132 lines
4.4 KiB
JavaScript
132 lines
4.4 KiB
JavaScript
import { DatePicker, Form, Input } from "antd";
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import React from "react";
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import { useTranslation } from "react-i18next";
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import FormItemEmail from "../form-items-formatted/email-form-item.component";
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import FormItemPhone from "../form-items-formatted/phone-form-item.component";
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import Car from "../job-damage-visual/job-damage-visual.component";
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import FormRow from "../layout-form-row/layout-form-row.component";
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export default function JobsDetailInsurance({ job, form }) {
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const { getFieldValue } = form;
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const { t } = useTranslation();
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return (
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<div>
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<FormRow header={t("jobs.forms.inscoinfo")}>
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<Form.Item label={t("jobs.fields.ins_co_id")} name='ins_co_id'>
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<Input />
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</Form.Item>
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<Form.Item label={t("jobs.fields.ins_co_nm")} name='ins_co_nm'>
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<Input />
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</Form.Item>
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<Form.Item label={t("jobs.fields.ins_addr1")} name='ins_addr1'>
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<Input />
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</Form.Item>
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<Form.Item label={t("jobs.fields.ins_city")} name='ins_city'>
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<Input />
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</Form.Item>
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<Form.Item label={t("jobs.fields.ins_ct_ln")} name='ins_ct_ln'>
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<Input />
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</Form.Item>
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<Form.Item label={t("jobs.fields.ins_ct_fn")} name='ins_ct_fn'>
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<Input />
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</Form.Item>
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<Form.Item label={t("jobs.fields.ins_ph1")} name='ins_ph1'>
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<FormItemPhone customInput={Input} />
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</Form.Item>
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<Form.Item
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label={t("jobs.fields.ins_ea")}
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name='ins_ea'
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rules={[
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{
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type: "email",
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message: "This is not a valid email address.",
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},
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]}>
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<FormItemEmail email={getFieldValue("ins_ea")} />
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</Form.Item>
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</FormRow>
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<FormRow header={t("jobs.forms.claiminfo")}>
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<Form.Item label={t("jobs.fields.clm_no")} name='clm_no'>
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<Input />
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</Form.Item>
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<Form.Item label={t("jobs.fields.policy_no")} name='policy_no'>
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<Input />
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</Form.Item>
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<Form.Item label={t("jobs.fields.regie_number")} name='regie_number'>
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<Input />
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</Form.Item>
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</FormRow>
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<FormRow header={t("jobs.forms.lossinfo")}>
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<div style={{ display: "inline", height: "8rem" }}>
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{job.area_of_damage ? (
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<Car
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dmg1={job.area_of_damage.impact1 || null}
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dmg2={job.area_of_damage.impact2 || null}
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/>
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) : (
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t("jobs.errors.nodamage")
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)}
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</div>
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<Form.Item label={t("jobs.fields.loss_desc")} name='loss_desc'>
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<Input />
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</Form.Item>
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<Form.Item label={t("jobs.fields.loss_date")} name='loss_date'>
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<DatePicker />
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</Form.Item>
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</FormRow>
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<FormRow header={t("jobs.forms.appraiserinfo")}>
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<Form.Item label={t("jobs.fields.est_co_nm")} name='est_co_nm'>
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<Input />
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</Form.Item>
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<Form.Item label={t("jobs.fields.est_ct_fn")} name='est_ct_fn'>
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<Input />
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</Form.Item>
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<Form.Item label={t("jobs.fields.est_ct_ln")} name='est_ct_ln'>
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<Input />
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</Form.Item>
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<Form.Item label={t("jobs.fields.est_ph1")} name='est_ph1'>
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<Input />
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</Form.Item>
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<Form.Item
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label={t("jobs.fields.est_ea")}
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name='est_ea'
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rules={[
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{
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type: "email",
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message: "This is not a valid email address.",
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},
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]}>
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<FormItemEmail email={getFieldValue("est_ea")} />
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</Form.Item>
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</FormRow>
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<FormRow header='TODO: TO BE PLACED'>
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<Form.Item label={t("jobs.fields.pay_date")} name='pay_date'>
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<Input />
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</Form.Item>
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<Form.Item
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label={t("jobs.fields.selling_dealer")}
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name='selling_dealer'>
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<Input />
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</Form.Item>
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<Form.Item
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label={t("jobs.fields.servicing_dealer")}
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name='servicing_dealer'>
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<Input />
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</Form.Item>
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<Form.Item
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label={t("jobs.fields.selling_dealer_contact")}
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name='selling_dealer_contact'>
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<Input />
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</Form.Item>
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<Form.Item
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label={t("jobs.fields.servicing_dealer_contact")}
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name='servicing_dealer_contact'>
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<Input />
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</Form.Item>
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TODO: Adding servicing/selling dealer contact info?
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</FormRow>
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</div>
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);
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}
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