{{-- Vista de solo lectura --}}
@if(isset($formulario))
	{!! Form::model($formulario, ['class' => 'form-horizontal']) !!}
@endif

<!-- Para cargar el último formulario registrado con la finalidad de que sea una muestra para el nuevo formulario -->
@if(!\Session::has('success'))
	@if(isset($ultimoFormulario))
		{!! Form::model($ultimoFormulario, ['class' => 'form-horizontal', 'route' => 'seguimiento.store', 'method' => 'post', 'id' => 'formularioSeguimiento']) !!}
	@elseif(!isset($formulario)  )
		{!! Form::open(['class' => 'form-horizontal', 'route' => 'seguimiento.store', 'method' => 'post']) !!}
	@endif
@else
	{!! Form::model(Session::get('ultimoFormularior'), ['class' => 'form-horizontal', 'route' => 'seguimiento.store', 'method' => 'post', 'id' => 'formularioSeguimiento']) !!}
@endif

@include('componentes.hidden-json-seguimiento')

{!!Form::hidden('hiddenEdad','')!!}
{!!Form::hidden('hiddenSexo','')!!}
@include('componentes.mensajeError')

<div class="list-group">

	<a class="list-group-item">
		<p class="list-group-item-heading"><b>Información básica</b></p>
		<div class="row formulario-horizontal">
			<div class="col-xs-12 text-right">
				@if(isset($formulario))
					@include('componentes.boton-volver-al-listado-de-historicos-e-imprimir-en-seguimiento')
				@else
					@include('componentes.boton-salir-de-seguimiento')
					@include('componentes.boton-guardar-seguimiento')
				@endif
			</div>

			<!--	<div class="col-xs-3">
				<div class="form-group form-group-sm">
					{!! Form::label('fecha', 'Fecha', ['class' => 'col-xs-5 control-label','autofocus']) !!}
					<div class="col-xs-7">
						@if(!isset($formulario))
							{!! Form::text('fecha', $fechaActual, ['class' => 'form-control', 'id' => 'fecha']) !!}
						@else
							{!! Form::text('fecha', explode(' ', $formulario->fecha_hora)[0], ['class' => 'form-control', 'id' => 'fecha']) !!}
						@endif
					</div>
				</div>
			</div>	
		-->
			<div class="col-xs-3">
				<div class="form-group form-group-sm">
					{!! Form::label('fecha', 'Fecha', ['class' => 'col-xs-5 control-label','autofocus']) !!}
					<div class="col-xs-7">
						@if(!isset($formulario))
							{!! Form::text('fecha', $fechaActual, ['class' => 'form-control', 'id' => 'fecha','autofocus']) !!}
						@else
							{!! Form::text('fecha', explode(' ', $formulario->fecha_hora)[0], ['class' => 'form-control', 'id' => 'fecha','autofocus']) !!}
						@endif
					</div>
				</div>
			</div>

			@if(!\Auth::user()->es_responsable && !isset($formulario))
				<div class="col-xs-5 col-xs-offset-1">
					<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('usuario_id')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
						{!! Form::label('usuario_id', 'Responsable', ['class' => 'col-xs-2 control-label']) !!}
						<div class="col-xs-8">
							{!! Form::select('usuario_id', $responsables, null, ['class' => 'form-control']) !!}
						</div>
					</div>
				</div>

				<div class="clearfix"></div>
			@endif

			<div class="col-xs-3">
				<div class="form-group form-group-sm">
					{!! Form::label('hora', 'Hora', ['class' => 'col-xs-5 control-label']) !!}
					<div class="col-xs-7">
						@if(!isset($formulario))
							{!! Form::text('hora', \Carbon\Carbon::now()->format('H:i:s'), ['class' => 'form-control', 'id' => 'hora']) !!}
						@else
							{!! Form::text('hora', explode(' ', $formulario->fecha_hora)[1], ['class' => 'form-control', 'id' => 'hora']) !!}
						@endif
					</div>
				</div>
			</div>

			<div class="col-xs-8">
				<div class="form-group form-group-sm '@if (count($errors)) @if($errors->has('entidad_id')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('entidad_id', 'Entidad', ['class' => 'col-xs-2 control-label']) !!}
					<div class="col-xs-10">
						{!! Form::select('entidad_id', $entidades, null, ['class' => 'form-control']) !!}
					</div>
				</div>
			</div>

