@extends('layouts.app', ['class' => 'g-sidenav-show bg-gray-100'])

@section('content')
@include('layouts.navbars.auth.topnav', ['title' => 'Ordenes'])
<div class="container-fluid py-4">
    <div class="row">
        {{-- Registrar Orden  --}}
        <div class="col-md-12">
            <div class="card mb-1 mb-xl-12 shadow show">
                <!--begin::Header-->
                <div class="card-header border-0 pt-1 pb-1">
                    <!--begin::Card title-->
                    <h4 class="card-title align-items-start flex-column">
                        <form action="/action_page.php" class="" novalidate>
                            <span class="card-label fw-boldest fs-1"> Solicitud de Estudio</span>
                            <div class="form-group">
                                <select class="form-select form-select" id="sel1" name="sellist1" placeholder="Ingrese nombre examen">
                                    <option value="" selected="" data-select2-id="select2-data-6-1bq4" placeholder="Ingrese nombre examen">Por favor seleccione Tipo de estudio requerido</option>
                                    <option value="1">RAYOS X</option>
                                    <option value="2">LABORATORIO</option>
                                    <option value="3">TOMOGRAFIA</option>
                                    <option value="4">OTROS</option>
                                </select>
                            </div>
                        </form> {{-- <span class="text-gray-400 fw-bold mt-2 fs-6">STUDIES</span> --}}
                    </h4>
                </div>
                <div class="text-muted fw-bold mb-2 text-center">Complete todos los campos </div>
                {{-- Registro datos --}}
                <!-- Boton registrar-->
                <div class="card-body pt-2  border-0 row">
                    <!-- Modificar para usar dinamicamente-->
                    <form onsubmit="generate();return false">
                        {{-- columna1 --}}
                        <div class="row ">
                            <!--fila 1  -->
                            <div class="col-3">
                                <label class="d-flex align-items-center fs-6 fw-bold form-label mb-2">
                                    <span>SEDES <b class="text-danger" id="ncodigo"></b></span>
                                    <i class="fas fa-exclamation-circle ms-2 fs-7" data-bs-toggle="tooltip" title="" data-bs-original-title="Seleccione SEDES" aria-label="Seleccione SEDES"></i>
                                </label>
                                <select id="codigo" class="form-select form-select-solid select2-hidden-accessible" data-control="select2" data-select2-id="select2-data-codigo" tabindex="-1" aria-hidden="true">
                                    <option value="1">Chuquisaca</option>
                                    <option value="2">Tarija</option>
                                    <option value="3">Cochabamba</option>
                                    <option value="4">Potosi</option>
                                    <option value="5">Oruro</option>
                                    <option value="6">La Paz</option>
                                    <option value="7">Beni</option>
                                    <option value="8">Pando</option>
                                    <option value="9">Santa Cruz</option>
                                </select>
                            </div>
                            <!-- fin fila 1 -->
                            <!--fila 2  -->
                            <div class="col-3">
                                <label class="d-flex align-items-center fs-6 fw-bold form-label mb-2">
                                    <span>RED<b class="text-danger" id="ncodigo"></b></span>
                                    <i class="fas fa-exclamation-circle ms-2 fs-7" data-bs-toggle="tooltip" title="" data-bs-original-title="Seleccione RED" aria-label="Seleccione RED"></i>
                                </label>
                                <select id="codigo" class="form-select form-select-solid select2-hidden-accessible" data-control="select2" data-select2-id="select2-data-codigo" tabindex="-1" aria-hidden="true">
                                    <option value="1001">Sucre</option>
                                    <option value="1002">Yotala</option>
                                    <option value="1003">Yamparaes</option>
                                    <option value="1004">Tarabuco</option>
                                    <option value="1005">Tomina</option>
