<!DOCTYPE html>
<html lang="en">
<head>
    <meta charset="UTF-8">
    <meta name="viewport" content="width=device-width, initial-scale=1, shrink-to-fit=no">
    <title>SEW REPORTS</title>

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    <link rel="stylesheet" href="https://mdbcdn.b-cdn.net/wp-content/themes/mdbootstrap4/docs-app/css/compiled-4.20.0.min.css">
    <!-- Include the plugin's CSS and JS: -->
    <script type="text/javascript" src="assets/js/bootstrap-multiselect.js"></script>
    <link rel="stylesheet" href="assets/styles/bootstrap-multiselect.css" type="text/css"/>
</head>
<body>
    <div class="container show-top-margin separate-rows tall-rows">
        <div class="d-flex justify-content-center align-items-center" style="padding-bottom: 2%;">
            <img src="https://upload.wikimedia.org/wikipedia/commons/thumb/9/92/SEW_LOGO.svg/2000px-SEW_LOGO.svg.png" alt="" class="card-img-top" style="max-height: 300px;max-width: 300px;">
        </div>
        <form action="<?php echo e(route('send.form')); ?>" method="post" enctype="multipart/form-data" target="_blank">
            <?php echo csrf_field(); ?>
            <!-- General data -->
            <div class="form-group row">
                <label for="reportNumber" class="col-sm-6 col-form-label">Reporte No.</label>
                <div class="col-sm-6">
                    <input required type="text" class="form-control" id="reportNumber" name="reportNumber">
                </div>
            </div>
            <div class="form-group row">
                <label for="reportClient" class="col-sm-6 col-form-label">Cliente</label>
                <div class="col-sm-6">
                    <input required type="text" class="form-control" id="reportClient" name="reportClient">
                </div>
            </div>
            <div class="form-group row">
                <label for="reportDate" class="col-sm-6 col-form-label">Fecha del reporte:</label>
                <div class="col-sm-6">
                    <input required type="date" id="name="reportDate" name="reportDate">
                </div>
            </div>
            <div class="form-group row">
                <label for="reportType" class="col-sm-6 col-form-label">Tipo de solicitud</label>
                <select required id="reportType" name="reportType" class="form-control col-sm-6">
                    <option value="mantenimiento">Mantenimiento básico</option>
                    <option value="reparacion">Reparación</option>
                    <option value="garantia">Garantía</option>
                    <option value="cambio">Cambio relación ?</option>
                </select>
            </div>
            <div class="form-group row">
                <label for="entryDate" class="col-sm-6 col-form-label">Fecha de ingreso:</label>
                <div class="col-sm-6">
                    <input required type="date" id="entryDate" name="entryDate">
                </div>
            </div>
            <div class="form-group row">
                <label for="remisionNumber" class="col-sm-6 col-form-label">No. Remisión y/o documento de envío del cliente:</label>
                <div class="col-sm-6">
                    <input required type="text" class="form-control" id="remisionNumber" name="remisionNumber">
                </div>
            </div>
            <div class="form-group row">
                <label for="machineType" class="col-sm-6 col-form-label">Tipo de equipo:</label>
                <div class="col-sm-6">
                    <input required type="text" class="form-control" id="machineType" name="machineType">
                </div>
            </div>
            <div class="form-group row">
                <label for="machineSerialNumber" class="col-sm-6 col-form-label">Número de serie:</label>
                <div class="col-sm-6">
                    <input required type="text" class="form-control" id="machineSerialNumber" name="machineSerialNumber">
                </div>
            </div>
            <!-- END General data -->
            <!-- Machine data -->
            <h2 class="text-center">Información del equipo</h2>
            <div class="form-group row">
                <label for="machineRelation" class="col-sm-6 col-form-label">Relación i = </label>
                <div class="col-sm-6">
                    <input required type="text" class="form-control" id="machineRelation" name="machineRelation">
                </div>
            </div>
            <div class="form-group row">
                <label for="machineMountingPosition" class="col-sm-6 col-form-label">Posición de Montaje</label>
                <div class="col-sm-6">
                    <input required type="text" class="form-control" id="machineMountingPosition" name="machineMountingPosition">
                </div>
            </div>
            <div class="form-group row">
                <label for="machineOilType" class="col-sm-6 col-form-label">Tipo de aceite</label>
