MINI
C:
/
siak
/
TOOL SIAK
/
tool9
/
malinau
/
tab
/
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files >> C:/siak/TOOL SIAK/tool9/malinau/tab/ubah.php
<div class="row"> <div class="form-group col-sm-12"> <label class="col-sm-2 control-label">PROPINSI</label> <div class="col-sm-3"> <input class="form-control" type="text" id="focusedInput" name="NO_PROP" value="<?=$NO_PROP; ?>"> </div> <label class="col-sm-2 control-label">KABUPATEN / KOTA</label> <div class="col-sm-3"> <input class="form-control" type="text" id="focusedInput" name="NO_KAB" value="<?=$NO_KAB; ?>"> </div> </div> <div class="form-group col-sm-12"> <label class="col-sm-2 control-label">KECAMATAN</label> <div class="col-sm-3"> <input class="form-control" type="text" id="focusedInput" name="NO_KEC" value="<?=$NO_KEC; ?>"> </div> <label class="col-sm-2 control-label">KELURAHAN / DESA</label> <div class="col-sm-3"> <input class="form-control" type="text" id="focusedInput" name="NO_KEL" value="<?=$NO_KEL; ?>"> </div> </div> <div class="form-group col-sm-12"> <label class="col-sm-2 control-label">NO KK</label> <div class="col-sm-3"> <input class="form-control" type="text" id="focusedInput" name="NO_KK" value="<?=$NO_KK; ?>"> </div> </div> </div> <hr> <div class="row"> <div class="form-group col-sm-12"> <label class="col-sm-2 control-label">NIK</label> <div class="col-sm-3"> <input class="form-control" type="text" id="focusedInput" name="NIK" value="<?=$NIK; ?>" <? if($status=="LAMA"){ echo "readonly"; } ?>> </div> <label class="col-sm-2 control-label">NAMA LENGKAP</label> <div class="col-sm-3"> <input class="form-control" type="text" id="focusedInput" name="NAMA_LGKP" value="<?=$NAMA_LGKP; ?>"> </div> </div> <div class="form-group col-sm-12"> <label class="col-sm-2 control-label">TEMPAT LAHIR</label> <div class="col-sm-3"> <input class="form-control" type="text" id="focusedInput" name="TMPT_LHR" value="<?=$TMPT_LHR; ?>"> </div> <label class="col-sm-2 control-label">TANGGAL LAHIR</label> <div class="col-sm-3"> <input type="text" id="focusedInput" name="TGL_LHR" value="<?=$TGL_LHR; ?>" class="form-control"> </div> </div> <div class="form-group col-sm-12"> <label class="col-sm-2 control-label">JENIS KELAMIN</label> <div class="col-sm-3"> <input class="form-control" type="text" id="focusedInput" name="JENIS_KLMIN" value="<?=$JENIS_KLMIN; ?>"> </div> <label class="col-sm-2 control-label">GOL. DARAH</label> <div class="col-sm-3"> <input class="form-control" type="text" id="focusedInput" name="GOL_DRH" value="<?=$GOL_DRH; ?>" > </div> </div> <div class="form-group col-sm-12"> <label class="col-sm-2 control-label">AKTA LAHIR</label> <div class="col-sm-3"> <input class="form-control" type="text" id="focusedInput" name="AKTA_LHR" value="<?=$AKTA_LHR; ?>"> </div> <label class="col-sm-2 control-label">NO AKTA LAHIR</label> <div class="col-sm-3"> <input class="form-control" type="text" id="focusedInput" name="NO_AKTA_LHR" value="<?=$NO_AKTA_LHR; ?>"> </div> </div> <div class="form-group col-sm-12"> <label class="col-sm-2 control-label">AGAMA</label> <div class="col-sm-3"> <input class="form-control" type="text" id="focusedInput" name="AGAMA" value="<?=$AGAMA; ?>" > </div> <label class="col-sm-2 control-label">STAT HUB KEL</label> <div class="col-sm-3"> <input class="form-control" type="text" id="focusedInput" name="STAT_HBKEL" value="<?=$STAT_HBKEL; ?>"> </div> </div> <div class="form-group col-sm-12"> <label class="col-sm-2 control-label">STAT KAWIN</label> <div class="col-sm-3"> <input class="form-control" type="text" id="focusedInput" name="STAT_KWN" value="<?=$STAT_KWN; ?>" > </div> <label class="col-sm-2 control-label">TGL KAWIN</label> <div class="col-sm-3"> <input class="form-control" type="text" id="focusedInput" name="TGL_KWN" value="<?=$TGL_KWN; ?>"> </div> </div> <div class="form-group col-sm-12"> <label class="col-sm-2 control-label">AKTA KAWIN</label> <div class="col-sm-3"> <input class="form-control" type="text" id="focusedInput" name="AKTA_KWN" value="<?=$AKTA_KWN; ?>"> </div> <label class="col-sm-2 control-label">NO AKTA KAWIN</label> <div class="col-sm-3"> <input class="form-control" type="text" id="focusedInput" name="NO_AKTA_KWN" value="<?=$NO_AKTA_KWN; ?>"> </div> </div> <div class="form-group col-sm-12"> <label class="col-sm-2 control-label">PENDIDIKAN</label> <div class="col-sm-3"> <input class="form-control" type="text" id="focusedInput" name="PDDK_AKH" value="<?=$PDDK_AKH; ?>"> </div> <label class="col-sm-2 control-label">PEKERJAAN</label> <div class="col-sm-3"> <input class="form-control" type="text" id="focusedInput" name="JENIS_PKRJN" value="<?=$JENIS_PKRJN; ?>"> </div> </div> <div class="form-group col-sm-12"> <label class="col-sm-2 control-label">NIK IBU</label> <div class="col-sm-3"> <input class="form-control" type="text" id="focusedInput" name="NIK_IBU" value="<?=$NIK_IBU; ?>"> </div> <label class="col-sm-2 control-label">NAMA LENGKAP IBU</label> <div class="col-sm-3"> <input class="form-control" type="text" id="focusedInput" name="NAMA_LGKP_IBU" value="<?=$NAMA_LGKP_IBU; ?>"> </div> </div> <div class="form-group col-sm-12"> <label class="col-sm-2 control-label">NIK AYAH</label> <div class="col-sm-3"> <input class="form-control" type="text" id="focusedInput" name="NIK_AYAH" value="<?=$NIK_AYAH; ?>"> </div> <label class="col-sm-2 control-label">NAMA LENGKAP AYAH</label> <div class="col-sm-3"> <input class="form-control" type="text" id="focusedInput" name="NAMA_LGKP_AYAH" value="<?=$NAMA_LGKP_AYAH; ?>"> </div> </div> <div class="form-group col-sm-12"> <label class="col-sm-2 control-label" data-toggle="tooltip" title="flag_status">STATUS</label> <div class="col-sm-3"> <input class="form-control" type="text" id="focusedInput" data-toggle="tooltip" title="flag_status" name="FLAG_STATUS" value="<?=$FLAG_STATUS; ?>"> </div> <label class="col-sm-2 control-label">TGL ENTRI</label> <div class="col-sm-3"> <input class="form-control" type="text" id="focusedInput" name="TGL_ENTRI" value="<?=$TGL_ENTRI; ?>"> </div> </div> <div class="form-group col-sm-12"> <div class="col-sm-3"> <input type="hidden" name="status" value="<?=$status; ?>"> </div> </div> </div>
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