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Larar121801
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<x-layouts.app> | ||
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<div class="col-md-9"> | ||
<div class="card"> | ||
<div class="card-header">Registro de Usuario</div> | ||
<div class="card-body"> | ||
<form action="{{ url('Usuario') }}" method="post"> | ||
<form action="{{ url('Usuario') }}" class="was-validated" method="post"> | ||
{!! csrf_field() !!} | ||
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<label>Nombres</label></br> | ||
<input type="text" name="nombre_per" class="form-control"></br> | ||
<label>Nombres</label></br> | ||
<input type="text" name="nombre_per" class="form-control" required></br> | ||
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<label>Apellido Paterno</label></br> | ||
<input type="text" name="apellido_pa_per" class="form-control"></br> | ||
<input type="text" name="apellido_pa_per" class="form-control" required></br> | ||
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<label>Apellido Materno</label></br> | ||
<input type="text" name="apellido_ma_per" class="form-control"></br> | ||
<input type="text" name="apellido_ma_per" class="form-control" required></br> | ||
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<label>Carnet de Identidad</label></br> | ||
<input type="number" name="ci_per" class="form-control"></br> | ||
<input type="number" name="ci_per" pattern="[0-9]{1,10}" oninput="this.value = this.value.replace(/[^0-9.]+/g, '').slice(0,7) ;" class="form-control" required></br> | ||
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<label>Celular</label></br> | ||
<input type="tel" name="cel_per" class="form-control"></br> | ||
<input type="tel" name="cel_per" pattern="[0-9]{1,10}" oninput="this.value = this.value.replace(/[^0-9.]+/g, '').slice(0,8) ;" class="form-control" required></br> | ||
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<label>Fecha Nacimiento</label></br> | ||
<input type="date" name="fecha_nac" class="form-control"></br> | ||
<input type="date" name="fecha_nac" class="form-control" required></br> | ||
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<label>Numero de Seguro</label></br> | ||
<input type="number" name="num_seguro" class="form-control"></br> | ||
<input type="number" name="num_seguro" pattern="[0-9]{1,10}" oninput="this.value = this.value.replace(/[^0-9.]+/g, '').slice(0,11) ;" class="form-control" required></br> | ||
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<label>Tipo de Sangre</label></br> | ||
<select class="form-control" name="id_tipo_sangre"> | ||
<select class="form-control" required name="id_tipo_sangre"> | ||
@foreach($tipos_sangre as $tipo_sangre) | ||
<option value="{{ $tipo_sangre->id_tipo_sangre }}">{{$tipo_sangre->nombre_tipo_sangre}}</option> | ||
@endforeach | ||
</select> <br> | ||
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<label>Pariente Donante</label></br> | ||
<select class="form-control" name="id_pariente"> | ||
<select class="form-control" required name="id_pariente"> | ||
@foreach($personas as $persona) | ||
<option value="{{ $persona->id_persona }}">{{$persona->nombre_per}}</option> | ||
@endforeach | ||
</select> <br> | ||
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<label>Es donante</label></br> | ||
<input type="text" name="donante" class="form-control"></br> | ||
<input type="text" name="donante" class="form-control" required></br> | ||
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<label>Usuario</label></br> | ||
<input type="text" name="username" id="id" class="form-control"></br> | ||
<input type="text" name="username" id="id" class="form-control" required></br> | ||
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<label>Email</label></br> | ||
<input type="text" name="email" id="email" class="form-control"></br> | ||
<input type="text" name="email" id="email" class="form-control" required></br> | ||
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<label>Password</label></br> | ||
<input type="text" name="password" id="password" class="form-control"></br> | ||
<input type="text" name="password" id="password" class="form-control" required></br> | ||
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<input type="submit" value="Save" class="btn btn-success"></br> | ||
</form> | ||
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</div> | ||
</div> | ||
</div> | ||
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</x-layouts.app> |