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C:/SiakApp/apps/ddn/modules/LintasCapilKelahiran/templates/
files >> C:/SiakApp/apps/ddn/modules/LintasCapilKelahiran/templates/LintasCatatLahirViewSuccess.php
 <?php
include SIAK_ROOT_INCLUDE."/pages/HeaderPop.php"; 

$disSimpan = "disabled";
$disEntry ="";
if (!$success)
{
	$disSimpan = "";
	$disEntry = "disabled";
}
?>
<link href="../../css/Style_V3.css" rel="stylesheet" type="text/css">
<link href="../../../css/style_white.css" rel="stylesheet" type="text/css" />
<script language="javascript" src="../../js/jquery-1.3.2.js"></script>
<script language="javascript" src="../../lst_file/jquery.block.js"></script>
<script language="javascript" src="../../../js/ajax.js"></script>
<script language="javascript" src="../../../js/update_tgl.js"></script>
<script language="javascript" src="../../../js/siak_form.js"></script>
<script language="javascript" src="../../../js/ucase.js"></script>
<script language="javascript" src="../../../CatatanSipilAssets/js/capilFunction.js"></script>
<script language="javascript" src="../../../CatatanSipilAssets/js/capilValidate.js"></script>
<script language="javascript" src="../../../CatatanSipilAssets/js/capilBase.js"></script>
<script src="../../../js/yav-cust.js"></script>
<script src="../../../js/yav-config-cust.js"></script>
<style type="text/css">
	.biodata_hidden{ display:none}
</style>

<script language="javascript">
jQuery.noConflict();
function getDecisionNumber()
{
	if (actionGet('adm_jenis_lahir')=="LT")
	{
		/*var index = ajax.length;
		ajax[index] = new sack();
		ajax[index].requestFile = "/OnAjax/GetDecisionNumberLahir?prov=" + actionGet('admProv') + "&kab=" + actionGet('admKab');
		ajax[index].onCompletion = function(){ setDecisionNumber(index) };
		ajax[index].runAJAX();*/
	}
	else
	{
		actionSet('adm_sp_no', '');
		//actionSet('adm_sp_nama', '');

		actionSet('adm_sp_day', '');
		actionSet('adm_sp_month', '');
		actionSet('adm_sp_year', '');
	}
}

function setDecisionNumber(index)
{
	if (ajax[index].response !="({})")
	{
		var result = eval(ajax[index].response);

		for(frm in result)
		{
			if(actionObject(frm) && result[frm]) 
			{
				actionSet(frm, result[frm]);
			}
		}
	}
}

function validateLateReport()
{
	var ret = true;

	if (actionGet('adm_jenis_lahir')=='LT')
	{
		//if (!actionGet('adm_sp_nama')) ret = false;
		if (!actionGet('adm_sp_no')) ret = false;
		if (!actionGet('adm_sp_day')) ret = false;
		if (!actionGet('adm_sp_month')) ret = false;
		if (!actionGet('adm_sp_year')) ret = false;
	}
	return ret;
}
function checkTerlambat(dateFirstPrefix, dateNextPrefix, batas)
{

	var firstDay = actionGet(dateFirstPrefix + '_day');
	var firstMonth = actionGet(dateFirstPrefix + '_month');
	var firstYear = actionGet(dateFirstPrefix + '_year');
	var nextDay = actionGet(dateNextPrefix + '_day');
	var nextMonth = actionGet(dateNextPrefix + '_month');
	var nextYear = actionGet(dateNextPrefix + '_year');
    
	if (firstDay.length < 2) firstDay = '0' + firstDay;
	if (firstMonth.length < 2) firstMonth = '0' + firstMonth;
	if (nextDay.length < 2) nextDay = '0' + nextDay;
	if (nextMonth.length < 2) nextMonth = '0' + nextMonth;
	
	var dateFirst = new Date(firstYear, firstMonth-1, firstDay);
	var dateNext = new Date(nextYear, nextMonth-1, nextDay);

	var jumlahms = 1000.0 * 60.0 * 60.0 * 24.0;
	var buffer = Date.parse(dateFirst.toGMTString()) - Date.parse(dateNext.toGMTString());
	var selisih = Math.abs(Math.ceil(buffer / jumlahms));
	if ( selisih < batas ) return false; 
	else return true;
}
function aturJenisLahir(batas){
var bts = batas;
if (!checkTerlambat('bayi_lahir','pelapor_lapor',bts)) return actionSet('adm_jenis_lahir','LU'); 
else return actionSet('adm_jenis_lahir','LT'); 
}
function performSubmit()
{
	if (!validateMaxLength()) return false;

