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

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

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

		</div>
	</a>

	<a class="list-group-item">
		<p class="list-group-item-heading"><b>Adicionalmente se realizan las siguientes preguntas a la paciente:</b></p>
		<div class="row formulario-horizontal">

			<div class="col-xs-7">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('conoce_los')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('conoce_los', 'Conoce los derechos y deberes en salud sexual y reproductiva ?', ['class' => 'col-xs-9 control-label']); ?>

					<div class="col-xs-1">
						<label class="radio-inline">
							<?php echo Form::radio('conoce_los', 1); ?>

							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							<?php echo Form::radio('conoce_los', 0, true); ?>

							no
						</label>
					</div>
				</div>
			</div>

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

					<div class="col-xs-2">
						<label class="radio-inline">
							<?php echo Form::radio('paridad_satisfecha', 1); ?>

							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							<?php echo Form::radio('paridad_satisfecha', 0, true); ?>

							no
						</label>
					</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('satisfaccion_con')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('satisfaccion_con', 'Satisfacción con la vida sexual ?', ['class' => 'col-xs-8 control-label']); ?>

					<div class="col-xs-2">
						<label class="radio-inline">
							<?php echo Form::radio('satisfaccion_con', 1); ?>

							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							<?php echo Form::radio('satisfaccion_con', 0, true); ?>

							no
						</label>
					</div>
				</div>
			</div>

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

					<div class="col-xs-2">
						<label class="radio-inline">
							<?php echo Form::radio('uso_de', 1); ?>

							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							<?php echo Form::radio('uso_de', 0, true); ?>

							no
						</label>
					</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('violencia_de')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('violencia_de', 'Violencia de género ?', ['class' => 'col-xs-8 control-label']); ?>

					<div class="col-xs-2">
						<label class="radio-inline">
							<?php echo Form::radio('violencia_de', 1); ?>

							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							<?php echo Form::radio('violencia_de', 0,true); ?>

							no
						</label>
					</div>
				</div>
			</div>

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

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

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

		</div>
	</a>

	<a class="list-group-item">
		<p class="list-group-item-heading"><b>Antecedentes</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_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('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>

<!-- asi estaba...lo deje de muestra !!!
			<div class="col-xs-4">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('antecedentes_ginecoobtetricios')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('antecedentes_ginecoobtetricios', 'Antecedentes gineco-obtetricios', ['class' => 'col-xs-7 control-label']); ?>

					<div class="col-xs-5">
						<?php echo Form::text('antecedentes_ginecoobtetricios', 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_ginecoobtetricios')): ?>
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<div class="col-xs-5">
						<?php echo Form::hidden('antecedentes_ginecoobtetricios', 0, ['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_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-5">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('realizacion_de_cirugias_abdominopelvicas')): ?>
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('realizacion_de_cirugias_abdominopelvicas', 'Realización de cirugias abdominopélvicas ?', ['class' => 'col-xs-8 control-label']); ?>

					<div class="col-xs-2">
						<label class="radio-inline">
							<?php echo Form::radio('realizacion_de_cirugias_abdominopelvicas', 1); ?>

							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							<?php echo Form::radio('realizacion_de_cirugias_abdominopelvicas', 0, true); ?>

							no
						</label>
					</div>
				</div>
			</div>

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

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

					</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('consumo_de_tabaco')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('consumo_de_tabaco', 'Consumo de tabaco ?', ['class' => 'col-xs-8 control-label']); ?>

					<div class="col-xs-2">
						<label class="radio-inline">
							<?php echo Form::radio('consumo_de_tabaco', 1); ?>

							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							<?php echo Form::radio('consumo_de_tabaco', 0,true); ?>

							no
						</label>
					</div>
				</div>
			</div>

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

					<div class="col-xs-6">
						<?php echo Form::text('cantidad_frecuencia_consumo_de_tabaco', 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('isiniciovicio')): ?>
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('isiniciovicio', 'Inicio Vida Sexual ?', ['class' => 'col-xs-8 control-label']); ?>

					<div class="col-xs-2">
						<label class="radio-inline">
							<?php echo Form::radio('isiniciovicio', 1, false, ['onClick' => 'validaInicioSexual()']); ?>

							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							<?php echo Form::radio('isiniciovicio', 0,true,['onClick' => 'validaInicioSexual()']); ?>

							no
						</label>
					</div>
				</div>
			</div>

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

					<div class="col-xs-4">
						<?php if(isset($ultimoFormulario->isiniciovicio)): ?>
								<?php if($ultimoFormulario->isiniciovicio): ?>
										<?php echo Form::number('edad_inicio_vida_sexual', null, ['class' => 'form-control', 'min' => 0, 'max' => 200, 'required']); ?>

								<?php else: ?>
											<?php echo Form::number('edad_inicio_vida_sexual', null, ['class' => 'form-control', 'min' => 0, 'max' => 200, 'disabled', 'required']); ?>