                <select required id="machineOilType" name="machineOilType" class="form-control col-sm-6">
                    <option value="sintetico">Sintético</option>
                    <option value="mineral">Mineral</option>
                </select>
            </div>
            <div class="form-group row">
                <label for="machineOilViscosity" class="col-sm-6 col-form-label">Viscocidad del aceite</label>
                <select required id="machineOilViscosity" name="machineOilViscosity" class="form-control col-sm-6" onchange="checkAnotherViscosity()">
                    <option value="220">220</option>
                    <option value="320">320</option>
                    <option value="460">460</option>
                    <option value="680">680</option>
                    <option value="another_viscosity">Otro</option>
                </select>
            </div>
            <div id="divMachineOilAnotherViscosity" class="form-group row" style="display:none">
                <label for="machineOilAnotherViscosity" class="col-sm-6 col-form-label">Valor viscocidad:</label>
                <div class="col-sm-6">
                    <input type="text" class="form-control" id="machineOilAnotherViscosity" name="machineOilAnotherViscosity">
                </div>
            </div>
            <div class="form-group row">
                <label for="machineOutputShaft" class="col-sm-6 col-form-label">Ø Eje de salida:</label>
                <div class="col-sm-6">
                    <input required type="text" class="form-control" id="machineOutputShaft" name="machineOutputShaft">
                </div>
            </div>
            <div class="form-group row">
                <label for="machineInputShaft" class="col-sm-6 col-form-label">Ø Eje de entrada:</label>
                <div class="col-sm-6">
                    <input required type="text" class="form-control" id="machineInputShaft" name="machineInputShaft">
                </div>
            </div>
            <div class="form-group row">
                <label for="machineRotor" class="col-sm-6 col-form-label">Ø de Rotor:</label>
                <div class="col-sm-6">
                    <input required type="text" class="form-control" id="machineRotor" name="machineRotor">
                </div>
            </div>
            <div class="form-group row">
                <label for="machineFlange" class="col-sm-6 col-form-label">Ø de Brida:</label>
                <div class="col-sm-6">
                    <input required type="text" class="form-control" id="machineFlange" name="machineFlange">
                </div>
            </div>
            <div class="form-group row">
                <label for="machinePower" class="col-sm-6 col-form-label">Potencia:</label>
                <div class="col-sm-6">
                    <input required type="text" class="form-control" id="machinePower" name="machinePower">
                </div>
            </div>
            <div class="form-group row">
                <label for="machineIPProtection" class="col-sm-6 col-form-label">Protección IP</label>
                <select required id="machineIPProtection" name="machineIPProtection" class="form-control col-sm-6">
                    <option value="54">54</option>
                    <option value="55">55</option>
                    <option value="56">56</option>
                    <option value="65">65</option>
                </select>
            </div>
            <div class="form-group row">
                <label for="machineTorqueArm" class="col-sm-6 col-form-label">Brazo de torque</label>
                <select required id="machineTorqueArm" name="machineTorqueArm" class="form-control col-sm-6">
                    <option value="si">Si</option>
                    <option value="no">No</option>
                </select>
            </div>
            <div class="form-group row">
                <label for="machineTorqueBrake" class="col-sm-6 col-form-label">Freno</label>
                <select required id="machineTorqueBrake" name="machineTorqueBrake" class="form-control col-sm-6">
                    <option value="si">Si</option>
                    <option value="no">No</option>
                </select>
            </div>
            <div class="form-group row">
                <label for="machineOtherInput" class="col-sm-6 col-form-label">Otros</label>
                <div class="col-sm-6">
                    <textarea required class="form-control" id="machineOtherInput" name="machineOtherInput" rows="3"></textarea>
                </div>
            </div>
            <!-- END Machine data -->
            <!-- Plate data -->
            <div class="form-group row">
                <label for="plateImage">Imagen de la placa</label>
                <input required type="file" class="form-control-file" id="plateImage" name="plateImage" accept="image/*" onchange="showPlateImage()">
