Formulario

${ parent.decodeEntities(`Nombre`) } * { parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el) }} /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-nombre" as=${html``} />

${ parent.decodeEntities(`Primer Apellido`) } * parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el) } /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-listing-lname_252508" as=${html``} />

${ parent.decodeEntities(`Segundo Apellido`) } * parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el) } /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-listing-lname" as=${html``} />

${ parent.decodeEntities(`Fecha de Nacimiento`) } * <${props.Flatpickr} name="mf-date" className="mf-input mf-date-input mf-left-parent " placeholder="${ parent.decodeEntities(``) } " options=${{"minDate":"","maxDate":"","dateFormat":"d-m-Y","enableTime":"","disable":[],"mode":"single","static":true,"disableMobile":true,"time_24hr":false}} value=${parent.getValue('mf-date')} onInput=${parent.handleDateTime} aria-invalid=${validation.errors['mf-date'] ? 'true' : 'false'} ref=${el => props.DateWidget( el, 'es', {"message":"This field is required.","required":true}, register, parent )} /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-date" as=${html``} />

${ parent.decodeEntities(`Sexo`) } * <${props.Select} className=${"mf-input mf-input-select " + ( validation.errors['mf-sexo'] ? 'mf-invalid' : '' )} classNamePrefix="mf_select" name="mf-sexo" placeholder="${ parent.decodeEntities(``) } " isSearchable=${false} options=${[{"label":"Hombre","value":"hombre","isDisabled":false},{"label":"Mujer","value":"mujer","isDisabled":false},{"label":"Intersex","value":"intersex","isDisabled":false},{"label":"Desconocido","value":"desconocido","isDisabled":false}]} value=${parent.getValue("mf-sexo") ? [{"label":"Hombre","value":"hombre","isDisabled":false},{"label":"Mujer","value":"mujer","isDisabled":false},{"label":"Intersex","value":"intersex","isDisabled":false},{"label":"Desconocido","value":"desconocido","isDisabled":false}].filter(item => item.value === parent.getValue("mf-sexo"))[0] : []} onChange=${(e)=> parent.handleSelect(e, "mf-sexo")} ref=${() => { register({ name: "mf-sexo" }, parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":true})); if ( parent.getValue("mf-sexo") === '' && false ) { parent.setValue( 'mf-sexo', '', true ); parent.handleChange({ target: { name: 'mf-sexo', value: '' } }); } }} /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-sexo" as=${html``} />

${ parent.decodeEntities(`Estado Civil`) } * <${props.Select} className=${"mf-input mf-input-select " + ( validation.errors['mf-estado'] ? 'mf-invalid' : '' )} classNamePrefix="mf_select" name="mf-estado" placeholder="${ parent.decodeEntities(``) } " isSearchable=${false} options=${[{"label":"Uni\u00f3n libre","value":"Uni\u00f3n libre","isDisabled":false},{"label":"Casado (a)","value":"Casado (a)","isDisabled":false},{"label":"Separado (a)","value":"Separado (a)","isDisabled":false},{"label":"Divorciado (a)","value":"Divorciado (a)","isDisabled":false},{"label":"Viudo (a)","value":"Viudo (a)","isDisabled":false},{"label":"Soltero (a)","value":"Soltero (a)","isDisabled":false},{"label":"Uni\u00f3n de Hecho","value":"Uni\u00f3n de Hecho","isDisabled":false},{"label":"Desconocido","value":"Desconocido","isDisabled":false}]} value=${parent.getValue("mf-estado") ? [{"label":"Uni\u00f3n libre","value":"Uni\u00f3n libre","isDisabled":false},{"label":"Casado (a)","value":"Casado (a)","isDisabled":false},{"label":"Separado (a)","value":"Separado (a)","isDisabled":false},{"label":"Divorciado (a)","value":"Divorciado (a)","isDisabled":false},{"label":"Viudo (a)","value":"Viudo (a)","isDisabled":false},{"label":"Soltero (a)","value":"Soltero (a)","isDisabled":false},{"label":"Uni\u00f3n de Hecho","value":"Uni\u00f3n de Hecho","isDisabled":false},{"label":"Desconocido","value":"Desconocido","isDisabled":false}].filter(item => item.value === parent.getValue("mf-estado"))[0] : []} onChange=${(e)=> parent.handleSelect(e, "mf-estado")} ref=${() => { register({ name: "mf-estado" }, parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":true})); if ( parent.getValue("mf-estado") === '' && false ) { parent.setValue( 'mf-estado', '', true ); parent.handleChange({ target: { name: 'mf-estado', value: '' } }); } }} /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-estado" as=${html``} />