								<?php endif; ?>
						<?php else: ?>
								<?php echo Form::number('edad_inicio_vida_sexual', null, ['class' => 'form-control', 'min' => 0, 'max' => 200, 'disabled', 'required']); ?>

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

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

					<div class="col-xs-4">
						<?php echo Form::number('numero_de_companeros_sexuales', null, ['class' => 'form-control', 'min' => 0, 'max' => 200, 'required']); ?>

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

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

			<div class="col-xs-5">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('antecedente_de_ets_epi_leucorreas_dispareunia')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('antecedente_de_ets_epi_leucorreas_dispareunia', 'Antecedente de ETS EPI leucorreas dispareunia', ['class' => 'col-xs-8 control-label']); ?>

					<div class="col-xs-2">
						<label class="radio-inline">
							<?php echo Form::radio('antecedente_de_ets_epi_leucorreas_dispareunia', 1); ?>

							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							<?php echo Form::radio('antecedente_de_ets_epi_leucorreas_dispareunia', 0,true); ?>

							no
						</label>
					</div>
				</div>
			</div>

			<div class="col-xs-3">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('cual_antecedente_de_ets_epi_leucorreas_dispareunia')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('cual_antecedente_de_ets_epi_leucorreas_dispareunia', 'Cual ?', ['class' => 'col-xs-4 control-label']); ?>

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

					</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('menarquia')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('menarquia', 'Menarquía', ['class' => 'col-xs-4 control-label']); ?>

					<div class="col-xs-8">
						<?php echo Form::text('menarquia', null, ['class' => 'form-control', 'min' => 0, 'max' => 200, 'required']); ?>

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

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

					<div class="col-xs-8">
						<?php echo Form::text('fum', null, ['class' => 'form-control', 'min' => 0, 'max' => 200, 'required']); ?>

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

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

					<div class="col-xs-7">
						<?php echo Form::text('ciclos_mestruales', null, ['class' => 'form-control', 'min' => 0, 'max' => 200,'required']); ?>

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

			<div class="col-xs-3">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('gestaciones')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('gestaciones', 'Gestaciones', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-6">
						<?php echo Form::number('gestaciones', null, ['class' => 'form-control', 'min' => 0, 'max' => 200,' required']); ?>

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

			<div class="col-xs-3">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('partos')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('partos', 'Partos', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-6">
						<?php echo Form::number('partos', null, ['class' => 'form-control', 'min' => 0, 'max' => 200,' required']); ?>

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

			<div class="col-xs-3">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('cesarias')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('cesarias', 'Cesáreas', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-6">
						<?php echo Form::number('cesarias', null, ['class' => 'form-control', 'min' => 0, 'max' => 200, 'required']); ?>

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

			<div class="col-xs-3">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('abortos')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('abortos', 'Abortos', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-6">
						<?php echo Form::number('abortos', null, ['class' => 'form-control', 'min' => 0, 'max' => 200, 'required']); ?>

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

			<div class="col-xs-3">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('ectopicos')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('ectopicos', 'Ectópicos', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-6">
						<?php echo Form::number('ectopicos', null, ['class' => 'form-control', 'min' => 0, 'max' => 200, 'required']); ?>

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

			<div class="col-xs-3">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('molas')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('molas', 'Molas', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-6">
						<?php echo Form::number('molas', null, ['class' => 'form-control', 'min' => 0, 'max' => 200, 'required']); ?>

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

			<div class="col-xs-3">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('nacidos_vivos')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('nacidos_vivos', 'Nacidos vivos', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-6">
						<?php echo Form::number('nacidos_vivos', null, ['class' => 'form-control', 'min' => 0, 'max' => 200, 'required']); ?>

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

			<div class="col-xs-3">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('nacidos_muertos')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('nacidos_muertos', 'Nacidos muertos', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-6">
						<?php echo Form::number('nacidos_muertos', null, ['class' => 'form-control', 'min' => 0, 'max' => 200, 'required']); ?>

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

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

					<div class="col-xs-2">
						<label class="radio-inline">
							<?php echo Form::radio('isultimoparto', 1,false, ['onClick' => 'validaParto()']); ?>

							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							<?php echo Form::radio('isultimoparto', 0,true,['onClick' => 'validaParto()']); ?>

							no
						</label>
					</div>
				</div>
			</div>

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

					<div class="col-xs-6">
						<?php if(isset($ultimoFormulario->isultimoparto)): ?>
							<?php if($ultimoFormulario->isultimoparto): ?>
								<?php echo Form::text('fecha_ultimo_parto', null, ['class' => 'form-control', 'id' => 'fecha_ultimo_parto']); ?>

							<?php else: ?>
								<?php echo Form::text('fecha_ultimo_parto', null, ['class' => 'form-control', 'id' => 'fecha_ultimo_parto', 'disabled']); ?>

							<?php endif; ?>
						<?php else: ?>
							<?php echo Form::text('fecha_ultimo_parto', null, ['class' => 'form-control', 'id' => 'fecha_ultimo_parto', 'disabled']); ?>

