<?php /* Vista de solo lectura */ ?>
<?php if(isset($formulario)): ?>
	<?php echo Form::model($formulario, ['class' => 'form-horizontal']); ?>

<?php endif; ?>

<!-- Para cargar el último formulario registrado con la finalidad de que sea una muestra para el nuevo formulario -->
<?php if(!\Session::has('success')): ?>
	<?php if(isset($ultimoFormulario)): ?>
		<?php echo Form::model($ultimoFormulario, ['class' => 'form-horizontal', 'route' => 'seguimiento.store', 'method' => 'post', 'id' => 'formularioSeguimiento']); ?>

	<?php elseif(!isset($formulario)  ): ?>
		<?php echo Form::open(['class' => 'form-horizontal', 'route' => 'seguimiento.store', 'method' => 'post']); ?>

	<?php endif; ?>
<?php else: ?>
	<?php echo Form::model(Session::get('ultimoFormularior'), ['class' => 'form-horizontal', 'route' => 'seguimiento.store', 'method' => 'post', 'id' => 'formularioSeguimiento']); ?>

<?php endif; ?>

<?php echo $__env->make('componentes.hidden-json-seguimiento', array_except(get_defined_vars(), array('__data', '__path')))->render(); ?>

<?php echo Form::hidden('hiddenEdad',''); ?>

<?php echo Form::hidden('hiddenSexo',''); ?>

<?php echo $__env->make('componentes.mensajeError', array_except(get_defined_vars(), array('__data', '__path')))->render(); ?>

<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">
				<?php if(isset($formulario)): ?>
					<?php echo $__env->make('componentes.boton-volver-al-listado-de-historicos-e-imprimir-en-seguimiento', array_except(get_defined_vars(), array('__data', '__path')))->render(); ?>
				<?php else: ?>
					<?php echo $__env->make('componentes.boton-salir-de-seguimiento', array_except(get_defined_vars(), array('__data', '__path')))->render(); ?>
					<?php echo $__env->make('componentes.boton-guardar-seguimiento', array_except(get_defined_vars(), array('__data', '__path')))->render(); ?>
				<?php endif; ?>
			</div>
			<div class="col-xs-3">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('fecha')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('fecha', 'Fecha', ['class' => 'col-xs-5 control-label']); ?>

					<div class="col-xs-7">
						<?php if(!isset($formulario)): ?>
							<?php echo Form::text('fecha', $fechaActual, ['class' => 'form-control', 'id' => 'fecha']); ?>

						<?php else: ?>
							<?php echo Form::text('fecha', explode(' ', $formulario->fecha_hora)[0], ['class' => 'form-control', 'id' => 'fecha']); ?>

						<?php endif; ?>
					</div>
				</div>
			</div>

			<?php if(!\Auth::user()->es_responsable && !isset($formulario)): ?>
				<div class="col-xs-5 col-xs-offset-1">
					<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('usuario_id')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
						<?php echo Form::label('usuario_id', 'Responsable', ['class' => 'col-xs-2 control-label']); ?>

						<div class="col-xs-8">
							<?php echo Form::select('usuario_id', $responsables, null, ['class' => 'form-control']); ?>

						</div>
					</div>
				</div>
				<div class="clearfix"></div>
			<?php endif; ?>
			<div class="col-xs-3">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('hora')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('hora', 'Hora', ['class' => 'col-xs-5 control-label']); ?>

					<div class="col-xs-7">
						<?php if(!isset($formulario)): ?>
							<?php echo Form::text('hora', \Carbon\Carbon::now()->format('H:i:s'), ['class' => 'form-control', 'id' => 'hora']); ?>

						<?php else: ?>
							<?php echo Form::text('hora', explode(' ', $formulario->fecha_hora)[1], ['class' => 'form-control', 'id' => 'hora']); ?>

						<?php endif; ?>
					</div>
				</div>
			</div>

			<div class="col-xs-8">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('entidad_id')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('entidad_id', 'Entidad', ['class' => 'col-xs-2 control-label']); ?>

					<div class="col-xs-10">
						<?php echo Form::select('entidad_id', $entidades, null, ['class' => 'form-control']); ?>

