<div id="modal-panel-inicio" class="modal fade bd-example-modal-lg" tabindex="-1" role="dialog" aria-labelledby="myLargeModalLabel" aria-hidden="true">
  <div class="modal-dialog modal-lg" role="document">
    <div class="modal-content">
      <div class="modal-header">
        <h6 class="modal-title azul-fidelitas"><b>EMPRESA MODELO S.A. - 301111118</b></h6>
        <button type="button" class="close" data-dismiss="modal" aria-label="Close">
          <span aria-hidden="true">&times;</span>
        </button>
      </div>
      <div class="modal-body">

        <form>  
        
        <div class="row">
          {{-- razon social - identificacion - fecha alta --}}
          <div class="col-md-6">
            <div class="form-group">
              <label for="">Razon Social</label>
              <input type="text" class="form-control" id="razon-social" aria-describedby="emailHelp" placeholder="Enter email" value="EMPRESA MODELO S.A">
            </div>
          </div>
          <div class="col-md-3">
            <div class="form-group">
                <label for="">Identificacion</label>
                <input type="text" class="form-control" id="identificacion" aria-describedby="emailHelp" placeholder="Enter email" value="301111118">
              </div>
          </div>
          <div class="col-md-3">
            <div class="form-group">
                <label for="">Fecha alta</label>
                <input type="text" class="form-control" id="fecha-alta" aria-describedby="emailHelp" placeholder="Enter email" value="14/11/2018">
              </div>
          </div>

        </div>

        {{-- telefono - direccion --}}
        <div class="row">
            <div class="col-md-6">
              <div class="form-group">
                <label for="">Telefono</label>
                <input type="text" class="form-control" id="razon-social" aria-describedby="emailHelp" placeholder="Enter email" value="123456789">
              </div>
            </div>

            <div class="col-md-6">
              <div class="form-group">
                <label for="">Direccion</label>
                <input type="text" class="form-control" id="razon-social" aria-describedby="emailHelp" placeholder="Enter email" value="TUCUMAN 944 - 2 * PISO - CIUDAD DE BUENOS AIRES (1049)">
              </div>
            </div>

        </div>  
        {{-- contacto - email --}}
        <div class="row">
          <div class="col-md-6">
            <div class="form-group">
              <label for="">Contacto</label>
              <input type="text" class="form-control" id="razon-social" aria-describedby="emailHelp" placeholder="Enter email" value="Contacto Dem">
            </div>
          </div>

          <div class="col-md-6">
            <div class="form-group">
              <label for="">Email</label>
              <input type="text" class="form-control" id="razon-social" aria-describedby="emailHelp" placeholder="Enter email" value="email@empresademo.com">
            </div>
          </div>

      </div>
        {{-- datos adicionales --}}
        <div class="row">
          <div class="col-md-12">
            <div class="form-group">
              <label for="">Datos adicionales</label>
              <input type="text" class="form-control" id="razon-social" aria-describedby="emailHelp" placeholder="Enter email">
            </div>
          </div>  
        </div>  
        {{-- usuarios --}}
        <div class="row">
            
            {{-- <div class="row"> --}}
              {{-- nombre apellido --}}
              <div class="col-md-6">
                <div class="form-group">
                  <label for="">Nombre y Apellido</label>
                  <input type="text" class="form-control" id="razon-social" aria-describedby="emailHelp" placeholder="Enter email">
                </div>
              </div>
              {{-- sector --}}
              <div class="col-md-3">
                <div class="form-group">
                  <label for="">Sector</label>
                  <input type="text" class="form-control" id="razon-social" aria-describedby="emailHelp" placeholder="Enter email">
                </div>
              </div>
              {{-- email --}}
              <div class="col-md-3">
                <div class="form-group">
                  <label for="">Email</label>
                  <input type="email" class="form-control" id="razon-social" aria-describedby="emailHelp" placeholder="Enter email">
                </div>
              </div>
            {{-- </div> --}}
        </div>

      </form>
        
      </div>
      <div class="modal-footer">
      </div>
    </div>
  </div>
</div>