<form id="formulario_datos_contacto">
    {{ csrf_field() }}
    <div class="row my-4">
        <div class="col-md-10">
            <h4 class="text-start">Datos de Contacto</h4>
        </div>
    </div>
    <!----->
    <div class="row form-group my-3 mx-1">
        <!----->
        <div class="col-12 col-md-3 my-2">
            <label for="calle" class="form-label ps-0">Calle <b class="text-danger">*</b> </label>
            <input type="text" class="form-control form-control-sm" id="calle" name="calle">
        </div>
        <!----->
        <div class="col-12 col-md-3 my-2">
            <label for="numero" class="form-label ps-0">Altura <b class="text-danger">*</b> </label>
            <input type="text" class="form-control form-control-sm" id="altura" name="numero">
        </div>
        <!------>
        <div class="col-12 col-md-3 my-2">
            <label for="piso" class="form-label ps-0">Piso </label>
            <input type="text" class="form-control form-control-sm" id="piso" name="piso">
        </div>
        <!------->
        <div class="col-12 col-md-3 my-2">
            <label for="dpto" class="form-label ps-0">Departamento</label>
            <input type="text" class="form-control form-control-sm" id="dpto" name="dpto">
        </div>
        <!----->
    </div>
    <!----->
    <div class="row form-group my-3 mx-1">
        <!-- Pais --->
        <div class="col-12 col-md-4 my-2">
            <label for="pais" class="form-label ps-0">País <b class="text-danger">*</b> </label>
            <select name="pais" id="pais" class="form-select form-select-sm">
                <option value="" selected>Seleccione el pais</option>
            </select>
        </div>
        <!-- Provincia --->
        <div class="col-12 col-md-4 my-2">
            <label for="provincia" class="form-label">Provincia <b class="text-danger">*</b></label>
            <select name="provincia" id="provincia" class="form-select form-select-sm">
                <option value="" selected>Seleccione la provincia</option>
            </select>
        </div>
        <!-- Localidad --->
        <div class="col-12 col-md-4 my-2">
            <label for="localidad" class="form-label">Localidad <b class="text-danger">*</b></label>
            <select name="localidad" id="localidad" class="form-select form-select-sm">
                <option value="" selected>Seleccione la localidad</option>
            </select>
        </div>
        <!----->
    </div>
    <!------->
    <div class="row my-3 mx-1">
        <!---Barrio -->
        <div class="col-12 col-md-3 my-2">
            <label for="barrio" class="form-label">Barrio <b class="text-danger">*</b></label>
            <input type="text" id="barrio" name="barrio" class="form-control form-control-sm">
        </div>
        <!---Codigo Postal --->
        <div class="col-12 col-md-3 my-2">
            <label for="cod_postal" class="form-label">Codigo Postal <b class="text-danger">*</b></label>
            <input type="text" id="cod_postal" name="cod_postal" class="form-control form-control-sm">
        </div>
        <!--- Wi-Fi --->
        <div class="col-12 col-md-3 my-2">
            <label for="wifi" class="form-label">¿Tiene Wi-Fi? <b class="text-danger">*</b></label>
            <select name="wifi" id="wifi" class="form-select form-select-sm">
                <option value="">Seleccione estado de wifi</option>
                <option value="Y">Si</option>
                <option value="N">No</option>
            </select>
        </div>
        <!--- Zona ---->
        <div class="col-12 col-md-3 my-2">
            <label for="zona" class="form-label">¿Vive en una zona anegable? <b class="text-danger">*</b></label>
            <select id="zona" name="zona" class="form-select form-select-sm">
                <option value="">Seleccione estado de zona</option>
                <option value="Y">Si</option>
                <option value="N">No</option>
            </select>
        </div>
        <!------>
    </div>
    <!----->
    <div class="row my-3 mx-1">
        <!--- Estado de Movilidad -->
        <div class="col-12 col-md-12 my-2" id="seccion_movilidad">
            <label for="movilidad" class="form-label">¿Cuenta con movilidad propia? <b class="text-danger">*</b></label>
