<?php $__env->startSection('content'); ?>
    <section class="container form-elements">
        <h2 class="text-center">Solicitar usuario</h2>
        <form action="<?php echo e(route('register')); ?>"  class="form-inlin mt-2" method="post" id="form-datos">
        <?php echo e(csrf_field()); ?>

            <div class="containe">
                <div class="row">
                    <div class="col-md-12">
                        <div class="container">
                            <div class="row">
                                <div class="form-group col-md-6">
                                    <label>Nombre:</label>
                                    <input type="text" id="name" name="name" class="form-control" placeholder="Nombre" required>
                                </div>
                                
                                <div class="form-group col-md-6">
                                    <label>Apellido:</label>
                                    <input type="text" class="form-control" id="surname" name="surname" placeholder="Apellido" required>
                                </div>

                                <div class="form-group col-md-6">
                                    <label>Correo Electronico:</label>
                                    <input type="email" class="form-control" id="email" name="email" placeholder="Correo Electronico" required>
                                </div>

                                <div class="form-group col-md-6">
                                    <label>Telefono:</label>
                                    <input id="tel" type="nomber" class="form-control" name="tel" required placeholder="Telefono">
                                </div>


                                <div class="form-group col-md-6">
                                    <label>Direccion:</label>
                                    <input id="address" type="text" class="form-control" name="address" required placeholder="Direccion">
                                </div>
                                
                                <div class="form-group col-md-6">
                                    <label for="" class="form-label-title">Cedula:</label>
                                    <input id="cedula" type="text" class="form-control" name="idCard" required placeholder="Cedula">
                                </div>
                                <div class="form-group col-md-3" style = "padding-right: 0;">
                                    <label>Contraseña:</label>
                                    <input type="password" id="password" name="password" class="form-control" placeholder="Contraseña">
                                </div>
                                
                                <div class="form-group col-md-3">
                                    <label>Confirmacion:</label>
                                    <input id="password-confirm" type="password" class="form-control" name="password_confirmation" required placeholder="Confirmacion">
                                </div>

                            </div>
                            <div class="col-md-12 text-center">
                                <a href="<?php echo e(url()->previous()); ?>" class="btn btn-dark">Cancelar</a>
                                <button type="submit" class="btn btn-light light2">Registrar</button>
                            </div> 
                        </div>                                
                    </div>
                </div>
            </div>
        </form>
    <section>
	<link rel="stylesheet" href="<?php echo e(asset('css/solicitar-usuario.css')); ?>">
    <link  media="all" rel="stylesheet" type="text/css" href="<?php echo e(asset('css/registrar.css')); ?>">
<?php $__env->stopSection(); ?>
<?php echo $__env->make('layouts.public', array_except(get_defined_vars(), array('__data', '__path')))->render(); ?>