                                    <option value="1006">Zudañes</option>
                                    <option value="1007">Padilla</option>
                                    <option value="1008">Monteagudo</option>
                                    <option value="1009">Camargo</option>
                                </select>
                            </div>
                            <!--fila 2  -->
                            <!--fila 3 fecha -->
                            <div class="col">
                                <label class="d-flex align-items-center fs-6 fw-bold form-label mb-2">
                                    <span>Fecha de solicitud<b class="text-danger" id="ncodigo"></b></span>
                                    <i class="fas fa-exclamation-circle ms-2 fs-7" data-bs-toggle="tooltip" title="" data-bs-original-title="Seleccione Producto" aria-label="Seleccione Producto"></i>
                                </label>
                                <script>
                                    var f = new Date();
                                    var h = new Date();
                                    document.write(f.getDate() + "/" + (f.getMonth() + 1) + "/" + f.getFullYear());

                                    function myFunction() {
                                        document.getElementById("FechaD").innerHTML = f;
                                    }
                                </script>
                                {{-- <input type="text" name="FechaD" class="form-control" id="FechaD"> --}}
                            </div>
                            <!--fila 3  -->
                            <!--fila 4  hora-->
                            <div class="col-1">
                                <label class="d-flex align-items-center fs-6 fw-bold form-label mb-2">
                                    <span>Hora <b class="text-danger" id="ncodigo"></b></span>
                                    <i class="fas fa-exclamation-circle ms-2 fs-7" data-bs-toggle="tooltip" title="" data-bs-original-title="Seleccione Producto" aria-label="Seleccione Producto"></i>
                                </label>
                                <script>
                                    var f = new Date();
                                    var h = new Date();
                                    document.write(h.getHours() + ":" + (h.getMinutes() + 1));

                                    function myFunction() {
                                        document.getElementById("FechaD").innerHTML = f;
                                    }
                                </script>
                                {{-- <input type="text" class="form-control" placeholder="Hora"> --}}
                            </div>
                            <!--fila 4  -->
                        </div>
                        {{-- columna2 --}}
                        <div class="row">
                            <div class="col-4">
                                <!-- Lista orden-->
                                <label class="d-flex align-items-center fs-6 fw-bold form-label mb-2">
                                    <span>Establecimiento<b class="text-danger" id="ncodigox"></b></span>
                                    <i class="fas fa-exclamation-circle ms-2 fs-7" data-bs-toggle="tooltip" title="" data-bs-original-title="Seleccione formato" aria-label="Seleccione formato"></i>
                                </label>
                                <select id="codigox" class="form-select form-select-solid select2-hidden-accessible" data-control="select2" data-select2-id="select2-data-codigox" tabindex="-1" aria-hidden="true">
                                    {{-- <option value="0" selected="" data-select2-id="select2-data-5-j6gb">Seleccione Establecimiento</option> --}}
                                    <option value="10001">Hospital "San Pedro Claver" </option>
                                    <option value="10002">Hospital "Santa Barbara" </option>
                                    <option value="10003">Hospital "Boliviano Japones" </option>
                                    <option value="10004">Hospital "San Juan de Dios" </option>
                                </select>
                                <!-- Fin Lista orden -->
                            </div>
                            <div class="col-4">
                                <div class="form-check form-check-inline ">
                                    <label class="fs-6 fw-bold form-label ">
                                        S.U.S.
