@extends('layouts.Registro.master')
@section('content')
    <div class="container">
        <div class="row center-block" style="width:50%">
            <div class="col-md-12 contentzoomform" id="registro">
                <div class="panel-heading">
                    <div class="panel-title text-center">RECUPERAR CORREO ELECTRÓNICO</div>
                </div>
                <div class="col-md-12 text-center panel-guide">
                    <h4>Ingrese los siguientes datos:</h4>
                </div>
                <form role="form" class="zoomform">
                    <div class="form-group" style="margin-bottom:5px;">
                        <label class="control-label sr-only" for="exampleInputEmail1">Documento de Identidad</label>
                    </div>
                    <div class="form-group col-md-3" style="padding-left:0px;">
                        <select class="form-control" ng-model="test">
                            <option value="0">Tipo Doc.</option>
                            <option value="1">V</option>
                            <option value="2">E</option>
                        </select>
                    </div>
                    <div class="form-group col-md-9" style="padding-left:0px;padding-right:0px;">
                        <input type="text" class="form-control invalidInput" placeholder="Nro. Documento de Identidad">
                    </div>
                    <div class="form-group col-sm-4" style="padding-left:0px;">
                        <select class="form-control" ng-model="test">
                            <option value="0">Seleccione</option>
                            <option value="0412">0412</option>
                            <option value="0414">0414</option>
                            <option value="0416">0416</option>
                            <option value="0424">0424</option>
                            <option value="0426">0426</option>
                        </select>
                    </div>
                    <div class="form-group col-sm-8" style="padding-left:0px;padding-right:0px;">
                        <input type="text" class="form-control invalidInput" placeholder="Nro. Teléfono Móvil">
                    </div>
                    <button type="submit" class="btn btn-primary center-block">ENVIAR</button>
                </form>
                <div class="panel-footer">
                    <a href="{!! url('/registro') !!}" onclick="" class="pull-left">Regresar</a>&nbsp;</div>
            </div>
        </div>
    </div>
@endsection