<?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::text('revision_por_sistemas', null, ['class' => 'form-control']); ?>-->
						<?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>Antecedentes familiares</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('diabetes')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('diabetes', 'Diabetes', ['class' => 'col-xs-4 control-label']); ?>

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

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

							no
						</label>
					</div>
					<div class="col-xs-4">
						<label class="radio-inline">
							<?php echo Form::radio('diabetes', 2); ?>

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

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

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

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

							no
						</label>
					</div>
					<div class="col-xs-4">
						<label class="radio-inline">
							<?php echo Form::radio('tuberculosis', 2); ?>

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

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

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

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

							no
						</label>
					</div>
					<div class="col-xs-4">
						<label class="radio-inline">
							<?php echo Form::radio('alergias', 2); ?>

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

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

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

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

							no
						</label>
					</div>
					<div class="col-xs-4">
						<label class="radio-inline">
							<?php echo Form::radio('psiquiatricos', 2); ?>

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

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

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

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

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

			<div class="col-xs-6">
				<div class="form-group form-group-sm 
				'<?php if(count($errors)): ?> <?php if($errors->has('hermanos_desnutridos_menores_5_anos')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('hermanos_desnutridos_menores_5_anos', 'Hermanos desnutridos < 5 años', ['class' => 'col-xs-5 control-label']); ?>

					<div class="col-xs-1">
						<label class="radio-inline">
							<?php echo Form::radio('hermanos_desnutridos_menores_5_anos', 1); ?>

							si
						</label>
					</div>
					<div class="col-xs-1">
						<label class="radio-inline">
							<?php echo Form::radio('hermanos_desnutridos_menores_5_anos', 0, true); ?>

							no
						</label>
					</div>
					<div class="col-xs-4">
						<label class="radio-inline">
							<?php echo Form::radio('hermanos_desnutridos_menores_5_anos', 2); ?>

							no sabe
						</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('numero_hermanos_muertos_menores_5_anos')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('numero_hermanos_muertos_menores_5_anos', 'Número de hermanos muertos < 5 años', ['class' => 'col-xs-9 control-label']); ?>

					<div class="col-xs-3">
						<?php echo Form::number('numero_hermanos_muertos_menores_5_anos', null, ['class' => 'form-control', 'min' => 0, 'required']); ?>

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

			<div class="col-xs-3">
				<div class="form-group form-group-sm 
				'<?php if(count($errors)): ?> <?php if($errors->has('numero_hermanos_vivos')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('numero_hermanos_vivos', 'Número de hermanos vivos', ['class' => 'col-xs-8 control-label']); ?>

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

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

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

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

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

		</div>
	</a>

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

			<div class="col-xs-3">
				<div class="form-group form-group-sm 
				'<?php if(count($errors)): ?> <?php if($errors->has('atencion_prenatal')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('atencion_prenatal', 'Atencion prenatal', ['class' => 'col-xs-8 control-label']); ?>

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

							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							<?php echo Form::radio('atencion_prenatal', 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('embarazo_no_deseado')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('embarazo_no_deseado', 'Embarazo no deseado', ['class' => 'col-xs-8 control-label']); ?>

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

							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							<?php echo Form::radio('embarazo_no_deseado', 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('embarazo_normal')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('embarazo_normal', 'Embarazo normal', ['class' => 'col-xs-8 control-label']); ?>

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

							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							<?php echo Form::radio('embarazo_normal', 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('edad_de_la_madre_al_nacer_el_hijo')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('edad_de_la_madre_al_nacer_el_hijo', 'Edad de la madre al nacer el hijo', ['class' => 'col-xs-8 control-label']); ?>

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

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

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
				'<?php if(count($errors)): ?> <?php if($errors->has('edad_gestacional_nacer_el_hijo')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('edad_gestacional_nacer_el_hijo', 'Edad gestacional al nacer el hijo', ['class' => 'col-xs-8 control-label']); ?>

					<div class="col-xs-4">
						<?php echo Form::text('edad_gestacional_nacer_el_hijo', 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('enfermedades_durante_el_embarazo')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('enfermedades_durante_el_embarazo', 'Enfermedades durante el embarazo', ['class' => 'col-xs-8 control-label']); ?>