	var ret = false;
	var err = new Array();
	//===========================================================================================================================
	// Fungsi validasi untuk field yang harus diisi
	//===========================================================================================================================
	if (!actionGet('admProv')) err.push("admProv|Provinsi Harap dipilih!");
	if (!actionGet('admKab')) err.push("admKab|Kabupaten Harap dipilih!");
	if (!actionGet('bayi_nama')) err.push("bayi_nama|Isilah Nama Lengkap Bayi!");
	if (!actionGet('bayi_tempat_lahir')) err.push("bayi_tempat_lahir|Isilah Kota/Tempat Lahir Bayi!");
	if (actionGet('bayi_jenis_kelamin')<1) err.push("bayi_jenis_kelamin|Pilihlah Jenis Kelamin Bayi!");
	if (actionGet('bayi_lahir_tempat')<1) err.push("bayi_lahir_tempat|Pilihlah Tempat Dilahirkannya Bayi Ini!");
	if (actionGet('bayi_jenis_kelahiran'<1)) err.push("bayi_jenis_kelahiran|Pilihlah Jenis Kelahiran Bayi!");
	if (!actionGet('bayi_jam_lahir')) err.push("bayi_jam_lahir|Isilah Waktu Kelahiran (jam) Bayi Ini!");
	if (actionGet('bayi_jam_lahir') > 23) err.push("bayi_jam_lahir|Isilah Waktu Kelahiran (jam) Bayi Ini Dengan Benar!");
	if (!actionGet('bayi_mnt_lahir')) err.push("bayi_mnt_lahir|Isilah Waktu Kelahiran (menit) Bayi Ini!");
	if (actionGet('bayi_mnt_lahir') > 59) err.push("bayi_mnt_lahir|Isilah Waktu Kelahiran (menit) Bayi Ini Dengan Benar!");
	if (actionGet('bayi_jenis_kelahiran') < 1) err.push("bayi_jenis_kelahiran|Isilah Jenis Kelahiran Bayi Ini!");
	if (actionGet('bayi_anak_ke') < 1) err.push("bayi_anak_ke|Isilah Anak Keberapa Bayi Ini!");
	if (actionGet('bayi_penolong') < 1) err.push("bayi_penolong|Isilah Siapa Penolong Kelahiran Bayi Ini!");
	if (actionGet('bayi_berat') < 0.1) err.push("bayi_berat|Isilah Berapa Berat Bayi Ini!");
	if (actionGet('bayi_panjang') < 0.1) err.push("bayi_panjang|Isilah Berapa Panjang Bayi Ini!");
	if (!actionGet('ibu_nama')) err.push("ibu_nama|Isilah Nama Lengkap Ibu!");
	if (!actionGet('pelapor_nama')) err.push("pelapor_nama|Isilah Nama Lengkap Pelapor");
	if (!actionGet('saksi_one_nama')) err.push("saksi_one_nama|Isilah Nama Lengkap Saksi I!");
	if (!actionGet('adm_regs_nama')) err.push("adm_regs_nama|Isilah Nama Lengkap Peregister!");
	//===========================================================================================================================
	// Fungsi validasi dengan logika
	//===========================================================================================================================
	if (!validateKey('lahir_kk_no')) err.push("lahir_kk_no|Isilah No. KK Jika ada!");
	if (!validateKey('bayi_nik')) err.push("bayi_nik|Isilah NIK Bayi dengan lengkap (16 Angka) jika ada!");
	if (!validateDate('bayi_lahir')) err.push("bayi_lahir_day|Isilah Tanggal Lahir Bayi dengan benar!");
	if (!validateDateMoreThanNow('bayi_lahir')) err.push("bayi_lahir_day|Tanggal Lahir Bayi tidak boleh lebih dari tanggal sekarang!");
	if (!validateKey('ibu_nik')) err.push("ibu_nik|Isilah NIK Ibu dengan lengkap (16 Angka) jika ada!");
	if (!validateDateParent('ibu_lahir')) err.push("ibu_lahir_day|Isilah Tanggal Lahir Ibu dengan benar!");
	if (!validateDateMoreThanNow('ibu_lahir')) err.push("ibu_lahir_day|Tanggal Lahir Ibu tidak boleh lebih dari tanggal sekarang!");
	if (!validateDateParent('ayah_lahir')) err.push("ayah_lahir_day|Isilah Tanggal Lahir Ayah dengan benar!");
	if (!validateDateMoreThanNow('ayah_lahir')) err.push("ayah_lahir_day|Tanggal Lahir Ayah tidak boleh lebih dari tanggal sekarang!");
	if (!validateKey('ayah_nik')) err.push("ayah_nik|Isilah NIK Ayah dengan lengkap (16 Angka) jika ada!");
	if (!validateKey('pelapor_nik')) err.push("pelapor_nik|Isilah NIK pelapor dengan lengkap (16 Angka) jika ada!");
	if (!validateAge('pelapor', 17)) err.push("pelapor_umur|Umur Pelapor kurang dari 17 tahun!");
	if (!validateDate('pelapor_lapor')) err.push("pelapor_lapor_day|Isilah Tanggal Lapor dengan benar!");
	if (!validateDateMoreThanNow('pelapor_lapor')) err.push("pelapor_lapor_day|Tanggal Lapor tidak boleh lebih dari tanggal sekarang!");
	if (!validateKey('saksi_one_nik')) err.push("saksi_one_nik|Isilah NIK Saksi I dengan lengkap (16 Angka) jika ada!");
	if (!validateAge('saksi_one', 17)) err.push("saksi_one_umur|Umur Saksi I kurang dari 17 tahun!");
	if (!validateKey('saksi_two_nik')) err.push("saksi_two_nik|Isilah NIK Saksi II dengan lengkap (16 Angka) jika ada!");
	if (!validateAge('saksi_two', 17)) err.push("saksi_two_umur|Umur Saksi II kurang dari 17 tahun!");
	if (!validateDateIncidental('ibu_kawin')) err.push("ibu_kawin_day|Isilah Tanggal Perkawinan Ibu dengan benar atau kosongkan sama sekali!");
	if (!validateDateMoreThanNow('ibu_kawin')) err.push("ibu_kawin_day|Tanggal Perkawinan Ibu tidak boleh lebih dari tanggal sekarang!");
	if (!validateDateIncidental('adm_sp')) err.push("adm_sp_day|Isilah Tanggal Surat Penetapan dengan benar atau kosongkan sama sekali!");
	if (!validateDateMoreThanNow('adm_sp')) err.push("adm_sp_day|Tanggal Surat Penetapan tidak boleh lebih dari tanggal sekarang!");
	if (!validateDateMoreThan('bayi_lahir', 'pelapor_lapor')) err.push("pelapor_lapor_day|Tanggal lapor tidak diperkenankan kurang dari tanggal lahir!");
	if (!validateDateMoreThan('ibu_lahir', 'bayi_lahir')) err.push("bayi_lahir_day|Tanggal lahir bayi tidak diperkenankan kurang dari tanggal lahir ibu!");
	if (!validateDateMoreThan('ayah_lahir', 'bayi_lahir')) err.push("bayi_lahir_day|Tanggal lahir bayi tidak diperkenankan kurang dari tanggal lahir ayah!");
	if (!validateSameNik('ibu', 'ayah')) err.push("ibu_nik|Terjadi penggandaan nik, NIK Ayah dan Ibu terjadi kesamaan.");
	{	
		if(!document.getElementById('admDokumen[1]').checked)
		if(!document.getElementById('admDokumen[2]').checked)
		if(!document.getElementById('admDokumen[3]').checked)
		if(!document.getElementById('admDokumen[4]').checked)
		if(!document.getElementById('admDokumen[5]').checked) err.push("admDokumen|Isilah Salah Satu Dokumen Administrasi!");
	}
	// fungsi untuk mengatur jenis kelahiran UMUM atau TERLAMBAT
	// nilai 60 berarti batas terlambat adalah 60 hari
	//aturJenisLahir(61);
	if (!validateLateReport()) {
	//err.push("adm_sp_nama|Isilah Syarat-syarat Surat Penetapan, Jika memilih Jenis Pelaporan Kelahiran TERLAMBAT");
	err.push("adm_sp_no|Isilah Syarat-syarat Surat Penetapan, Jika memilih Jenis Pelaporan Kelahiran TERLAMBAT");
	err.push("adm_sp_day|Isilah Syarat-syarat Surat Penetapan, Jika memilih Jenis Pelaporan Kelahiran TERLAMBAT");
	}
	//date = new Date();
//	if (!validateAge('pelapor', date.getFullYear()-actionGet('bayi_lahir_year'))) err.push("pelapor_umur|Umur Pelapor kurang dari Umur Bayi!");
//	if (!validateAge('saksi_one', date.getFullYear()-actionGet('bayi_lahir_year'))) err.push("saksi_one_umur|Umur Saksi I kurang dari Umur Bayi!");
//	if (!validateAge('saksi_two', date.getFullYear()-actionGet('bayi_lahir_year'))) err.push("saksi_two_umur|Umur Saksi II kurang dari Umur Bayi!");
	//==========================================================================================================================
	if(actionGet('ibu_no_prov')!=actionGet('admProv')){
		err.push("ibu_no_prov|Isilah Provinsi Ibu sesuai domisili");
	}
	if(actionGet('ibu_no_kab')!=actionGet('admKab')){
		err.push("ibu_no_kab|Isilah Kabupaten Ibu sesuai domisili");
	}	
	if (err.length > 0)
	{
		ret = false;
		setValidateResponse(err);
	}
	else 
	{
		//Validasi Tambahan
		//Verifikasi Tanggal Lahir
		var strTglLahir = strTrim(document.getElementById("bayi_lahir_day").value) 
			+ strTrim(document.getElementById("bayi_lahir_month").value)  
			+ strTrim(document.getElementById("bayi_lahir_year").value);
			
		if(strTrim(strTglLahir).length < 8){
			if(strTrim(document.getElementById("bayi_lahir_day").value).length < 2){
				actionHighlightCapil(document.getElementById("bayi_lahir_day"),"errorHighlight");
			}else{
				actionHighlightCapil(document.getElementById("bayi_lahir_day"),"");
			}
			
			if(strTrim(document.getElementById("bayi_lahir_month").value).length < 2){
				actionHighlightCapil(document.getElementById("bayi_lahir_month"),"errorHighlight");
			}else{
				actionHighlightCapil(document.getElementById("bayi_lahir_month"),"");
			}
			
			if(strTrim(document.getElementById("bayi_lahir_year").value).length < 4){
				actionHighlightCapil(document.getElementById("bayi_lahir_year"),"errorHighlight");
			}else{
				actionHighlightCapil(document.getElementById("bayi_lahir_year"),"");
			}
	
			alert("Tanggal lahir bayi/anak harus benar(dd-mm-yyyy)");		
			return false;
		}else{
			actionHighlightCapil(document.getElementById("bayi_lahir_day"),"");
			actionHighlightCapil(document.getElementById("bayi_lahir_month"),"");
			actionHighlightCapil(document.getElementById("bayi_lahir_year"),"");
		}

		//Verifikasi tanggal lahir Ibu
		var strTglLahirIbu = strTrim(document.getElementById("ibu_lahir_day").value) 
			+ strTrim(document.getElementById("ibu_lahir_month").value)  
			+ strTrim(document.getElementById("ibu_lahir_year").value);
			
		if(strTrim(strTglLahirIbu).length > 0 && strTrim(strTglLahirIbu).length < 8){
			if(strTrim(document.getElementById("ibu_lahir_day").value).length < 2){
				actionHighlightCapil(document.getElementById("ibu_lahir_day"),"errorHighlight");
			}else{
				actionHighlightCapil(document.getElementById("ibu_lahir_day"),"");
			}
			
			if(strTrim(document.getElementById("ibu_lahir_month").value).length < 2){
				actionHighlightCapil(document.getElementById("ibu_lahir_month"),"errorHighlight");
			}else{
				actionHighlightCapil(document.getElementById("ibu_lahir_month"),"");
			}
			
			if(strTrim(document.getElementById("ibu_lahir_year").value).length < 4){
				actionHighlightCapil(document.getElementById("ibu_lahir_year"),"errorHighlight");
			}else{
				actionHighlightCapil(document.getElementById("ibu_lahir_year"),"");
			}
	
			alert("Jika Tanggal lahir ibu diisi, isilah dengan benar(dd-mm-yyyy)");		
			return false;
		}else{
			actionHighlightCapil(document.getElementById("ibu_lahir_day"),"");
			actionHighlightCapil(document.getElementById("ibu_lahir_month"),"");
			actionHighlightCapil(document.getElementById("ibu_lahir_year"),"");
		}
		
		
		//Verifikasi tanggal lahir Ayah
		var strTglLahirAyah = strTrim(document.getElementById("ayah_lahir_day").value) 
			+ strTrim(document.getElementById("ayah_lahir_month").value)  
			+ strTrim(document.getElementById("ayah_lahir_year").value);
			
		if(strTrim(strTglLahirAyah).length > 0 && strTrim(strTglLahirAyah).length < 8){
			if(strTrim(document.getElementById("ayah_lahir_day").value).length < 2){
				actionHighlightCapil(document.getElementById("ayah_lahir_day"),"errorHighlight");
			}else{
				actionHighlightCapil(document.getElementById("ayah_lahir_day"),"");
			}
			
			if(strTrim(document.getElementById("ayah_lahir_month").value).length < 2){
				actionHighlightCapil(document.getElementById("ayah_lahir_month"),"errorHighlight");
			}else{
				actionHighlightCapil(document.getElementById("ayah_lahir_month"),"");
			}
			
			if(strTrim(document.getElementById("ayah_lahir_year").value).length < 4){
				actionHighlightCapil(document.getElementById("ayah_lahir_year"),"errorHighlight");
			}else{
				actionHighlightCapil(document.getElementById("ayah_lahir_year"),"");
			}
	
			alert("Jika Tanggal lahir ayah diisi, isilah dengan benar(dd-mm-yyyy)");		
			return false;
		}else{
			actionHighlightCapil(document.getElementById("ayah_lahir_day"),"");
			actionHighlightCapil(document.getElementById("ayah_lahir_month"),"");
			actionHighlightCapil(document.getElementById("ayah_lahir_year"),"");
		}	
		