            <select name="movilidad" id="movilidad" class="form-select form-select-sm">
                <option value="">Seleccione estado de movilidad</option>
                <option value="Y">Si</option>
                <option value="N">No</option>
            </select>
        </div>
        <!--- Marca Movilidad -->
        <div class="col-12 col-md-2 my-2 d-none" id="seccion_marca_movilidad">
            <label for="marca" class="form-label">Marca </label>
            <input type="text" id="marca" name="marca" class="form-control form-control-sm">
        </div>
        <!--- Modelo Movilidad --->
        <div class="col-12 col-md-2 my-2 d-none" id="seccion_modelo_movilidad">
            <label for="modelo" class="form-label">Modelo</label>
            <input type="text" id="modelo" name="modelo" class="form-control form-control-sm">
        </div>
        <!--- Año Movilidad --->
        <div class="col-12 col-md-2 my-2 d-none" id="seccion_edicion_movilidad">
            <label for="edicion" class="form-label">Año</label>
            <input type="text" id="edicion" name="edicion" class="form-control form-control-sm">
        </div>
        <!--- Dominio Movilidad --->
        <div class="col-12 col-md-2 my-2 d-none" id="seccion_dominio_movilidad">
            <label for="dominio" class="form-label">Dominio</label>
            <input type="text" id="dominio" name="dominio" class="form-control form-control-sm">
        </div>
        <!---- Prenda --->
        <div class="col-12 col-md-2 my-2 d-none" id="seccion_prenda_movilidad">
            <label for="prenda" class="form-label">¿Tiene Prenda?</label>
            <select name="prenda" id="prenda" class="form-select form-select-sm">
                <option value="">Seleccionar estado prenda</option>
                <option value="Y">Si</option>
                <option value="N">No</option>
            </select>
        </div>
        <!------>
    </div>
    <!----->
    <div class="row my-3 mx-1">
        <!--- Telefono --->
        <div class="col-12 col-md-3 my-2">
            <label for="telefono" class="form-label">Telefono <b class="text-danger">*</b></label>
            <input type="text" id="telefono" name="telefono" class="form-control form-control-sm">
        </div>
        <!--- Celular --->
        <div class="col-12 col-md-3 my-2">
            <label for="telefono" class="form-label">Celular <b class="text-danger">*</b></label>
            <input type="text" id="celular" name="celular" class="form-control form-control-sm">
        </div>
        <!---Email --->
        <div class="col-12 col-md-3 my-2">
            <label for="email" class="form-label">Email <b class="text-danger">*</b></label>
            <input type="text" id="email" name="email" class="form-control form-control-sm" readonly>
        </div>
        <!-- Email Secundario ---->
        <div class="col-12 col-md-3 my-2">
            <label for="email2" class="form-label">Email Secundario </label>
            <input type="text" id="email2" name="email2" class="form-control form-control-sm">
        </div>
        <!------->
    </div>
    <!------>
    <div class="row my-3 mx-1">
        <!--- Facebook --->
        <div class="col-12 col-md-3 my-2">
            <label for="facebook" class="form-label">Facebook </label>
            <input type="text" id="facebook" name="facebook" class="form-control form-control-sm">
        </div>
        <!--- Instagram ---->
        <div class="col-12 col-md-3 my-2">
            <label for="instagram" class="form-label">Instagram </label>
            <input type="text" id="instagram" name="instagram" class="form-control form-control-sm">
        </div>
        <!--- Twitter ---->
        <div class="col-12 col-md-3 my-2">
            <label for="twitter" class="form-label">Twitter </label>
            <input type="text" id="twitter" name="twitter" class="form-control form-control-sm">
        </div>
        <!--- Linkedin ---->
        <div class="col-12 col-md-3 my-2">
            <label for="linkedin" class="form-label">Linkedin </label>
            <input type="text" id="linkedin" name="linkedin" class="form-control form-control-sm">
        </div>
    </div>
</form>