					<div class="col-xs-4">
						<?php echo Form::text('enfermedades_durante_el_embarazo', 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('enfermedades_del_recien_nacido')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('enfermedades_del_recien_nacido', 'Enfermedades del recién nacido', ['class' => 'col-xs-8 control-label']); ?>

					<div class="col-xs-4">
						<?php echo Form::text('enfermedades_del_recien_nacido', null, ['class' => 'form-control', 'required']); ?>

					</div>
				</div>
			</div>			
	
			<div class="col-xs-3">
				<div class="form-group form-group-sm 
				'<?php if(count($errors)): ?> <?php if($errors->has('parto_institucional')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('parto_institucional', 'Parto institucional', ['class' => 'col-xs-8 control-label']); ?>

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

							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							<?php echo Form::radio('parto_institucional', 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('parto_espontaneo')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('parto_espontaneo', 'Parto espontaneo', ['class' => 'col-xs-8 control-label']); ?>

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

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

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

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

			<div class="col-xs-3">
				<div class="form-group form-group-sm 
				'<?php if(count($errors)): ?> <?php if($errors->has('presentacion_cefalica')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('presentacion_cefalica', 'Presentación cefálica', ['class' => 'col-xs-8 control-label']); ?>

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

							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							<?php echo Form::radio('presentacion_cefalica', 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('producto_unico')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('producto_unico', 'Producto único', ['class' => 'col-xs-8 control-label']); ?>

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

							si
						</label>
					</div>
					<div class="col-xs-2">
						<label class="radio-inline">
							<?php echo Form::radio('producto_unico', 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('apgar')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('apgar', 'Apgar', ['class' => 'col-xs-4 control-label']); ?>

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

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

							no
						</label>
					</div>
					<div class="col-xs-4">
						<label class="radio-inline">
							<?php echo Form::radio('apgar', 2); ?>

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

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

					<div class="col-xs-6">
						<?php echo Form::number('obstetricos_peso', 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('obstetricos_talla')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('obstetricos_talla', 'Talla', ['class' => 'col-xs-6 control-label']); ?>

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

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

		</div>
	</a>

	<a class="list-group-item">
		<p class="list-group-item-heading"><b>Antecedentes patológicos</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('sarampion')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('sarampion', 'Sarampion', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-3">
						<label class="radio-inline">
							<?php echo Form::radio('sarampion', 1); ?>

							si
						</label>
					</div>
					<div class="col-xs-3">
						<label class="radio-inline">
							<?php echo Form::radio('sarampion', 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('tosferina')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('tosferina', 'Tosferina', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-3">
						<label class="radio-inline">
							<?php echo Form::radio('tosferina', 1); ?>

							si
						</label>
					</div>
					<div class="col-xs-3">
						<label class="radio-inline">
							<?php echo Form::radio('tosferina', 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('difteria')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('difteria', 'Difteria', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-3">
						<label class="radio-inline">
							<?php echo Form::radio('difteria', 1); ?>

							si
						</label>
					</div>
					<div class="col-xs-3">
						<label class="radio-inline">
							<?php echo Form::radio('difteria', 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('polio')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('polio', 'Polio', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-3">
						<label class="radio-inline">
							<?php echo Form::radio('polio', 1); ?>

							si
						</label>
					</div>
					<div class="col-xs-3">
						<label class="radio-inline">
							<?php echo Form::radio('polio', 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('parotiditis')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('parotiditis', 'Parotiditis', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-3">
						<label class="radio-inline">
							<?php echo Form::radio('parotiditis', 1); ?>

							si
						</label>
					</div>
					<div class="col-xs-3">
						<label class="radio-inline">
							<?php echo Form::radio('parotiditis', 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('diarrea')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('diarrea', 'diarrea', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-3">
						<label class="radio-inline">
							<?php echo Form::radio('diarrea', 1); ?>