					</div>
				</div>
			</div>

			<div class="col-xs-5">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('enfermedad_actual')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('motivo_de_consulta', 'Motivo de consulta', ['class' => 'col-xs-4 control-label']); ?>

					<div class="col-xs-8">
						<?php echo Form::textarea('motivo_de_consulta', null, ['class' => 'form-control', 'rows' => 4, 'maxlength' => 2000,'required']); ?>

						<?php if( ! isset($formulario) ): ?>
							<span id="contador-motivo_de_consulta">0 de 2000</span>
						<?php endif; ?>
					</div>
				</div>
			</div>

			<div class="col-xs-5">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('enfermedad_actual')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('enfermedad_actual', 'Enfermedad actual', ['class' => 'col-xs-4 control-label']); ?>

					<div class="col-xs-8">
						<?php echo Form::textarea('enfermedad_actual', null, ['class' => 'form-control', 'rows' => 4, 'maxlength' => 2000,'required']); ?>

						<?php if( ! isset($formulario) ): ?>
							<span id="contador-enfermedad_actual">0 de 2000</span>
						<?php endif; ?>
					</div>
				</div>
			</div>

		</div>
	</a>

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

			<div class="col-md-3">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('cefalea')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('cefalea', 'Cefaléa', ['class' => 'col-xs-5 control-label']); ?>

					<div class="col-xs-7">
						<?php echo Form::checkbox('cefalea', 1, false); ?>

					</div>
				</div>
			</div>

			<div class="col-md-3">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('alteraciones_visuales')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('alteraciones_visuales', 'Alteraciones visuales', ['class' => 'col-xs-7 control-label']); ?>

					<div class="col-xs-5">
						<?php echo Form::checkbox('alteraciones_visuales', 1, false); ?>

					</div>
				</div>
			</div>

			<div class="col-md-3">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('palpitaciones')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('palpitaciones', 'Palpitaciones', ['class' => 'col-xs-5 control-label']); ?>

					<div class="col-xs-7">
						<?php echo Form::checkbox('palpitaciones', 1, false); ?>

					</div>
				</div>
			</div>

			<div class="col-md-3">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('dolor_precordial')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('dolor_precordial', 'Dolor precordial', ['class' => 'col-xs-5 control-label']); ?>

					<div class="col-xs-7">
						<?php echo Form::checkbox('dolor_precordial', 1, false); ?>

					</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 '<?php if(count($errors)): ?> <?php if($errors->has('antecedentes_familiares')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('antecedentes_familiares', 'Antecedentes familiares', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-6">
						<?php echo Form::text('antecedentes_familiares', null, ['class' => 'form-control','required']); ?>

					</div>
				</div>
			</div>

			<div class="col-xs-2" style="display: none;">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('hta')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('hta', 'HTA', ['class' => 'col-xs-3 control-label']); ?>

					<div class="col-xs-9">
						<?php echo Form::text('hta', 0, ['class' => 'form-control','required']); ?>

					</div>
				</div>
			</div>

			<div class="col-xs-6">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('enfermedad_cardiovascular')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('enfermedad_cardiovascular', 'Enfermedad cardiovascular', ['class' => 'col-xs-5 control-label']); ?>

					<div class="col-xs-7">
						<?php echo Form::text('enfermedad_cardiovascular', null, ['class' => 'form-control','required']); ?>

					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('antecedentes_patologicos')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('antecedentes_patologicos', 'Antecedentes patológicos', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-6">
						<?php echo Form::text('antecedentes_patologicos', null, ['class' => 'form-control','required']); ?>

					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('duracion')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('duracion', 'Duración (hace cuanto)', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-6">
						<?php echo Form::text('duracion', null, ['class' => 'form-control','required']); ?>

					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('tratamientos_recibidos')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('tratamientos_recibidos', 'Tratamientos recibidos', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-6">
						<?php echo Form::text('tratamientos_recibidos', null, ['class' => 'form-control','required']); ?>

					</div>
				</div>
			</div>

			<div class="col-xs-4 col-xs-offset-4">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('adherencia')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('adherencia', 'Adherencia', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-6">
						<?php echo Form::text('adherencia', null, ['class' => 'form-control','required']); ?>