                <div id="plateImagePreview"></div>
            </div>
            <!-- END plate data -->
            <!-- Gearmotor data -->
            <div class="form-group row">
                <label for="pulleyInputShaft" class="col-sm-6 col-form-label">Accesorios adicionales entregados con el reductor</label>
                <div class="col-sm-6">
                    <textarea required class="form-control" id="pulleyInputShaft" name="pulleyInputShaft" rows="3"></textarea>
                </div>
            </div>
            <div class="form-group row">
                <label for="problemDescription" class="col-sm-6 col-form-label">Descripción del problema</label>
                <div class="col-sm-6">
                    <textarea required class="form-control" id="problemDescription" name="problemDescription" rows="3"></textarea>
                </div>
            </div>
            <h4 class="text-center">Pruebas de ingreso realizadas</h5>
            <div class="form-group row">
                <label for="powerConsumption" class="col-sm-6 col-form-label">Consumo de corriente</label>
                <div class="col-sm-6">
                    <input type="text" class="form-control" id="powerConsumption" name="powerConsumption" required>
                </div>
            </div>
            <div class="form-group row">
                <label for="electricalIsolation" class="col-sm-6 col-form-label">Aislamiento</label>
                <div class="col-sm-6">
                    <input type="text" class="form-control" id="electricalIsolation" name="electricalIsolation" required>
                </div>
            </div>
            <div class="form-group row">
                <label for="averageCoilResistance" class="col-sm-6 col-form-label">Resitencia media de bobinas</label>
                <div class="col-sm-6">
                    <input type="text" class="form-control" id="averageCoilResistance" name="averageCoilResistance" required>
                </div>
            </div>
            <div class="form-group row">
                <label for="noiseLevel" class="col-sm-6 col-form-label">Nivel de ruido</label>
                <select class="form-control col-sm-6" id="noiseLevel" name="noiseLevel" required>
                    <option value="normal">Normal</option>
                    <option value="medio">Medio</option>
                    <option value="alto">Alto</option>
                </select>
            </div>
            <div class="form-group row">
                <label for="vibration" class="col-sm-6 col-form-label">Vibración</label>
                <select class="form-control col-sm-6" id="vibration" name="vibration" required>
                    <option value="normal">Normal</option>
                    <option value="medio">Medio</option>
                    <option value="alto">Alto</option>
                </select>
            </div>
            <div class="form-group row">
                <label for="workSummary" class="col-sm-12 col-form-label">Trabajos realizados:</label>
                <div class="col-sm-12">
                    <input type="text" class="form-control" id="workSummary" name="workSummary" required>
                </div>
            </div>
            <div class="form-group row">
                <label for="price" class="col-sm-6 col-form-label">Cotización</label>
                <div class="col-sm-6">
                    <input type="text" class="form-control" id="price" name="price" required>
                </div>
            </div>
            <div class="form-group row">
                <label for="preliminaryComments" class="col-sm-6 col-form-label">Comentarios preliminares</label>
                <div class="col-sm-6">
                    <input type="text" class="form-control" id="preliminaryComments" name="preliminaryComments" required>
                </div>
            </div>
            <!-- END Gearmotor data -->
            <h3 class="text-center">OBSERVACIONES GENERALES</h3>
            <h4 class="text-center">REGISTRO FOTOGRAFICO</h4>
            <!-- Gearbox revision -->
            <h5 class="text-center">Inspección Caja Reductora:</h5>
            <!-- <div class="form-group row">
                <label for="gearboxDescription" class="col-sm-6 col-form-label">Descripción</label>
                <div class="col-sm-6">
                    <input type="text" class="form-control" id="gearboxDescription">
                </div>
            </div> -->
            <div class="form-group row">
                <div class="col-sm-6">
                    <label for="gearboxImage1">Imagen 1 de la caja reductora</label>
                    <input type="file" class="form-control-file" id="gearboxImage1" name="gearboxImage1" accept="image/*" onchange="showGearboxImage1()">
                </div>
                <div class="col-sm-6">
                    <label for="gearboxImage2">Imagen 2 de la caja reductora</label>
