<!DOCTYPE html>
<html class="no-js" lang="en" dir="ltr">
<head>
    <meta charset="utf-8">
    <meta http-equiv="x-ua-compatible" content="ie=edge">
    <meta name="viewport" content="width=device-width, initial-scale=1.0">
    <title>Invoice No. {{ patientBilling.invoiceNo }}</title>
</head>
<body style="font-family:'Arial'; font-size:15px;">
<div style="width: 816px; height: 1056px; box-sizing:border-box; padding:80px; padding-top:30px; margin: 0 auto; box-shadow:3px 1px 10px 1px;">
    {% set patient = patientBilling.patient %}
    {% set branch = patientBilling.healthFacilityForAddress|default('') %}
    {% set company = patientBilling.healthFacilityForAddress.company|default('') %}
    {% set street = patientBilling.healthFacilityForAddress.street|default('') %}
    {% set city = patientBilling.healthFacilityForAddress.city.description|default('') %}
    {% set province = patientBilling.healthFacilityForAddress.city.province.code|default('') %}
    {% set postalCode = patientBilling.healthFacilityForAddress.postalCode.description|default('') %}
    {% if hasPrintBtn is defined and hasPrintBtn %}
    <div style="text-align: right; margin-bottom: 25px;">
        <a style="display: inline-block; padding: 10px 20px; border: 1px solid #e0e0e0; border-radius: 3px; color: #353535;" href="{{ path('patient_billing_invoice_print', {id: patientBilling.idEncoded}) }}">Download</a>
    </div>
    {% endif %}
    <div style="width:100%; height: 100px; position: relative; text-align: center;">
            {% if patientBilling.payerType != 'Financing' %}
                <img src="{{ app.request.getSchemeAndHttpHost() ~ company.photoWebPath|default('') }}" style="height:100%;"/>
            {% else %}
                <img src="{{ app.request.getSchemeAndHttpHost() ~ patientBilling.patientPaymentFinancing.financingCompany.photoWebPath is defined and patientBilling.patientPaymentFinancing.financingCompany.photoWebPath is not empty ? app.request.getSchemeAndHttpHost() ~ patientBilling.patientPaymentFinancing.financingCompany.photoWebPath : '/uploads/company/photo/'~patientBilling.patient.healthFacility.company.parsedPhotoDescription|default('') }}" style="height: 100%;"/>
            {% endif %}
    </div>
    <div style="width:100%; height: auto; position: relative; text-align: center;">
        {% if patientBilling.payerType != 'Financing' %}
        
            {#<p style="font-size:16px; font-weight:500; margin-top:0; margin-bottom:5px;"><b>{{ company.description|default('') }}</b></p>#}
            {#<p style="font-size:16px; font-weight:500; margin-top:0; margin-bottom:5px;"><b>{{ branch.description|default('') }}</b></p>#}
            <p style=" margin:3px 0; font-size: 12px;">{{ street }} {{ city }}, {{ province }} {{ postalCode }}</p>
            <p style=" margin:3px 0; font-size: 12px;">{{ branch.concatenatedEmail|default('') }}</p>
            <p style=" margin:3px 0; font-size: 12px;">{{ branch.concatenatedPhoneNo|default('') }}</p>
            <p style=" margin:3px 0; font-size: 12px;">{{ branch.concatenatedMobileNo|default('') }}</p>            

        {% else %}
            {% set financingCompany = patientBilling.patientPaymentFinancing.financingCompany %}
        
            <p style="font-size:18px; font-weight:500; margin-top:0; margin-bottom:5px;"><b>{{ financingCompany.description }}</b></p>
            <p style=" margin:3px 0;">{{ financingCompany.street }}</p>
            <p style=" margin:3px 0;">{{ financingCompany.city.description }} {{ financingCompany.postalCode.description }}</p>
            <p style=" margin:3px 0;">{{ financingCompany.concatenatedPhoneNo|default('') }}</p>
            <p style=" margin:3px 0;">{{ financingCompany.concatenatedMobileNo|default('') }}</p>
            <p style=" margin:3px 0;">{{ financingCompany.concatenatedEmail|default('') }}</p>
            {#<p style="margin-top:8px; margin-bottom:0; font-size:18px; color: darkblue; font-weight:500;">INVOICE</p>#}
        