					</div>
				</div>
			</div>

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

			<div class="col-xs-4">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('antecedentes_quirurgicos')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('antecedentes_quirurgicos', 'Antecedentes quirúrgicos', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-6">
						<?php echo Form::text('antecedentes_quirurgicos', null, ['class' => 'form-control','required']); ?>

					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('antecedentes_toxico_alergicos')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('antecedentes_toxico_alergicos', 'Antecedentes tóxico alérgicos', ['class' => 'col-xs-7 control-label']); ?>

					<div class="col-xs-5">
						<?php echo Form::text('antecedentes_toxico_alergicos', null, ['class' => 'form-control','required']); ?>

					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('antecedentes_farmacologicos')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('antecedentes_farmacologicos', 'Antecedentes farmacológicos', ['class' => 'col-xs-7 control-label']); ?>

					<div class="col-xs-5">
						<?php echo Form::text('antecedentes_farmacologicos', null, ['class' => 'form-control','required']); ?>

					</div>
				</div>
			</div>

		</div>
	</a>

	<a class="list-group-item">
		<p class="list-group-item-heading"><b>Factores de riesgo cardiovascular<</b></p>
		<div class="row formulario-horizontal">

			<?php /* 1 */ ?>
			<?php if($pacienteSolicitado->sexo == 'm' || $pacienteSolicitado->sexo == 'i'): ?>
				<div class="col-xs-3">
					<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('hombre_mayor_o_igual_55_anos')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
						<?php echo Form::label('hombre_mayor_o_igual_55_anos', 'Hombre >= 55 años', ['class' => 'col-xs-9 control-label']); ?>

						<div class="col-xs-3">
							<?php echo Form::checkbox('hombre_mayor_o_igual_55_anos', 1, false); ?>

						</div>
					</div>
				</div>
			<?php endif; ?>

			<?php if($pacienteSolicitado->sexo == 'f' || $pacienteSolicitado->sexo == 'i'): ?>
				<div class="col-xs-3">
					<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('mujer_mayor_o_igual_65_anos')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
						<?php echo Form::label('mujer_mayor_o_igual_65_anos', 'Mujer >= 65 años', ['class' => 'col-xs-9 control-label']); ?>

						<div class="col-xs-3">
							<?php echo Form::checkbox('mujer_mayor_o_igual_65_anos', 1, false); ?>

						</div>
					</div>
				</div>
			<?php endif; ?>

			<?php if($pacienteSolicitado->sexo == 'i'): ?>
				<div class="clearfix"></div>
			<?php endif; ?>

			<?php if($pacienteSolicitado->sexo == 'm' || $pacienteSolicitado->sexo == 'i'): ?>
				<div class="col-xs-4">
					<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('circunferencia_abdominal_mayor_o_igual_102_en_hombres')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
						<?php echo Form::label('circunferencia_abdominal_mayor_o_igual_102_en_hombres', 'Circunferencia abdominal >= 102 en hombres', ['class' => 'col-xs-10 control-label']); ?>

						<div class="col-xs-2">
							<?php echo Form::checkbox('circunferencia_abdominal_mayor_o_igual_102_en_hombres', 1, false); ?>

						</div>
					</div>
				</div>
			<?php endif; ?>

			<?php if($pacienteSolicitado->sexo == 'f' || $pacienteSolicitado->sexo == 'i'): ?>
				<div class="col-xs-4">
					<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('circunferencia_abdominal_mayor_o_igual_88_en_mujeres')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
						<?php echo Form::label('circunferencia_abdominal_mayor_o_igual_88_en_mujeres', 'Circunferencia abdominal >= 88 en mujeres', ['class' => 'col-xs-10 control-label']); ?>

						<div class="col-xs-2">
							<?php echo Form::checkbox('circunferencia_abdominal_mayor_o_igual_88_en_mujeres', 1, false); ?>

						</div>
					</div>
				</div>
			<?php endif; ?>

			<?php if($pacienteSolicitado->sexo == 'i'): ?>
				<div class="clearfix"></div>
			<?php endif; ?>

