| 202
| <![CDATA[<input type="radio" required="required" name="categoria" value="AUXILIAR DE ENFERMAEGM">]]>
|
| 203
| <![CDATA[<input type="radio" required="required" name="categoria" value="TÉCNICO DE ENFERMAGEM">]]>
|
| 204
| <![CDATA[<input type="radio" required="required" name="categoria" value="ENFERMEIRO">]]>
|
| 205
| <![CDATA[<input type="radio" required="required" name="categoria" value="OBSTETRIZ">]]>
|
| 206
| <![CDATA[<input type="radio" required="required" name="categoria" value="CIDADAO">]]>
|
| 214
| <![CDATA[<input class="form-control" required="required" type="text" name="nome_profissional" id="nome_profissional"/>]]>
|
| 219
| <![CDATA[<input class="form-control" required type="text" name="telefone_profissional" size="11" minlength="11" maxlength="11" pattern="^\d{2}\d{5}\d{4}$" id="telefone_profissional"/>]]>
|
| 223
| <![CDATA[<input class="form-control" required="required" type="text" name="cpf_profissional" size="11" minlength="0" maxlength="11"/>]]>
|
| 227
| <![CDATA[<input class="form-control" required="required" type="email" name="email_profissional" id="email_profissional" />]]>
|
| 231
| <![CDATA[<input class="form-control" required="required" type="email" name="confirmaremail" id="confirmaremail" onpaste="return false;" />]]>
|
| 240
| <![CDATA[<input class="form-control" id="capcha2" name="capcha2" type="text" class="input-xlarge" required="required" >]]>
|
| 236
| <![CDATA[<textarea required="required" name="mensagem" rows="5" cols="30" class="form-control"></textarea>]]>
|
| 210
| <![CDATA[<select class="form-control" name="id_assunto" required="true"><option value=""></option><option value="1">INSCRIÇÃO</option><option value="2">FINANCEIRO</option><option value="3">FISCALIZAÇÃO</option><option value="4">OUTROS</option><option value="6">RESP. TÉCNICA</option><option value="7">COREN ONLINE</option><option value="8">CURSOS E EVENTOS</option><option value="9">PROCESSO ÉTICO</option><option value="10">ANUIDADE</option><option value="11">COBRANÇA</option><option value="12">DENÚNCIA DE INSTITUIÇÃO</option><option value="13">PARECER TÉCNICO</option></select>]]>
|
| 258
| <![CDATA[<input class="form-control" required="required" type="text" name="cpf_profissional" size="11" minlength="0" maxlength="11"/>]]>
|
| 262
| <![CDATA[<input class="form-control" required="required" type="email" name="email_profissional" id="email_profissional" />]]>
|
| 266
| <![CDATA[<input class="form-control" id="capcha2" name="capcha2" type="text" class="input-xlarge" required="required" >]]>
|