                    <input type="file" class="form-control-file" id="gearboxImage2" name="gearboxImage2" accept="image/*" onchange="showGearboxImage2()">
                </div>
                <div class="col-sm-6">
                    <div id="gearboxImagePreview1"></div>
                </div>
                <div class="col-sm-6">
                    <div id="gearboxImagePreview2"></div>
                </div>
            </div>
            <div class="form-group row">
                <label for="gearboxRevision" class="col-sm-6 col-form-label">Revisión técnica</label>
                <select class="form-control col-sm-6" multiple="multiple" id="gearboxRevision" name="gearboxRevision[]">
                    <option value="fuga">Llega con fuga</option>
                    <option value="eje_malo">Eje en mal estado</option>
                    <option value="fisuras">Carcasa Fisurada</option>
                    <option value="aceite">Fuga aceite</option>
                </select>
            </div>
            <div class="form-group row">
                <label for="gearboxComments" class="col-sm-6 col-form-label">Comentarios:</label>
                <div class="col-sm-6">
                    <input type="text" class="form-control" id="gearboxComments" name="gearboxComments">
                </div>
            </div>
            <!-- END Gearbox revision -->
            <!-- Gears revision -->
            <h5 class="text-center">Inspección Engranajes:</h5>
            <div class="form-group row">
                <div class="col-sm-6">
                    <label for="gearImage1">Imagen 1 del engranaje</label>
                    <input type="file" class="form-control-file" id="gearImage1" name="gearImage1" accept="image/*" onchange="showGearImage(1)">
                </div>
                <div class="col-sm-6">
                    <label for="gearImage2">Imagen 2 del engranaje</label>
                    <input type="file" class="form-control-file" id="gearImage2" name="gearImage2" accept="image/*" onchange="showGearImage(2)">
                </div>
                <div class="col-sm-6">
                    <div id="gearImagePreview1"></div>
                </div>
                <div class="col-sm-6">
                    <div id="gearImagePreview2"></div>
                </div>
            </div>
            <div class="form-group row">
                <div class="col-sm-6">
                    <label for="gearImage3">Imagen 3 del engranaje</label>
                    <input type="file" class="form-control-file" id="gearImage3" name="gearImage3" accept="image/*" onchange="showGearImage(3)">
                </div>
                <div class="col-sm-6">
                    <label for="gearImage4">Imagen 4 del engranaje</label>
                    <input type="file" class="form-control-file" id="gearImage4" name="gearImage4" accept="image/*" onchange="showGearImage(4)">
                </div>
                <div class="col-sm-6">
                    <div id="gearImagePreview3"></div>
                </div>
                <div class="col-sm-6">
                    <div id="gearImagePreview4"></div>
                </div>
            </div>
            <div class="form-group row">
                <label for="gearRevision" class="col-sm-6 col-form-label">Revisión técnica</label>
                <select class="form-control col-sm-6" multiple="multiple" id="gearRevision" name="gearRevision[]">
                    <option value="ok">Piñoneria OK</option>
                    <option value="normal">Muestra trabajo normal</option>
                    <option value="anormal">Desgaste anormal</option>
                    <option value="pitting">Pitting</option>
                    <option value="dientes_rotos">Dientes rotos</option>
                    <option value="perdida">Perdida de ajuste</option>
                    <option value="alta_temperatura">Trabajo a alta temperatura</option>
                </select>
            </div>
            <div class="form-group row">
                <label for="gearComments" class="col-sm-6 col-form-label">Comentarios:</label>
                <div class="col-sm-6">
                    <input type="text" class="form-control" id="gearComments" name="gearComments">
                </div>
            </div>
            <div class="form-group row">
                <label for="gearOil" class="col-sm-6 col-form-label">Aceite</label>
                <select id="gearOil" name="gearOil" class="form-control col-sm-6" onchange="checkAnotherGearOil()">
                    <option value="anormal">Desgaste anormal</option>
                    <option value="degradado">Degradado</option>
                    <option value="contaminado">Contaminado</option>
                    <option value="another_gear_oil">Otro</option>
                </select>
            </div>
            <div id="divGearAnotherOil" class="form-group row" style="display:none">
                <label for="gearAnotherOil" class="col-sm-6 col-form-label">Otro aceite:</label>