			<div class="col-sm-4">
				<div class="form-group form-group-sm '@if (count($errors)) @if($errors->has('motivo_de_consulta')) 
						{{'form-group has-error has-feedback'}} @endif @endif'">
						{!! Form::label('motivo_de_consulta', 'Motivo de consulta', ['class' => 'col-xs-4 control-label']) !!}
					<div class="col-xs-8">
						{!! Form::textarea('motivo_de_consulta', null, ['class' => 'form-control', 'rows' => 4, 'maxlength' => 2000,'required']) !!}
							@if( ! isset($formulario) )
								<span id="contador-motivo_de_consulta">0 de 2000</span>
							@endif
					</div>
				</div>
			</div>

			<div class="col-sm-4">
				<div class="form-group form-group-sm '@if (count($errors)) @if($errors->has('enfermedad_actual')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('enfermedad_actual', 'Enfermedad actual', ['class' => 'col-xs-4 control-label']) !!}
					<div class="col-xs-8">
						{!! Form::textarea('enfermedad_actual', null, ['class' => 'form-control', 'rows' => 4, 'maxlength' => 2000,'required']) !!}
						@if( ! isset($formulario) )
							<span id="contador-enfermedad_actual">0 de 2000</span>
						@endif
					</div>
				</div>
			</div>

			<div class="col-sm-4">
				<div class="form-group form-group-sm '@if (count($errors)) @if($errors->has('revision_por_sistemas')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('revision_por_sistemas', 'Revisión por sistemas', ['class' => 'col-xs-4 control-label']) !!}
					<div class="col-xs-8">
						{!! Form::textarea('revision_por_sistemas', null, ['class' => 'form-control', 'rows' => 4, 'maxlength' => 2000,'required']) !!}
						@if( ! isset($formulario) )
							<span id="contador-revision_por_sistemas">0 de 2000</span>
						@endif
					</div>
				</div>
			</div>
			
		</div>
	</a>

	<a class="list-group-item">
		<p class="list-group-item-heading"><b>Antecedentes familiares</b></p>
		<div class="row formulario-horizontal">

			<div class="col-xs-2">
				<div class="form-group form-group-sm ">
					{!! Form::label('diabetes', 'Diabetes?', ['class' => 'col-xs-8 control-label']) !!}
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('diabetes', 1 ) !!}
							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('diabetes', 0, true) !!}
							no
						</label>
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm '@if (count($errors)) @if($errors->has('diabetes-parentesco')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('diabetes-parentesco', 'Diabetes parentesco', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('diabetes-parentesco', null, ['class' => 'form-control']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-2">
				<div class="form-group form-group-sm">
					{!! Form::label('obesidad', 'Obesidad?', ['class' => 'col-xs-8 control-label']) !!}
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('obesidad', 1) !!}
							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('obesidad', 0, true) !!}
							no
						</label>
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm '@if (count($errors)) @if($errors->has('obesidad-parentesco')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('obesidad-parentesco', 'Obesidad parentesco', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('obesidad-parentesco', null, ['class' => 'form-control']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-2">
				<div class="form-group form-group-sm">
					{!! Form::label('cardiovascular', 'Cardiovascular?', ['class' => 'col-xs-8 control-label']) !!}
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('cardiovascular', 1) !!}
							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('cardiovascular', 0, true) !!}
							no
						</label>
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm '@if (count($errors)) @if($errors->has('cardiovascular-parentesco')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('cardiovascular-parentesco', 'Cardiovascular parentesco', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('cardiovascular-parentesco', null, ['class' => 'form-control']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-2">
				<div class="form-group form-group-sm">
					{!! Form::label('psiquiatricos', 'Psiquiatricos?', ['class' => 'col-xs-8 control-label']) !!}
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('psiquiatricos', 1) !!}
							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('psiquiatricos', 0, true) !!}
							no
						</label>
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm '@if (count($errors)) @if($errors->has('psiquiatricos-parentesco')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('psiquiatricos-parentesco', 'Psiquiatricos parentesco', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('psiquiatricos-parentesco', null, ['class' => 'form-control']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-2">
				<div class="form-group form-group-sm">
					{!! Form::label('cancer', 'Cancer?', ['class' => 'col-xs-8 control-label']) !!}
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('cancer', 1) !!}
							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('cancer', 0, true) !!}
							no
						</label>
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('cancer-parentesco')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('cancer-parentesco', 'Cancer parentesco', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('cancer-parentesco', null, ['class' => 'form-control']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-2">
				<div class="form-group form-group-sm">
					{!! Form::label('tabaquismo', 'Tabaquismo?', ['class' => 'col-xs-8 control-label']) !!}
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('tabaquismo', 1) !!}
							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('tabaquismo', 0, true) !!}
							no
						</label>
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('tabaquismo-parentesco')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('tabaquismo-parentesco', 'Tabaquismo parentesco', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('tabaquismo-parentesco', null, ['class' => 'form-control']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-2">
				<div class="form-group form-group-sm">
					{!! Form::label('alcoholismo', 'Alcoholismo?', ['class' => 'col-xs-8 control-label']) !!}
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('alcoholismo', 1) !!}
							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('alcoholismo', 0, true) !!}
							no
						</label>
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('alcoholismo-parentesco')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('alcoholismo-parentesco', 'Alcoholismo parentesco', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('alcoholismo-parentesco', null, ['class' => 'form-control']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-2">
				<div class="form-group form-group-sm">
					{!! Form::label('drogadiccion', 'Drogadiccion?', ['class' => 'col-xs-8 control-label']) !!}
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('drogadiccion', 1) !!}
							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('drogadiccion', 0, true) !!}
							no
						</label>
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('drogadiccion-parentesco')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('drogadiccion-parentesco', 'Drogadiccion parentesco', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('drogadiccion-parentesco', null, ['class' => 'form-control']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-6">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('otros-familiares')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('otros-familiares', 'Otros familiares', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('otros-familiares', null, ['class' => 'form-control']) !!}
					</div>
				</div>
			</div>
		</div>
	</a>