${ parent.decodeEntities(`Nivel de Educación`) } * <${props.Select} className=${"mf-input mf-input-select " + ( validation.errors['mf-educacion'] ? 'mf-invalid' : '' )} classNamePrefix="mf_select" name="mf-educacion" placeholder="${ parent.decodeEntities(``) } " isSearchable=${false} options=${[{"label":"Otra","value":"Otra","isDisabled":false},{"label":"Primaria Completa","value":"Primaria Completa","isDisabled":false},{"label":"Primaria Incompleta","value":"Primaria Incompleta","isDisabled":false},{"label":"Secundaria Completa","value":"Secundaria Completa","isDisabled":false},{"label":"Secundaria Incompleta","value":"Secundaria Incompleta","isDisabled":false},{"label":"T\u00e9cnico Ina (Escuela, Comercial)","value":"T\u00e9cnico Ina (Escuela, Comercial)","isDisabled":false},{"label":"Universitario Completo","value":"Universitario Completo","isDisabled":false},{"label":"Universitario Incompleto","value":"Universitario Incompleto","isDisabled":false},{"label":"Edu.Diversificada Vocacional","value":"Edu.Diversificada Vocacional","isDisabled":false}]} value=${parent.getValue("mf-educacion") ? [{"label":"Otra","value":"Otra","isDisabled":false},{"label":"Primaria Completa","value":"Primaria Completa","isDisabled":false},{"label":"Primaria Incompleta","value":"Primaria Incompleta","isDisabled":false},{"label":"Secundaria Completa","value":"Secundaria Completa","isDisabled":false},{"label":"Secundaria Incompleta","value":"Secundaria Incompleta","isDisabled":false},{"label":"T\u00e9cnico Ina (Escuela, Comercial)","value":"T\u00e9cnico Ina (Escuela, Comercial)","isDisabled":false},{"label":"Universitario Completo","value":"Universitario Completo","isDisabled":false},{"label":"Universitario Incompleto","value":"Universitario Incompleto","isDisabled":false},{"label":"Edu.Diversificada Vocacional","value":"Edu.Diversificada Vocacional","isDisabled":false}].filter(item => item.value === parent.getValue("mf-educacion"))[0] : []} onChange=${(e)=> parent.handleSelect(e, "mf-educacion")} ref=${() => { register({ name: "mf-educacion" }, parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":true})); if ( parent.getValue("mf-educacion") === '' && false ) { parent.setValue( 'mf-educacion', '', true ); parent.handleChange({ target: { name: 'mf-educacion', value: '' } }); } }} /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-educacion" as=${html``} />

${ parent.decodeEntities(`Situación Laboral`) } * <${props.Select} className=${"mf-input mf-input-select " + ( validation.errors['mf-laboral'] ? 'mf-invalid' : '' )} classNamePrefix="mf_select" name="mf-laboral" placeholder="${ parent.decodeEntities(``) } " isSearchable=${false} options=${[{"label":"Desempleado","value":"Desempleado","isDisabled":false},{"label":"Subempleado","value":"Subempleado","isDisabled":false},{"label":"Ocupado","value":"Ocupado","isDisabled":false},{"label":"Estudiante","value":"Estudiante","isDisabled":false}]} value=${parent.getValue("mf-laboral") ? [{"label":"Desempleado","value":"Desempleado","isDisabled":false},{"label":"Subempleado","value":"Subempleado","isDisabled":false},{"label":"Ocupado","value":"Ocupado","isDisabled":false},{"label":"Estudiante","value":"Estudiante","isDisabled":false}].filter(item => item.value === parent.getValue("mf-laboral"))[0] : []} onChange=${(e)=> parent.handleSelect(e, "mf-laboral")} ref=${() => { register({ name: "mf-laboral" }, parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":true})); if ( parent.getValue("mf-laboral") === '' && false ) { parent.setValue( 'mf-laboral', '', true ); parent.handleChange({ target: { name: 'mf-laboral', value: '' } }); } }} /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-laboral" as=${html``} />