                <div class="col-sm-6">
                    <input type="text" class="form-control" id="gearAnotherOil" name="gearAnotherOil">
                </div>
            </div>
            <!-- END Gears revision -->
            <!-- Bearings revision -->
            <h5 class="text-center">Inspección Rodamientos:</h5>
            <div class="form-group row">
                <div class="col-sm-6">
                    <label for="bearingImage1">Imagen 1 del rodamiento</label>
                    <input type="file" class="form-control-file" id="bearingImage1" name="bearingImage1" accept="image/*" onchange="showBearingImage(1)">
                </div>
                <div class="col-sm-6">
                    <label for="bearingImage2">Imagen 2 del rodamiento</label>
                    <input type="file" class="form-control-file" id="bearingImage2" name="bearingImage2" accept="image/*" onchange="showBearingImage(2)">
                </div>
                <div class="col-sm-6">
                    <div id="bearingImagePreview1"></div>
                </div>
                <div class="col-sm-6">
                    <div id="bearingImagePreview2"></div>
                </div>
            </div>
            <div class="form-group row">
                <div class="col-sm-6">
                    <label for="bearingImage3">Imagen 3 del rodamiento</label>
                    <input type="file" class="form-control-file" id="bearingImage3" name="bearingImage3" accept="image/*" onchange="showBearingImage(3)">
                </div>
                <div class="col-sm-6">
                    <label for="bearingImage4">Imagen 4 del rodamiento</label>
                    <input type="file" class="form-control-file" id="bearingImage4" name="bearingImage4" accept="image/*" onchange="showBearingImage(4)">
                </div>
                <div class="col-sm-6">
                    <div id="bearingImagePreview3"></div>
                </div>
                <div class="col-sm-6">
                    <div id="bearingImagePreview4"></div>
                </div>
            </div>
            <div class="form-group row">
                <label for="bearingRevision" class="col-sm-6 col-form-label">Revisión técnica</label>
                <select class="form-control col-sm-6" multiple="multiple" id="bearingRevision" name="bearingRevision[]">
                    <option value="normal">Desgaste normal</option>
                    <option value="anormal">Desgaste anormal</option>
                    <option value="rayadas">Pistas rayadas</option>
                    <option value="mal_estado">Elementos rodantes en mal estado</option>
                    <option value="rota">Pista rota</option>
                    <option value="destruido">Rodamiento destruido</option>
                    <option value="alta_temperatura">Trabajo a alta temperatura</option>
                    <option value="carga_anormal">Evidencia carga anormal</option>
                    <option value="lubricacion">Falta lubricacion</option>
                </select>
            </div>
            <div class="form-group row">
                <label for="bearingComments" class="col-sm-6 col-form-label">Comentarios:</label>
                <div class="col-sm-6">
                    <input type="text" class="form-control" id="bearingComments" name="bearingComments">
                </div>
            </div>
            <!-- END Bearings revision -->
            <!-- Axis revision -->
            <h5 class="text-center">Inspección Ejes:</h5>
            <div class="form-group row">
                <div class="col-sm-6">
                    <label for="axisImage1">Imagen 1 del eje</label>
                    <input type="file" class="form-control-file" id="axisImage1" name="axisImage1" accept="image/*" onchange="showAxisImage(1)">
                </div>
                <div class="col-sm-6">
                    <label for="axisImage2">Imagen 2 del eje</label>
                    <input type="file" class="form-control-file" id="axisImage2" name="axisImage2" accept="image/*" onchange="showAxisImage(2)">
                </div>
                <div class="col-sm-6">
                    <div id="axisImagePreview1"></div>
                </div>
                <div class="col-sm-6">
                    <div id="axisImagePreview2"></div>
                </div>
            </div>
            <div class="form-group row">
                <label for="axisRevision" class="col-sm-6 col-form-label">Revisión técnica</label>
                <select class="form-control col-sm-6" multiple="multiple" id="axisRevision" name="axisRevision[]">
                    <option value="marcado">Eje marcado en zona de retenedor</option>
                    <option value="desprendimiento">Desprendimiento material</option>
                    <option value="deformado">Cuñero deformado</option>
                    <option value="torcido">Eje torcido</option>