        {% endif %}
        <p style="text-align: center"><strong style="color: #262262;">INVOICE</strong></p>
    </div>
    <div style="width:100%; height: 135px; position: relative;">
        <div style="width:100%; height: 155px;">
            <div style="width:40%; float:right; box-sizing:border-box; padding:5px; text-align: left;">
                <p style="font-size:15px; font-weight:500; margin-top:0; margin-bottom:7px;"><strong style="color: #262262;">DATE</strong> : {{ patientBilling.billingDateAsString|date('F j, Y') }}</p>
                <p style="font-size:15px; font-weight:500; margin-top:0; margin-bottom:1px;"><strong style="color: #262262;">INVOICE #</strong> : {{ patientBilling.invoiceNo ? patientBilling.invoiceNo : patientBilling.prevSysInvoiceNo }}</p>
            </div>
            <div style="box-sizing: border-box; height:auto; width: auto;">                
                <div style="padding: 5px;">
                    <p style="margin:0; margin-bottom:5px;"><strong>{{ patient.firstName }} {{ patient.lastName }}</strong></p>
                    <p style="margin:0; margin-bottom:2px; font-size: 15px;">{{ patient.street }}</p>
                    <p style="margin:0; margin-bottom:2px; font-size: 15px;">{{ patient.city.description|default('') ~ ', ' ~ patient.city.province.description|default('') }}</p>
                    <p style="margin:0; margin-bottom:2px; font-size: 15px;">{{ patient.postalCode.description|default('') }}</p>
                </div>
            </div>
        </div>        
    </div>
    <div style="margin-top:20px;">
    <table width="100%" style="border-collapse: collapse;">
        <thead>
        <tr style="border-bottom: 1px solid #cacaca;">
            <td style="font-size:15px; padding: 5px; color: #262262;"><strong>DESCRIPTION</strong></td>
            <td style="font-size:15px; padding: 5px; text-align: right;  color: #262262;"><strong>QTY</strong></td>
            <td style="font-size:15px; padding: 5px; text-align: right; color: #262262;"><strong>UNIT PRICE</strong></td>
            <td style="font-size:15px; padding: 5px; text-align: right; color: #262262;"><strong>AMOUNT</strong></td>
        </tr>
        </thead>
        <tbody>
        {% set totalReturnAmt = 0 %}
        {% set isReturn = 0 %}

        {#{% set refundAmt = 0 %}#}
        {#{% if patientBilling.patientBillingRefunds|length > 0 %}#}
            {#{% for refunds in patientBilling.patientBillingRefunds %}#}
                {#{% set refundAmt = refundAmt + refunds.amount %}#}
            {#{% endfor %}#}
        {#{% endif %}#}

        {% for pbb in patientBilling.patientBillingBreakdowns %}
            {% set pc = pbb.patientChart %}
            {% set description = pbb.description %}
            {% if constant('RxconnexionBundle\\Entity\\PatientBillingBreakdownEntity::TYPE_CHART_PROCEDURE') == pbb.type %}
                {% set description = pbb.chartProcedure.description %}
            {% elseif constant('RxconnexionBundle\\Entity\\PatientBillingBreakdownEntity::TYPE_ITEM') == pbb.type %}
                {% set description = pbb.item.description %}
            {% endif %}
            {% set status = pbb.status|default('') %}
            {% if status == 'Return' %}
                {% set isReturn = 1 %}
                {% set totalReturnAmt = totalReturnAmt + pbb.amount %}
            {% endif %}