		
				//Verifikasi tanggal pelapor
		var strTglLahirLapor = strTrim(document.getElementById("pelapor_lapor_day").value) 
			+ strTrim(document.getElementById("pelapor_lapor_month").value)  
			+ strTrim(document.getElementById("pelapor_lapor_year").value);
			
		if(strTrim(strTglLahirLapor).length < 8){
			if(strTrim(document.getElementById("pelapor_lapor_day").value).length < 2){
				actionHighlightCapil(document.getElementById("pelapor_lapor_day"),"errorHighlight");
			}else{
				actionHighlightCapil(document.getElementById("pelapor_lapor_day"),"");
			}
			
			if(strTrim(document.getElementById("pelapor_lapor_month").value).length < 2){
				actionHighlightCapil(document.getElementById("pelapor_lapor_month"),"errorHighlight");
			}else{
				actionHighlightCapil(document.getElementById("pelapor_lapor_month"),"");
			}
			
			if(strTrim(document.getElementById("pelapor_lapor_year").value).length < 4){
				actionHighlightCapil(document.getElementById("pelapor_lapor_year"),"errorHighlight");
			}else{
				actionHighlightCapil(document.getElementById("pelapor_lapor_year"),"");
			}
	
			alert("Tanggal lapor harus benar(dd-mm-yyyy)");		
			return false;
		}else{
			actionHighlightCapil(document.getElementById("pelapor_lapor_day"),"");
			actionHighlightCapil(document.getElementById("pelapor_lapor_month"),"");
			actionHighlightCapil(document.getElementById("pelapor_lapor_year"),"");
		}
		
		//Verifikasi tanggal penetapan
		var strTglPenetapan = strTrim(document.getElementById("adm_sp_day").value) 
			+ strTrim(document.getElementById("adm_sp_month").value)  
			+ strTrim(document.getElementById("adm_sp_year").value);
			
		if(strTrim(strTglPenetapan).length > 0 && strTrim(strTglPenetapan).length < 8){
			if(strTrim(document.getElementById("adm_sp_day").value).length < 2){
				actionHighlightCapil(document.getElementById("adm_sp_day"),"errorHighlight");
			}else{
				actionHighlightCapil(document.getElementById("adm_sp_day"),"");
			}
			
			if(strTrim(document.getElementById("adm_sp_month").value).length < 2){
				actionHighlightCapil(document.getElementById("adm_sp_month"),"errorHighlight");
			}else{
				actionHighlightCapil(document.getElementById("adm_sp_month"),"");
			}
			
			if(strTrim(document.getElementById("adm_sp_year").value).length < 4){
				actionHighlightCapil(document.getElementById("adm_sp_year"),"errorHighlight");
			}else{
				actionHighlightCapil(document.getElementById("adm_sp_year"),"");
			}
	
			alert("Jika tanggal penetapan diisi, isilah dengan benar(dd-mm-yyyy)");		
			return false;
		}else{
			actionHighlightCapil(document.getElementById("adm_sp_day"),"");
			actionHighlightCapil(document.getElementById("adm_sp_month"),"");
			actionHighlightCapil(document.getElementById("adm_sp_year"),"");
		}
		
		//verifikasi jeda capil
		var d1 = new Date(actionGet('pelapor_lapor_year'),actionGet('pelapor_lapor_month')-1,actionGet('pelapor_lapor_day'));
		var d2 = new Date(actionGet('bayi_lahir_year'),actionGet('bayi_lahir_month')-1,actionGet('bayi_lahir_day'));
		var n = count_days(d1,d2);
		var jedaCapil = "<?php echo $jedaCapil?>";
		if(jedaCapil != "") {
			jedaCapil = parseInt(jedaCapil);
		} else {
			jedaCapil = 60;
		}
		
		if(n <= jedaCapil) {
			if(actionGet('adm_jenis_lahir') != "LU"){
				actionHighlightCapil(document.getElementById("adm_jenis_lahir"),"errorHighlight");
				alert("Jeda Lapor dengan Tanggal Lahir Bayi adalah "+n+" hari, maka pilih Jenis Lahir dengan benar");		
				return false;
			}else{
				actionHighlightCapil(document.getElementById("adm_jenis_lahir"),"");
			}
			/*
			if(actionGet('adm_sp_nama') == "KEPALA DINAS"){// Tidak ada yang menetapkan
				actionHighlightCapil(document.getElementById("adm_sp_nama"),"errorHighlight");
				alert("Jeda Lapor dengan Tanggal Lahir Bayi adalah "+n+" hari, maka pilih Yang Menetapkan dengan benar");		
				return false;
			}else{
				actionHighlightCapil(document.getElementById("adm_sp_nama"),"");
			}
			*/		
		} else if(n > jedaCapil) {
			if(actionGet('adm_jenis_lahir') != "LT"){
				actionHighlightCapil(document.getElementById("adm_jenis_lahir"),"errorHighlight");
				alert("Jeda Lapor dengan Tanggal Lahir Bayi adalah "+n+" hari, maka pilih Jenis Lahir dengan benar");		
				return false;
			}else{
				actionHighlightCapil(document.getElementById("adm_jenis_lahir"),"");
			}
			/*
			if(actionGet('adm_sp_nama') != "KEPALA DINAS"){
				actionHighlightCapil(document.getElementById("adm_sp_nama"),"errorHighlight");
				alert("Jeda Lapor dengan Tanggal Lahir Bayi adalah "+n+" hari, maka pilih Yang Menetapkan dengan benar");		
				return false;
			}else{
				actionHighlightCapil(document.getElementById("adm_sp_nama"),"");
			}
			*/		
		}/* else {
			if(actionGet('adm_jenis_lahir') != "LT"){
				actionHighlightCapil(document.getElementById("adm_jenis_lahir"),"errorHighlight");
				alert("Jeda Lapor dengan Tanggal Lahir Bayi adalah "+n+" hari, maka pilih Jenis Lahir dengan benar");		
				return false;
			}else{
				actionHighlightCapil(document.getElementById("adm_jenis_lahir"),"");
			}
			
			//if(actionGet('adm_sp_nama') != "PENGADILAN NEGERI"){
			//	actionHighlightCapil(document.getElementById("adm_sp_nama"),"errorHighlight");
			//	alert("Jeda Lapor dengan Tanggal Lahir Bayi adalah "+n+" hari, maka pilih Yang Menetapkan dengan benar");		
			//	return false;
			//}else{
			//	actionHighlightCapil(document.getElementById("adm_sp_nama"),"");
			//}		
		}*/
            var conf = confirm("Apakah data ini disimpan?");

            if (conf) 
            {
                ret = true;
				setEnableElement();		
            }
            else ret = false;
        }

        if (ret){
            var data=jQuery('#formulir').serialize();
            jQuery.blockUI({ message: '<img src="../../images/ajax-loader.gif" /><p> Mohon Tunggu...</p>' }); 
            jQuery.ajax({
                type: "POST",
                url: "<?php echo $pageUrl ?>",
                data: data,
                success: function(hasil) {
                    jQuery.unblockUI();
                    if(hasil['pesan']=="Data Berhasil Disimpan"){
                        alert(hasil['pesan']);
                        jQuery('#btnPROSES').attr('disabled',hasil['btnPROSES']);
                        jQuery('#btnBATALKAN').attr('disabled',hasil['btnBATALKAN']);
                        jQuery('#MATI_NO').val(hasil['MATI_NO']);
                        jQuery('#PROCESS_STATUS').val(hasil['PROCESS_STATUS']);
						jQuery('#ADM_AKTA_NO').html(hasil['ADM_AKTA_NO']);
						jQuery('#ADM_AKTA_KTP_TGL').html(hasil['ADM_AKTA_KTP_TGL']);
                    }					
                },
                dataType: "json"
            });		
        }

}
</script>
<?php
$dis = " disabled=\"disabled\" ";
if($bayiNikExists) $bayiDis = $dis;
if($ibuNikExists) $ibuDis = $dis;
if($ayahNikExists) $ayahDis = $dis;
if($pelaporNikExists) $pelaporDis = $dis;
if($saksiOneNikExists) $saksiOneDis = $dis;
if($saksiTwoNikExists) $saksiTwoDis = $dis;
?>