	<a class="list-group-item">
		<p class="list-group-item-heading"><b>Antecedentes personales</b></p>
		<div class="row formulario-horizontal">

			<div class="col-xs-3">
				<div class="form-group form-group-sm">
					{!! Form::label('perinatales-normales', 'Perinatales-normales?', ['class' => 'col-xs-8 control-label']) !!}
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('perinatales-normales', 1) !!}
							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('perinatales-normales', 0, true) !!}
							no
						</label>
					</div>
				</div>
			</div>

			<div class="col-xs-3">
				<div class="form-group form-group-sm">
					{!! Form::label('crecimiento-normales', 'Crecimiento-normales?', ['class' => 'col-xs-8 control-label']) !!}
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('crecimiento-normales', 1) !!}
							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('crecimiento-normales', 0, true) !!}
							no
						</label>
					</div>
				</div>
			</div>

			<div class="col-xs-3">
				<div class="form-group form-group-sm">
					{!! Form::label('desarrollo-normales', 'Desarrollo-normales?', ['class' => 'col-xs-8 control-label']) !!}
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('desarrollo-normales', 1) !!}
							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('desarrollo-normales', 0, true) !!}
							no
						</label>
					</div>
				</div>
			</div>

			<div class="col-xs-3">
				<div class="form-group form-group-sm">
					{!! Form::label('vacunas-completas', 'Vacunas completas?', ['class' => 'col-xs-8 control-label']) !!}
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('vacunas-completas', 1) !!}
							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('vacunas-completas', 0, true) !!}
							no
						</label>
					</div>
				</div>
			</div>

			<div class="col-xs-3">
				<div class="form-group form-group-sm">
					{!! Form::label('enfermedad-cronicas', 'Enfermedad-cronicas?', ['class' => 'col-xs-8 control-label']) !!}
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('enfermedad-cronicas', 1) !!}
							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('enfermedad-cronicas', 0, true) !!}
							no
						</label>
					</div>
				</div>
			</div>

			<div class="col-xs-3">
				<div class="form-group form-group-sm">
					{!! Form::label('enf-infectocontagiosa', 'Enf-infectocontagiosa?', ['class' => 'col-xs-8 control-label']) !!}
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('enf-infectocontagiosa', 1) !!}
							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('enf-infectocontagiosa', 0, true) !!}
							no
						</label>
					</div>
				</div>
			</div>

