Sinistre 1

Nature du sinistre

Responsabilité du conducteur

Sinistre 1

Nature du sinistre

Responsabilité du conducteur

          

HTML


PUG

.form-details-info  
  .details-info
    header
      | Sinistre 1
      button.chip.-icon.-icon-with-text-md
        i.maificon.maificon-trash(aria-hidden="true")
        span Supprimer
    .content
      .form-group
        .row
          .col-md-4.col-8
            label Date du sinistre
            label.label-sub (au format MM/AAAA)
            .form-date.form-date-lointaine
              input(type='month')
      .form-group(role="radiogroup" aria-labelledby="radio-details-info")
        p#radio-details-info.field-label Nature du sinistre
        .field-item.form-check.inline
          .row
            .col-md-3.col-6
              .item
                input(type='radio' name='name-details-info')#radio-details-info-1
                label(for='radio-details-info-1') 
                  span Collision
            .col-md-3.col-6
              .item
                input(type='radio' name='name-details-info')#radio-details-info-2
                label(for='radio-details-info-2') 
                  span  Autre
      .form-group(role="radiogroup" aria-labelledby="radio-details-info-1")
        p#radio-details-info-1.field-label Responsabilité du conducteur
        .field-item.form-check.inline
          .row
            .col-md-3.col-6
              .item
                input(type='radio' name='name-details-info-1')#radio-details-info-1-1
                label(for='radio-details-info-1-1') 
                  span Entière
            .col-md-3.col-6
              .item
                input(type='radio' name='name-details-info-1')#radio-details-info-1-2
                label(for='radio-details-info-1-2') 
                  span  Partielle
            .col-md-3.col-6
              .item
                input(type='radio' name='name-details-info-1')#radio-details-info-1-2
                label(for='radio-details-info-1-2') 
                  span  Aucune

.form-details-info.has-error
  .details-info
    header
      | Sinistre 1
      button.chip.-icon.-icon-with-text-md
        i.maificon.maificon-trash(aria-hidden="true")
        span Supprimer
    .content
      .form-group
        .row
          .col-md-4.col-8
            label Date du sinistre
            label.label-sub (au format MM/AAAA)
            .form-date.form-date-lointaine
              input(type='month')
      .form-group(role="radiogroup" aria-labelledby="radio-details-info-2")
        p#radio-details-info-2.field-label Nature du sinistre
        .field-item.form-check.inline
          .row
            .col-md-3.col-6
              .item
                input(type='radio' name='name-details-info-2')#radio-details-info-2-1
                label(for='radio-details-info-2-1') 
                  span Collision
            .col-md-3.col-6
              .item
                input(type='radio' name='name-details-info-2')#radio-details-info-2-2
                label(for='radio-details-info-2-2') 
                  span  Autre
      .form-group(role="radiogroup" aria-labelledby="radio-details-info-1")
        p#radio-details-info-1.field-label Responsabilité du conducteur
        .field-item.form-check.inline
          .row
            .col-md-3.col-6
              .item
                input(type='radio' name='name-details-info-2-1')#radio-details-info-2-1
                label(for='radio-details-info-2-1') 
                  span Entière
            .col-md-3.col-6
              .item
                input(type='radio' name='name-details-info-2-1')#radio-details-info-2-2
                label(for='radio-details-info-2-2') 
                  span  Partielle
            .col-md-3.col-6
              .item
                input(type='radio' name='name-details-info-2-1')#radio-details-info-2-2
                label(for='radio-details-info-2-2') 
                  span  Aucune