			<div class="col-xs-2">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('tabaquismo')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('tabaquismo', 'Tabaquisco', ['class' => 'col-xs-9 control-label']); ?>

					<div class="col-xs-3">
						<?php echo Form::checkbox('tabaquismo', 1, false); ?>

					</div>
				</div>
			</div>

			<?php if($pacienteSolicitado->sexo == 'i'): ?>
				<div class="clearfix"></div>
			<?php endif; ?>

			<?php if($pacienteSolicitado->sexo == 'm' || $pacienteSolicitado->sexo == 'i'): ?>
				<div class="col-xs-3">
					<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('hdl_menor_40_mg_dl_en_hombres')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
						<?php echo Form::label('hdl_menor_40_mg_dl_en_hombres', 'HDL < 40 mg/dl en hombres', ['class' => 'col-xs-9 control-label']); ?>

						<div class="col-xs-3">
							<?php echo Form::checkbox('hdl_menor_40_mg_dl_en_hombres', 1, false); ?>

						</div>
					</div>
				</div>
			<?php endif; ?>

			<?php if($pacienteSolicitado->sexo == 'f' || $pacienteSolicitado->sexo == 'i'): ?>
				<div class="col-xs-3">
					<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('hdl_menor_48_mg_dl_en_mujeres')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
						<?php echo Form::label('hdl_menor_48_mg_dl_en_mujeres', 'HDL < 48 mg/dl en mujeres', ['class' => 'col-xs-9 control-label']); ?>

						<div class="col-xs-3">
							<?php echo Form::checkbox('hdl_menor_48_mg_dl_en_mujeres', 1, false); ?>

						</div>
					</div>
				</div>
			<?php endif; ?>

			<?php if($pacienteSolicitado->sexo == 'i'): ?>
				<div class="clearfix"></div>
			<?php endif; ?>

			<?php /* 2 */ ?>
			<div class="col-xs-3">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('colesterol_total_mayor_255_mg_dl')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('colesterol_total_mayor_255_mg_dl', 'Colesterol total > 255 mg/dl', ['class' => 'col-xs-9 control-label']); ?>

					<div class="col-xs-3">
						<?php echo Form::checkbox('colesterol_total_mayor_255_mg_dl', 1, false); ?>

					</div>
				</div>
			</div>

			<?php if($pacienteSolicitado->sexo == 'i'): ?>
				<div class="clearfix"></div>
			<?php endif; ?>

			<?php if($pacienteSolicitado->sexo == 'm' || $pacienteSolicitado->sexo == 'i'): ?>
				<div class="col-xs-4">
					<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('historia_familiar_ecv_menor_55_anos_en_hombres')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
						<?php echo Form::label('historia_familiar_ecv_menor_55_anos_en_hombres', 'Historia familiar ECV < 55 anos en hombres', ['class' => 'col-xs-10 control-label']); ?>

						<div class="col-xs-2">
							<?php echo Form::checkbox('historia_familiar_ecv_menor_55_anos_en_hombres', 1, false); ?>

						</div>
					</div>
				</div>
			<?php endif; ?>

			<?php if($pacienteSolicitado->sexo == 'f' || $pacienteSolicitado->sexo == 'i'): ?>
				<div class="col-xs-4">
					<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('historia_familiar_ecv_menor_65_anos_en_mujeres')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
						<?php echo Form::label('historia_familiar_ecv_menor_65_anos_en_mujeres', 'Historia familiar ECV < 65 anos en mujeres', ['class' => 'col-xs-10 control-label']); ?>

						<div class="col-xs-2">
							<?php echo Form::checkbox('historia_familiar_ecv_menor_65_anos_en_mujeres', 1, false); ?>

						</div>
					</div>
				</div>
			<?php endif; ?>

			<?php if($pacienteSolicitado->sexo == 'i'): ?>
				<div class="clearfix"></div>
			<?php endif; ?>

			<div class="col-xs-2">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('ta')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('ta', 'TA', ['class' => 'col-xs-9 control-label']); ?>