                    <option value="fracturado">Eje fracturado</option>
                </select>
            </div>
            <div class="form-group row">
                <label for="axisComments" class="col-sm-6 col-form-label">Comentarios:</label>
                <div class="col-sm-6">
                    <input type="text" class="form-control" id="axisComments" name="axisComments">
                </div>
            </div>
            <!-- END Axis revision -->
            <!-- Casing revision -->
            <h5 class="text-center">Inspección Carcazas:</h5>
            <div class="form-group row">
                <div class="col-sm-6">
                    <label for="casingImage1">Imagen 1 de la carcaza</label>
                    <input type="file" class="form-control-file" id="casingImage1" name="casingImage1" accept="image/*" onchange="showCasingImage(1)">
                </div>
                <div class="col-sm-6">
                    <label for="casingImage2">Imagen 2 de la carcaza</label>
                    <input type="file" class="form-control-file" id="casingImage2" name="casingImage2" accept="image/*" onchange="showCasingImage(2)">
                </div>
                <div class="col-sm-6">
                    <div id="casingImagePreview1"></div>
                </div>
                <div class="col-sm-6">
                    <div id="casingImagePreview2"></div>
                </div>
            </div>
            <div class="form-group row">
                <label for="casingRevision" class="col-sm-6 col-form-label">Revisión técnica</label>
                <select class="form-control col-sm-6" multiple="multiple" id="casingRevision" name="casingRevision[]">
                    <option value="fisurado">Fisurado</option>
                    <option value="normal">Normal</option>
                    <option value="fuera_de_ajuste">Asiento de rodamiento fuera de ajuste</option>
                </select>
            </div>
            <div class="form-group row">
                <label for="casingComments" class="col-sm-6 col-form-label">Comentarios:</label>
                <div class="col-sm-6">
                    <input type="text" class="form-control" id="casingComments" name="casingComments">
                </div>
            </div>
            <!-- END Casing revision -->
            <h4 class="text-center">Motor</h4>
            <!-- general engine revision -->
            <h5 class="text-center">Inspección General:</h5>
            <div class="form-group row">
                <div class="col-sm-6">
                    <label for="engineImage">Foto general</label>
                    <input type="file" class="form-control-file" id="engineImage" name="engineImage" accept="image/*" onchange="showEngineImage()">
                </div>
                <div class="col-sm-6">
                    <div id="engineImagePreview"></div>
                </div>
            </div>
            <div class="form-group row">
                <label for="engineRevision" class="col-sm-6 col-form-label">Revisión técnica</label>
                <select class="form-control col-sm-6" multiple="multiple" id="engineRevision" name="engineRevision[]">
                    <option value="quemado">Motor quemado</option>
                    <option value="rebobinado">Rebobinado</option>
                    <option value="ninguna">Ninguna</option>
                </select>
            </div>
            <div class="form-group row">
                <label for="engineComments" class="col-sm-6 col-form-label">Comentarios:</label>
                <div class="col-sm-6">
                    <input type="text" class="form-control" id="engineComments" name="engineComments">
                </div>
            </div>
            <!-- END Engine revision -->
            <!-- Stator revision -->
            <h5 class="text-center">Inspección Estator:</h5>
            <div class="form-group row">
                <div class="col-sm-6">
                    <label for="statorImage1">Imagen 1 del estator</label>
                    <input type="file" class="form-control-file" id="statorImage1" name="statorImage1" accept="image/*" onchange="showStatorImage(1)">
                </div>
                <div class="col-sm-6">
                    <label for="statorImage2">Imagen 2 del estator</label>
                    <input type="file" class="form-control-file" id="statorImage2" name="statorImage2" accept="image/*" onchange="showStatorImage(2)">
                </div>
                <div class="col-sm-6">
                    <div id="statorImagePreview1"></div>
                </div>
                <div class="col-sm-6">
                    <div id="statorImagePreview2"></div>
                </div>
            </div>
            <div class="form-group row">
                <label for="statorRevision" class="col-sm-6 col-form-label">Revisión técnica</label>