			<div class="col-xs-3">
				<div class="form-group form-group-sm">
					{!! Form::label('accidentes', 'Accidentes?', ['class' => 'col-xs-8 control-label']) !!}
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('accidentes', 1) !!}
							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('accidentes', 0, true) !!}
							no
						</label>
					</div>
				</div>
			</div>

			<div class="col-xs-3">
				<div class="form-group form-group-sm">
					{!! Form::label('intoxicacion', 'Intoxicacion?', ['class' => 'col-xs-8 control-label']) !!}
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('intoxicacion', 1) !!}
							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('intoxicacion', 0, true) !!}
							no
						</label>
					</div>
				</div>
			</div>

			<div class="col-xs-3">
				<div class="form-group form-group-sm">
					{!! Form::label('psicologicos', 'Psicologicos?', ['class' => 'col-xs-8 control-label']) !!}
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('psicologicos', 1) !!}
							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('psicologicos', 0, true) !!}
							no
						</label>
					</div>
				</div>
			</div>

			<div class="col-xs-3">
				<div class="form-group form-group-sm">
					{!! Form::label('maltrato', 'Maltrato?', ['class' => 'col-xs-8 control-label']) !!}
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('maltrato', 1) !!}
							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('maltrato', 0, true) !!}
							no
						</label>
					</div>
				</div>
			</div>

			<div class="col-xs-3">
				<div class="form-group form-group-sm">
					{!! Form::label('judiciales', 'Judiciales?', ['class' => 'col-xs-8 control-label']) !!}
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('judiciales', 1) !!}
							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('judiciales', 0, true) !!}
							no
						</label>
					</div>
				</div>
			</div>

			<div class="col-xs-6">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('otros-personales')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('otros-personales', 'Otros personales', ['class' => 'col-xs-4 control-label']) !!}
					<div class="col-xs-8">
						{!! Form::text('otros-personales', null, ['class' => 'form-control']) !!}
					</div>
				</div>
			</div>

		</div>
	</a>

	<a class="list-group-item">
		<p class="list-group-item-heading"><b>Otros antecedentes</b></p>
		<div class="row formulario-horizontal">

			<div class="col-xs-3">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('quirurgicos')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('quirurgicos', 'Quirurgicos', ['class' => 'col-xs-4 control-label']) !!}
					<div class="col-xs-8">
						{!! Form::text('quirurgicos', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-3">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('farmacologicos')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('farmacologicos', 'Farmacologicos', ['class' => 'col-xs-4 control-label']) !!}
					<div class="col-xs-8">
						{!! Form::text('farmacologicos', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-3">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('inmunizaciones')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('inmunizaciones', 'Inmunizaciones', ['class' => 'col-xs-4 control-label']) !!}
					<div class="col-xs-8">
						{!! Form::text('inmunizaciones', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-3">
				<div class="form-group form-group-sm">
					{!! Form::label('vph', 'Vph?', ['class' => 'col-xs-8 control-label']) !!}
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('vph', 1) !!}
							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('vph', 0, true) !!}
							no
						</label>
					</div>
				</div>
			</div>

			<div class="clearfix"></div>

			<div class="col-xs-3">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('vph-dosis')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('vph-dosis', 'Vph dosis', ['class' => 'col-xs-8 control-label']) !!}
					<div class="col-xs-4">
						{!! Form::number('vph-dosis', null, ['class' => 'form-control', 'min' => 0,'required']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-3">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('toxico-alergicos')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('toxico-alergicos', 'Tóxico alérgicos', ['class' => 'col-xs-4 control-label']) !!}
					<div class="col-xs-8">
						{!! Form::text('toxico-alergicos', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-3">
				<div class="form-group form-group-sm">
					{!! Form::label('alcohol', 'Alcohol?', ['class' => 'col-xs-8 control-label']) !!}
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('alcohol', 1) !!}
							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('alcohol', 0, true) !!}
							no
						</label>
					</div>
				</div>
			</div>

			<div class="col-xs-3">
				<div class="form-group form-group-sm">
					{!! Form::label('tabaco', 'Tabaco?', ['class' => 'col-xs-8 control-label']) !!}
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('tabaco', 1) !!}
							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('tabaco', 0, true) !!}
							no
						</label>
					</div>
				</div>
			</div>

