@if($mode=="show")
         <div class="row form-group">
            <div class="col-md-6">
                {!! html()->label('Employeur','sonum') !!}
                {!! html()->text('employeur', $med->NomEmployeur." ".$med->NomEmployeur)->attributes(['disabled','class' => 'form-control']) !!}
            </div>
        </div>
    @endif

        <div class="row form-group">
            <div class="col-md-4">
                {!! html()->label('Date d\'envoi','date_envoi') !!}
                <div class="input-group">
                    <div class='input-group date' id='datepicker_date_envoi'>
                        {!! html()->text('date_envoi', date('j/m/Y'))->placeholder('')->attributes([($mode=="show"?'disabled':''),'class' => 'form-control']) !!}
                        <span class='input-group-addon'><span class='glyphicon glyphicon-calendar'></span></span>
                    </div>
                </div>
            </div>

            <div class='col-md-4'>
                {!! html()->label('Motif','motif') !!}
                {!! html()->select('motif',$listes_med,null)->placeholder('A définir')
                    ->attributes([($mode=="show"?'disabled':''),'class' => 'form-control']) !!}
            </div>

            <div class="col-md-3">
                {!! html()->label('Mois&nbsp;manquants','nbmois') !!}
                {!! html()->text('nbmois', null)->placeholder('')->attributes([($mode=="show"?'disabled':''),'class' => 'form-control']) !!}
            </div>
        </div>

        <div class='row form-group callout callout-danger'>
            <legend class="h4">Période</legend>
            <div class="col-md-4">
                {!! html()->label('Début','periode_deb') !!}
                <div class="input-group">
                    <div class='input-group date' id='datepicker_periode_debut'>
                        {!! html()->text('periode_deb', null)->placeholder('')->attributes([($mode=="show"?'disabled':''),'class' => 'form-control']) !!}
                        <span class='input-group-addon'><span class='glyphicon glyphicon-calendar'></span></span>
                    </div>
                </div>
            </div>
            <div class="col-md-4">
                {!! html()->label('Fin','periode_fin') !!}
                <div class="input-group">
                    <div class='input-group date' id='datepicker_periode_fin'>
                        {!! html()->text('periode_fin', null)->placeholder('')->attributes([($mode=="show"?'disabled':''),'class' => 'form-control']) !!}
                        <span class='input-group-addon'><span class='glyphicon glyphicon-calendar'></span></span>
                    </div>
                </div>
            </div>
        </div>

        <div class='callout callout-warning'>
            <div class='row form-group'>
                <div class="col-md-3">
                    {!! html()->label('Cotisations','cotisations') !!}
                    {!! html()->text('cotisations', null)->placeholder('')->attributes([($mode=="show"?'disabled':''),'class' => 'form-control']) !!}
                </div>
                <div class="col-md-3">
                    {!! html()->label('Majorations','majorations') !!}
                    {!! html()->text('majorations', null)->placeholder('')->attributes([($mode=="show"?'disabled':''),'class' => 'form-control']) !!}
                </div>
            </div>
            <div class='row form-group'>
                <div class="col-md-3">
                    {!! html()->label('Total de la dette','total') !!}
                </div>
                <div class="col-md-3" >
                    {!! html()->text('total', isset($med)?$med->majorations+$med->cotisations:null)->placeholder('')->attributes([($mode=="show"?'disabled':''),'class' => 'text-danger form-control']) !!}
                </div>
            </div>
        </div>


        <div class='form-group'>
            <div class="col-md-12">
                {!! html()->label('Observations','obs') !!}
                {!! html()->textarea('obs', null)->placeholder('Observations')->attributes([($mode=="show"?'disabled':''),'class' => 'form-control', 'rows'=>'3']) !!}
            </div>
        </div>


        <div class='form-group row '>
            @if($mode!="show")
                {!! html()->button('Enregistrer')->value('Enregistrer')->type('submit')->attributes(['class' => 'btn btn-primary']) !!}
            @else
                <a href="{!! url('med_print/').'/'.$med->id !!}" class="btn btn-info pull-left" style="margin-right: 3px;" target="_blank">
                    <span class="glyphicon glyphicon-print">Imprimer</span>
                </a>
                @if($user->can("MED_SUP") || $user->HasRole("ADMINISTRATEUR"))  
                    {{ html()->form('DELETE', url('med/' . $med->id))->attributes(['class'=>''])->open() }} 
                    &nbsp;<button class="btn btn-sm btn-danger pull-left" value="Supprimer" type="submit">Supprimer</button>&nbsp;
                    {{ html()->form()->close() }}
                @endif
                @if($user->can("MED_MAJ") || $user->HasRole("ADMINISTRATEUR"))  
                    <a class="btn btn-primary" href="{!! url('med/'.$med->id.'/edit') !!}" id="btn_modifier">Modifier</a>
                @endif
            @endif
            &nbsp;<a class="btn btn-warning"  href="{!! url('med_prepa') !!}">Retour</a>       
        </div>