<ion-view>
    <ion-content padding="true">
        <div id="register_form" class="center">
            <form ng-init="fillFormWithFacebookData()">

                <label class="item item-input">
                  <span class="input-label">Username</span>
                  <input type="text" id="username" name="username">
                </label>

                <label class="item item-input">
                  <span class="input-label">Password</span>
                  <input type="password" id="password" name="password">
                </label>

                <label class="item item-input">
                  <span class="input-label">Fist Name</span>
                  <input type="text" id="first_name" name="first_name">
                </label>

                <label class="item item-input">
                  <span class="input-label">Last Name</span>
                  <input type="text" id="last_name" name="last_name">
                </label>

                <label class="item item-input">
                  <span class="input-label">E-mail</span>
                  <input type="email" id="email" name="email">
                </label>

                <label class="item item-input item-select">
                    <span name="gender" class="input-label">Gender</span>
                    <select id="gender">
                        <option value=""></option>
                        <option id="gender_male" value="M">Male</option>
                        <option id="gender_female" value="F">Female</option>
                    </select>
                </label>

                <label class="item item-input">
                  <span class="input-label">Birthdate</span>
                  <input type="date" id="birthdate" name="birthdate">
                </label>

                <label class="item item-input item-select">
                  <span class="input-label">Document Category</span>
                  <select id="document_category">
                    <option value=""></option>
                  </select>
                </label>

                <label class="item item-input">
                  <span class="input-label">Document Number</span>
                  <input type="text" id="document_number" name="document_number">
                </label>

                <label class="item item-input">
                  <span class="input-label">Celphone Number</span>
                  <input type="text" id="cellphone_number" name="cellphone_number">
                </label>

                <label class="item item-input item-select">
                  <span class="input-label">Smoker?</span>
                  <select id="is_smoker">
                    <option value=""></option>
                    <option value="1">Yes</option>
                    <option value="0">No</option>
                  </select>
                </label>

            </form>

            <br>

            <img align="center" style="width: 75%" src="img/social_buttons/viapp_register_button.png" ng-click="register()">

        </div>
    </ion-content>
</ion-view>