                                        <i class="fas fa-exclamation-circle ms-2 fs-7" data-bs-toggle="tooltip" title="" data-bs-original-title="Seleccione Producto" aria-label="Seleccione Producto"></i>
                                    </label>
                                </div>
                                <form action="from">
                                    <div class="from-check" action="/action_page.php">
                                        <div class="form-check form-check-inline">
                                            <input class="form-check-input border-1" type="radio" name="inlineRadioOptions" id="gridCheck" aria-label="Si">
                                            <label class="fw-bold form-check-label " for="gridCheck">Si
                                            </label>
                                        </div>
                                        <div class="form-check form-check-inline">
                                            <input class="form-check-input" type="radio" name="inlineRadioOptions" id="gridCheck1" aria-label="No">
                                            <label class=" fw-bold form-check-label " for="gridCheck1">NO
                                            </label>
                                        </div>
                                    </div>
                                </form>
                            </div>
                            <div class="col-4">
                                <label class="d-flex align-items-center fs-6 fw-bold form-label mb-2">
                                    <span>Servicio<b class="text-danger" id="ncodigo"></b></span>
                                    <i class="fas fa-exclamation-circle ms-2 fs-7" data-bs-toggle="tooltip" title="" data-bs-original-title="Seleccione Producto" aria-label="Seleccione Servicio"></i>
                                </label>
                                <input type="text" class="form-control" placeholder="Selecione Servicio">
                            </div>
                        </div>
                        {{-- columna3 --}}
                        <div class="row">
                            <div class="col-4">
                                <label class="d-flex align-items-center fs-6 fw-bold form-label mb-2">
                                    <span>Nombre Paciente<b class="text-danger" id="ncodigo"></b></span>
                                    <i class="fas fa-exclamation-circle ms-2 fs-7" data-bs-toggle="tooltip" title="" data-bs-original-title="Seleccione Producto" aria-label="Seleccione Servicio"></i>
                                </label>
                                <input type="text" class="form-control" placeholder="Selecione Servicio">
                            </div>
                            <div class="col-4">
                                <label class="d-flex align-items-center fs-6 fw-bold form-label mb-2">
                                    <span>N° REgistro (Fecha Naciento)<b class="text-danger" id="ncodigo"></b></span>
                                    <i class="fas fa-exclamation-circle ms-2 fs-7" data-bs-toggle="tooltip" title="" data-bs-original-title="Seleccione Producto" aria-label="Seleccione Servicio"></i>
                                </label>
                                <input type="text" class="form-control" placeholder="Selecione Servicio">
                            </div>
                            <div class="col-4">
                                <label class="d-flex align-items-center fs-6 fw-bold form-label mb-2">
                                    <span>N° Historia Cliente<b class="text-danger" id="ncodigo"></b></span>
                                    <i class="fas fa-exclamation-circle ms-2 fs-7" data-bs-toggle="tooltip" title="" data-bs-original-title="Seleccione Producto" aria-label="Seleccione Servicio"></i>
                                </label>
                                <input type="text" class="form-control" placeholder="Selecione Servicio">
                            </div>
                        </div>
                        {{-- columna4 --}}
                        <div class="row">
                            <div class="col-12">
                                <label class="d-flex align-items-center fs-6 fw-bold form-label mb-2">
                                    <span>Nombre y Aplellidos Paciente<b class="text-danger" id="ncodigo"></b></span>
                                    <i class="fas fa-exclamation-circle ms-2 fs-7" data-bs-toggle="tooltip" title="" data-bs-original-title="Seleccione Producto" aria-label="Seleccione Servicio"></i>
                                </label>
                                <input type="text" class="form-control" placeholder="Escriba Nombre y Aplellidos Paciente...">
                            </div>
                        </div>
                        {{-- columna5 --}}
                        <div class="row">
                            <div class="col-12">
                                <label class="d-flex align-items-center fs-6 fw-bold form-label mb-2">
                                    <span>Diagnostico principa (registro nombre y CIE.10)<b class="text-danger" id="ncodigo"></b></span>
                                    <i class="fas fa-exclamation-circle ms-2 fs-7" data-bs-toggle="tooltip" title="" data-bs-original-title="Seleccione Producto" aria-label="Seleccione Servicio"></i>
                                </label>
                                <input type="text" class="form-control" placeholder="Escriba Diagnostico principal...">
                            </div>
                        </div>
                        {{-- columna6 --}}
                        <div class="row">
                            <div class="col-3">