<!-- start of TITLE -->
<table cellpadding="0" cellspacing="0" border="0" width="100%">
	<tr>
		<!--Content Area -->
		<td width="100%">
		<table cellpadding="0" cellspacing="0" border="0" width="100%">
			<tr>
				<td width="224" height="102"><img
					src="../../images/V3/HeaderContentLeft_2011.gif" /></td>
				<td width="100%"
					background="../../images/V3/HeaderContentBg_2011.gif"
					style="background-repeat: repeat-x" align="center">
				<div id="TextTitle_2011">PENCATATAN KELAHIRAN</div>
				</td>
				<td width="220" height="102"><img
					src="../../images/V3/HeaderContentRight_2011.gif" /></td>
			</tr>
		</table>
		<table cellpadding="0" cellspacing="0" border="0" width="100%">
			<!--<tr>-->
				<td width="100%" bgcolor="#94b1db" align="center" height="571"
					valign="top"><?php echo form_tag($pageUrl,'id=\'formulir\' ') ?>
				<div style="width: 930px;" class="small"><?php if ($lahirIndex) { $dis = " "; ?><input
					type="hidden" name="lahir_no" value="<?php echo $lahirIndex?>" /><?php }?>
				<input type="hidden" name="num_update"
					value="<?php echo $numUpdate+1;?>" />
				<div class="accordHeader arial-narrow pointer">DATA WILAYAH</div>
				<div
					style="background-color: #cce6b3; padding: 4px; margin-left: auto; margin-right: auto;"
					class="small">
				<div
					style="background: url(../../CatatanSipilAssets/images/filter_bg.jpg) repeat-x;"
					class="accordMain">
				<table border="0" cellspacing="3" cellpadding="0">
				<?php switch($ses_siak_level_code) {
					case "8":
						?>
					<input type="hidden" name="admProv" id="admProv"
						value="<?php echo $admNoProv;?>" />
					<input type="hidden" name="admKab" id="admKab"
						value="<?php echo $admNoKab;?>" />
					<tr>
						<td height="22" width="120">Provinsi</td>
						<td width="15" align="center">:</td>
						<td width="280" class="bold"><?php echo $namaProv ?></td>
						<td width="120">Kabupaten / Kota</td>
						<td width="15" align="center">:</td>
						<td class="bold"><?php echo $namaKab ?></td>
					</tr>
					<?php
					break;
					case "7":
						?>
					<input type="hidden" name="admProv" id="admProv"
						value="<?php echo $admNoProv;?>" />
					<input type="hidden" name="admKab" id="admKab"
						value="<?php echo $admNoKab;?>" />
						<?php if ($admNoKec) {?>
					<input type="hidden" name="admKec" id="admKec"
						value="<?php echo $admNoKec;?>" />
						<?php }?>
                                                <tr>

                                                    <td width="120">Provinsi *</td>
                                                    <td width="15" align="center">:</td>
                                                    <td width="280"><div style="width:240px; text-align:left"><?php echo tebal(siakGetNameProvinsiByParam($admNoProv)); ?><input type="hidden" name="admProv" id="admProv"
				value="<?php echo $admNoProv;?>" /></div></td>
                                                    <td width="120">Kabupaten / Kota *</td>
                                                    <td width="15" align="center">:</td>
                                                    <td><div style="width:240px; text-align:left"><?php echo tebal(siakGetNameKabupatenByParam($admNoProv,$admNoKab)); ?><input type="hidden" name="admKab" id="admKab"
				value="<?php echo $admNoKab;?>" /></div></td>
                                                </tr>
					<?php
					break;
case "13":
	?>
					<input type="hidden" name="admProv" id="admProv"
						value="<?php echo $admNoProv;?>" />
					<input type="hidden" name="admKab" id="admKab"
						value="<?php echo $admNoKab;?>" />
						<?php if ($admNoKec) {?>
					<input type="hidden" name="admKec" id="admKec"
						value="<?php echo $admNoKec;?>" />
						<?php }?>
					<tr>
						<td height="22" width="120">Provinsi</td>
						<td width="15" align="center">:</td>
						<td width="280" class="bold"><?php echo $namaProv ?></td>
						<td width="120">Kabupaten / Kota</td>
						<td width="15" align="center">:</td>
						<td class="bold"><?php echo $namaKab ?></td>
					</tr>
					<tr>
						<td height="22" width="120">Kecamatan</td>
						<td width="15" align="center">:</td>
						<td width="280" class="bold"><?php echo $namaKec ?></td>
					</tr>
					<?php
					break;
default:
	?>
                                                <tr>

                                                    <td width="120">Provinsi *</td>
                                                    <td width="15" align="center">:</td>
                                                    <td width="280"><div style="width:240px; text-align:left"><?php echo tebal(siakGetNameProvinsiByParam($admNoProv)); ?><input type="hidden" name="admProv" id="admProv"
				value="<?php echo $admNoProv;?>" /></div></td>
                                                    <td width="120">Kabupaten / Kota *</td>
                                                    <td width="15" align="center">:</td>
                                                    <td><div style="width:240px; text-align:left"><?php echo tebal(siakGetNameKabupatenByParam($admNoProv,$admNoKab)); ?><input type="hidden" name="admKab" id="admKab"
				value="<?php echo $admNoKab;?>" /></div></td>
                                                </tr>
					<?php
					break;
		  }?>
				</table>
				</div>
				</div>

				<div class="accordHeader arial-narrow pointer">DATA KELUARGA</div>
				<div class="accordContent">
				<table border="0" cellspacing="3" cellpadding="0">
					<tr>
						<td width="120">No. KK</td>
						<td width="15" align="center">:</td>
						<td width="280">
						<?php //echo formNikHelperNew("lahir_kk_no", $lahirKkNo, "fields", "ibu_;ayah_", "getKartuKeluarga('lahir_kk_no', 'lahir');", 3);?>
                        <?php echo formNikHelperNew3("lahir_kk_no",$lahirKkNo, "fields", "lahir", "getKartuKeluarga2('lahir_kk_no', 'lahir');", 3,"setFieldResetKk","getFunctionForCapil3('lahir',this.value);");?>
                        </td>
						<td width="120">Nama Kepala Keluarga</td>
						<td width="15" align="center">:</td>
						<td><input type="text" name="lahir_kk_nama" id="lahir_kk_nama"
							maxlength="128" style="width: 300px;"
							value="<?php echo $lahirKkNama?>"
							onchange="ucase(this); this.className='';" tabindex="4" /></td>
					</tr>
				</table>
				</div>

				<div class="accordHeader arial-narrow pointer">DATA KELAHIRAN</div>
				<div class="accordContent">
				<table border="0" cellspacing="3" cellpadding="0">
					<tr>
						<td width="120">NIK Bayi</td>
						<td width="15" align="center">:</td>
						<td width="280"><?php echo formNikHelper01("bayi_nik", $bayiNik, "fields", "bayi", "getBiodataWithParentBayi01('bayi_nik', 'bayi', 'ayah', 'ibu', '', 'bayi_nik;ibu_nik;ayah_nik;pelapor_nik;saksi_one_nik;saksi_two_nik');", 5);?>
					    </td>
						<td width="120">Nama Lengkap *</td>
						<td width="15" align="center">:</td>
						<td><input type="text" name="bayi_nama" id="bayi_nama"
							onchange="ucase(this); this.className='';" maxlength="128"
							style="width: 300px;" value="<?php echo $bayiNama?>" tabindex="7"
							<?php echo $bayiDis;?> /></td>
					</tr>
					<tr>

						<td>Jenis Kelamin *</td>
						<td align="center">:</td>
						<td><?php echo select_tag('bayi_jenis_kelamin', options_for_select($cbJenisKelamin, $bayiJenisKelamin),'style="width: 124px" onfocus="this.className=\'\';" tabindex="8" ' . $bayiDis . ' '); ?></td>

						<td>Tempat Dilahirkan *</td>
						<td align="center">:</td>
						<td><?php echo select_tag('bayi_lahir_tempat', options_for_select($cbTempatLahir, $bayiLahirTempat),'style="width: 200px" onfocus="this.className=\'\';" tabindex="9" '); ?></td>
					</tr>
					<tr>

						<td>Tempat Kelahiran *</td>
						<td align="center">:</td>
						<td><input type="text" style="width: 120px"
							name="bayi_tempat_lahir" id="bayi_tempat_lahir" maxlength="64"
							onchange="ucase(this); this.className='';"
							value="<?php echo $bayiTempatLahir?>" <?php echo $bayiDis;?>
							tabindex="10" /></td>

						<td>Tanggal Lahir *</td>
						<td align="center">:</td>
						<td><?php echo formDateHelper("bayi_lahir", $bayiTglLahir, false, $bayiDis, 11);?></td>
					</tr>
					<tr>

						<td>Pukul *</td>
						<td align="center">:</td>
						<td><input type="text" style="width: 25px; text-align: center;"
							name="bayi_jam_lahir" id="bayi_jam_lahir"
							value="<?php echo $bayiJamLahir?>" maxlength="2"
							onchange="validateInteger(this.id); this.className=''; return actionGoNext(this, event);"
							tabindex="14" /> : <input type="text"
							style="width: 25px; text-align: center;" name="bayi_mnt_lahir"
							id="bayi_mnt_lahir" value="<?php echo $bayiMntLahir?>"
							maxlength="2"
							onchange="validateInteger(this.id); this.className=''; return actionGoNext(this, event);"
							tabindex="15" />&nbsp;&nbsp;Waktu Setempat</td>