					<div class="col-xs-3">
						<?php echo Form::checkbox('ta', 1, false); ?>

					</div>
				</div>
			</div>

			<div class="col-xs-3">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('ldl_mayor_155_mg_dl')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('ldl_mayor_155_mg_dl', 'LDL > 155 mg dl', ['class' => 'col-xs-9 control-label']); ?>

					<div class="col-xs-3">
						<?php echo Form::checkbox('ldl_mayor_155_mg_dl', 1, false); ?>

					</div>
				</div>
			</div>

		</div>
	</a>

	<a class="list-group-item">
		<div class="row">

			<div class="col-xs-12">
				<table class="table table-bordered table-condensed informe">
					<thead>
						<th>FACTORES DE RIESGO \ TENSIÓN ARTERIAL</th>
						<th>PAS 140 - 159 | PAD 90 - 99</th>
						<th>PAS 140 - 159 | PAD 90 - 99</th>
						<th>PAS 140 - 159 | PAD 90 - 99</th>
					</thead>
					<tbody>
						<tr>
							<th>SIN FACTORES DE RIESGO</th>
							<td>RIESGO BAJO</td>
							<td>RIESGO MODERADO</td>
							<td>RIESGO ALTO</td>
						</tr>
						<tr>
							<th>1 - 2 FACTORES DE RIESGO</th>
							<td>RIESGO MODERADO</td>
							<td>RIESGO MODERADO</td>
							<td>RIESGO MUY ALTO</td>
						</tr>
						<tr>
							<th>3 Ó MÁS FACTORES DE RIESGO, LESIÓN DE ÓRGANO BLANCO O DIABETES</th>
							<td>RIESGO ALTO</td>
							<td>RIESGO ALTO</td>
							<td>RIESGO MUY ALTO</td>
						</tr>
						<tr>
							<th>CONDICIONES CLÍNICAS ASOCIADAS</th>
							<td>RIESGO MUY ALTO</td>
							<td>RIESGO MUY ALTO</td>
							<td>RIESGO MUY ALTO</td>
						</tr>
					</tbody>
				</table>
			</div>

		</div>

		<div class="row formulario-horizontal">
			<div class="col-xs-12">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('entidad_id')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<div class="col-xs-3 ">
						<label class="radio-inline">
							<?php echo Form::radio('factores_de_riesgo_cardiovascular', 1); ?>

							Bajo < 15 %
						</label>
					</div>
					<div class="col-xs-3">
						<label class="radio-inline">
							<?php echo Form::radio('factores_de_riesgo_cardiovascular', 2); ?>

							Moderado 15 - 20%
						</label>
					</div>
					<div class="col-xs-3">
						<label class="radio-inline">
							<?php echo Form::radio('factores_de_riesgo_cardiovascular', 3); ?>

							Alto 20 - 30%
						</label>
					</div>
					<div class="col-xs-3">
						<label class="radio-inline">
							<?php echo Form::radio('factores_de_riesgo_cardiovascular', 4); ?>

							Muy alto > 30%
						</label>
					</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 '<?php if(count($errors)): ?> <?php if($errors->has('ta_sentado')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('ta_sentado', 'TA sentado', ['class' => 'col-xs-4 control-label']); ?>

					<div class="col-xs-8">
						<div class="input-group">
							<?php echo Form::text('ta_sentado', 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 '<?php if(count($errors)): ?> <?php if($errors->has('ta_de_pie')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('ta_de_pie', 'TA de pié', ['class' => 'col-xs-4 control-label']); ?>

					<div class="col-xs-8">
						<div class="input-group">
							<?php echo Form::text('ta_de_pie', 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 '<?php if(count($errors)): ?> <?php if($errors->has('ta_acostado')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('ta_acostado', 'TA acostado', ['class' => 'col-xs-4 control-label']); ?>

					<div class="col-xs-8">
						<div class="input-group">
							<?php echo Form::text('ta_acostado', 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 '<?php if(count($errors)): ?> <?php if($errors->has('fc')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('fc', 'FC', ['class' => 'col-xs-4 control-label']); ?>

					<div class="col-xs-8">
						<div class="input-group">
							<?php echo 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 '<?php if(count($errors)): ?> <?php if($errors->has('fr')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('fr', 'FR', ['class' => 'col-xs-4 control-label']); ?>