                                <label class="d-flex align-items-center fs-6 fw-bold form-label mb-2">
                                    <span>Sala<b class="text-danger" id="ncodigo"></b></span>
                                    <i class="fas fa-exclamation-circle ms-2 fs-7" data-bs-toggle="tooltip" title="" data-bs-original-title="Seleccione Producto" aria-label="Seleccione Servicio"></i>
                                </label>
                                <input type="text" class="form-control" placeholder="Selecione Servicio">
                            </div>
                            <div class="col-3">
                                <label class="d-flex align-items-center fs-6 fw-bold form-label mb-2">
                                    <span>N° Cama<b class="text-danger" id="ncodigo"></b></span>
                                    <i class="fas fa-exclamation-circle ms-2 fs-7" data-bs-toggle="tooltip" title="" data-bs-original-title="Seleccione Producto" aria-label="Seleccione Servicio"></i>
                                </label>
                                <input type="text" class="form-control" placeholder="Selecione Servicio">
                            </div>
                            <div class="col-3">
                                <label class="d-flex align-items-center fs-6 fw-bold form-label mb-2">
                                    <span>Edad<b class="text-danger" id="ncodigo"></b></span>
                                    <i class="fas fa-exclamation-circle ms-2 fs-7" data-bs-toggle="tooltip" title="" data-bs-original-title="Seleccione Producto" aria-label="Seleccione Servicio"></i>
                                </label>
                                <input type="text" class="form-control" placeholder="Selecione Servicio">
                            </div>
                            <div class="col-3">
                                <div class="form-check form-check-inline ">
                                    <label class="fs-6 fw-bold form-label ">
                                        Sexo
                                        <i class="fas fa-exclamation-circle ms-2 fs-7" data-bs-toggle="tooltip" title="" data-bs-original-title="Seleccione Producto" aria-label="Seleccione Producto"></i>
                                    </label>
                                </div>
                                <form action="from">
                                    <div>
                                        <div class="form-check form-check-inline">
                                            <input class="form-check-input" type="radio" name="inlineRadioOptions" id="gridCheck" aria-label="Si">
                                            <label class="fw-bold form-check-label " for="gridCheck">M
                                            </label>
                                        </div>
                                        <div class="form-check form-check-inline">
                                            <input class="form-check-input" type="radio" name="inlineRadioOptions" id="gridCheck1" aria-label="No">
                                            <label class=" fw-bold form-check-label " for="gridCheck1">F
                                            </label>
                                        </div>
                                    </div>
                                </form>
                            </div>
                        </div>
                    </form>
                    <!-- fin Modificar para usar dinamicamente-->
                    <div class="text-center row col-8">
                        <div class="form-row col-4 float-right ">
                            <label class="d-flex align-items-center fs-6 fw-bold form-label mb-2">
                                <span>Soliciatante<b class="text-danger" id="ncodigo"></b></span>
                                <i class="fas fa-exclamation-circle ms-2 fs-7" data-bs-toggle="tooltip" title="" data-bs-original-title="Seleccione Solicitante" aria-label="Seleccione Solicitante"></i>
                            </label>
                            <input type="text" class="form-control" placeholder="Selecione Soliciatane">
                        </div>
                        <div class="form-row col-4 border-7 pt-3 justify-content-end">
                            <button type="button" data-bs-toggle="modal" data-bs-target="#LlenarExam" class="btn btn-outline-primary btn-sm">
                                <span class="indicator-label">
                                    <i class="fa fa-plus"></i> Registrar Examenes
                                </span>
                            </button>
                        </div>
                    </div>
                </div>
            </div>
            {{--Fin Registro datos --}}
            <br>
        </div>
    </div>
    {{-- Fin Registrar Paciente --}}
    {{-- Realizar Examenes --}}
    <div class="col-md-12 collapse " id="ListExam">{{-- collapse, oculta una vez llenado deve mostrar para leuego imprimir --}}
        <div class="card mb-1 mb-xl-12 shadow show">
            <!--begin::Header-->
            <div class="card-header border-0 pt-2 pb-1">
                <!--begin::Card title-->
                <h3 class="card-title align-items-start flex-column">
                    <span class="card-label fw-boldest fs-3">Lita de Examenes </span>
                    {{-- <span class="text-gray-400 fw-bold mt-1 fs-6">STUDIES</span> --}}
                </h3>
                <!--end:begin::Card title-->
            </div>
            <div class="form-row ">
                {{-- area izquierda --}}
                <div class="col-6">
                    <label class="d-flex align-items-center fs-6 fw-bold form-label mb-2">
                        <span>Cabeza y cuello<b class="text-danger" id="ncodigo"></b></span>