						<td>Jenis Kelahiran *</td>
						<td align="center">:</td>
						<td><?php echo select_tag('bayi_jenis_kelahiran', options_for_select($cbJenisKelahiran, $bayiJenisLahir),'style="width: 124px" onfocus="this.className=\'\';" tabindex="16" '); ?></td>
					</tr>
					<tr>

						<td>Kelahiran Ke *</td>
						<td align="center">:</td>
						<td><input type="text" style="width: 30px; text-align: center;"
							name="bayi_anak_ke" id="bayi_anak_ke" maxlength="2"
							onchange="validateInteger(this.id); this.className=''; return actionGoNext(this, event);"
							value="<?php echo $bayiAnakKe?>" tabindex="17" /></td>

						<td>Penolong Kelahiran *</td>
						<td align="center">:</td>
						<td><?php echo select_tag('bayi_penolong', options_for_select($cbPenolong, $bayiPenolong),'style="width: 124px" onfocus="this.className=\'\';" tabindex="18" '); ?></td>
					</tr>

					<tr>

						<td>Berat Bayi *</td>
						<td align="center">:</td>
						<td><input type="text" style="width: 30px; text-align: center;"
							name="bayi_berat" id="bayi_berat"
							onchange="return actionGoNext(this, event);" maxlength="5"
							value="<?php echo $bayiBerat?>" tabindex="19" />&nbsp;&nbsp;Kg</td>

						<td>Panjang Bayi *</td>
						<td align="center">:</td>
						<td><input type="text" style="width: 30px; text-align: center;"
							name="bayi_panjang" id="bayi_panjang"
							onchange="return actionGoNext(this, event);" maxlength="4"
							tabindex="20" value="<?php echo $bayiPanjang?>" />&nbsp;&nbsp;Cm</td>
					</tr>
					<tr class="biodata_hidden">

						<td>Gol Darah Bayi *</td>
						<td align="center">:</td>
						<td><?php echo select_tag('bayi_gol_darah', options_for_select($dpGolDarah, $bayi_gol_darah),'class="formobj11"'); ?></td>

						<td>Agama Bayi *</td>
						<td align="center">:</td>
						<td><?php echo select_tag('bayi_agama', options_for_select($dpAgama, $bayi_agama),'class="formobj11" onChange="formStandarDisable("bayi_agama","7",new Array("bayi_agama_ket"),new Array(""));"'); ?>&nbsp;
					    <input type="text" name="bayi_agama_ket" id="bayi_agama_ket" size="15" maxlength="30" value="<?php echo $bayi_agama_ket ?>" class="formobj11" onchange="ucase(this);" <?php echo SiakObjectHTMLDisabled(strlen($bayi_agama_ket))?> /></td>
					</tr>
                    <tr class="biodata_hidden">

						<td>Kelainan Fisik Bayi </td>
						<td align="center">:</td>
						<td><?php echo select_tag('bayi_penyandang_cacat', options_for_select($dpPenyandangCacat, $bayi_penyandang_cacat),'class="formobj11" '); ?></td>

						<td>Generate Nik *</td>
						<td align="center">:</td>
						<td><input type="checkbox" name="bayi_generate_nik"
									id="bayi_generate_nik" value="y" <?php echo ($bayi_generate_nik=='y')?'checked="checked"':'' ?> 
									/></td>
					</tr>
				</table>
				</div>

				<div class="accordHeader arial-narrow pointer">DATA IBU</div>
				<div class="accordContent">
				<table border="0" cellspacing="3" cellpadding="0">
					<tr>
						<td width="120">NIK Ibu</td>
						<td width="15" align="center">:</td>
						<td width="280"><?php echo formNikHelper("ibu_nik", $ibuNik, "fields", "ibu", "getBiodataWithParent('ibu_nik', 'ibu', '', '', 'ibu_wrg_ngr', 'bayi_nik;ibu_nik;ayah_nik;saksi_one_nik;saksi_two_nik');", 30);?></td>

						<td width="120">Nama Lengkap Ibu *</td>
						<td width="15" align="center">:</td>
						<td><input type="text" style="width: 300px;" name="ibu_nama"
							id="ibu_nama" maxlength="128" value="<?php echo $ibuNama?>"
							onchange="ucase(this); this.className='';" tabindex="32"
							<?php echo $ibuDis;?> /></td>
					</tr>
					<tr>

						<td>Tanggal Lahir</td>
						<td align="center">:</td>
						<td><?php echo formDateHelper("ibu_lahir", $ibuTglLahir, false, $ibuDis, 33);?></td>
						<td>Jenis Pekerjaan</td>
						<td align="center">:</td>
						<td><?php echo select_tag('ibu_pekerjaan', options_for_select($cbPekerjaan, $ibuPekerjaan), 'style="width: 240px" ' . $ibuDis . ' tabindex="36"'); ?></td>
					</tr>
					<tr>
						<td>Alamat</td>
						<td align="center">:</td>
						<td><input type="text" style="width: 240px;" name="ibu_alamat"
							id="ibu_alamat" maxlength="128" value="<?php echo $ibuAlamat?>"
							<?php echo $ibuDis;?> onchange="ucase(this);" tabindex="37" /></td>
						<td>RT/RW</td>
						<td align="center">:</td>
						<td><input type="text" style="width: 25px; text-align: center;"
							maxlength="3" name="ibu_no_rt" id="ibu_no_rt"
							value="<?php echo $ibuNoRt?>" <?php echo $ibuDis;?> tabindex="38"
							onchange="return actionGoNext(this, event);" /> / <input
							type="text" style="width: 25px; text-align: center;"
							name="ibu_no_rw" id="ibu_no_rw" value="<?php echo $ibuNoRw?>"
							maxlength="3" onchange="return actionGoNext(this, event);"
							<?php echo $ibuDis;?> tabindex="39" /></td>
					</tr>
					<tr>
						<td>Provinsi</td>
						<td align="center">:</td>
						<td><?php echo select_tag('ibu_no_prov', options_for_select($cbProvinsi, $ibuNoProv),'style="width:240px" ' . $ibuDis . ' onChange="getKab(\'ibu_no_prov\', \'ibu_no_kab\', \'ibu_no_kec\', \'ibu_no_kel\', \'\', \'\');" tabindex="40"'); ?></td>
						<td>Kab./Kota</td>
						<td align="center">:</td>
						<td><?php echo select_tag('ibu_no_kab', options_for_select($cbIbuKabupaten, $ibuNoKab), 'style="width:240px" ' . $ibuDis . ' onChange="getKec(\'ibu_no_prov\', \'ibu_no_kab\', \'ibu_no_kec\', \'ibu_no_kel\', \'\', \'\', \'\');" tabindex="41"'); ?></td>
					</tr>
					<tr>
						<td>Kecamatan</td>
						<td align="center">:</td>
						<td><?php echo select_tag('ibu_no_kec', options_for_select($cbIbuKecamatan, $ibuNoKec), 'style="width:240px" ' . $ibuDis . ' onChange="getKel(\'ibu_no_prov\', \'ibu_no_kab\', \'ibu_no_kec\', \'ibu_no_kel\', \'\', \'\', \'\', \'\');" tabindex="42"'); ?></td>
						<td>Desa/Kelurahan</td>
						<td align="center">:</td>
						<td><?php echo select_tag('ibu_no_kel', options_for_select($cbIbuKelurahan, $ibuNoKel), 'style="width:240px" ' . $ibuDis . ' tabindex="43"'); ?></td>
					</tr>
					<tr>
						<td>Kewarganegaraan</td>
						<td align="center">:</td>
						<td><?php echo select_tag('ibu_wrg_ngr', options_for_select($cbKewarganegaraan, $ibuWrgNgr), ' onfocus="this.className=\'\';" ' . $ibuDis . ' tabindex="44"'); ?></td>
						<td>Kebangsaan (Bagi WNA)</td>
						<td align="center">:</td>
						<td><input type="text" style="width: 240px;" name="ibu_bangsa"
							maxlength="64" id="ibu_bangsa" value="<?php echo $ibuBangsa?>"
							onchange="ucase(this);" tabindex="45" /></td>
					</tr>
					<tr>
						<td>Tanggal Perkawinan</td>
						<td align="center">:</td>
						<td><?php echo formDateHelper("ibu_kawin", $ibuTglKawin, false, false, 46);?></td>
						<td></td>
						<td align="center"></td>
						<td></td>
					</tr>
				</table>
				</div>
				<div class="accordHeader arial-narrow pointer">DATA AYAH</div>
				<div class="accordContent">
				<table border="0" cellspacing="3" cellpadding="0">
					<tr>
						<td width="120">NIK Ayah</td>
						<td width="15" align="center">:</td>
						<td width="280"><?php echo formNikHelper("ayah_nik", $ayahNik, "fields", "ayah", "getBiodataWithParent('ayah_nik', 'ayah', '', '', 'ayah_wrg_ngr', 'bayi_nik;ibu_nik;ayah_nik;saksi_one_nik;saksi_two_nik');", 50);?></td>
						<td width="120">Nama Lengkap Ayah</td>
						<td width="15" align="center">:</td>
						<td><input type="text" style="width: 300px;" name="ayah_nama"
							id="ayah_nama" maxlength="128" value="<?php echo $ayahNama?>"
							onchange="ucase(this); this.className='';" tabindex="53"
							<?php echo $ayahDis;?> /></td>
					</tr>
					<tr>
						<td>Tanggal Lahir</td>
						<td align="center">:</td>
						<td><?php echo formDateHelper("ayah_lahir", $ayahTglLahir, false, $ayahDis, 54);?></td>
						<td>Jenis Pekerjaan</td>
						<td align="center">:</td>
						<td><?php echo select_tag('ayah_pekerjaan', options_for_select($cbPekerjaan, $ayahPekerjaan), 'style="width: 240px" ' . $ayahDis . ' tabindex="57" '); ?></td>
					</tr>
					<tr>
						<td>Alamat</td>
						<td align="center">:</td>
						<td><input type="text" style="width: 240px;" name="ayah_alamat"
							id="ayah_alamat" maxlength="128" tabindex="58"
							value="<?php echo $ayahAlamat?>" <?php echo $ayahDis;?>
							onchange="ucase(this);" /></td>
						<td>RT/RW</td>
						<td align="center">:</td>
						<td><input type="text" style="width: 25px; text-align: center;"
							name="ayah_no_rt" maxlength="3" id="ayah_no_rt"
							<?php echo $ayahDis;?> value="<?php echo $ayahNoRt?>"
							onchange="validateInteger(this.id); this.className=''; return actionGoNext(this, event);" tabindex="59" /> / <input
							type="text" style="width: 25px; text-align: center;"
							maxlength="3" <?php echo $ayahDis;?> name="ayah_no_rw"
							id="ayah_no_rw" value="<?php echo $ayahNoRw?>"
							onchange="validateInteger(this.id); this.className=''; return actionGoNext(this, event);" tabindex="60" /></td>
					</tr>
					<tr>
						<td>Provinsi</td>
						<td align="center">:</td>
						<td><?php echo select_tag('ayah_no_prov', options_for_select($cbProvinsi, $ayahNoProv),'style="width:240px" ' . $ayahDis . ' onChange="getKab(\'ayah_no_prov\', \'ayah_no_kab\', \'ayah_no_kec\', \'ayah_no_kel\', \'\', \'\');" tabindex="61"'); ?></td>
						<td>Kab./Kota</td>
						<td align="center">:</td>
						<td><?php echo select_tag('ayah_no_kab', options_for_select($cbAyahKabupaten, $ayahNoKab), 'style="width:240px" ' . $ayahDis . ' onChange="getKec(\'ayah_no_prov\', \'ayah_no_kab\', \'ayah_no_kec\', \'ayah_no_kel\', \'\', \'\', \'\');" tabindex="62"'); ?></td>

