{{-- 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 '@if (count($errors)) @if($errors->has('fecha')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('fecha', 'Fecha', ['class' => 'col-xs-5 control-label']) !!}
					<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>
		
			@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 '@if (count($errors)) @if($errors->has('hora')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! 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-xs-5">
				<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::text('motivo_de_consulta', null, ['class' => 'form-control']) !!}-->
						{!! 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-xs-5">
				<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::text('enfermedad_actual', null, ['class' => 'form-control']) !!}-->
						{!! 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>
	</a>
	<a class="list-group-item">
		<p class="list-group-item-heading"><b>Antacedentes</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('antecedentes_patologicos')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('antecedentes_patologicos', 'Patológicos', ['class' => 'col-xs-5 control-label']) !!}
					<div class="col-xs-7">
						{!! Form::text('antecedentes_patologicos', 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('antecedentes_quirurgicos')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('antecedentes_quirurgicos', 'Quirúrgicos', ['class' => 'col-xs-5 control-label']) !!}
					<div class="col-xs-7">
						{!! Form::text('antecedentes_quirurgicos', 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('antecedentes_alergicos')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('antecedentes_alergicos', 'Alérgicos', ['class' => 'col-xs-5 control-label']) !!}
					<div class="col-xs-7">
						{!! Form::text('antecedentes_alergicos', 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('antecedentes_toxicos')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('antecedentes_toxicos', 'Tóxicos', ['class' => 'col-xs-5 control-label']) !!}
					<div class="col-xs-7">
						{!! Form::text('antecedentes_toxicos', 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('antecedentes_farmacologicos')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('antecedentes_farmacologicos', 'Farmacológicos', ['class' => 'col-xs-5 control-label']) !!}
					<div class="col-xs-7">
						{!! Form::text('antecedentes_farmacologicos', 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('tabaquismo')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('tabaquismo', 'Tabaquismo', ['class' => 'col-xs-5 control-label']) !!}
					<div class="col-xs-7">
						{!! Form::text('tabaquismo', 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('factor_riesgo')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('factor_riesgo', 'Factores de Riesgo', ['class' => 'col-xs-5 control-label']) !!}
					<div class="col-xs-7">
						{!! Form::text('factor_riesgo', 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('antecedentes_familiares')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('antecedentes_familiares', 'Familiares', ['class' => 'col-xs-5 control-label']) !!}
					<div class="col-xs-7">
						{!! Form::text('antecedentes_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('antecedentes_familiares')) 
				{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('antecedentes_familiares', 'Familiares de Glaucoma', ['class' => 'col-xs-4 control-label']) !!}
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('antecedentes_familiares', 1) !!}
							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							{!! Form::radio('antecedentes_familiares', 0, true) !!}
							no
						</label>
					</div>
					<div class="col-xs-4">
						<label class="radio-inline">
							{!! Form::radio('antecedentes_familiares', 2) !!}
							no sabe
						</label>
					</div>
				</div>
			</div>

		</div>
	</a>

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

			<div class="col-xs-6">
				<div class="form-group form-group-sm">
					{!! Form::label('vision_lejana_ojo_derecho', 'Visión lejana ojo derecho', ['class' => 'col-xs-5 control-label']) !!}
					<div class="col-xs-7">
						{!! Form::text('vision_lejana_ojo_derecho', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>

			<div class="col-xs-6">
				<div class="form-group form-group-sm ">
					{!! Form::label('vision_lejana_ojo_izquierdo', 'Visión lejana ojo izquierdo', ['class' => 'col-xs-5 control-label']) !!}
					<div class="col-xs-7">
						{!! Form::text('vision_lejana_ojo_izquierdo', null, ['class' => 'form-control','required']) !!}
					</div>
				</div>
			</div>

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

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

			<div class="col-xs-6" style="display: none;">
				<div class="form-group form-group-sm '@if (count($errors)) @if($errors->has('vision_cromatica')) 
					{{'form-group has-error has-feedback'}} @endif @endif'">
					{!! Form::label('vision_cromatica', 'Visión cromática', ['class' => 'col-xs-5 control-label']) !!}
					<div class="col-xs-7">
						{!! Form::text('vision_cromatica', null, ['class' => 'form-control','required']) !!}
					</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-6">
					<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' => 7, 'maxlength' => 2000,'required']) !!}
						@if( ! isset($formulario) )
							<span id="contador-recomendaciones">0 de 2000</span>
						@endif
					</div>
				</div>

				<div class="col-sm-6">
					<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' => 7, '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']) !!}
					</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')
@include('componentes.script-verificar-sexo-diagnosticos')