                        <i class="fas fa-exclamation-circle ms-2 fs-7" data-bs-toggle="tooltip" title="" data-bs-original-title="Seleccione Producto" aria-label="Seleccione Producto"></i>
                    </label>
                    <div class="table-responsive">
                        <table class="table table-borderless">
                            <tbody>
                                <tr>
                                    <td>Perfilograma nasal</td>
                                    <td>
                                        <label class="fw-bold form-check-label ">
                                            <input type="checkbox" class="form-input" id="" placeholder="AP">AP
                                        </label>
                                    </td>
                                    <td>
                                        <label class="fw-bold form-check-label ">
                                            <input type="checkbox" class="form-input" id="" placeholder="AP">LAT
                                        </label>
                                    </td>
                                </tr>
                                <tr>
                                    <td>CRANEO</td>
                                    <td>
                                        <label class="fw-bold form-check-label ">
                                            <input type="checkbox" class="form-input" id="" placeholder="AP">AP
                                        </label>
                                    </td>
                                    <td>
                                        <label class="fw-bold form-check-label ">
                                            <input type="checkbox" class="form-input" id="" placeholder="AP">LAT
                                        </label>
                                    </td>
                                </tr>
                            </tbody>
                        </table>
                    </div>
                </div>
                {{-- in area izquierda --}}
                {{-- area derecha --}}
                <div class="col-6">
                    <label class="d-flex align-items-center fs-6 fw-bold form-label mb-2">
                        <span>Miembro superior<b class="text-danger" id="ncodigo"></b></span>
                        <i class="fas fa-exclamation-circle ms-2 fs-7" data-bs-toggle="tooltip" title="" data-bs-original-title="Seleccione Producto" aria-label="Seleccione Producto"></i>
                    </label>
                    <div class="table-responsive">
                        <table class="table table-borderless">
                            <tbody>
                                <tr>
                                    <td>Perfilograma nasal</td>
                                    <td>
                                        <label class="fw-bold form-check-label ">
                                            <input type="checkbox" class="form-input" id="" placeholder="AP">AP
                                        </label>
                                    </td>
                                    <td>
                                        <label class="fw-bold form-check-label ">
                                            <input type="checkbox" class="form-input" id="" placeholder="AP">LAT
                                        </label>
                                    </td>
                                </tr>
                                <tr>
                                    <td>CRANEO</td>
                                    <td>
                                        <label class="fw-bold form-check-label ">
                                            <input type="checkbox" class="form-input" id="" placeholder="AP">AP
                                        </label>
                                    </td>
                                    <td>
                                        <label class="fw-bold form-check-label ">
                                            <input type="checkbox" class="form-input" id="" placeholder="AP">LAT
                                        </label>
                                    </td>
                                </tr>
                            </tbody>
                        </table>
                    </div>
                </div>
            </div>
            <div class="form-row ">
                {{-- area izquierda --}}
                <div class="col-6">
                    <label class="d-flex align-items-center fs-6 fw-bold form-label mb-2">
                        <span>Columna Vertebral Plvis y cadera<b class="text-danger" id="ncodigo"></b></span>
                        <i class="fas fa-exclamation-circle ms-2 fs-7" data-bs-toggle="tooltip" title="" data-bs-original-title="Seleccione Producto" aria-label="Seleccione Producto"></i>
                    </label>
                    <div class="table-responsive">
                        <table class="table table-borderless">
                            <tbody>
                                <tr>
                                    <td>Perfilograma nasal</td>
                                    <td>
                                        <label class="fw-bold form-check-label ">
                                            <input type="checkbox" class="form-input" id="" placeholder="AP">AP
                                        </label>
                                    </td>
                                    <td>
                                        <label class="fw-bold form-check-label ">
                                            <input type="checkbox" class="form-input" id="" placeholder="AP">LAT
                                        </label>
                                    </td>
