@extends('frontend.layouts.app')

@section('title', app_name() . ' | ' . __('labels.frontend.afiliacion.box_title'))

@section('breadcrumb')
<ol class="breadcrumb" style="padding-left:130px;margin-top:0px;background-color#283659">
        <li class="breadcrumb-item text-primary">Inicio</li>
            <li class="breadcrumb-item active">Nueva Asistencia</li>
        </li>
    </ol>
@endsection

@section('content')
    <!--
    <ol class="breadcrumb" style="padding-left:120px;margin-top:0px;background-color:#355C9D">
        <li class="breadcrumb-item text-primary">Inicio</li>
            <li class="breadcrumb-item active">Nueva Asistencia</li>
        </li>
    </ol>
    -->

    <div class="justify-content-center">
    <!--<div class="container-fluid">-->
    
        <div class="card">

            <div class="card-body">

                <div class="row">
                    <div class="col-sm-5">
                        <h4 class="card-title mb-0 text-primary">
                            Registre su asistencia <!--<small class="text-muted">Usuarios activos</small>-->
                        </h4>
                    </div><!--col-->
                </div>

        <br>
        <div class="row justify-content-center">
        
        <div class="col col-sm-11 align-self-center">

        {{ html()->form('POST', route('frontend.contact.send'))->open() }}

            <div class="card">
                <div class="card-header">
                    <strong>
                        @lang('labels.frontend.asistencia.box_title')
                    </strong>
                </div>
               
                <div class="card-body">
                    <input type='hidden' name='txt_IdEmpresa' id="txt_IdEmpresa" value='{{Auth::user()->IdEmpresa}}'>
                    <div class="row">
                        <div class="col-lg-3 col-md-3 col-sm-12 col-xs-12">
                            <div class="form-group form-group-sm">
                                <label>Tipo Documento</label>
                                <select name="tdicod" id="tdicod" class="form-control">
                                    <option></option>
                                </select>
                            </div>
                        </div>

                        <div class="col-lg-2 col-md-2 col-sm-12 col-xs-12">
                            <div class="form-group form-group-sm">
                                <label for="clinum">N° Documento</label>
                                <input type="text"  name="clinum" id="clinum" value="{{old('clinum')}}"  placeholder="" class="form-control">
                            </div>
                        </div>

                        <!--<div class="col-lg-6 col-md-6 col-sm-12 col-xs-12">
                            <div class="form-group form-group-sm">
                                <label>Nombre</label>
                                <input type="text" name="clinom" id="clinom" value="{{old('clinom')}}" class="form-control">
                            </div>
                        </div>-->
                    </div>

                    <div class="row">
                        <div class="col-lg-3 col-md-3 col-sm-12 col-xs-12">
                            <div class="form-group form-group-sm">
                                <label>Nombre</label>
                                <input name="clidir" id="clidir" value="{{old('clidir')}}" class="form-control">
                            </div>
                        </div>
                        <div class="col-lg-3 col-md-3 col-sm-12 col-xs-12">
                            <div class="form-group form-group-sm">
                                <label>Apellido Paterno</label>
                                <input name="clicor" id="clicor" value="{{old('clicor')}}" class="form-control">
                            </div>
                        </div>
                        <div class="col-lg-3 col-md-3 col-sm-12 col-xs-12">
                            <div class="form-group form-group-sm">
                                <label>Apellido Materno</label>
                                <input name="clicor" id="clicor" value="{{old('clicor')}}" class="form-control">
                            </div>
                        </div>
                    </div>

                </div>
           
            </div>

            <br>

            <div class="card">
                <div class="card-header">
                    <strong>
                        @lang('labels.frontend.asistencia.box_asistencia')
                    </strong>
                </div>

                <div class="card-body">
           
                    <div class="row">
                        <div class="col-lg-3 col-md-3 col-sm-12 col-xs-12">
                            <div class="form-group form-group-sm">
                                <label>Area</label>
                                <select name="tdicod" id="tdicod" class="form-control">
                                    <option></option>
                                </select>
                            </div>
                        </div>
                        <!--
                        <div class="col-lg-2 col-md-2 col-sm-12 col-xs-12">
                            <div class="form-group form-group-sm">
                                <label for="clinum">Carnet de Saneamiento</label>
                                <input type="text"  name="clinum" id="clinum" value="{{old('clinum')}}"  placeholder="" class="form-control">
                            </div>
                        </div>
                        -->
                        <!--<div class="col-lg-6 col-md-6 col-sm-12 col-xs-12">
                            <div class="form-group form-group-sm">
                                <label>Nombre</label>
                                <input type="text" name="clinom" id="clinom" value="{{old('clinom')}}" class="form-control">
                            </div>
                        </div>-->
                    </div>

                    <div class="row">
                        <div class="col-lg-3 col-md-3 col-sm-12 col-xs-12">
                            <div class="form-group form-group-sm">
                                <label>Fecha de Ingreso</label>
                                <input name="clidir" id="clidir" value="{{old('clidir')}}" class="form-control">
                            </div>
                        </div>
                        <div class="col-lg-3 col-md-3 col-sm-12 col-xs-12">
                            <div class="form-group form-group-sm">
                                <label>Fecha de Salida</label>
                                <input name="clicor" id="clicor" value="{{old('clicor')}}" class="form-control">
                            </div>
                        </div>
                    </div>

                    <div class="row">
                        <div class="col">
                            <div class="form-group mb-0 clearfix">
                                {{ form_submit(__('labels.frontend.contact.button')) }}
                            </div><!--form-group-->
                        </div><!--col-->
                    </div><!--row-->
                
                </div><!--card-body-->
            </div><!--card-->

            {{ html()->form()->close() }}

        </div><!--col-->
    </div><!--row-->
@endsection

@push('after-scripts')
    @if(config('access.captcha.contact'))
        @captchaScripts
    @endif
@endpush