			<div class="clearfix"></div>

			<div class="col-xs-3">
				<div class="form-group form-group-sm">
					{!! Form::label('drogodependencia', 'Drogodependencia?', ['class' => 'col-xs-8 control-label']) !!}
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('drogodependencia', 1) !!}
							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('drogodependencia', 0, true) !!}
							no
						</label>
					</div>
				</div>
			</div>

		</div>
	</a>

	<a class="list-group-item">
		<p class="list-group-item-heading"><b>Psicosocial</b></p>
		<div class="row formulario-horizontal">

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('ocupacion-padre')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('ocupacion-padre', 'Ocupacion padre', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('ocupacion-padre', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('escolaridad-padre')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('escolaridad-padre', 'Escolaridad padre', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('escolaridad-padre', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('ocupacion-madre')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('ocupacion-madre', 'Ocupacion madre', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('ocupacion-madre', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('escolaridad-madre')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('escolaridad-madre', 'Escolaridad madre', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('escolaridad-madre', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('comunicacion-padres')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('comunicacion-padres', 'Comunicacion padres', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('comunicacion-padres', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('relaciones-familiares')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('relaciones-familiares', 'Relaciones familiares', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('relaciones-familiares', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('dependencia-economica')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('dependencia-economica', 'Dependencia economica', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('dependencia-economica', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('red-de-apoyo')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('red-de-apoyo', 'Red de apoyo', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('red-de-apoyo', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('proyecto-de-vida')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('proyecto-de-vida', 'Proyecto de vida', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('proyecto-de-vida', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('animo-autopercepcion')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('animo-autopercepcion', 'Ánimo autopercepción', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('animo-autopercepcion', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('proyecto-de-vida')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('proyecto-de-vida', 'Proyecto de vida', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('proyecto-de-vida', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('estudia')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('estudia', 'Estudia', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('estudia', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('problemas-en-la-escuela')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('problemas-en-la-escuela', 'Problemas en la escuela', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('problemas-en-la-escuela', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('anos-perdidos')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('anos-perdidos', 'Años perdidos', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('anos-perdidos', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('desercion-exclusion')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('desercion-exclusion', 'Deserción exclusión', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('desercion-exclusion', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('educacion-no-formal')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('educacion-no-formal', 'Eeducación no formal', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('educacion-no-formal', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>

		</div>
	</a>

	<a class="list-group-item">
		<p class="list-group-item-heading"><b>Trabajo</b></p>
		<div class="row formulario-horizontal">

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('trabajo')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('trabajo', 'Trabajo', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('trabajo', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>

		</div>
	</a>

	<a class="list-group-item">
		<p class="list-group-item-heading"><b>Hábitos</b></p>
		<div class="row formulario-horizontal">

			<div class="col-xs-4">
				<div class="form-group form-group-sm">
					{!! Form::label('sueno-normal', 'Sueño normal?', ['class' => 'col-xs-8 control-label']) !!}
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('sueno-normal', 1) !!}
							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('sueno-normal', 0, true) !!}
							no
						</label>
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm">
					{!! Form::label('alimentacion-adecuada', 'Alimentación adecuada?', ['class' => 'col-xs-8 control-label']) !!}
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('alimentacion-adecuada', 1) !!}
							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('alimentacion-adecuada', 0, true) !!}
							no
						</label>
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('recreacion')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('recreacion', 'recreacion', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('recreacion', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('uso-del-tiempo-libre')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('uso-del-tiempo-libre', 'Uso del tiempo libre', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('uso-del-tiempo-libre', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>
		</div>
	</a>

	<a class="list-group-item">
		<p class="list-group-item-heading"><b>Sexualidad</b></p>
		<div class="row formulario-horizontal">

			<div class="col-xs-4">
				<div class="form-group form-group-sm">
					{!! Form::label('inicio-relaciones-sexuales', 'Inicio relaciones sexuales?', ['class' => 'col-xs-8 control-label']) !!}
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('inicio-relaciones-sexuales', 1) !!}
							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('inicio-relaciones-sexuales', 0, true) !!}
							no
						</label>
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('edad-inicio-relaciones-sexuales')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('edad-inicio-relaciones-sexuales', 'Edad inicio relaciones sexuales', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('edad-inicio-relaciones-sexuales', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm">
					{!! Form::label('antecedente-its', 'Antecedente its?', ['class' => 'col-xs-8 control-label']) !!}
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('antecedente-its', 1) !!}
							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('antecedente-its', 0, true) !!}
							no
						</label>
					</div>
				</div>
			</div>