                                </tr>
                                <tr>
                                    <td>CRANEO</td>
                                    <td>
                                        <label class="fw-bold form-check-label ">
                                            <input type="checkbox" class="form-input" id="" placeholder="AP">AP
                                        </label>
                                    </td>
                                    <td>
                                        <label class="fw-bold form-check-label ">
                                            <input type="checkbox" class="form-input" id="" placeholder="AP">LAT
                                        </label>
                                    </td>
                                </tr>
                            </tbody>
                        </table>
                    </div>
                </div>
                {{-- Din area izquierda --}}
                {{-- area derecha --}}
                <div class="col-6">
                    <label class="d-flex align-items-center fs-6 fw-bold form-label mb-2">
                        <span>Miembro Inferior<b class="text-danger" id="ncodigo"></b></span>
                        <i class="fas fa-exclamation-circle ms-2 fs-7" data-bs-toggle="tooltip" title="" data-bs-original-title="Seleccione Producto" aria-label="Seleccione Producto"></i>
                    </label>
                    <div class="table-responsive">
                        <table class="table table-borderless">
                            <tbody>
                                <tr>
                                    <td>Perfilograma nasal</td>
                                    <td>
                                        <label class="fw-bold form-check-label ">
                                            <input type="checkbox" class="form-input" id="" placeholder="AP">AP
                                        </label>
                                    </td>
                                    <td>
                                        <label class="fw-bold form-check-label ">
                                            <input type="checkbox" class="form-input" id="" placeholder="AP">LAT
                                        </label>
                                    </td>
                                </tr>
                                <tr>
                                    <td>CRANEO</td>
                                    <td>
                                        <label class="fw-bold form-check-label ">
                                            <input type="checkbox" class="form-input" id="" placeholder="AP">AP
                                        </label>
                                    </td>
                                    <td>
                                        <label class="fw-bold form-check-label ">
                                            <input type="checkbox" class="form-input" id="" placeholder="AP">LAT
                                        </label>
                                    </td>
                                </tr>
                            </tbody>
                        </table>
                    </div>
                </div>
            </div>
        </div>
    </div>
    {{-- Fin Registro Examenss --}}

    {{-- Aviso registor --}}
    <div class=" border-0  d-flex bg-light-primary border-light-primary border border-dashed p-2 col-md-12"">
                <div class=" form-row col-6">
        <span class="svg-icon svg-icon-2tx svg-icon-primary me-14">
            <svg xmlns="http://www.w3.org/2000/svg" width="24px" height="24px" viewBox="0 0 24 24" version="1.1">
                <circle fill="#000000" opacity="0.3" cx="12" cy="12" r="10"></circle>
                <rect fill="#000000" x="11" y="7" width="2" height="8" rx="1"></rect>
                <rect fill="#000000" x="11" y="16" width="2" height="2" rx="1"></rect>
            </svg>
        </span>
        <div class="d-flex flex-stack flex-grow-1">
            <!--begin::Content-->
            <div class="fw-bold">
                <h4 class="text-primary ">Información</h4>
                <h6 class=" text-primary">La orden se registrara en estado <b> pendiente</b></h6>
            </div>
        </div>
    </div>
</div>
{{-- fin Aviso registor --}}
</div>

<!--Modal Registro Estudio -->
<div id="LlenarExam" class="modal fade modal-dialog modal-lg " data-bs-backdrop="static" data-bs-keyboard="false" tabindex="-1" aria-labelledby="staticBackdropLabel" aria-hidden="false">
    <div class="modal-dialog ">
        <div class="modal-content ">
            <!-- Modal Cabesa -->
            <div class="modal-header">
                <h4 class="modal-title">Registro Examen:</h4>
                <button type="button" class="bt btn-outline-danger close">&times;</button>
            </div>
            <!-- Fin Modal hear -->
            <!-- Modal body -->
            <div class="modal-body">
                <form onsubmit="generate();return false">
                    <div class="row">
                        <!-- area izquierda -->
                        <div class="col-6">
                            <label class="d-flex align-items-center fs-6 fw-bold form-label mb-2">
                                <span>Cabeza y cuello<b class="text-danger" id="ncodigo"></b></span>
                                <i class="fas fa-exclamation-circle ms-2 fs-7" data-bs-toggle="tooltip" title="" data-bs-original-title="Seleccione Producto" aria-label="Seleccione Producto"></i>
                            </label>
                            <div>
                                <table class="table table-borderless">
                                    <tbody>
                                        <tr>