							si
						</label>
					</div>
					<div class="col-xs-3">
						<label class="radio-inline">
							<?php echo Form::radio('diarrea', 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('enfermedades_respiratorias')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('enfermedades_respiratorias', 'Enfermedades respiratorias', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-3">
						<label class="radio-inline">
							<?php echo Form::radio('enfermedades_respiratorias', 1); ?>

							si
						</label>
					</div>
					<div class="col-xs-3">
						<label class="radio-inline">
							<?php echo Form::radio('enfermedades_respiratorias', 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('sindrome_convulsivo')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('sindrome_convulsivo', 'Síndrome convulsivo', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-3">
						<label class="radio-inline">
							<?php echo Form::radio('sindrome_convulsivo', 1); ?>

							si
						</label>
					</div>
					<div class="col-xs-3">
						<label class="radio-inline">
							<?php echo Form::radio('sindrome_convulsivo', 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('traumatismos')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('traumatismos', 'Traumatismos', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-3">
						<label class="radio-inline">
							<?php echo Form::radio('traumatismos', 1); ?>

							si
						</label>
					</div>
					<div class="col-xs-3">
						<label class="radio-inline">
							<?php echo Form::radio('traumatismos', 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('otros')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('otros', 'Otros', ['class' => 'col-xs-6 control-label']); ?>

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

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

		</div>
	</a>

	<a class="list-group-item">
		<p class="list-group-item-heading"><b>Antecedentes alimentarios</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('alimentarios')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('alimentarios', 'Alimentarios', ['class' => 'col-xs-4 control-label']); ?>

					<div class="col-xs-8">
						<?php echo Form::text('alimentarios', 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('lactancia_materna')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('lactancia_materna', 'Lactancia materna', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-3">
						<label class="radio-inline">
							<?php echo Form::radio('lactancia_materna', 1); ?>

							si
						</label>
					</div>
					<div class="col-xs-3">
						<label class="radio-inline">
							<?php echo Form::radio('lactancia_materna', 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('lactancia_materna_exclusiva_o_mixta')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('lactancia_materna_exclusiva_o_mixta', 'Tipo de lactancia materna', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-3">
						<label class="radio-inline">
							<?php echo Form::radio('lactancia_materna_exclusiva_o_mixta', 1); ?>

							exclusiva
						</label>
					</div>
					<div class="col-xs-3">
						<label class="radio-inline">
							<?php echo Form::radio('lactancia_materna_exclusiva_o_mixta', 0); ?>

							mixta
						</label>
					</div>
				</div>
			</div>

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

					<div class="col-xs-3">
						<label class="radio-inline">
							<?php echo Form::radio('otras_leches', 1); ?>

							si
						</label>
					</div>
					<div class="col-xs-3">
						<label class="radio-inline">
							<?php echo Form::radio('otras_leches', 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('alimentacion_complementaria')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('alimentacion_complementaria', 'Alimentacion complementaria', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-3">
						<label class="radio-inline">
							<?php echo Form::radio('alimentacion_complementaria', 1); ?>

							si
						</label>
					</div>
					<div class="col-xs-3">
						<label class="radio-inline">
							<?php echo Form::radio('alimentacion_complementaria', 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('edad_del_nino_al_destete')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('edad_del_nino_al_destete', 'Edad del nino al destete', ['class' => 'col-xs-8 control-label']); ?>

					<div class="col-xs-4">
						<?php echo Form::text('edad_del_nino_al_destete', 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('edad_del_nino_al_iniciar_otras_leches')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('edad_del_nino_al_iniciar_otras_leches', 'Edad del niño al iniciar otras leches', ['class' => 'col-xs-8 control-label']); ?>

					<div class="col-xs-4">
						<?php echo Form::text('edad_del_nino_al_iniciar_otras_leches', 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('cuales_leches')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('cuales_leches', 'Cuales leches', ['class' => 'col-xs-4 control-label']); ?>

					<div class="col-xs-8">
						<?php echo Form::text('cuales_leches', null, ['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('edad_del_nino_al_iniciar_alimentacion_complementaria')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('edad_del_nino_al_iniciar_alimentacion_complementaria', 'Edad del nino al iniciar alimentacion complementaria', ['class' => 'col-xs-8 control-label']); ?>

