@props([
    'user' => null,
    'roles' => [],
    'accountStatuses' => ['active', 'inactive'],
    'mode' => 'create',
    'prefill' => ['entity_name' => null, 'entity_city' => null, 'entity_phone' => null],
])

@php
    $isEdit = $mode === 'edit';
    $roleValue = old('role', $user?->role);
    $accountStatusValue = old('account_status', $user?->account_status ?? 'active');

    // Keep old values if validation failed, otherwise use prefill.
    $entityName = old('entity_name', $prefill['entity_name'] ?? null);
    $entityCity = old('entity_city', $prefill['entity_city'] ?? null);
    $entityPhone = old('entity_phone', $prefill['entity_phone'] ?? null);
@endphp

<div class="space-y-4">
    <div class="grid grid-cols-1 gap-4 sm:grid-cols-2">
        <div class="sm:col-span-2">
            <label class="mb-1 block text-sm font-medium">{{ __('Name') }}</label>
            <input name="name" value="{{ old('name', $user?->name) }}" required
                class="w-full rounded-sm border border-neutral-300 bg-white px-3 py-2 text-sm outline-none focus:border-blue-500 focus:ring-2 focus:ring-blue-500/20 dark:border-neutral-700 dark:bg-neutral-900" />
            @error('name') <div class="mt-1 text-xs text-red-600">{{ $message }}</div> @enderror
        </div>

        <div>
            <label class="mb-1 block text-sm font-medium">{{ __('Email') }}</label>
            <input type="email" name="email" value="{{ old('email', $user?->email) }}" required
                class="w-full rounded-sm border border-neutral-300 bg-white px-3 py-2 text-sm outline-none focus:border-blue-500 focus:ring-2 focus:ring-blue-500/20 dark:border-neutral-700 dark:bg-neutral-900" />
            @error('email') <div class="mt-1 text-xs text-red-600">{{ $message }}</div> @enderror
        </div>

        <div>
            <label class="mb-1 block text-sm font-medium">{{ __('Phone') }}</label>
            <input name="phone_number" value="{{ old('phone_number', $user?->phone_number) }}"
                class="w-full rounded-sm border border-neutral-300 bg-white px-3 py-2 text-sm outline-none focus:border-blue-500 focus:ring-2 focus:ring-blue-500/20 dark:border-neutral-700 dark:bg-neutral-900" />
            @error('phone_number') <div class="mt-1 text-xs text-red-600">{{ $message }}</div> @enderror
        </div>

        <div>
            <label class="mb-1 block text-sm font-medium">{{ __('Role') }}</label>
            <select name="role" required
                class="w-full rounded-sm border border-neutral-300 bg-white px-3 py-2 text-sm outline-none focus:border-blue-500 focus:ring-2 focus:ring-blue-500/20 dark:border-neutral-700 dark:bg-neutral-900">
                @foreach ($roles as $role)
                    <option value="{{ $role }}" @selected($roleValue === $role)>{{ $role }}</option>
                @endforeach
            </select>
            @error('role') <div class="mt-1 text-xs text-red-600">{{ $message }}</div> @enderror
            <div class="mt-1 text-xs text-neutral-500">{{ __('Use pharmacy/hospital/medicalCouncil for portal access.') }}</div>
        </div>

        <div>
            <label class="mb-1 block text-sm font-medium">{{ __('Account Status') }}</label>
            <select name="account_status" required
                class="w-full rounded-sm border border-neutral-300 bg-white px-3 py-2 text-sm outline-none focus:border-blue-500 focus:ring-2 focus:ring-blue-500/20 dark:border-neutral-700 dark:bg-neutral-900">
                @foreach ($accountStatuses as $status)
                    <option value="{{ $status }}" @selected($accountStatusValue === $status)>{{ $status }}</option>
                @endforeach
            </select>
            @error('account_status') <div class="mt-1 text-xs text-red-600">{{ $message }}</div> @enderror
            <div class="mt-1 text-xs text-neutral-500">{{ __('Inactive users cannot log in.') }}</div>
        </div>

        <div>
            <label class="mb-1 block text-sm font-medium">{{ __('Password') }}</label>
            <input type="password" name="password" @if(!$isEdit) required @endif
                class="w-full rounded-sm border border-neutral-300 bg-white px-3 py-2 text-sm outline-none focus:border-blue-500 focus:ring-2 focus:ring-blue-500/20 dark:border-neutral-700 dark:bg-neutral-900" />
            @error('password') <div class="mt-1 text-xs text-red-600">{{ $message }}</div> @enderror
            @if ($isEdit)
                <div class="mt-1 text-xs text-neutral-500">{{ __('Leave blank to keep current password.') }}</div>
            @endif
        </div>

        <div>
            <label class="mb-1 block text-sm font-medium">{{ __('Confirm Password') }}</label>
            <input type="password" name="password_confirmation" @if(!$isEdit) required @endif
                class="w-full rounded-sm border border-neutral-300 bg-white px-3 py-2 text-sm outline-none focus:border-blue-500 focus:ring-2 focus:ring-blue-500/20 dark:border-neutral-700 dark:bg-neutral-900" />
        </div>
    </div>

    <div class="rounded-sm border border-neutral-200 bg-neutral-50 p-4 dark:border-neutral-700 dark:bg-neutral-900">
        <div class="mb-2 flex items-center justify-between">
            <div class="text-sm font-semibold">{{ __('Portal Details (optional)') }}</div>
            <div class="text-xs text-neutral-500">{{ __('Used for pharmacy/hospital records.') }}</div>
        </div>

        <div class="grid grid-cols-1 gap-4 sm:grid-cols-3">
            <div>
                <label class="mb-1 block text-sm font-medium">{{ __('Entity Name') }}</label>
                <input name="entity_name" value="{{ $entityName }}" placeholder="{{ __('Pharmacy/Hospital name') }}"
                    class="w-full rounded-sm border border-neutral-300 bg-white px-3 py-2 text-sm outline-none focus:border-blue-500 focus:ring-2 focus:ring-blue-500/20 dark:border-neutral-700 dark:bg-neutral-800" />
                @error('entity_name') <div class="mt-1 text-xs text-red-600">{{ $message }}</div> @enderror
            </div>

            <div>
                <label class="mb-1 block text-sm font-medium">{{ __('City') }}</label>
                <input name="entity_city" value="{{ $entityCity }}"
                    class="w-full rounded-sm border border-neutral-300 bg-white px-3 py-2 text-sm outline-none focus:border-blue-500 focus:ring-2 focus:ring-blue-500/20 dark:border-neutral-700 dark:bg-neutral-800" />
                @error('entity_city') <div class="mt-1 text-xs text-red-600">{{ $message }}</div> @enderror
            </div>

            <div>
                <label class="mb-1 block text-sm font-medium">{{ __('Entity Phone') }}</label>
                <input name="entity_phone" value="{{ $entityPhone }}" placeholder="{{ __('Optional override') }}"
                    class="w-full rounded-sm border border-neutral-300 bg-white px-3 py-2 text-sm outline-none focus:border-blue-500 focus:ring-2 focus:ring-blue-500/20 dark:border-neutral-700 dark:bg-neutral-800" />
                @error('entity_phone') <div class="mt-1 text-xs text-red-600">{{ $message }}</div> @enderror
            </div>
        </div>

        <div class="mt-2 text-xs text-neutral-500">
            {{ __('If role is pharmacy/hospital, a linked record will be created/updated using these fields (or user name/phone).') }}
        </div>
    </div>
</div>