			<div class="clearfix"></div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('cual-antecedente-its')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('cual-antecedente-its', 'Cual antecedente its', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('cual-antecedente-its', null, ['class' => 'form-control']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('numero-de-parejas-sexuales')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('numero-de-parejas-sexuales', 'Número de parejas sexuales', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('numero-de-parejas-sexuales', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('metodo-anticonceptivo')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('metodo-anticonceptivo', 'Método anticonceptivo', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('metodo-anticonceptivo', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>

		</div>
	</a>

	<a class="list-group-item">
		<p class="list-group-item-heading"><b>Examen físico</b></p>
		<div class="row formulario-horizontal">

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('ta')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('ta', 'TA', ['class' => 'col-xs-4 control-label']) !!}
					<div class="col-xs-8">
					    <div class="input-group">		   
							{!! Form::text('ta', null, ['class' => 'form-control','required']) !!}
							<span class="input-group-addon">mmHg</span>					  
						</div>
					</div>
				</div>
			</div>

			<!--<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('perimetro-cefalico')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('perimetro-cefalico', 'Perimetro cefálico', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('perimetro-cefalico', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>
			-->
			<div class="col-xs-4">
				<div class="form-group form-group-sm
				'@if (count($errors)) @if($errors->has('perimetro-cefalico'))
				{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('perimetro-cefalico', 'Perimetro cefálico', ['class' => 'col-xs-4 control-label']) !!}
					<div class="col-xs-8">
						<div class="input-group">
							{!! Form::text('perimetro-cefalico', null, ['class' => 'form-control','required']) !!}
							<span class="input-group-addon">cm</span>
						</div>
					</div>
				</div>
			</div>
			
<!--			
			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('fc')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('fc', 'FC', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('fc', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>
-->
			
			<div class="col-xs-4">
				<div class="form-group form-group-sm
				'@if (count($errors)) @if($errors->has('fc'))
				{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('fc', 'FC', ['class' => 'col-xs-4 control-label']) !!}
					<div class="col-xs-8">
						<div class="input-group">
							{!! Form::text('fc', null, ['class' => 'form-control','required']) !!}
							<span class="input-group-addon">Lat / min</span>
						</div>
					</div>
				</div>
			</div>
<!--			
			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('fr')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('fr', 'FR', ['class' => 'col-xs-4 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('fr', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>
-->
			<div class="col-xs-4">
				<div class="form-group form-group-sm
				'@if (count($errors)) @if($errors->has('fr'))
				{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('fr', 'FR', ['class' => 'col-xs-4 control-label']) !!}
					<div class="col-xs-8">
						<div class="input-group">
							{!! Form::text('fr', null, ['class' => 'form-control','required']) !!}
							<span class="input-group-addon">Resp / min</span>
						</div>
					</div>
				</div>
			</div>
			
<!--			
			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('peso')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('peso', 'Peso', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-5">
						{!! Form::text('peso', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>

-->			

			<div class="col-xs-4">
				<div class="form-group form-group-sm
				'@if (count($errors)) @if($errors->has('peso'))
				{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('peso', 'Peso', ['class' => 'col-xs-4 control-label']) !!}
					<div class="col-xs-8">
						<div class="input-group">
							{!! Form::text('peso', null, ['class' => 'form-control','required']) !!}
							<span class="input-group-addon">Kg</span>
						</div>
					</div>
				</div>
			</div>

<!--			
			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('talla')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('talla', 'Talla', ['class' => 'col-xs-7 control-label']) !!}
					<div class="col-xs-4">
						{!! Form::text('talla', null, ['class' => 'form-control','required']) !!}
						<span class="input-group-addon">m</span>
					</div>
				</div>
			</div>
-->
			<div class="col-xs-4">
				<div class="form-group form-group-sm
				'@if (count($errors)) @if($errors->has('talla'))
				{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('talla', 'Talla', ['class' => 'col-xs-4 control-label']) !!}
					<div class="col-xs-8">
						<div class="input-group">
							{!! Form::text('talla', null, ['class' => 'form-control','required']) !!}
							<span class="input-group-addon">m</span>
						</div>
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('imc')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('imc', 'IMC', ['class' => 'col-xs-4 control-label']) !!}
					<div class="col-xs-8">
						<div class="input-group">
							{!! Form::text('imc', null, ['class' => 'form-control', 'readonly']) !!}
							<span class="input-group-addon">Kg / m<sup>2</sup></span>
						</div>
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
					'@if (count($errors)) @if($errors->has('tanner')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('tanner', 'Tanner', ['class' => 'col-xs-4 control-label']) !!}
					<div class="col-xs-8">
						<div class="input-group">
							{!! Form::text('tanner', null, ['class' => 'form-control','required']) !!}
							<span class="input-group-addon">mL / min / 1.73</span>
						</div>
					</div>
				</div>
			</div>
		</div>
	</a>