					<div class="col-xs-8">
						<div class="input-group">
							<?php echo 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 '<?php if(count($errors)): ?> <?php if($errors->has('peso')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('peso', 'Peso', ['class' => 'col-xs-4 control-label']); ?>

					<div class="col-xs-8">
						<div class="input-group">
							<?php echo 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 '<?php if(count($errors)): ?> <?php if($errors->has('talla')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('talla', 'Talla', ['class' => 'col-xs-4 control-label']); ?>

					<div class="col-xs-8">
						<div class="input-group">
							<?php echo 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 '<?php if(count($errors)): ?> <?php if($errors->has('imc')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('imc', 'IMC', ['class' => 'col-xs-4 control-label']); ?>

					<div class="col-xs-8">
						<div class="input-group">
							<?php echo 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 '<?php if(count($errors)): ?> <?php if($errors->has('perimetro_abdominal')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('perimetro_abdominal', 'Perímetro abdominal', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-6">
						<div class="input-group">
							<?php echo Form::text('perimetro_abdominal', 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 '<?php if(count($errors)): ?> <?php if($errors->has('creatinina')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('creatinina', 'Creatinina', ['class' => 'col-xs-4 control-label']); ?>

					<div class="col-xs-8">
						<div class="input-group">
							<?php echo Form::text('creatinina', null, ['class' => 'form-control','required']); ?>

							<span class="input-group-addon">mg / dL</span>
						</div>
					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('tfg')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('tfg', 'TFG', ['class' => 'col-xs-4 control-label']); ?>

					<div class="col-xs-8">
						<div class="input-group">
							<?php echo Form::text('tfg', null, ['class' => 'form-control', 'readonly']); ?>

							<span class="input-group-addon">mL / min / 1.73</span>
						</div>
					</div>
				</div>
			</div>

		</div>
	</a>

	<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 '<?php if(count($errors)): ?> <?php if($errors->has('paciente')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('paciente', 'Paciente', ['class' => 'col-xs-4 control-label']); ?>

					<div class="col-xs-8">
						<?php echo Form::textarea('paciente', null, ['class' => 'form-control', 'rows' => 3,'required']); ?>

					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('cabeza_y_orl')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('cabeza_y_orl', 'Cabeza y orl', ['class' => 'col-xs-4 control-label']); ?>

					<div class="col-xs-8">
						<?php echo Form::textarea('cabeza_y_orl', null, ['class' => 'form-control', 'rows' => 3,'required']); ?>

					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('fondo_de_ojo')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('fondo_de_ojo', 'Fondo de ojo', ['class' => 'col-xs-4 control-label']); ?>

					<div class="col-xs-8">
						<?php echo Form::textarea('fondo_de_ojo', null, ['class' => 'form-control', 'rows' => 3,'required']); ?>

					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('cuello')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('cuello', 'Cuello', ['class' => 'col-xs-4 control-label']); ?>

					<div class="col-xs-8">
						<?php echo Form::textarea('cuello', null, ['class' => 'form-control', 'rows' => 3,'required']); ?>

					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('torax_y_cp')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('torax_y_cp', 'Torax y cp', ['class' => 'col-xs-4 control-label']); ?>

					<div class="col-xs-8">
						<?php echo Form::textarea('torax_y_cp', null, ['class' => 'form-control', 'rows' => 3,'required']); ?>

					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('abdomen')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('abdomen', 'Abdomen', ['class' => 'col-xs-4 control-label']); ?>

					<div class="col-xs-8">
						<?php echo Form::textarea('abdomen', null, ['class' => 'form-control', 'rows' => 3,'required']); ?>

					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('extremidades')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('extremidades', 'Extremidades', ['class' => 'col-xs-4 control-label']); ?>

					<div class="col-xs-8">
						<?php echo Form::textarea('extremidades', null, ['class' => 'form-control', 'rows' => 3,'required']); ?>

					</div>
				</div>
			</div>

			<div class="col-xs-4">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('piel')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('piel', 'Piel', ['class' => 'col-xs-4 control-label']); ?>