						<?php endif; ?>
					</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('isultimacitologia')): ?>
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('isultimacitologia', 'Última Citología ?', ['class' => 'col-xs-8 control-label']); ?>

					<div class="col-xs-2">
						<label class="radio-inline">
							<?php echo Form::radio('isultimacitologia', 1,false, ['onClick' => 'validaCitologia()']); ?>

							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							<?php echo Form::radio('isultimacitologia', 0,true,['onClick' => 'validaCitologia()']); ?>

							no
						</label>
					</div>
				</div>
			</div>

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

					<div class="col-xs-6">
						<?php if(isset($ultimoFormulario->isultimacitologia)): ?>
							<?php if($ultimoFormulario->isultimacitologia): ?>
									<?php echo Form::text('fecha_ultima_citologia', null, ['class' => 'form-control', 'id ' => 'fecha_ultima_citologia','required']); ?>

							<?php else: ?>
									<?php echo Form::text('fecha_ultima_citologia', null, ['class' => 'form-control', 'id ' => 'fecha_ultima_citologia','required', 'disabled']); ?>

							<?php endif; ?>
						<?php else: ?>
								<?php echo Form::text('fecha_ultima_citologia', null, ['class' => 'form-control', 'id ' => 'fecha_ultima_citologia','required', 'disabled']); ?>

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

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

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

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

			<div class="col-xs-8">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('metodos_de_planificacion_utilizados_hasta_la_fecha')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('metodos_de_planificacion_utilizados_hasta_la_fecha', 'Métodos de planificacion utilizados hasta la fecha', ['class' => 'col-xs-6 control-label']); ?>

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

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

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

			<div class="col-xs-5">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('satisfaccion_con_los_metodos_utilizados')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('satisfaccion_con_los_metodos_utilizados', 'Satisfacción con los métodos utilizados', ['class' => 'col-xs-8 control-label']); ?>

					<div class="col-xs-2">
						<label class="radio-inline">
							<?php echo Form::radio('satisfaccion_con_los_metodos_utilizados', 1); ?>

							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							<?php echo Form::radio('satisfaccion_con_los_metodos_utilizados', 0,true); ?>

							no
						</label>
					</div>
				</div>
			</div>

			<div class="col-xs-5">
				<div class="form-group form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('adherencia_a_metodos_utilizados')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('adherencia_a_metodos_utilizados', 'Adherencia a métodos utilizados', ['class' => 'col-xs-8 control-label']); ?>

					<div class="col-xs-2">
						<label class="radio-inline">
							<?php echo Form::radio('adherencia_a_metodos_utilizados', 1); ?>

							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							<?php echo Form::radio('adherencia_a_metodos_utilizados', 0,true); ?>

							no
						</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" style="display: none;">
					<?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', 1, ['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" style="display: none;">
					<?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', 1, ['class' => 'form-control','required']); ?>

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

			<div class="col-xs-4" style="display: none;">
				<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', 1, ['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]); ?>

					</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]); ?>

					</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]); ?>

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

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

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

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

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

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

					</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]); ?>

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

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

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

					</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]); ?>

					</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>
	<?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-6">
					<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' => 7, 'maxlength' => 2000,'required']); ?>

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

				<div class="col-sm-6">
					<div class="form-group-sm '<?php if(count($errors)): ?> <?php if($errors->has('analisis_y_conducta')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
						<?php echo Form::label('analisis_y_conducta', 'Análisis y conducta', ['class' => 'control-label']); ?>

						<?php echo Form::textarea('analisis_y_conducta', null, ['class' => 'form-control', 'rows' => 7, 'maxlength' => 2000,'required']); ?>

						<?php if( ! isset($formulario) ): ?>
							<span id="contador-analisis_y_conducta">0 de 2000</span>
						<?php 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">
						<?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']); ?>

						<?php echo Form::hidden('auto_carga', $consulta->detalle); ?>

						
					</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(); ?>

<script>

	function validaInicioSexual(){
		if($('input:radio[name=isiniciovicio]:checked').val()==1){
				document.getElementById("edad_inicio_vida_sexual").disabled = false;
		}else{
			  document.getElementById("edad_inicio_vida_sexual").disabled = true;
				document.getElementById("edad_inicio_vida_sexual").value = "";
		}
	}

	function validaParto(){
		if($('input:radio[name=isultimoparto]:checked').val()==1){
				document.getElementById("fecha_ultimo_parto").disabled = false;
		}else{
			  document.getElementById("fecha_ultimo_parto").disabled = true;
				document.getElementById("fecha_ultimo_parto").value = "";
		}
	}

	function validaCitologia(){
			if($('input:radio[name=isultimacitologia]:checked').val()==1){
					document.getElementById("fecha_ultima_citologia").disabled = false;
			}else{
				  document.getElementById("fecha_ultima_citologia").disabled = true;
					document.getElementById("fecha_ultima_citologia").value = "";
			}
		}
</script>