					</tr>
					<tr>
						<td>Kecamatan</td>
						<td align="center">:</td>
						<td><?php echo select_tag('ayah_no_kec', options_for_select($cbAyahKecamatan, $ayahNoKec), 'style="width:240px" ' . $ayahDis . ' onChange="getKel(\'ayah_no_prov\', \'ayah_no_kab\', \'ayah_no_kec\', \'ayah_no_kel\', \'\', \'\', \'\', \'\');" tabindex="63"'); ?></td>
						<td>Desa/Kelurahan</td>
						<td align="center">:</td>
						<td><?php echo select_tag('ayah_no_kel', options_for_select($cbAyahKelurahan, $ayahNoKel), 'style="width:240px" ' . $ayahDis . ' tabindex="64"'); ?></td>
					</tr>
					<tr>
						<td>Kewarganegaraan</td>
						<td align="center">:</td>
						<td><?php echo select_tag('ayah_wrg_ngr', options_for_select($cbKewarganegaraan, $ayahWrgNgr), ' tabindex="65" ' . $ayahDis . ' '); ?></td>
						<td>Kebangsaan (Bagi WNA)</td>
						<td align="center">:</td>
						<td><input type="text" style="width: 240px;" name="ayah_bangsa"
							id="ayah_bangsa" maxlength="64" tabindex="66"
							value="<?php echo $ayahBangsa;?>" onchange="ucase(this);" /></td>
					</tr>
				</table>
				</div>

				<div class="accordHeader arial-narrow pointer">DATA PELAPOR</div>
				<div class="accordContent">
				<table border="0" cellspacing="3" cellpadding="0">
					<tr>
						<td width="120">NIK Pelapor</td>
						<td width="15" align="center">:</td>
						<td width="280"><?php echo formNikHelper("pelapor_nik", $pelaporNik, "fields", "pelapor", "getBiodataWithParent('pelapor_nik', 'pelapor', '', '', '', 'bayi_nik;pelapor_nik;saksi_one_nik;saksi_two_nik');", 70);?></td>

						<td width="120">Nama Pelapor *</td>
						<td width="15" align="center">:</td>
						<td><input type="text" style="width: 240px;" name="pelapor_nama"
							id="pelapor_nama" maxlength="128"
							value="<?php echo $pelaporNama?>" onchange="ucase(this);"
							onfocus="this.className='';" <?php echo $pelaporDis;?>
							tabindex="72" /></td>
					</tr>
					<tr>

						<td>Umur *</td>
						<td align="center">:</td>
						<td><input type="text" style="width: 30px; text-align: center;"
							name="pelapor_umur" id="pelapor_umur" maxlength="2"
							onchange="validateInteger(this.id); this.className=''; return actionGoNext(this, event);"
							value="<?php echo $pelaporUmur?>" <?php echo $pelaporDis;?>
							tabindex="73" />&nbsp;&nbsp;&nbsp;Tahun</td>
						<td>Jenis Kelamin</td>
						<td align="center">:</td>
						<td><?php echo select_tag('pelapor_kelamin', options_for_select($cbJenisKelamin, $pelaporKelamin),'style="width: 124px" ' . $pelaporDis . ' tabindex="74" '); ?></td>
					</tr>
					<tr>
						<td>Jenis Pekerjaan</td>
						<td align="center">:</td>
						<td><?php echo select_tag('pelapor_pekerjaan', options_for_select($cbPekerjaan, $pelaporPekerjaan), 'style="width: 240px" ' . $pelaporDis . ' tabindex="75" '); ?></td>
						<td></td>
						<td align="center"></td>
						<td></td>
					</tr>
					<tr>
						<td>Alamat</td>
						<td align="center">:</td>
						<td><input type="text" onchange="ucase(this);"
							style="width: 240px;" name="pelapor_alamat" maxlength="128"
							id="pelapor_alamat" <?php echo $pelaporDis;?>
							value="<?php echo $pelaporAlamat?>" tabindex="76" /></td>
						<td>RT/RW</td>
						<td align="center">:</td>
						<td><input type="text" style="width: 25px; text-align: center;"
							name="pelapor_no_rt" id="pelapor_no_rt" maxlength="3"
							<?php echo $pelaporDis;?> value="<?php echo $pelaporNoRt?>"
							onchange="validateInteger(this.id); this.className=''; return actionGoNext(this, event);" tabindex="77" /> / <input
							type="text" style="width: 25px; text-align: center;"
							name="pelapor_no_rw" maxlength="3" id="pelapor_no_rw"
							value="<?php echo $pelaporNoRw?>"
							onchange="validateInteger(this.id); this.className=''; return actionGoNext(this, event);"
							<?php echo $pelaporDis;?> tabindex="78" /></td>
					</tr>
					<tr>
						<td>Provinsi</td>
						<td align="center">:</td>
						<td><?php echo select_tag('pelapor_no_prov', options_for_select($cbProvinsi, $pelaporNoProv),'style="width:240px" ' . $pelaporDis . ' onChange="getKab(\'pelapor_no_prov\', \'pelapor_no_kab\', \'pelapor_no_kec\', \'pelapor_no_kel\', \'\', \'\');" tabindex="79"'); ?></td>
						<td>Kab./Kota</td>
						<td align="center">:</td>
						<td><?php echo select_tag('pelapor_no_kab', options_for_select($cbPelaporKabupaten, $pelaporNoKab), 'style="width:240px" ' . $pelaporDis . ' onChange="getKec(\'pelapor_no_prov\', \'pelapor_no_kab\', \'pelapor_no_kec\', \'pelapor_no_kel\', \'\', \'\', \'\');" tabindex="80"'); ?></td>

					</tr>
					<tr>
						<td>Kecamatan</td>
						<td align="center">:</td>
						<td><?php echo select_tag('pelapor_no_kec', options_for_select($cbPelaporKecamatan, $pelaporNoKec), 'style="width:240px" ' . $pelaporDis . ' onChange="getKel(\'pelapor_no_prov\', \'pelapor_no_kab\', \'pelapor_no_kec\', \'pelapor_no_kel\', \'\', \'\', \'\', \'\');" tabindex="81"'); ?></td>
						<td>Desa/Kelurahan</td>
						<td align="center">:</td>
						<td><?php echo select_tag('pelapor_no_kel', options_for_select($cbPelaporKelurahan, $pelaporNoKel), 'style="width:240px" ' . $pelaporDis . ' tabindex="82"'); ?></td>
					</tr>