<!-- desde aqui es donde se adiciona la descripcion del examen fisico-->

	<a class="list-group-item">
		<p class="list-group-item-heading"><b>Descripción</b></p>
		<div class="row formulario-horizontal">

			<div class="col-xs-4">
				<div class="form-group form-group-sm '@if (count($errors)) @if($errors->has('paciente')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('paciente', 'Paciente', ['class' => 'col-xs-4 control-label']) !!}
					<div class="col-xs-8">
						{!! Form::textarea('paciente', null, ['class' => 'form-control', 'rows' => 3]) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm '@if (count($errors)) @if($errors->has('cabeza_y_orl')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('cabeza_y_orl', 'Cabeza y orl', ['class' => 'col-xs-4 control-label']) !!}
					<div class="col-xs-8">
						{!! Form::textarea('cabeza_y_orl', null, ['class' => 'form-control', 'rows' => 3]) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm '@if (count($errors)) @if($errors->has('cuello')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('cuello', 'Cuello', ['class' => 'col-xs-4 control-label']) !!}
					<div class="col-xs-8">
						{!! Form::textarea('cuello', null, ['class' => 'form-control', 'rows' => 3]) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm '@if (count($errors)) @if($errors->has('torax')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('torax', 'Torax', ['class' => 'col-xs-4 control-label']) !!}
					<div class="col-xs-8">
						{!! Form::textarea('torax', null, ['class' => 'form-control', 'rows' => 3]) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm '@if (count($errors)) @if($errors->has('cp')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('cp', 'CP', ['class' => 'col-xs-4 control-label']) !!}
					<div class="col-xs-8">
						{!! Form::textarea('cp', null, ['class' => 'form-control', 'rows' => 3]) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm '@if (count($errors)) @if($errors->has('abdomen')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('abdomen', 'Abdomen', ['class' => 'col-xs-4 control-label']) !!}
					<div class="col-xs-8">
						{!! Form::textarea('abdomen', null, ['class' => 'form-control', 'rows' => 3]) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm '@if (count($errors)) @if($errors->has('genitales')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('genitales', 'Genitales', ['class' => 'col-xs-4 control-label']) !!}
					<div class="col-xs-8">
						{!! Form::textarea('genitales', null, ['class' => 'form-control', 'rows' => 3]) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm '@if (count($errors)) @if($errors->has('extremidades')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('extremidades', 'Extremidades', ['class' => 'col-xs-4 control-label']) !!}
					<div class="col-xs-8">
						{!! Form::textarea('extremidades', null, ['class' => 'form-control', 'rows' => 3]) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm '@if (count($errors)) @if($errors->has('piel')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('piel', 'Piel', ['class' => 'col-xs-4 control-label']) !!}
					<div class="col-xs-8">
						{!! Form::textarea('piel', null, ['class' => 'form-control', 'rows' => 3,'required']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm '@if (count($errors)) @if($errors->has('neurologico')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('neurologico', 'Neurológico', ['class' => 'col-xs-4 control-label']) !!}
					<div class="col-xs-8">
						{!! Form::textarea('neurologico', null, ['class' => 'form-control', 'rows' => 3,'required']) !!}
					</div>
				</div>
			</div>

