<?php
if (!empty($_SESSION["USER_MATRICULA"])){ $NUM_DOCUMENTO = $_GET["NUM_DOCUMENTO"];
/*<!-- Llamamos a las funciones en PHP -->*/
require_once '../../app/php/controller/app.controller.php';
require_once '../../app/php/controller/formulario.salud.colectivos.controller.php';
echo '
<head>
<meta charset="utf-8">
<meta http-equiv="X-UA-Compatible" content="IE=edge">
<meta name="viewport" content="width=device-width, initial-scale=1">
<title>Salud Colectivos</title>
<!-- Bootstrap nucleo CSS -->
<link rel="stylesheet" href="https://maxcdn.bootstrapcdn.com/bootstrap/3.3.5/css/bootstrap.min.css">
<!-- FontAwesome nucleo CSS -->
<link rel="stylesheet" href="https://maxcdn.bootstrapcdn.com/font-awesome/4.4.0/css/font-awesome.min.css">
</head>
<body>';
/*<!-- Mostramos el Menu usando Bootstrap -->*/
include_once '../dashboard/dashboard.forms.salud.colectivos.php';
echo '</p>
<div class="container-fluid">
<div class="page-header container-fluid">
<h3 class="sub-header text-success"><em>N° Caso: '.$NUM_DOCUMENTO.'</em></h3>
</div>
<form class="form-horizontal" name="frm" method="POST" onkeypress="return pulsar(event)" onsubmit="return checkSubmit();" autocomplete="off" enctype="multipart/form-data">
<!-- Asunto del Correo -->
<div class="form-group">
<label class="control-label col-xs-3">Asunto del Correo:</label>
<div class="col-xs-8">
<input type="text" class="form-control" name="MAIL_ASUNTO" value="'.$_POST["MAIL_ASUNTO"].'" placeholder="Asunto del Correo" required>
</div>
</div>
<!-- Area Solicitante -->
<div class="form-group">
<label class="control-label col-xs-3">Area Solicitante:</label>
<div class="col-xs-8">
<input type="search" class="form-control" list="DES_TERCERO_1" name="DES_TERCERO_1" value="'.$_POST["DES_TERCERO_1"].'" placeholder="Area Solicitante" required>
<datalist id="DES_TERCERO_1">';
$Q_DES_TERCERO = consulta_Tabla_Tercero_por_Agrupacion("RES","TDS","13Q","");
$TOT_DES_TERCERO = $Q_DES_TERCERO->fetchAll();
foreach ($TOT_DES_TERCERO as $rsTe1) {
echo "<option>".$rsTe1['DES_TERCERO']."</option>";
} echo '
</datalist>
</div>
</div>
<!-- Ramo (EPS o PPS) -->
<div class="form-group" onchange="frm.submit()">
<label class="control-label col-xs-3">Ramo:</label>
<div class="col-xs-2">
<label class="radio-inline">
<input type="radio" name="RAD_RAMO" value="10A"'; if ($_POST["RAD_RAMO"] == "10A") {echo 'checked="checked"';} echo 'required> EPS
</label>
</div>
<div class="col-xs-2">
<label class="radio-inline">
<input type="radio" name="RAD_RAMO" value="10B"'; if ($_POST["RAD_RAMO"] == "10B") {echo 'checked="checked"';} echo 'required> PPS
</label>
</div>
</div>
<!-- Cliente -->
<div class="form-group">
<label class="control-label col-xs-3">Cliente:</label>
<div class="col-xs-8">
<div class="input-group">
<input type="text" class="form-control" placeholder="Cliente" name="DES_CLIENTE" value="'.$DES_CLIENTE.'" disabled>
<span class="input-group-addon">';
if(isset($_POST["RAD_RAMO"])) { $_SESSION["RAMO"] = $_POST["RAD_RAMO"];
$LINK = "../../soporte.comercial.php";
echo '<a href=\'' . $LINK . '\'target=\'_blank\' onClick=\'window.open(this.href,this.target,"Width=800,Height=200");return false;\'>';
} echo '<i class="fa fa-user-plus fa-fw"></i></span>
</a>
</div>
</div>
</div>
<!-- Broker -->
<div class="form-group">
<label class="control-label col-xs-3">Broker:</label>
<div class="col-xs-8">
<input type="text" class="form-control" placeholder="Broker" name="DES_BROKER" value="'.$DES_BROKER.'" disabled>
</div>
</div>
<!-- Tiene Observacion? -->
<div class="form-group" onchange="frm.submit()">
<label class="control-label col-xs-3">Tiene Observacion:</label>
<div class="col-xs-2">
<label class="radio-inline">
<input type="radio" name="RAD_OBSERVACION" value="1"'; if ($_POST["RAD_OBSERVACION"] == 1) {echo 'checked="checked"';} echo 'required> SI
</label>
</div>
<div class="col-xs-2">
<label class="radio-inline">
<input type="radio" name="RAD_OBSERVACION" value="2"'; if ($_POST["RAD_OBSERVACION"] == 2) {echo 'checked="checked"';} echo 'required> NO
</label>
</div>
</div>';
if($_POST["RAD_OBSERVACION"] == 1){
echo '