					</tr>

					<td width="120">Tanggal Lapor *</td>
					<td width="15" align="center">:</td>
					<td><?php echo formDateHelper("pelapor_lapor", $pelaporTglLapor, false, false, 83);?></td>
					<td>Hub. Keluarga</td>
					<td align="center">:</td>
					<td><input type="text" style="width: 240px;" name="pelapor_hub_kel"
						maxlength="64" onchange="ucase(this);" id="pelapor_hub_kel"
						value="<?php echo $pelaporHubKel?>" tabindex="86" /></td>
					</tr>
				</table>
				</div>

				<div class="accordHeader arial-narrow pointer">DATA SAKSI I</div>
				<div class="accordContent">
				<table border="0" cellspacing="3" cellpadding="0">
					<tr>
						<td width="120">NIK</td>
						<td width="15" align="center">:</td>
						<td width="280"><?php echo formNikHelper("saksi_one_nik", $saksiOneNik, "fields", "saksi_one", "getBiodata('saksi_one_nik', 'saksi_one', '', 'bayi_nik;pelapor_nik;saksi_one_nik;saksi_two_nik');", 91);?></td>

						<td width="120">Nama Lengkap *</td>
						<td width="15" align="center">:</td>
						<td><input type="text" style="width: 240px;" name="saksi_one_nama"
							id="saksi_one_nama" maxlength="128" onchange="ucase(this);"
							value="<?php echo $saksiOneNama?>" tabindex="93"
							<?php echo $saksiOneDis;?> /></td>
					</tr>
					<tr>

						<td>Umur *</td>
						<td align="center">:</td>
						<td><input type="text" style="width: 30px; text-align: center;"
							name="saksi_one_umur" id="saksi_one_umur" maxlength="2"
							onchange="validateInteger(this.id); this.className=''; return actionGoNext(this, event);"
							value="<?php echo $saksiOneUmur?>" <?php echo $saksiOneDis;?>
							tabindex="94" />&nbsp;&nbsp;&nbsp;Tahun</td>
						<td>Jenis Kelamin</td>
						<td align="center">:</td>
						<td><?php echo select_tag('saksi_one_kelamin', options_for_select($cbJenisKelamin, $saksiOneKelamin),'style="width: 124px" ' . $saksiOneDis . ' tabindex="95" '); ?></td>
					</tr>
					<tr>
						<td>Jenis Pekerjaan</td>
						<td align="center">:</td>
						<td><?php echo select_tag('saksi_one_pekerjaan', options_for_select($cbPekerjaan, $saksiOnePekerjaan), 'style="width: 240px" ' . $saksiOneDis . ' tabindex="96" '); ?></td>
						<td></td>
						<td align="center"></td>
						<td></td>
					</tr>
					<tr>
						<td>Alamat</td>
						<td align="center">:</td>
						<td><input type="text" style="width: 240px;"
							name="saksi_one_alamat" id="saksi_one_alamat"
							<?php echo $saksiOneDis;?> maxlength="128"
							onchange="ucase(this);" value="<?php echo $saksiOneAlamat?>"
							tabindex="97" /></td>
						<td>RT/RW</td>
						<td align="center">:</td>
						<td><input type="text" style="width: 25px; text-align: center;"
							name="saksi_one_no_rt" id="saksi_one_no_rt" maxlength="3"
							value="<?php echo $saksiOneNoRt?>"
							onchange="return actionGoNext(this, event);" tabindex="98"
							<?php echo $saksiOneDis;?> /> / <input type="text"
							style="width: 25px; text-align: center;" name="saksi_one_no_rw"
							maxlength="3" id="saksi_one_no_rw"
							value="<?php echo $saksiOneNoRw?>"
							onchange="return actionGoNext(this, event);" tabindex="99"
							<?php echo $saksiOneDis;?> /></td>
					</tr>
					<tr>
						<td>Provinsi</td>
						<td align="center">:</td>
						<td><?php echo select_tag('saksi_one_no_prov', options_for_select($cbProvinsi, $saksiOneNoProv),'style="width:240px" ' . $saksiOneDis . ' onChange="getKab(\'saksi_one_no_prov\', \'saksi_one_no_kab\', \'saksi_one_no_kec\', \'saksi_one_no_kel\', \'\', \'\');" tabindex="100"'); ?></td>
						<td>Kab./Kota</td>
						<td align="center">:</td>
						<td><?php echo select_tag('saksi_one_no_kab', options_for_select($cbSaksiOneKabupaten,  $saksiOneNoKab), 'style="width:240px" ' . $saksiOneDis . ' onChange="getKec(\'saksi_one_no_prov\', \'saksi_one_no_kab\', \'saksi_one_no_kec\', \'saksi_one_no_kel\', \'\', \'\', \'\');" tabindex="101"'); ?></td>
					</tr>
					<tr>
						<td>Kecamatan</td>
						<td align="center">:</td>
						<td><?php echo select_tag('saksi_one_no_kec', options_for_select($cbSaksiOneKecamatan,  $saksiOneNoKec), 'style="width:240px" ' . $saksiOneDis . ' onChange="getKel(\'saksi_one_no_prov\', \'saksi_one_no_kab\', \'saksi_one_no_kec\', \'saksi_one_no_kel\', \'\', \'\', \'\', \'\');" tabindex="102"'); ?></td>
						<td>Desa/Kelurahan</td>
						<td align="center">:</td>
						<td><?php echo select_tag('saksi_one_no_kel', options_for_select($cbSaksiOneKelurahan,  $saksiOneNoKel), 'style="width:240px" ' . $saksiOneDis . ' tabindex="103"'); ?></td>
					</tr>
				</table>
				</div>

				<div class="accordHeader arial-narrow pointer">DATA SAKSI II</div>
				<div class="accordContent">
				<table border="0" cellspacing="3" cellpadding="0">
					<tr>
						<td width="120">NIK</td>
						<td width="15" align="center">:</td>
						<td width="280"><?php echo formNikHelper("saksi_two_nik", $saksiTwoNik, "fields", "saksi_two", "getBiodata('saksi_two_nik', 'saksi_two', '', 'bayi_nik;pelapor_nik;saksi_one_nik;saksi_two_nik');", 110);?></td>
						<td width="120">Nama Lengkap</td>
						<td width="15" align="center">:</td>
						<td><input type="text" style="width: 240px;" name="saksi_two_nama"
							id="saksi_two_nama" maxlength="128" onchange="ucase(this);"
							value="<?php echo $saksiTwoNama?>" tabindex="112"
							<?php echo $saksiTwoDis;?> /></td>
					</tr>
					<tr>
						<td>Umur</td>
						<td align="center">:</td>
						<td><input type="text" style="width: 30px; text-align: center;"
							name="saksi_two_umur" id="saksi_two_umur" maxlength="2"
							onchange="validateInteger(this.id); this.className=''; return actionGoNext(this, event);"
							value="<?php echo $saksiTwoUmur?>" tabindex="113"
							<?php echo $saksiTwoDis;?> />&nbsp;&nbsp;&nbsp;Tahun</td>
						<td>Jenis Kelamin</td>
						<td align="center">:</td>
						<td><?php echo select_tag('saksi_two_kelamin', options_for_select($cbJenisKelamin, $saksiTwoKelamin),'style="width: 124px" ' . $saksiTwoDis . ' tabindex="114" '); ?></td>
					</tr>
					<tr>
						<td>Jenis Pekerjaan</td>
						<td align="center">:</td>
						<td><?php echo select_tag('saksi_two_pekerjaan', options_for_select($cbPekerjaan, $saksiTwoPekerjaan), 'style="width: 240px" ' . $saksiTwoDis . ' tabindex="115" '); ?></td>
						<td></td>
						<td align="center"></td>
						<td></td>
					</tr>
					<tr>
						<td>Alamat</td>
						<td align="center">:</td>
						<td><input type="text" style="width: 240px;"
							name="saksi_two_alamat" id="saksi_two_alamat" maxlength="128"
							onchange="ucase(this);" value="<?php echo $saksiTwoAlamat?>"
							tabindex="116" <?php echo $saksiTwoDis;?> /></td>
						<td>RT/RW</td>
						<td align="center">:</td>
						<td><input type="text" style="width: 25px; text-align: center;"
							name="saksi_two_no_rt" id="saksi_two_no_rt" maxlength="3"
							value="<?php echo $saksiTwoNoRt?>"
							onchange="return actionGoNext(this, event);" tabindex="117"
							<?php echo $saksiTwoDis;?> /> / <input type="text"
							style="width: 25px; text-align: center;" name="saksi_two_no_rw"
							maxlength="3" id="saksi_two_no_rw"
							value="<?php echo $saksiTwoNoRw?>"
							onchange="return actionGoNext(this, event);" tabindex="118"
							<?php echo $saksiTwoDis;?> /></td>
					</tr>
					<tr>
						<td>Provinsi</td>
						<td align="center">:</td>
						<td><?php echo select_tag('saksi_two_no_prov', options_for_select($cbProvinsi, $saksiTwoNoProv),'style="width:240px" ' . $saksiTwoDis . ' onChange="getKab(\'saksi_two_no_prov\', \'saksi_two_no_kab\', \'saksi_two_no_kec\', \'saksi_two_no_kel\', \'\', \'\');" tabindex="119"'); ?></td>
						<td>Kab./Kota</td>
						<td align="center">:</td>
						<td><?php echo select_tag('saksi_two_no_kab', options_for_select($cbSaksiOneKabupaten,  $saksiTwoNoKab), 'style="width:240px" ' . $saksiTwoDis . ' onChange="getKec(\'saksi_two_no_prov\', \'saksi_two_no_kab\', \'saksi_two_no_kec\', \'saksi_two_no_kel\', \'\', \'\', \'\');" tabindex="120"'); ?></td>
					</tr>
					<tr>
						<td>Kecamatan</td>
						<td align="center">:</td>
						<td><?php echo select_tag('saksi_two_no_kec', options_for_select($cbSaksiOneKecamatan,  $saksiTwoNoKec), 'style="width:240px" ' . $saksiTwoDis . ' onChange="getKel(\'saksi_two_no_prov\', \'saksi_two_no_kab\', \'saksi_two_no_kec\', \'saksi_two_no_kel\', \'\', \'\', \'\', \'\');" tabindex="121"'); ?></td>
						<td>Desa/Kelurahan</td>
						<td align="center">:</td>
						<td><?php echo select_tag('saksi_two_no_kel', options_for_select($cbSaksiOneKelurahan,  $saksiTwoNoKel), 'style="width:240px" ' . $saksiTwoDis . ' tabindex="122"'); ?></td>
					</tr>
				</table>
				</div>