${ parent.decodeEntities(`Tipo Dependiente`) } * <${props.Select} className=${"mf-input mf-input-select " + ( validation.errors['mf-dependiente'] ? 'mf-invalid' : '' )} classNamePrefix="mf_select" name="mf-dependiente" placeholder="${ parent.decodeEntities(``) } " isSearchable=${false} options=${[{"label":"Padre,Madre o ambos","value":"Padre,Madre o ambos","isDisabled":false},{"label":"Esposa (o) Compa\u00f1era (o)","value":"Esposa (o) Compa\u00f1era (o)","isDisabled":false},{"label":"Padres e Hijo (s)","value":"Padres e Hijo (s)","isDisabled":false},{"label":"Abuelos y hermanos","value":"Abuelos y hermanos","isDisabled":false},{"label":"Hijos (as)","value":"Hijos (as)","isDisabled":false},{"label":"Otros Familiares","value":"Otros Familiares","isDisabled":false},{"label":"Esposo (a) Compa\u00f1ero (a) e Hijos (as)","value":"Esposo (a) Compa\u00f1ero (a) e Hijos (as)","isDisabled":false},{"label":"Padres y Hermano (s)","value":"Padres y Hermano (s)","isDisabled":false},{"label":"Vive Solo (a)","value":"Vive Solo (a)","isDisabled":false},{"label":"Hermano (s)","value":"Hermano (s)","isDisabled":false},{"label":"Abuelo, abuela o ambos","value":"Abuelo, abuela o ambos","isDisabled":false},{"label":"Hijo (a) y Nieto (s)","value":"Hijo (a) y Nieto (s)","isDisabled":false},{"label":"Padres, hermanos (as) Hijos (as)","value":"Padres, hermanos (as) Hijos (as)","isDisabled":false},{"label":"Nieto (s)","value":"Nieto (s)","isDisabled":false}]} value=${parent.getValue("mf-dependiente") ? [{"label":"Padre,Madre o ambos","value":"Padre,Madre o ambos","isDisabled":false},{"label":"Esposa (o) Compa\u00f1era (o)","value":"Esposa (o) Compa\u00f1era (o)","isDisabled":false},{"label":"Padres e Hijo (s)","value":"Padres e Hijo (s)","isDisabled":false},{"label":"Abuelos y hermanos","value":"Abuelos y hermanos","isDisabled":false},{"label":"Hijos (as)","value":"Hijos (as)","isDisabled":false},{"label":"Otros Familiares","value":"Otros Familiares","isDisabled":false},{"label":"Esposo (a) Compa\u00f1ero (a) e Hijos (as)","value":"Esposo (a) Compa\u00f1ero (a) e Hijos (as)","isDisabled":false},{"label":"Padres y Hermano (s)","value":"Padres y Hermano (s)","isDisabled":false},{"label":"Vive Solo (a)","value":"Vive Solo (a)","isDisabled":false},{"label":"Hermano (s)","value":"Hermano (s)","isDisabled":false},{"label":"Abuelo, abuela o ambos","value":"Abuelo, abuela o ambos","isDisabled":false},{"label":"Hijo (a) y Nieto (s)","value":"Hijo (a) y Nieto (s)","isDisabled":false},{"label":"Padres, hermanos (as) Hijos (as)","value":"Padres, hermanos (as) Hijos (as)","isDisabled":false},{"label":"Nieto (s)","value":"Nieto (s)","isDisabled":false}].filter(item => item.value === parent.getValue("mf-dependiente"))[0] : []} onChange=${(e)=> parent.handleSelect(e, "mf-dependiente")} ref=${() => { register({ name: "mf-dependiente" }, parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":true})); if ( parent.getValue("mf-dependiente") === '' && false ) { parent.setValue( 'mf-dependiente', '', true ); parent.handleChange({ target: { name: 'mf-dependiente', value: '' } }); } }} /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-dependiente" as=${html``} />

${ parent.decodeEntities(`Núcleo Familiar`) } * { parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el) }} /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-nucleo" as=${html``} /> ${ parent.decodeEntities(`Con quien vive`) }

${ parent.decodeEntities(`Tipo de Identificación`) } * <${props.Select} className=${"mf-input mf-input-select " + ( validation.errors['mf-typo'] ? 'mf-invalid' : '' )} classNamePrefix="mf_select" name="mf-typo" placeholder="${ parent.decodeEntities(``) } " isSearchable=${false} options=${[{"label":"Nacional","value":"Nacional","isDisabled":false},{"label":"Residente","value":"Residente","isDisabled":false},{"label":"Residente Temporal","value":"Residente Temporal","isDisabled":false},{"label":"Persona Extranjera","value":"Persona Extranjera","isDisabled":false},{"label":"Persona Refugiada","value":"Persona Refugiada","isDisabled":false},{"label":"Otro","value":"Otro","isDisabled":false},{"label":"Desconocido","value":"Desconocido","isDisabled":false}]} value=${parent.getValue("mf-typo") ? [{"label":"Nacional","value":"Nacional","isDisabled":false},{"label":"Residente","value":"Residente","isDisabled":false},{"label":"Residente Temporal","value":"Residente Temporal","isDisabled":false},{"label":"Persona Extranjera","value":"Persona Extranjera","isDisabled":false},{"label":"Persona Refugiada","value":"Persona Refugiada","isDisabled":false},{"label":"Otro","value":"Otro","isDisabled":false},{"label":"Desconocido","value":"Desconocido","isDisabled":false}].filter(item => item.value === parent.getValue("mf-typo"))[0] : []} onChange=${(e)=> parent.handleSelect(e, "mf-typo")} ref=${() => { register({ name: "mf-typo" }, parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":true})); if ( parent.getValue("mf-typo") === '' && false ) { parent.setValue( 'mf-typo', '', true ); parent.handleChange({ target: { name: 'mf-typo', value: '' } }); } }} /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-typo" as=${html``} />

