<div class="modal" id="modalPaquete" data-keyboard="false" data-backdrop="static">
    <div class="modal-dialog">
        <div class="modal-content">
            <div class="modal-header color-sigiep">
                <h4 class="modal-title">Registrar Paquete</h4>
            </div>
            <div class="modal-body">
                <div class="container-fluid">
                    <p class="parrafo-forma">Los campos marcados con <strong class="requerido">*</strong> son obligatorios.</p>
                    <form id="form" action="<?php echo e(route('RegistrarPaquete')); ?>" method="post" accept-charset="utf-8">
                        <?php echo e(csrf_field()); ?>

                        <div class="form-group row">
                            <label for="txtFecha" class="col-form-label col-sm-5 col-md-5 col-lg-5 col-xl-5 text-right test">
                                <strong class="requerido">*</strong>Fecha:
                            </label>
                            <div class="col-sm-6 col-md-6 col-lg-6 col-xl-6">
                                <input class="form-control" type="text" name="txtFecha" id="txtFecha" placeholder="Fecha" title="Fecha" required="">
                            </div>
                        </div>
                        <div class="form-group row">
                            <label for="txtFecha" class="col-form-label col-sm-5 col-md-5 col-lg-5 col-xl-5 text-right test">
                                <strong class="requerido">*</strong>Bancos:
                            </label>
                            <div class="col-sm-6 col-md-6 col-lg-6 col-xl-6">
                                <select name="sltBancos" id="sltBancos" class="form-control select" required="" title="Seleccione banco">
                                    <option value="">Bancos</option>
                                    <?php $__currentLoopData = $bancos; $__env->addLoop($__currentLoopData); foreach($__currentLoopData as $row): $__env->incrementLoopIndices(); $loop = $__env->getLastLoop(); ?>
                                        <option value="<?php echo e($row->id_unico); ?>"><?php echo e($row->cod." ".ucwords(mb_strtolower($row->descripcion))); ?></option>
                                    <?php endforeach; $__env->popLoop(); $loop = $__env->getLastLoop(); ?>
                                </select>
                            </div>
                        </div>
                        <div class="form-group row">
                            <label for="txtNumeroPaquete" class="col-form-label col-sm-5 col-md-5 col-lg-5 col-xl-5 text-right test">
                                <strong class="requerido">*</strong>N° de paquete:
                            </label>
                            <div class="col-sm-6 col-md-6 col-lg-6 col-xl-6">
                                <input class="form-control" type="number" name="txtNumeroPaquete" id="txtNumeroPaquete" placeholder="N° de Paquete" title="N° de paquete" required="">
                            </div>
                        </div>
                        <div class="form-group row">
                            <label for="txtCupones" class="col-form-label col-sm-5 col-md-5 col-lg-5 col-xl-5 text-right test">
                                <strong class="requerido">*</strong>Cupones Reportados:
                            </label>
                            <div class="col-sm-6 col-md-6 col-lg-6 col-xl-6">
                                <input class="form-control" type="number" name="txtCupones" id="txtCupones" placeholder="Cupones" title="Cupones" required="">
                            </div>
                        </div>
                        <div class="form-group row">
                            <label for="txtValorR" class="col-form-label col-sm-5 col-md-5 col-lg-5 col-xl-5 text-right test">
                                <strong class="requerido">*</strong>Valor Reportado:
                            </label>
                            <div class="col-sm-6 col-md-6 col-lg-6 col-xl-6">
                                <input class="form-control" type="number" name="txtValorR" id="txtValorR" placeholder="Valor Reportado" title="Valor Reportado" required="">
                            </div>
                        </div>
                        <div class="form-group row">
                            <label for="btn-guardarP" class="col-form-label col-sm-5 col-md-5 col-lg-5 col-xl-5 text-right test"></label>
                            <div class="col-sm-6 col-md-6 col-lg-6 col-xl-6">
                                <button type="submit" class="btn btn-sm btn-default sombra cursor" id="btn-guardarP">Guardar <span class="fa fa-save"></span></button>
                            </div>
                        </div>
                    </form>
                </div>
            </div>
            <div class="modal-footer color-sigiep">
            </div>
        </div>
    </div>
</div>