'}}) }}
                            {{ form_errors(form.prescripteurStructure) }}
                        </td>
                    </tr>
                    <tr>
                        <td class="fw-bold text-muted">Date prescription :</td>
                        <td>
                            {{ form_widget(form.datePrescription, {'attr': {'class': 'form-control'}}) }}
                            {{ form_errors(form.datePrescription) }}
                        </td>
                    </tr>
                    </tbody>
                </table>
            </div>
        </div>
    </div>
</div>

<!-- Légende champs obligatoires -->
<div class="mt-3 text-muted small">
    <i class="fas fa-info-circle me-1"></i>
    Les champs marqués d'un <span class="text-danger">*</span> sont obligatoires
</div>

<!-- Bouton de soumission -->
<div class="d-flex justify-content-start my-4">
    <button type="submit" class="btn btn-save-inline">
        <i class="fas fa-save me-2"></i>
        {{ button_label|default('Sauvegarder') }}
    </button>
</div>

{{ form_end(form) }}

<script>
    document.addEventListener('DOMContentLoaded', function() {
        // Validation du formulaire
        const form = document.querySelector('.needs-validation');

        if (form) {
            form.addEventListener('submit', function(event) {
                if (!form.checkValidity()) {
                    event.preventDefault();
                    event.stopPropagation();

                    // Scroll vers le premier champ en erreur
                    const firstInvalid = form.querySelector(':invalid');
                    if (firstInvalid) {
                        firstInvalid.scrollIntoView({ behavior: 'smooth', block: 'center' });
                        firstInvalid.focus();
                    }
                }
                form.classList.add('was-validated');
            }, false);
        }

        // Validation du code postal (5 chiffres)
        const codePostalInput = document.querySelector('input[name*="codePostal"]');
        if (codePostalInput) {
            codePostalInput.addEventListener('input', function() {
                this.value = this.value.replace(/[^0-9]/g, '').substring(0, 5);
            });
        }

        // Formatage automatique du numéro de sécurité sociale
        const numeroSecuInput = document.querySelector('input[name*="numeroSecuriteSociale"]');
        if (numeroSecuInput) {
            numeroSecuInput.addEventListener('input', function() {
                this.value = this.value.replace(/[^0-9]/g, '').substring(0, 15);
            });
        }
    });
</script>