					<div class="col-xs-8">
						<?php echo 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 '<?php if(count($errors)): ?> <?php if($errors->has('neurologico')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('neurologico', 'Neurológico', ['class' => 'col-xs-4 control-label']); ?>

					<div class="col-xs-8">
						<?php echo Form::textarea('neurologico', null, ['class' => 'form-control', 'rows' => 3,'required']); ?>

					</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 '<?php if(count($errors)): ?> <?php if($errors->has('auto_carga')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
						<?php echo Form::label('auto_carga', 'Auto Cargado', $consulta->detalle, ['class' => 'control-label']); ?>

						<?php echo Form::textarea('auto_carga', $consulta->detalle, ['class' => 'form-control', 'rows' => 8, 'maxlength' => 2000,'disabled']); ?>

					</div>
				</div>
			</div>
		</div>
	</a>	
		<?php echo $__env->make('componentes/formulario-diagnosticos', array_except(get_defined_vars(), array('__data', '__path')))->render(); ?>
	<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 '<?php if(count($errors)): ?> <?php if($errors->has('analisis')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
						<?php echo Form::label('analisis', 'Análisis', ['class' => 'control-label']); ?>

						<?php echo Form::textarea('analisis', null, ['class' => 'form-control', 'rows' => 8, 'maxlength' => 2000,'required']); ?>

						<?php if( ! isset($formulario) ): ?>
							<span id="contador-analisis">0 de 2000</span>
						<?php endif; ?>
					</div>
				</div>

				<div class="col-sm-4">
					<div class="form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('conducta')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
						<?php echo Form::label('conducta', 'Conducta', ['class' => 'control-label']); ?>

						<?php echo Form::textarea('conducta', null, ['class' => 'form-control', 'rows' => 8, 'maxlength' => 2000,'required']); ?>

						<?php if( ! isset($formulario) ): ?>
							<span id="contador-conducta">0 de 2000</span>
						<?php endif; ?>
					</div>
				</div>

				<div class="col-sm-4">
					<div class="form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('recomendaciones')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
						<?php echo Form::label('recomendaciones', 'Recomendaciones', ['class' => 'control-label']); ?>

						<?php echo Form::textarea('recomendaciones', null, ['class' => 'form-control', 'rows' => 8, 'maxlength' => 2000,'required']); ?>

						<?php if( ! isset($formulario) ): ?>
							<span id="contador-recomendaciones">0 de 2000</span>
						<?php endif; ?>
					</div>
				</div>

			</div>
		</div>
	</a>

	<?php if(isset($formulario)): ?> <?php /* Para poder ver y utilizar el form model */ ?>

		<?php echo $__env->make('componentes.lista-de-medicamentos', array_except(get_defined_vars(), array('__data', '__path')))->render(); ?>
		<?php echo $__env->make('componentes.lista-de-procedimientos', array_except(get_defined_vars(), array('__data', '__path')))->render(); ?>
		<?php echo $__env->make('componentes.lista-de-remisiones', array_except(get_defined_vars(), array('__data', '__path')))->render(); ?>

		<?php echo Form::close(); ?>

	<?php elseif(isset($ultimoFormulario) || !isset($formulario)): ?>
		<?php echo $__env->make('componentes.modal-confirmar-registro-de-seguimineto', array_except(get_defined_vars(), array('__data', '__path')))->render(); ?>

		<?php echo Form::hidden('paciente_id', $paciente); ?>

		<?php echo Form::hidden('programa', $programa); ?>


		<?php echo Form::close(); ?>


		<a class="list-group-item">
			<div class="row formulario-horizontal">
				<div class="col-xs-12 text-right">
					<?php echo $__env->make('componentes.boton-guardar-seguimiento', array_except(get_defined_vars(), array('__data', '__path')))->render(); ?>
				</div>
			</div>
		</a>
	<?php endif; ?>

</div> <?php /* list group */ ?>

<?php /* Cargar los inputs tipo custom de fecha y hora cuando se solicita el formulario actual desde seguimiento o inscripción */ ?>
<?php echo $__env->make('componentes.script-cargar-inputs-fecha-hora-desde-seguimiento', array_except(get_defined_vars(), array('__data', '__path')))->render(); ?>
