{{ HTML::style('css/travel/new_address.css') }}

{{ Form::hidden('new-address-url', action('AddressController@postSaveFamilyAddress', array()), array('id'=>'new-address-url')) }}
{{ Form::hidden('load-counties', action('NewAddressController@getCounties', array()), array('id'=>'load-counties')) }}
{{ Form::hidden('load-parishes', action('NewAddressController@getParishes', array()), array('id'=>'load-parishes')) }}

{{ Form::open(array('url' => '', 'class' => 'form-create', 'method' => 'POST', 'id' => 'newAddressForm')) }}

{{ Form::hidden('serial_fml', $serial_fml, array('id'=>'serial_fml')) }}
{{ Form::hidden('travel_address_fma', $familyAddres->travel_address_fma ? $familyAddres->travel_address_fma:'YES', array('id'=>'travel_address_fma')) }}
{{ Form::hidden('serial_fma', $familyAddres->serial_fma, array('id'=>'serial_fma')) }}
{{ Form::hidden('status_fma', $status, array('id'=>'status_fma')) }}
{{ Form::hidden('serial_std', $serial_std, array('id'=>'serial_std')) }}

<div class="form-group" hidden>
    <div class="input-group">
        <span class="input-group-addon addon-lg" id="basic-addon6">Tipo</span>
        {{ Form::select('address_type_fma',$types,$familyAddres->address_type_fma ? $familyAddres->address_type_fma:'OTHER', array('class'=>'form-control', 'id'=>'address_type_fma')) }}
    </div>
</div>
<div class="form-group">
    <div class="input-group">
        <span class="input-group-addon addon-lg">Calle Principal</span>
        {{ Form::text('main_street_fma', $familyAddres->main_street_fma, array('class'=>'form-control', 'id'=>'main_street_fma')) }}
    </div>
</div>
<div class="form-group">
    <div class="input-group">
        <span class="input-group-addon addon-lg">Número</span>
        {{ Form::text('number_fma', $familyAddres->number_fma, array('class'=>'form-control', 'id'=>'number_fma')) }}
    </div>
</div>
<div class="form-group">
    <div class="input-group">
        <span class="input-group-addon addon-lg">Calle Secundaria</span>
        {{ Form::text('secondary_street_fma', $familyAddres->secondary_street_fma, array('class'=>'form-control', 'id'=>'secondary_street_fma')) }}
    </div>
</div>
<div class="form-group">
    <div class="input-group">
        <span class="input-group-addon addon-lg">Provincia</span>
        {{ Form::select('serial_ste',array(''=>'- Seleccione -') + $states,$familyAddres->serial_ste ? $familyAddres->serial_ste:19, array('class'=>'form-control', 'id'=>'serial_ste')) }}
    </div>
</div>
<div class="form-group">
    <div class="input-group">
        <span class="input-group-addon addon-lg">Cantón</span>
        {{ Form::select('serial_cnt',$counties,$familyAddres->serial_cnt?$familyAddres->serial_cnt:188, array('class'=>'form-control', 'id'=>'serial_cnt')) }}
    </div>
</div>
<div class="form-group">
    <div class="input-group">
        <span class="input-group-addon addon-lg" id="basic-addon6">Parroquia</span>
        {{ Form::select('serial_par',$parishes,$familyAddres->serial_par, array('class'=>'form-control', 'id'=>'serial_par')) }}
    </div>
</div>
<div class="form-group">
    <div class="input-group">
        <span class="input-group-addon addon-lg">Teléfono</span>
        {{ Form::text('phone1_fma', $familyAddres->phone1_fma, array('class'=>'form-control', 'id'=>'phone1_fma')) }}
    </div>
</div>
<div class="form-group toHide">
    <div class="input-group">
        <span class="input-group-addon addon-lg">Extensión</span>
        {{ Form::text('ext_phone1_fma', $familyAddres->ext_phone1_fma, array('class'=>'form-control', 'id'=>'ext_phone1_fma')) }}
    </div>
</div>
<div class="form-group">
    <div class="input-group">
        <span class="input-group-addon addon-lg">Sector</span>
        {{ Form::text('sector_fma', $familyAddres->sector_fma, array('class'=>'form-control', 'id'=>'sector_fma')) }}
    </div>
</div>
<div class="form-group">
    <div class="input-group">
        <span class="input-group-addon addon-lg">Referencia</span>
        {{ Form::text('refenece_fma', $familyAddres->refenece_fma, array('class'=>'form-control', 'id'=>'refenece_fma')) }}
    </div>
</div>
{{ Form::close() }}
{{ HTML::script('js/address/info.js') }}