                <select class="form-control col-sm-6" multiple="multiple" id="statorRevision" name="statorRevision[]">
                    <option value="normal">Condiciones normales</option>
                    <option value="recalentado">Recalentado</option>
                    <option value="amarres_rotos">Amarres rotos</option>
                    <option value="corto">En corto</option>
                    <option value="rebobinado">Rebobinado</option>
                    <option value="paso_aceite">Con paso de aceite</option>
                </select>
            </div>
            <div class="form-group row">
                <label for="statorComments" class="col-sm-6 col-form-label">Comentarios:</label>
                <div class="col-sm-6">
                    <input type="text" class="form-control" id="statorComments" name="statorComments">
                </div>
            </div>
            <!-- END Stator revision -->
            <!-- Rotor revision -->
            <h5 class="text-center">Inspección Rotor:</h5>
            <div class="form-group row">
                <div class="col-sm-6">
                    <label for="rotorImage1">Imagen 1 del rotor</label>
                    <input type="file" class="form-control-file" id="rotorImage1" name="rotorImage1" accept="image/*" onchange="showRotorImage(1)">
                </div>
                <div class="col-sm-6">
                    <label for="rotorImage2">Imagen 2 del rotor</label>
                    <input type="file" class="form-control-file" id="rotorImage2" name="rotorImage2" accept="image/*" onchange="showRotorImage(2)">
                </div>
                <div class="col-sm-6">
                    <div id="rotorImagePreview1"></div>
                </div>
                <div class="col-sm-6">
                    <div id="rotorImagePreview2"></div>
                </div>
            </div>
            <div class="form-group row">
                <label for="rotorRevision" class="col-sm-6 col-form-label">Revisión técnica</label>
                <select class="form-control col-sm-6" multiple="multiple" id="rotorRevision" name="rotorRevision[]">
                    <option value="normal">Condiciones normales</option>
                    <option value="marcado">Marcado en zona de retenedor</option>
                    <option value="torcido">Torcido</option>
                    <option value="fracturado">Fracturado</option>
                    <option value="golpeado">Golpeado</option>
                    <option value="recalentado">Recalentado</option>
                </select>
            </div>
            <div class="form-group row">
                <label for="rotorComments" class="col-sm-6 col-form-label">Comentarios:</label>
                <div class="col-sm-6">
                    <input type="text" class="form-control" id="rotorComments" name="rotorComments">
                </div>
            </div>
            <!-- END Rotor revision -->
            <!-- Cover revision -->
            <h5 class="text-center">Inspección de las tapas:</h5>
            <div class="form-group row">
                <div class="col-sm-6">
                    <label for="coverImage1">Foto lado A</label>
                    <input type="file" class="form-control-file" id="coverImage1" name="coverImage1" accept="image/*" onchange="showCoverImage(1)">
                </div>
                <div class="col-sm-6">
                    <label for="coverImage2">Foto lado B</label>
                    <input type="file" class="form-control-file" id="coverImage2" name="coverImage2" accept="image/*" onchange="showCoverImage(2)">
                </div>
                <div class="col-sm-6">
                    <div id="coverImagePreview1"></div>
                </div>
                <div class="col-sm-6">
                    <div id="coverImagePreview2"></div>
                </div>
            </div>
            <div class="form-group row">
                <div class="col-sm-6">
                    <label for="coverRevisionA" class="col-sm-6 col-form-label">Revisión técnica lado A</label>
                    <select class="form-control col-sm-6" multiple="multiple" id="coverRevisionA" name="coverRevisionA[]">
                        <option value="normal">Normal</option>
                        <option value="fuera">Fuera de ajuste</option>
                        <option value="fracturado">Fracturado</option>
                        <option value="oxidado">Oxidado</option>
                    </select>
                </div>
                <div class="col-sm-6">
                    <label for="coverRevisionB" class="col-sm-6 col-form-label">Revisión técnica lado B</label>
                    <select class="form-control col-sm-6" multiple="multiple" id="coverRevisionB" name="coverRevisionB[]">
                        <option value="normal">Normal</option>
                        <option value="fuera">Fuera de ajuste</option>
                        <option value="fracturado">Fracturado</option>