				<div class="accordHeader arial-narrow pointer">DATA ADMINISTRASI</div>
				<div class="accordContent">
				<table border="0" cellspacing="3" cellpadding="0">
					<tr>
						<td width="177">Jenis Kelahiran</td>
					  <td width="12" align="center">:</td>
					  <td width="275"><?php echo select_tag('adm_jenis_lahir', options_for_select($cbJenisLahir, $admJenisLahir), 'style="width:124px" tabindex="125" onchange="getDecisionNumber();" '); ?></td>
					  <td width="120"></td>
						<td width="15" align="center"></td>
						<td width="124"></td>
				  </tr>
					<?php //if ($lahirIndex) {?>
					<tr>
						<td colspan="6" height="5"></td>
					</tr>
					<tr>
						<td height="22">No. Akta Kelahiran</td>
						<td align="center">:</td>
						<td class="trebuchet bigger blue bold green"><div id="ADM_AKTA_NO"><?php echo $admAktaNo?></div><input
							type="hidden" name="admAktaNo" id="admAktaNo"
							value="<?php echo $admAktaNo;?>" /></td>

						<td>Tgl. Akta Kelahiran</td>
						<td align="center">:</td>
						<td class="trebuchet bigger blue bold green"><div id='ADM_AKTA_KTP_TGL'><?php if ($lahirIndex) {
							echo $admAktaTgl;
						}?></div></td>
					</tr>
					<?php if ($admAktaKtpTgl) {?>
					<tr>
						<td height="22">Tgl Cetak Kutipan Akta</td>
						<td align="center">:</td>
						<td class="trebuchet bigger blue bold green" colspan="4"><?php echo $admAktaKtpTgl;?></td>
					</tr>
					<?php }?>
					<?php //}?>
					<tr>
						<td colspan="6" height="5"></td>
					</tr>
					<tr>

						<td valign="top" style="padding-top: 3px;">Dokumen Persyaratan *</td>
						<td valign="top" style="padding-top: 3px;" align="center">:</td>
						<td colspan="4" height="22">
						<table cellpadding="0" cellspacing="2">
						<?php for ($i = 1; $i <= count($cbDokumen); $i ++) {?>
							<tr>
								<td><input type="checkbox" name="admDokumen[<?php echo $i?>]"
									id="admDokumen[<?php echo $i?>]" value="<?php echo $i?>"
									<?php if ($admDokumen[$i]=="1") {?> checked="checked" <?php }?>
									tabindex="<?php echo (130 + $i)?>" /></td>
								<td><?php echo $cbDokumen[$i]?></td>
							</tr>
							<?php }?>
						</table>
						</td>
					</tr>
					<tr>
						<td colspan="6" height="5"></td>
					</tr>
					<tr valign="top">
						<td style="padding-top: 2px;">No. Surat Keputusan Kadis</td>
						<td style="padding-top: 2px;" align="center">:</td>
						<td style="padding-top: 2px;"><input type="text" style="width: 240px;" name="adm_sp_no"
							onchange="ucase(this);" maxlength="64" id="adm_sp_no"
							value="<?php echo $admSpNo?>" tabindex="141" /></td>
						<td>Tgl. Keputusan</td>
						<td align="center">:</td>
						<td><?php echo formDateHelper("adm_sp", $admSpTgl, false, false, 142);?></td>                            
				  </tr>
					<tr>
						<td width="177">Nama Kades/Lurah</td>
					  <td width="12" align="center">:</td>
					  <td width="275"><input type="text" style="width: 240px;"
							name="adm_kades_nama" maxlength="128" id="adm_kades_nama"
							onchange="ucase(this);" value="<?php echo $admKadesNama?>"
							tabindex="150" /></td>
					  <td width="120">NIP Kades/Lurah</td>
						<td width="15" align="center">:</td>
						<td><input type="text" style="width: 124px;" name="adm_kades_nip"
							id="adm_kades_nip" maxlength="25"
							onchange="ucase(this); return actionGoNext(this, event);"
							value="<?php echo $admKadesNip?>" tabindex="152" /></td>
					</tr>
					<tr>

						<td width="177">Nama Pet. Registrar *</td>
					  <td width="12" align="center">:</td>
					  <td width="275"><input type="text" style="width: 240px;"
							name="adm_regs_nama" maxlength="128" onchange="ucase(this);"
							id="adm_regs_nama" value="<?php echo $admRegsNama?>"
							tabindex="153" /></td>
					  <td width="120">NIP Pet. Registrar</td>
						<td width="15" align="center">:</td>
						<td><input type="text" style="width: 124px;" name="adm_regs_nip"
							id="adm_regs_nip" maxlength="25" onchange="ucase(this);"
							value="<?php echo $admRegsNip?>" tabindex="154" /></td>
					</tr>
					<tr>
						<td height="20">Nama &amp; NIP Pet. Entri</td>
						<td align="center">:</td>
						<td class="red italic"><?php echo $ses_siak_nip ?> - <?php echo $ses_siak_name ?></td>
						<td>Tgl. Entri Data</td>
						<td align="center">:</td>
						<td class="red italic"><?php echo date("d-m-Y")?></td>
					</tr>

				</table>
				</div>
                            <table border="0" cellspacing="0" cellpadding="0" width="100%">
			<tr>
				<td align="left">
					<b><font color="#FF0000">(*) Wajib diisi</font></b>
				</td>
			</tr>
                                <tr>
                                    <td align="center">
                                        <input type="hidden" name="admProv" id="admProv" value="<?php echo $admNoProv; ?>" /> 
                                        <input type="hidden" name="admKab" id="admKab" value="<?php echo $admNoKab; ?>" /> 
                                        <input type="hidden" name="admKec" id="admKec" value="<?php echo $admNoKec; ?>" /> 
                                        <input type="hidden" name="admKel" id="admKel" value="<?php echo $admNoKel; ?>" /> 
                                        <input type="hidden" name="BAYI_NO" id="BAYI_NO" value="<?php echo $BAYI_NO; ?>" /> 
                                        <input type="hidden" name="PROCESS_STATUS" id="PROCESS_STATUS" value="<?php echo $PROCESS_STATUS; ?>" /> 
                                        <input type="button" name="btnPROSES" id="btnPROSES" style="height: 30px;" value="PROSES" <?php echo $disProses; ?> onclick="performSubmit();"/>
                                        <input type="button" name="btnCancel" id="btnCancel" style="height: 30px;" value="KELUAR" onclick="window.close();"/>
                                    </td>
                                </tr>
                            </table>
				</form>
				<input type="text" style="background-color: #94b1db; border: none"
					name="jegat" id="jegat" /> <?php //include SIAK_ROOT_INCLUDE."/pages/FooterPop.php"; 
							if ($success=='true')
							{
								?><script language="javascript">
	//window.opener.actionSubmit(); 
	alert('Data telah tersimpan');</script> <!--
	<script language="javascript">window.opener.actionSubmit(); actionShowSuccessBox();</script>--><?php
							}
							?></td>
			</tr>
		</table>
		<table cellpadding="0" cellspacing="0" border="0" width="100%">
			<tr>
				<td width="224" height="72"><img
					src="../../images/V3/FooterContentLeft_2011.gif" /></td>
				<td width="100%"
					background="../../images/V3/FooterContentBg_2011.gif"
					style="background-repeat: repeat-x"></td>
				<td width="220" height="72"><img
					src="../../images/V3/FooterContentRight_2011.gif" /></td>
			</tr>
		</table>
		</td>
	</tr>
</table>
<script language="javascript">		
		jQuery( "#bayi_nik_ada" ).bind( "change", function() {
			tampil_biodata(jQuery(this).val());
			//alert(jQuery(this).val());				
		});
		function tampil_biodata(ada_nik){
			if(ada_nik==1){
				jQuery(".biodata_hidden").show();				
			}else{
				jQuery(".biodata_hidden").hide();				
			}
		}
		tampil_biodata(jQuery("#bayi_nik_ada").val());		
</script>	
</body>
</html>