                                            <td>Perfilograma nasal</td>
                                            <td>
                                                <label class="fw-bold form-check-label ">
                                                    <input type="checkbox" class="form-input" id="" placeholder="AP">AP
                                                </label>
                                            </td>
                                            <td>
                                                <label class="fw-bold form-check-label ">
                                                    <input type="checkbox" class="form-input" id="" placeholder="AP">LAT
                                                </label>
                                            </td>
                                        </tr>
                                        <tr>
                                            <td>CRANEO</td>
                                            <td>
                                                <label class="fw-bold form-check-label ">
                                                    <input type="checkbox" class="form-input" id="" placeholder="AP">AP
                                                </label>
                                            </td>
                                            <td>
                                                <label class="fw-bold form-check-label ">
                                                    <input type="checkbox" class="form-input" id="" placeholder="AP">LAT
                                                </label>
                                            </td>
                                        </tr>
                                        <tr>
                                            <td>Silla Turaca</td>
                                            <td>
                                                <label class="fw-bold form-check-label ">
                                                    <input type="checkbox" class="form-input" id="" placeholder="AP">AP
                                                </label>
                                            </td>
                                            <td>
                                                <label class="fw-bold form-check-label ">
                                                    <input type="checkbox" class="form-input" id="" placeholder="AP">LAT
                                                </label>
                                            </td>
                                        </tr>
                                        <tr>
                                            <td>Oido</td>
                                            <td>
                                                <label class="fw-bold form-check-label ">
                                                    <input type="checkbox" class="form-input" id="" placeholder="AP">AP
                                                </label>
                                            </td>
                                            <td>
                                                <label class="fw-bold form-check-label ">
                                                    <input type="checkbox" class="form-input" id="" placeholder="AP">LAT
                                                </label>
                                            </td>
                                        </tr>
                                    </tbody>
                                </table>
                            </div>
                        </div>
                        <!-- area izquierda -->
                        <!-- area derecha -->
                        <div class="col-5">
                            <label class="d-flex align-items-center fs-6 fw-bold form-label mb-2">
                                <span>Miembro superior<b class="text-danger" id="ncodigo"></b></span>
                                <i class="fas fa-exclamation-circle ms-2 fs-7" data-bs-toggle="tooltip" title="" data-bs-original-title="Seleccione Producto" aria-label="Seleccione Producto"></i>
                            </label>
                            <div>
                                <table class="table table-borderless">
                                    <tbody>
                                        <tr>
                                            <td>Clavicula</td>
                                            <td>
                                                <label class="fw-bold form-check-label ">
                                                    <input type="checkbox" class="form-input" id="" placeholder="AP">AP
                                                </label>
                                            </td>
                                            <td>
                                                <label class="fw-bold form-check-label ">
                                                    <input type="checkbox" class="form-input" id="" placeholder="AP">LAT
                                                </label>
                                            </td>
                                        </tr>
                                        <tr>
                                            <td>Escapula en Y</td>
                                            <td>
                                                <label class="fw-bold form-check-label ">
                                                    <input type="checkbox" class="form-input" id="" placeholder="AP">AP
                                                </label>
                                            </td>
                                            <td>
                                                <label class="fw-bold form-check-label ">