		</div>
	</a>
<!-- hasta aqui es donde se adiciona la descripcion del examen fisico-->
	<a class="list-group-item">
		<p class="list-group-item-heading"><b>Tanner</b></p>
		<div class="row formulario-horizontal">
			<div class="col-xs-12">
				<div class="col-sm-12">
					<div id="div-tanner" class="form-group form-group-sm" align='center'>
						@if($pacienteSolicitado->sexo === 'm')
							<img height="300px" id="imagen-output" src='{{ URL::to("/img/test/test_tanner_hombre.jpg") }}'>
						@elseif($pacienteSolicitado->sexo === 'f')
							<img height="300px" id="imagen-output" src='{{ URL::to("/img/test/test_tanner_mujer.png") }}'><br>
						{{-- @else
							<img height="300px" id="imagen-output" src='{{ URL::to("/img/test/test_tanner_hombre.jpg") }}'>
							<img height="300px" id="imagen-output" src='{{ URL::to("/img/test/test_tanner_mujer.png") }}'><br> --}}
						@endif
					</div>
				</div>
			</div>
		</div>
	</a>	

	@include('componentes/formulario-diagnosticos')
	<a class="list-group-item">
		<p class="list-group-item-heading"><b>Anotaciones finales</b></p>
		<div class="row formulario-horizontal">
			<div class="col-xs-12">

				<div class="col-sm-4">
					<div class="form-group-sm '@if (count($errors)) @if($errors->has('descripcion')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
						{!! Form::label('descripcion', 'Descripción', ['class' => 'control-label']) !!}
						{!! Form::textarea('descripcion', null, ['class' => 'form-control', 'rows' => 4, 'maxlength' => 2000,'required']) !!}
						@if( ! isset($formulario) )
							<span id="contador-descripcion">0 de 2000</span>
						@endif
					</div>
				</div>

				<div class="col-sm-4">
					<div class="form-group-sm '@if (count($errors)) @if($errors->has('recomendaciones')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
						{!! Form::label('recomendaciones', 'Recomendaciones', ['class' => 'control-label']) !!}
						{!! Form::textarea('recomendaciones', null, ['class' => 'form-control', 'rows' => 4, 'maxlength' => 2000,'required']) !!}
						@if( ! isset($formulario) )
							<span id="contador-recomendaciones">0 de 2000</span>
						@endif
					</div>
				</div>

				<div class="col-sm-4">
					<div class="form-group-sm '@if (count($errors)) @if($errors->has('analisis-y-conducta')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
						{!! Form::label('analisis-y-conducta', 'Análisis y conducta', ['class' => 'control-label']) !!}
						{!! Form::textarea('analisis-y-conducta', null, ['class' => 'form-control', 'rows' => 4, 'maxlength' => 2000,'required']) !!}
						@if( ! isset($formulario) )
							<span id="contador-analisis-y-conducta">0 de 2000</span>
						@endif
					</div>
				</div>

			</div>
		</div>
	</a>
	<a class="list-group-item">
		<p class="list-group-item-heading"><b>Añadido</b></p>
		<div class="row formulario-horizontal">
			<div class="col-xs-12">
				<div class="col-sm-4">
					<div class="form-group-sm">
						{!! Form::label('auto_carga', 'Auto Cargado', $consulta->detalle, ['class' => 'control-label']) !!}
						{!! Form::textarea('auto_carga', $consulta->detalle, ['class' => 'form-control', 'rows' => 8, 'maxlength' => 2000,'disabled']) !!}
						{!! Form::hidden('auto_carga', $consulta->detalle) !!}
					</div>
				</div>
			</div>
		</div>
	</a>
	
	@if(isset($formulario)) {{-- Para poder ver y utilizar el form model --}}

		@include('componentes.lista-de-medicamentos')
		@include('componentes.lista-de-procedimientos')
		@include('componentes.lista-de-remisiones')

		{!! Form::close() !!}
	@elseif(isset($ultimoFormulario) || !isset($formulario))
		@include('componentes.modal-confirmar-registro-de-seguimineto')

		{!! Form::hidden('paciente_id', $paciente) !!}
		{!! Form::hidden('programa', $programa) !!}

		{!! Form::close() !!}

		<a class="list-group-item">
			<div class="row formulario-horizontal">
				<div class="col-xs-12 text-right">
					@include('componentes.boton-guardar-seguimiento')
				</div>
			</div>
		</a>
	@endif

</div> {{-- list group --}}

{{-- Cargar los inputs tipo custom de fecha y hora cuando se solicita el formulario actual desde seguimiento o inscripción --}}
@include('componentes.script-cargar-inputs-fecha-hora-desde-seguimiento')