            <tr>
                {#<td style="font-size:12px;">{{ pc.chartDateAsString|default('') }}</td>
                <td style="font-size:12px;">{{ pc ? 'Services' : 'Misc.' }}</td>#}
                <td style="padding:5px; font-size:15px;">{{ description }}</td>
                <td style="padding:5px; text-align: right; font-size:15px;">{{ pbb.invoicequantity|number_format(0, '.', ',') }}</td>
                <td style="padding:5px; text-align: right; font-size:15px;">{{ pbb.invoiceprice|number_format(2, '.', ',') }}</td>
                <td style="padding:5px; text-align: right; font-size:15px;">{{ pbb.invoiceamount|number_format(2, '.', ',') }}</td>
            </tr>
        {% endfor %}
        </tbody>
    </table>
</div>
    <p style="color:#cacaca;">-----------------------------------------------------------------------------------------------------------------------------------</p>
    <div style="width: 100%;float: right; margin-bottom: 50px;">
        <table style="width:100%;">
        <tr>
            <td colspan="2" style="text-align: right; color: #262262;"><strong>TOTAL :</strong></td>
            {#<td style="text-align: right; border-top: 2px solid #aaaaaa;">{{ patientBilling.patientBillingRefunds|length > 0 or isReturn == 1 ? (patientBilling.amountDue + totalReturnAmt)|number_format(2, '.', ',') : patientBilling.amountDue|number_format(2, '.', ',') }}</td>#}
            <td style="text-align: right;">{{ patientBilling.invoiceamountDue|number_format(2, '.', ',') }}</td>
        </tr>
        <tr>
                <td colspan="2" style="text-align: right; color: #262262;"><strong>PAYMENT :</strong></td>
                <td style="text-align: right;">{{ patientBilling.amountPaid|number_format(2, '.', ',') }}</td>
        </tr>
        <tr>
            {% if constant('RxconnexionBundle\\Entity\\PatientBillingEntity::PAYER_TYPE_FINANCING') == patientBilling.payerType %}
                <td colspan="2" style="text-align: right;">Balance Due:</td>
            {% else %}
                <td colspan="2" style="text-align: right; color: #262262;"><strong>BALANCE :</strong></td>
            {% endif %}
            {#<td style="text-align: right; border-top: 4px double #aaaaaa; font-weight: 600; font-size: 18px;">{{ patientBilling.patientBillingRefunds|length > 0 or isReturn == 1 ? (patientBilling.amountBalance + totalReturnAmt - patientBilling.amountRefunded|default(0))|number_format(2, '.', ',') : patientBilling.amountBalance|number_format(2, '.', ',') }}</td>#}
            <td style="text-align: right; border-top: 4px double #aaaaaa; font-weight: 600; font-size: 18px;">{{ patientBilling.invoiceamountBalance|number_format(2, '.', ',') }}</td>
        </tr>
        </table>
    </div>
    <div style="width: 100%;">
        <p style="margin: 0; padding-bottom: 20px; color: #262262;"><strong>PAYMENTS</strong></p>
        <table width="100%" style="border-collapse: collapse; float: right;">
            <thead>
            <tr style="border-bottom: 1px dotted #676767;">
                <td style="font-size:15px; padding: 5px; text-align: center;">DATE</td>
                <td style="font-size:15px; padding: 5px; text-align: center;">TYPE</td>
                <td style="font-size:15px; padding: 5px; text-align: right;">AMOUNT</td>
            </tr>
            </thead>
            <tbody>
            {% for pp in patientBilling.patientPayments if pp.paymentStatus != constant('RxconnexionBundle\\Entity\\PatientPaymentEntity::PAYMENT_STATUS_VOID') %}
                {% set payType = pp.payTypeForPrint %}
                {% set amount = pp.amount %}
                {% set payDate = pp.payDateAsString|date('F j, Y') %}
                <tr>
                    <td style="text-align: center; font-size: 15px;">{{ payDate }}</td>
                    <td style="text-align: center; font-size: 15px;">{{ payType }}</td>
                    <td style="text-align: right; font-size: 15px;">{{ amount|number_format(2, '.', ',') }}</td>
                </tr>
            {% endfor %}
            <tr>
                <td style="height: 30px;"></td>
            </tr>
            <tr>
                <td style="height: 20px;"></td>
            </tr>
            </tbody>
        </table>
    </div>

    <div style="width:50%; height: 155px; float:left;">
        <br>
        <p>{{ patientBilling.note }}</p>
        {#<h5>ALL SALES ARE FINAL</h5>#}
    </div>
</div>
</body>
</html>