{% extends 'consulta.base.html' %}
{% load staticfiles %}
{% block title %}Perfil{% endblock %}
{% block contenido %}
    <form action="" role="form" class="form form-horizontal validate-form" method="post" autocomplete="off">
        {% csrf_token %}
        <div class="row text-center">
            <h1>Actualizar Perfil</h1><hr>
            <div class="col-md-12 col-sm-12 col-xs-12">
                <div class="form-group {% if form.cedula.errors %}has-error{% endif %}">
                    <label class="col-md-3 col-xs-3 col-sm-3 control-label" for="{{ form.cedula.auto_id }}">
                        {{ form.cedula.label }}
                    </label>
                    <div class="col-md-4 col-xs-4 col-sm-4">
                      <div class="form-inline">
                        {{ form.cedula }}
                      </div>
                        {% include 'base.forms.errors.html' with form_errors=form.cedula.errors col_title_error='col-sm-2' col_msg_error='col-sm-10' %}
                    </div>
                    <div class="col-sm-1"><i class="ion ion-ios-medical item-requerido"></i></div>
                </div>
            </div><br><br><br>
            
            <div class="col-md-4 col-sm-4 col-xs-4">
                <div class="form-group {% if form.estado.errors %}has-error{% endif %}">
                    <label class="col-md-3 col-xs-3 col-sm-3 control-label" for="{{ form.estado.auto_id }}">
                        {{ form.estado.label }}
                    </label>
                    <div class="col-md-5 col-xs-5 col-sm-5">
                        {{ form.estado }}
                        {% include 'base.forms.errors.html' with form_errors=form.estado.errors col_title_error='col-sm-2' col_msg_error='col-sm-10' %}
                    </div>
                </div>
            </div>
            
            <div class="col-md-4 col-sm-4 col-xs-4">
                <div class="form-group {% if form.municipio.errors %}has-error{% endif %}">
                    <label class="col-md-3 col-xs-3 col-sm-3 control-label" for="{{ form.municipio.auto_id }}">
                        {{ form.municipio.label }}
                    </label>
                    <div class="col-md-5 col-xs-5 col-sm-5">
                        {{ form.municipio }}
                        {% include 'base.forms.errors.html' with form_errors=form.municipio.errors col_title_error='col-sm-2' col_msg_error='col-sm-10' %}
                    </div>
                </div>
            </div>
            
            <div class="col-md-4 col-sm-4 col-xs-4">
                <div class="form-group {% if form.parroquia.errors %}has-error{% endif %}">
                    <label class="col-md-3 col-xs-3 col-sm-3 control-label" for="{{ form.parroquia.auto_id }}">
                        {{ form.parroquia.label }}
                    </label>
                    <div class="col-md-5 col-xs-5 col-sm-5">
                        {{ form.parroquia }}
                        {% include 'base.forms.errors.html' with form_errors=form.parroquia.errors col_title_error='col-sm-2' col_msg_error='col-sm-10' %}
                    </div>
                </div>
            </div><br><br><br><br><br><br>
             <div class="col-md-12 col-sm-12 col-xs-12">
                 <a type="button" class="btn btn-info pull-left" href="{% url 'consulta_index' %}">Regresar</a>
                <button type="submit" class="btn btn-primary pull-right">Actualizar</button>
             </div>
        </div>
    </form>
{% endblock %}