					<div class="col-xs-4">
						<?php echo Form::text('edad_del_nino_al_iniciar_alimentacion_complementaria', null, ['class' => 'form-control', 'required']); ?>

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

		</div>
	</a>

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

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

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

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

			<div class="col-xs-3">
				<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', '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-3">
				<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', 'Toxico alérgicos', ['class' => 'col-xs-6 control-label']); ?>

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

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

			<div class="col-xs-3">
				<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', 'Farmacológicos', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-6">
						<?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>Psicosocial</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('riesgos_psicosociales')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('riesgos_psicosociales', 'Riesgos psicosociales', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-6">
						<?php echo Form::text('riesgos_psicosociales', 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('red_de_apoyo')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('red_de_apoyo', 'Red de apoyo', ['class' => 'col-xs-6 control-label']); ?>

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

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

		</div>
	</a>

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

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
				'<?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-4 control-label']); ?>

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

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

			<div class="col-xs-4">
				<div class="form-group form-group-sm 
				'<?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('peso')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('peso', 'Peso', ['class' => 'col-xs-7 control-label']); ?>

					<div class="col-xs-5">
						<?php echo Form::text('peso', 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('talla')): ?> 
					<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('talla', 'Talla', ['class' => 'col-xs-7 control-label']); ?>

					<div class="col-xs-5">
						<?php echo Form::text('talla', 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('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_cefalico')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('perimetro_cefalico', 'Perimetro cefálico hasta los 5 años', ['class' => 'col-xs-4 control-label']); ?>

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

							<span class="input-group-addon">cm</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('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>Valoraciones del desarrollo por conductas</b></p>
		<div class="row formulario-horizontal">
			
			<div class="col-xs-3">
				<div class="form-group form-group-sm 
				'<?php if(count($errors)): ?> <?php if($errors->has('sostuvo_la_cabeza')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('sostuvo_la_cabeza', 'Sostuvo la cabeza', ['class' => 'col-xs-6 control-label']); ?>

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

		</div>
	</a>

	<a class="list-group-item">
		<p class="list-group-item-heading"><b>Crecimiento</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('peso_para_la_edad')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('peso_para_la_edad', 'Peso para la edad', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-6">
						<?php echo Form::text('peso_para_la_edad', 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('talla_para_la_edad')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('talla_para_la_edad', 'Talla para la edad', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-6">
						<?php echo Form::text('talla_para_la_edad', 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('peso_para_la_talla')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('peso_para_la_talla', 'Peso para la talla', ['class' => 'col-xs-6 control-label']); ?>

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

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

		</div>
	</a>

	<a class="list-group-item">
		<p class="list-group-item-heading"><b>Estado nutricional</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('normal')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('normal', 'Normal', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-6">
						<?php echo Form::text('normal', 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('exceso_de_peso')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('exceso_de_peso', 'Exceso de peso', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-6">
						<?php echo Form::text('exceso_de_peso', 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('a_riesgo_de_desnutricion')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('a_riesgo_de_desnutricion', 'A riesgo de desnutrición', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-6">
						<?php echo Form::text('a_riesgo_de_desnutricion', 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('desnutricion_aguda')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('desnutricion_aguda', 'Desnutricion aguda', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-6">
						<?php echo Form::text('desnutricion_aguda', 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('desnutricion_cronica')): ?> 
				<?php echo e('form-group has-error has-feedback'); ?> <?php endif; ?> <?php endif; ?>'">
					<?php echo Form::label('desnutricion_cronica', 'Desnutricion crónica', ['class' => 'col-xs-6 control-label']); ?>

					<div class="col-xs-6">
						<?php echo Form::text('desnutricion_cronica', null, ['class' => 'form-control', '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 /* <?php echo Form::hidden('datos', $datos); ?> */ ?>
		<?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(); ?>
<?php echo $__env->make('componentes.script-verificar-sexo-diagnosticos', array_except(get_defined_vars(), array('__data', '__path')))->render(); ?>
<?php echo $__env->make('componentes.script-validarEntidad', array_except(get_defined_vars(), array('__data', '__path')))->render(); ?>
