{"id":7084,"date":"2020-11-26T15:26:03","date_gmt":"2020-11-26T15:26:03","guid":{"rendered":"http:\/\/www.soyclienteprisma.com\/?page_id=7084"},"modified":"2020-11-27T15:11:20","modified_gmt":"2020-11-27T15:11:20","slug":"gastos-medicos","status":"publish","type":"page","link":"https:\/\/www.segurosprismacr.com\/gastos-medicos\/","title":{"rendered":"Formulario &#8211; Gastos M\u00e9dicos"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"7084\" class=\"elementor elementor-7084\">\n\t\t\t\t\t\t<div class=\"elementor-inner\">\n\t\t\t\t<div class=\"elementor-section-wrap\">\n\t\t\t\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-26b0528 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"26b0528\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t\t\t<div class=\"elementor-row\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-eb425b0\" data-id=\"eb425b0\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-column-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-08fa3a3 elementor-widget elementor-widget-heading\" data-id=\"08fa3a3\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<p class=\"elementor-heading-title elementor-size-default\">Adquiera su Seguro ya !!!\n<\/p>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-62cafcb elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"62cafcb\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t\t\t<div class=\"elementor-row\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-b3f7d40\" data-id=\"b3f7d40\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-column-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-d878591 elementor-widget elementor-widget-wpforms\" data-id=\"d878591\" data-element_type=\"widget\" data-widget_type=\"wpforms.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<div class=\"wpforms-container wpforms-container-full\" id=\"wpforms-7148\"><form id=\"wpforms-form-7148\" class=\"wpforms-validate wpforms-form\" data-formid=\"7148\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/wp-json\/wp\/v2\/pages\/7084\" data-token=\"cc9a6a2bf09c7cd453431d25ec240334\"><noscript class=\"wpforms-error-noscript\">Por favor, activa JavaScript en tu navegador para completar este formulario.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-7148-field_5-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half wpforms-first\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-7148-field_5\">Nombre Completo o Raz\u00f3n Social <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-7148-field_5\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][5]\" required><\/div><div id=\"wpforms-7148-field_17-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half\" data-field-id=\"17\"><label class=\"wpforms-field-label\" for=\"wpforms-7148-field_17\">N\u00famero de Identificaci\u00f3n <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-7148-field_17\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][17]\" required><\/div><div id=\"wpforms-7148-field_7-container\" class=\"wpforms-field wpforms-field-email wpforms-one-half wpforms-first\" data-field-id=\"7\"><label class=\"wpforms-field-label\" for=\"wpforms-7148-field_7\">Correo electr\u00f3nico <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-7148-field_7\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][7]\" required><\/div><div id=\"wpforms-7148-field_15-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half\" data-field-id=\"15\"><label class=\"wpforms-field-label\" for=\"wpforms-7148-field_15\">Tel\u00e9fono <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-7148-field_15\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][15]\" required><\/div><div id=\"wpforms-7148-field_9-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"9\"><label class=\"wpforms-field-label\" for=\"wpforms-7148-field_9\">Provincia <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-7148-field_9\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][9]\" required><\/div><div id=\"wpforms-7148-field_10-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half wpforms-first\" data-field-id=\"10\"><label class=\"wpforms-field-label\" for=\"wpforms-7148-field_10\">Fecha de Nacimiento <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-7148-field_10\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][10]\" required><\/div><div id=\"wpforms-7148-field_16-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half\" data-field-id=\"16\"><label class=\"wpforms-field-label\" for=\"wpforms-7148-field_16\">Edad <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-7148-field_16\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][16]\" required><\/div><div id=\"wpforms-7148-field_20-container\" class=\"wpforms-field wpforms-field-radio wpforms-one-half wpforms-first\" data-field-id=\"20\"><label class=\"wpforms-field-label\" for=\"wpforms-7148-field_20\">G\u00e9nero <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-7148-field_20\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-7148-field_20_1\" name=\"wpforms[fields][20]\" value=\"Masculino\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-7148-field_20_1\">Masculino<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-7148-field_20_2\" name=\"wpforms[fields][20]\" value=\"Femenino\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-7148-field_20_2\">Femenino<\/label><\/li><\/ul><\/div><div id=\"wpforms-7148-field_21-container\" class=\"wpforms-field wpforms-field-radio wpforms-one-half\" data-field-id=\"21\"><label class=\"wpforms-field-label\" for=\"wpforms-7148-field_21\">Padecimientos o Enfermedades <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-7148-field_21\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-7148-field_21_1\" name=\"wpforms[fields][21]\" value=\"No\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-7148-field_21_1\">No<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-7148-field_21_2\" name=\"wpforms[fields][21]\" value=\"Si\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-7148-field_21_2\">Si<\/label><\/li><\/ul><\/div><\/div><div class=\"wpforms-submit-container\"><input type=\"hidden\" name=\"wpforms[id]\" value=\"7148\"><input type=\"hidden\" name=\"wpforms[author]\" value=\"1\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-7148\" class=\"wpforms-submit\" data-alt-text=\"Enviando...\" data-submit-text=\"Enviar\" aria-live=\"assertive\" value=\"wpforms-submit\">Enviar<\/button><\/div><\/form><\/div>  <!-- .wpforms-container -->\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Adquiera su Seguro ya !!!<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/www.segurosprismacr.com\/wp-json\/wp\/v2\/pages\/7084"}],"collection":[{"href":"https:\/\/www.segurosprismacr.com\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.segurosprismacr.com\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.segurosprismacr.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.segurosprismacr.com\/wp-json\/wp\/v2\/comments?post=7084"}],"version-history":[{"count":7,"href":"https:\/\/www.segurosprismacr.com\/wp-json\/wp\/v2\/pages\/7084\/revisions"}],"predecessor-version":[{"id":7151,"href":"https:\/\/www.segurosprismacr.com\/wp-json\/wp\/v2\/pages\/7084\/revisions\/7151"}],"wp:attachment":[{"href":"https:\/\/www.segurosprismacr.com\/wp-json\/wp\/v2\/media?parent=7084"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}