                                                    <input type="checkbox" class="form-input" id="" placeholder="AP">LAT
                                                </label>
                                            </td>
                                        </tr>
                                        <tr>
                                            <td>Hombro</td>
                                            <td>
                                                <label class="fw-bold form-check-label ">
                                                    <input type="checkbox" class="form-input" id="" placeholder="AP">AP
                                                </label>
                                            </td>
                                            <td>
                                                <label class="fw-bold form-check-label ">
                                                    <input type="checkbox" class="form-input" id="" placeholder="AP">LAT
                                                </label>
                                            </td>
                                        </tr>
                                        <tr>
                                            <td>Brazo (adulto)</td>
                                            <td>
                                                <label class="fw-bold form-check-label ">
                                                    <input type="checkbox" class="form-input" id="" placeholder="AP">AP
                                                </label>
                                            </td>
                                            <td>
                                                <label class="fw-bold form-check-label ">
                                                    <input type="checkbox" class="form-input" id="" placeholder="AP">LAT
                                                </label>
                                            </td>
                                        </tr>
                                    </tbody>
                                </table>
                            </div>
                        </div>
                        <!--Fin area derecha -->
                    </div>
                </form>
                <div class="text-muted fw-bold mb-1 text-center">Complete todos los campos requeridos</div>
            </div>
            <!-- Fin Modal body -->
            <!-- Modal footer -->
            <div class="modal-footer">
                <button type="button" class="btn btn-secondary" data-bs-dismiss="modal" onclick="window.modal1.close()">
                    Salir
                </button>
                <button type="button" class="btn btn-primary" data-target="" data-toggle="modal">
                    Siguiete
                </button>
                <button type="button" class="btn btn-primary" data-target="" data-toggle="modal" disabled>
                    Finalizar
                </button>
            </div>
            <!--fin Modal footer -->
        </div>
    </div>
</div>
<div class="modal fade" id="RegEstudio" tabindex="-1" role="dialog" aria-labelledby="exampleModalLabel" aria-hidden="true">
    <div class="modal-dialog" role="document">
        <div class="modal-content">
            <div class="modal-header">
                <h2 class="mb-0">Registro Estudio</h2>
                <button type="button" class="close" data-dismiss="modal" aria-label="Close">
                    <span aria-hidden="true">&times;</span>
                </button>
            </div>
            <div class="modal-body">
                <form>
                    <h3 class="text-dark fw-bolder fs-3 mb-2 text-center">Datos Estudio</h3>
                    <div class="text-muted fw-bold mb-10 text-center">Complete todos los campos requeridos</div>
                    <div class="form-group">
                        <label for="recipient-name" class="col-form-label">Nombre del estudio</label>
                        <input type="text" class="form-control" placeholder="Ingrese nombre del estudio" id="recipient-name">
                    </div>
                </form>
            </div>
            <div class="modal-footer">
                <button type="button" class="btn btn-secondary" data-dismiss="modal">Salir</button>
                <button type="button" class="btn btn-primary">Registrar</button>
            </div>
        </div>
    </div>
</div>
<div class="modal fade" id="RegDatosEstudio" tabindex="-1" role="dialog" aria-labelledby="exampleModalLabel" aria-hidden="true">
    <div class="modal-dialog" role="document">
        <div class="modal-content">
            <div class="modal-header">
                <h2 class="mb-0">Registro Estudio</h2>
                <button type="button" class="close" data-dismiss="modal" aria-label="Close">
                    <span aria-hidden="true">&times;</span>
                </button>
            </div>
            <div class="modal-body">
                <form>
                    <h3 class="text-dark fw-bolder fs-3 mb-2 text-center">Datos Estudio</h3>
                    <div class="text-muted fw-bold mb-10 text-center">Complete todos los campos requeridos</div>
                    <div class="form-group">
                        <label for="recipient-name" class="col-form-label">Nombre del estudio</label>
                        <input type="text" class="form-control" placeholder="Ingrese nombre del estudio" id="recipient-name">
                    </div>
                </form>
            </div>
            <div class="modal-footer">
                <button type="button" class="btn btn-secondary" data-dismiss="modal">Salir</button>
                <button type="button" class="btn btn-primary">Registrar</button>
            </div>
        </div>
    </div>
</div>
<!--Modal Registro Estudio -->

@endsection