{!!  Form::open(array('url' =>  URL::to("painel/cliente/perfil/gravar"),'method'=>'post', 'id'=>'form-cadastro-cliente', 'class'=>"formSend navioSend",'files'=> true))  !!}
<input name="_token" class="token" type="hidden" value="">
<div class="">
    <div class="row">
        <div class="col-xs-12 col-sm-4">
            <div class="form-group"> 
                <input type="hidden" name="id" value="" class="   idCliente"/>
                <label> Nome Completo* </label><br/>
                {!!  Form::text('Nome', null, array('class'=>'form-control Nome'))  !!}
            </div>
        </div>
        <div class="col-xs-12 col-sm-4">
            <div class="form-group">
                <label> Cpf * </label><br/>
                {!!  Form::text('Cpf', null, array('class'=>'form-control  Cpf'))  !!}
            </div>
        </div>  
        <div class="col-xs-12 col-sm-3">
            <div class="form-group">
                <label> Data de nascimento * </label><br/>
                {!!  Form::text('DataNascimento', null, array('class'=>'form-control datepickBirth DataNascimento'))  !!}
            </div>
        </div>
    </div>  
    <div class="row">
        <div class="col-xs-12 col-sm-6">
            <div class="form-group"> 
                <label> E-mail * </label><br/>
                {!!  Form::text('Email', null, array('class'=>'form-control Email'))  !!}
            </div>
        </div>
        <div class="col-xs-12 col-sm-6">
            <div class="form-group">
                <label> Confirmar E-mail* </label><br/>
                {!!  Form::text('Confirma', null, array('class'=>'form-control Confirma'))  !!}
            </div>
        </div>      
    </div>  
    <div class="row">
        <div class="col-xs-12 col-sm-6">
            <div class="form-group"> 
                <label> Telefone * </label><br/>
                {!!  Form::text('Telefone', null, array('class'=>'form-control tel Telefone'))  !!}
            </div>
        </div>
        <div class="col-xs-12 col-sm-6">
            <div class="form-group">
                <label> Celular  </label><br/>
                {!!  Form::text('Celular', null, array('class'=>'form-control tel Celular'))  !!}
            </div>
        </div>      
    </div>  
    <div class="row">
        <div class="col-xs-4">
            <div class="form-group">
                <label> CEP * </label> 
                {!!  Form::text('Cep',  isset($row->u_cd_cep) ? $row->u_cd_cep: null, array('class'=>'form-control Cep cep-mask' ))  !!}
            </div>
        </div>
    </div>

    <div class="row">
        <div class="col-sm-4">
            <div class="form-group">
                <label> Endereço * </label>
                {!!  Form::text('Endereco',   null, array('class'=>'form-control Endereco  ' ))  !!}
            </div>
        </div> 
        <div class="col-sm-4">
            <div class="form-group">
                <label> Numero * </label>
                {!!  Form::text('Numero',    null, array('class'=>'form-control Numero ' ))  !!}
            </div>
        </div> 
        <div class="col-sm-4">
            <div class="form-group">
                <label> Complemento   </label>
                {!!  Form::text('Complemento',  null, array('class'=>'form-control Complemento  ' ))  !!}
            </div>
        </div> 

    </div>



    <div class="row">
        <div class="col-xs-4">
            <div class="form-group">
                <input type="hidden" value="" class="loadCidadesScript"   />
                <label> Bairro </label>
                {!!  Form::text('Bairro',  isset($row->u_ds_bairro) ? $row->u_ds_bairro: null, array('class'=>'form-control Bairro  ' ))  !!}
                <!--<input class="form-control Bairro" name="Bairro" placeholder=" ex. Ex" type="text">-->
            </div>
        </div> 
        <div class="col-xs-4">
            <div class="form-group">
                <label> Estado * </label> 
                {!!  Form::select('Estado', App\Services\UsuarioServices::loadEstado(),'', array('class'=>'form-control  Estado'))   !!}

            </div>
        </div>
        <div class="col-xs-4">
            <div class="form-group">
                <label> Cidade * </label>
                {!!  Form::select('Cidade', App\Services\UsuarioServices::loadCidade(), '', array('class'=>'form-control  Cidade'))   !!}
            </div>
        </div> 
    </div>
    
    <hr/>  
    
    <div class="row">
        <div class="col-sm-12">
            <button type="submit" class="btn btn-default alt btnAdicionaTicket btnSend">
                Salvar  <i class="fa fa-save "></i>
            </button> 
        </div>
    </div>
</div>
{!!  Form::close()  !!}