@extends('layouts.master-horizontal')
@section('title') @lang('Portal Regional de Notificación en línea de Sospecha de Reacciones Adversas a Medicamentos de uso humano') @endsection

@section('css')
    <link href="{{ URL::asset('assets/libs/jquery-ui/jquery-ui.min.css')}}" type="text/css" />
    <link href="{{ URL::asset('assets/css/bootstrap.min.css')}}" id="bootstrap-style" rel="stylesheet" type="text/css" />
	<link href="{{ URL::asset('assets/css/app.min.css')}}" id="app-style" rel="stylesheet" type="text/css" />
    <link href="{{ URL::asset('assets/libs/twitter-bootstrap-wizard/twitter-bootstrap-wizard.min.css')}}" rel="stylesheet" type="text/css" />


@endsection

@section('content')
@component('common-components.breadcrumb')
    @slot('pagetitle') @lang('translation.Gestión Usuarios') @endslot
    @slot('title') @lang('translation.Administración de Usuarios') @endslot
@endcomponent
<div class="row">
    <div class="col-lg-12">
        <div class="card">
            <div class="card-body">
                <!--fin botones flotantes --> 
                <h4 class="card-title mb-4">@lang('translation.Menu principal / Alta')</h4>
                <!-- FORMULARIO 1 ------------------------------------------------->
                <hr>
                <br>
                @if ($errors->any())
                    <div class="alert alert-danger">
                        <ul>
                            @foreach ($errors->all() as $error)
                                <li>{{ $error }}</li>
                            @endforeach
                        </ul>
                    </div>
                @endif
				<br>
				@include('flash::message')
                <div class="tab-pane" id="progress-seller-details">
                    <h5>@lang('translation.Datos usuario')</h5>
                    <hr>
                    <h5></h5>
                    <form class="custom-validation" id="formPaciente"  method="post" action="{{Route('usuario.store')}}" data-parsley-validate>
                        @csrf
                        <div class="mb-3 row"> 
                            <label for="progresspill-phoneno-input" class="col-md-2 col-form-label">@lang('translation.Código')<span class="text-danger">(*)</span></label>
                            <div class="col-md-8">
                                <input type="text" class="form-control parsley-error" id="codigo" name="codigo"  required placeholder="Código de usuario">
                            </div>                            
                        </div>
                        <div class="mb-3 row"> 
                            <label for="progresspill-phoneno-input" class="col-md-2 col-form-label">@lang('translation.Nombre')<span class="text-danger">(*)</span></label>
                            <div class="col-md-8">
                                <input type="text" class="form-control parsley-error" id="nombre" name="nombre" data-parsley-pattern="^[a-zA-Z ]+$"  data-parsley-trigger="keyup" required placeholder="Nombre">
                            </div>                            
                        </div>
                        <div class="mb-3 row"> 
                            <label for="progresspill-phoneno-input" class="col-md-2 col-form-label">@lang('translation.Apellidos')<span class="text-danger">(*)</span></label>
                            <div class="col-md-8">
                                <input type="text" class="form-control parsley-error" id="apellido" name="apellido" data-parsley-pattern="^[a-zA-Z ]+$"  data-parsley-trigger="keyup" required placeholder="Apellido">
                            </div>                            
                        </div>
                        <div class="mb-3 row">
                            <label for="progresspill-phoneno-input" class="col-md-2 col-form-label">@lang('Télefono')</label>
                            <div class="col-md-8">
                                <input type="text" class="form-control parsley-error" id="telefono" name="telefono" data-parsley-pattern="^[0-9 ]+$"  data-parsley-trigger="keyup" required placeholder="Telefono">
                            </div>
                        </div>
                        <div class="mb-3 row">
                            <label for="progresspill-phoneno-input" class="col-md-2 col-form-label">@lang('Email')<span class="text-danger">(*)</span></label>
                            <div class="col-md-8">
                                <input type="email" class="form-control parsley-error" id="email" name="email" required placeholder="eMail">
                            </div>
                        </div>
                        <div class="mb-3 row">
                            <label for="progresspill-phoneno-input" class="col-md-2 col-form-label">@lang('Confimar email')<span class="text-danger">(*)</span></label>
                            <div class="col-md-8">
                                <input type="email" class="form-control parsley-error" id="confirmar_email" name="confirmar_email"  required placeholder="Confirmacion eMail">
                            </div>
                        </div>
                        <div class="mb-3 row">
                            <label for="progresspill-firstname-input" class="col-md-2 col-form-label">@lang('País')</label>
                            <div class="col-md-8">
                                <select class="form-control" data-live-search="true" name="id_pais" id="id_pais" >
                                    <option value="" >Seleccione</option>
                                    @foreach($pais as $item)
                                            <option   value="{{ $item->PAIS_ID_PAIS }}">{{ $item->PAIS_NOMBRE }} </option>
                                    @endforeach       
                                </select>
                            </div>
                        </div>
                        <div class="mb-3 row">
                            <label for="progresspill-phoneno-input" class="col-md-2 col-form-label">@lang('Fecha Baja')</label>
                            <div class="col-md-8">
                                <input type="date" class="form-control parsley-error" id="fecha" name="fecha">
                            </div>
                        </div>
                        <div class="mb-3 row">
                            <label for="progresspill-phoneno-input" class="col-md-2 col-form-label">Password</label>
                            <div class="col-md-8">
                                <input type="password" class="form-control parsley-error" id="password" name="password">
                            </div>
                        </div>
                        <div class="mb-3 row">        
                            <label for="example-text-input" class="col-md-2 col-form-label">@lang('Usuario bloqueado')</label>
                            <div class="col-md-8">
                                <div class="custom-control custom-checkbox">
                                    <input type="checkbox" class="custom-control-input jqcheck1" name="user_bloqueado" id="user_bloqueado" value="1">
                                    <label class="custom-control-label" for="user_bloqueado"></label>
                                </div>
                            </div>
                        </div>
                        <div class="row">
                            <div class="col-md-12">
                                <button type="submit" class="btn btn-primary w-md" id="guardar">@lang('Guardar Datos')</button>
                            </div>
                        </div>
                    </form>
                </div>
            </div>
        </div>
    </div>
</div>
<!-- end row -->

@endsection
@section('script')
    <script src="{{ URL::asset('assets/libs/twitter-bootstrap-wizard/twitter-bootstrap-wizard.min.js')}}"></script>
    <script src="{{ URL::asset('assets/js/pages/form-wizard.init.js')}}"></script>
    <script src="{{ URL::asset('assets/libs/jquery-ui/jquery-ui.min.js')}}"></script>
    <script> 








    </script>
@endsection