                        <option value="oxidado">Oxidado</option>
                    </select>
                </div>
            </div>
            <div class="form-group row">
                <div class="col-sm-6">
                    <label for="coverCommentsA" class="col-sm-6 col-form-label">Comentarios lado A:</label>
                    <div class="col-sm-6">
                        <input type="text" class="form-control" id="coverCommentsA" name="coverCommentsA">
                    </div>
                </div>
                <div class="col-sm-6">
                    <label for="coverCommentsB" class="col-sm-6 col-form-label">Comentarios lado B:</label>
                    <div class="col-sm-6">
                        <input type="text" class="form-control" id="coverCommentsB" name="coverCommentsB">
                    </div>
                </div>
            </div>
            <!-- END Rotor revision -->
            <!-- Brake revision -->
            <h5 class="text-center">Inspección Freno:</h5>
            <div class="form-group row">
                <div class="col-sm-6">
                    <label for="brakeImage1">Imagen 1 del freno</label>
                    <input type="file" class="form-control-file" id="brakeImage1" name="brakeImage1" accept="image/*" onchange="showBrakeImage(1)">
                </div>
                <div class="col-sm-6">
                    <label for="brakeImage2">Imagen 2 del freno</label>
                    <input type="file" class="form-control-file" id="brakeImage2" name="brakeImage2" accept="image/*" onchange="showBrakeImage(2)">
                </div>
                <div class="col-sm-6">
                    <div id="brakeImagePreview1"></div>
                </div>
                <div class="col-sm-6">
                    <div id="brakeImagePreview2"></div>
                </div>
            </div>
            <div class="form-group row">
                <label for="brakeRevision" class="col-sm-6 col-form-label">Revisión técnica</label>
                <select class="form-control col-sm-6" multiple="multiple" id="brakeRevision" name="brakeRevision[]">
                    <option value="normal">Normal</option>
                    <option value="recalentado">Recalentado</option>
                    <option value="quemado">Quemado</option>
                    <option value="intervenido">Intervenido por el cliente</option>
                    <option value="descalibrado">Descalibrado</option>
                    <option value="desgaste">Desgaste anormal del disco</option>
                </select>
            </div>
            <div class="form-group row">
                <label for="brakeComments" class="col-sm-6 col-form-label">Comentarios:</label>
                <div class="col-sm-6">
                    <input type="text" class="form-control" id="brakeComments" name="brakeComments">
                </div>
            </div>
            <!-- END Brake revision -->
            <h4 class="text-center">Reporte técnico y conclusiones</h4>
            <div class="form-group row">
                <div class="col-sm-12">
                    <textarea class="form-control" id="finalReportTextarea" name="finalReportTextarea" rows="3" required></textarea>
                </div>
            </div>
            <div class="form-group row">
                <label for="autorName" class="col-sm-6 col-form-label">Revisado por:</label>
                <select class="form-control col-sm-6" id="autorName" name="autorName" required>
                    <option value="elvis">Elvis Medina</option>
                    <option value="felipe">Felipe Romero</option>
                    <option value="juan">Juan Gamboa</option>
                    <option value="jose">José Gómez</option>
                    <option value="jairo">Jairo Fajardo</option>
                    <option value="michael">Michael Mora</option>
                    <option value="estiben">Estiben Henao</option>
                    <option value="patino">Juan Patiño</option>
                    <option value="carlos">Carlos Castellanos</option>
                    <option value="cristian">Cristian Cuitiva</option>
                    <option value="edwin">Edwin Bedoya</option>
                    <option value="ramiro">Ramiro Mahecha</option>
                    <option value="jhon">Jhon Llano</option>
                    <option value="serna">Edwin Serna</option>
                    <option value="jesus">Jesús Cantillo</option>
                    <option value="jimenez">Jesús Jiménez</option>
                </select>
            </div>
            <div class="d-flex justify-content-center align-items-center" style="padding-bottom: 2%;">
                <button type="submit" class="btn btn-primary">Generar informe PDF</button>
            </div>
        </form>
    </div>
</div>
<!-- Central Modal Medium Success-->
</body>
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