${ parent.decodeEntities(`Referencia`) } * <${props.Select} className=${"mf-input mf-input-select " + ( validation.errors['mf-ref'] ? 'mf-invalid' : '' )} classNamePrefix="mf_select" name="mf-ref" placeholder="${ parent.decodeEntities(``) } " isSearchable=${false} options=${[{"label":"Ordinario","value":"value-1","isDisabled":false},{"label":"Fis Imas","value":"value-2","isDisabled":false},{"label":"Puente al Desarrollo","value":"value-3","isDisabled":false},{"label":"Sinirube","value":"Input Value","isDisabled":false}]} value=${parent.getValue("mf-ref") ? [{"label":"Ordinario","value":"value-1","isDisabled":false},{"label":"Fis Imas","value":"value-2","isDisabled":false},{"label":"Puente al Desarrollo","value":"value-3","isDisabled":false},{"label":"Sinirube","value":"Input Value","isDisabled":false}].filter(item => item.value === parent.getValue("mf-ref"))[0] : []} onChange=${(e)=> parent.handleSelect(e, "mf-ref")} ref=${() => { register({ name: "mf-ref" }, parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":true})); if ( parent.getValue("mf-ref") === '' && false ) { parent.setValue( 'mf-ref', '', true ); parent.handleChange({ target: { name: 'mf-ref', value: '' } }); } }} /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-ref" as=${html``} />

${ parent.decodeEntities(`Número de Teléfono`) } * parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el)} /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-telephone" as=${html``} /> ${ parent.decodeEntities(`Numero telefónico o Whatsapp`) }

${ parent.decodeEntities(`Correo Electrónico`) } * parent.activateValidation({"message":"This field is required.","emailMessage":"Please enter a valid Email address","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el)} /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-email" as=${html``} />

${ parent.decodeEntities(`Identidad Étnica`) } * <${props.Select} className=${"mf-input mf-input-select " + ( validation.errors['mf-etnica'] ? 'mf-invalid' : '' )} classNamePrefix="mf_select" name="mf-etnica" placeholder="${ parent.decodeEntities(``) } " isSearchable=${false} options=${[{"label":"Blanco o Mestizo","value":"Blanco o Mestizo","isDisabled":false},{"label":"Ind\u00edgena","value":"Ind\u00edgena","isDisabled":false},{"label":"Negra, Afrodescendiente o Mulata","value":"Negra, Afrodescendiente o Mulata","isDisabled":false},{"label":"Oriental (Asi\u00e1tico)","value":"Oriental (Asi\u00e1tico)","isDisabled":false},{"label":"Otra","value":"Otra","isDisabled":false},{"label":"No especificada","value":"No especificada","isDisabled":false}]} value=${parent.getValue("mf-etnica") ? [{"label":"Blanco o Mestizo","value":"Blanco o Mestizo","isDisabled":false},{"label":"Ind\u00edgena","value":"Ind\u00edgena","isDisabled":false},{"label":"Negra, Afrodescendiente o Mulata","value":"Negra, Afrodescendiente o Mulata","isDisabled":false},{"label":"Oriental (Asi\u00e1tico)","value":"Oriental (Asi\u00e1tico)","isDisabled":false},{"label":"Otra","value":"Otra","isDisabled":false},{"label":"No especificada","value":"No especificada","isDisabled":false}].filter(item => item.value === parent.getValue("mf-etnica"))[0] : []} onChange=${(e)=> parent.handleSelect(e, "mf-etnica")} ref=${() => { register({ name: "mf-etnica" }, parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":true})); if ( parent.getValue("mf-etnica") === '' && false ) { parent.setValue( 'mf-etnica', '', true ); parent.handleChange({ target: { name: 'mf-etnica', value: '' } }); } }} /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-etnica" as=${html``} />

${ parent.decodeEntities(`Provincia`) } * { parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el) }} /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-provincia" as=${html``} />

${ parent.decodeEntities(`Cantón`) } * { parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el) }} /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-canton" as=${html``} />

${ parent.decodeEntities(`Distrito`) } * { parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el) }} /> <${validation.ErrorMessage} errors=${validation.errors} name="mf-distrito" as=${html``} />

${ parent.decodeEntities(`Enviar`) }