
<div style="width:800px; margin-right:auto; margin-left:auto;">
<fieldset style="margin:0px;text-align:left;">
<legend>TROUBLE TICKET</legend>
<form action="" method="post">


<h3>Ticket Information</h3>
	<!--Table 1 Start --><div>
 	<table width="100%" border="0" cellspacing="1" cellpadding="2">
  <tr>
    <th width="12%">T.T NO.</th>
    <td width="20%"><input name="tt_no." type="text" style="width:150px;" /></td>
    <th width="17%">Date</th>
    <td width="13%"><input name="tt_no." type="text" style="width:100px;" /></td>
    <th width="8%">Party Name</th>
    <td width="30%"><select style="width:150px">
		<option id="0">Select Name</option>
		<option id="0">Select Name</option>
		<option id="0">Select Name</option>
	</select>
	</td>
  </tr>
  <tr>
    <th width="12%">Mode Of Complaint</th>
    <td width="20%"><select style="width:150px">
		<option id="0">Select Name</option>
		<option id="0">Select Name</option>
		<option id="0">Select Name</option>
	</select></td>
    <th width="17%">Scope of service</th>
    <td width="13%"><select style="width:100px">
		<option id="0">Select Name</option>
		<option id="0">Select Name</option>
		<option id="0">Select Name</option>
	</select></td>
    <th width="8%">Category</th>
    <td width="30%"><select style="width:150px">
		<option id="0">Select Name</option>
		<option id="0">Select Name</option>
		<option id="0">Select Name</option>
	</select>
	</td>
  </tr>
  <tr>
    <th width="12%">Mode Of Contract</th>
    <td width="20%"><select style="width:150px">
		<option id="0">Select Name</option>
		<option id="0">Select Name</option>
		<option id="0">Select Name</option>
	</select></td>
    <th width="17%">Priority</th>
    <td width="13%"><select style="width:100px">
		<option id="0">Select Name</option>
		<option id="0">Select Name</option>
		<option id="0">Select Name</option>
	</select></td>
    <th width="8%">Status</th>
    <td width="30%"><select style="width:150px">
		<option id="0">Select Name</option>
		<option id="0">Select Name</option>
		<option id="0">Select Name</option>
	</select>
	</td>
  </tr>
  <tr>
    <th width="12%">Estimated Time</th>
    <td width="20%"><input name="tt_no." type="text" style="width:150px;" /></td>
    <th width="17%">Severity</th>
    <td colspan="3"><select style="width:300px">
		<option id="0">Select Name</option>
		<option id="0">Select Name</option>
		<option id="0">Select Name</option>
	</select></td>
  </tr>
  
  
</table>
	</div><!--Table 6 Start -->


<h3>Product Information</h3>
	<!--Table 1 Start --><div>
 	<table width="100%" border="0" cellspacing="1" cellpadding="2">
  <tr>
    <th width="15%">Service Sr. No</th>
    <td width="20%"><input name="tt_no." type="text" style="width:150px;" /></td>
    <th width="15%">Invoice No</th>
    <td width="13%"><input name="tt_no." type="text" style="width:100px;" /></td>
    <th width="18%">Invoice Date</th>
    <td width="19%"><select style="width:150px">
		<option id="0">Select Name</option>
		<option id="0">Select Name</option>
		<option id="0">Select Name</option>
	</select>
	</td>
  </tr>
</table>

 	<table width="100%" border="0" cellspacing="1" cellpadding="2">
  <tr>
    <th width="5%">Part Code</th>
    <td width="8%"><input name="tt_no." type="text" style="width:50px;" /></td>
    <th width="7%">Item Name</th>
    <td width="10%"><input name="tt_no." type="text" style="width:70px;" /></td>
    <th width="5%">Uom</th>
    <td width="8%"><input name="tt_no." type="text" style="width:50px;" /></td>
    <th width="5%">Qty</th>
    <td width="7%"><input name="tt_no." type="text" style="width:50px;" /></td>
    <th width="5%">Rate</th>
    <td width="7%"><input name="tt_no." type="text" style="width:50px;" /></td>
    <th width="9%">Amount </th>
    <td width="7%"><input name="tt_no." type="text" style="width:50px;" /></td>
    <th width="10%">Total Inv Amt</th>
    <td width="7%"><input name="tt_no." type="text" style="width:50px;" /></td>

</table>
<table width="100%" border="0" cellspacing="1" cellpadding="2">
 <tr>
    <th width="16%">Estimated Time</th>
    <td width="25%"><input name="tt_no." type="text" style="width:223px;" /></td>
    <th width="14%">Severity</th>
    <td width="45%" colspan="3"><select style="width:195px">
		<option id="0">Select Name</option>
		<option id="0">Select Name</option>
		<option id="0">Select Name</option>
	</select></td>
  </tr>
</table>

	</div><!--Table 6 Start -->

<h3>Complaint Description</h3>
	<!--Table 1 Start --><div>
 	<table width="100%" border="0" cellspacing="1" cellpadding="2">
  <tr>
    <th width="29%">Description</th>
    <td width="71%" colspan="5"><textarea name="tt_no." type="text" style="width:530px; height:100px;" > </textarea></td>
   
  </tr>
 
  
  
</table>
	</div><!--Table 6 Start -->
	
<h3>Group & User Assignment</h3>
	<!--Table 1 Start --><div>
	
	<table width="100%" border="0" cellspacing="2" cellpadding="1">
  <tr>
    <th width="27%">Group</th>
    <td colspan="2"><select style="width:195px">
		<option id="0">Select Name</option>
		<option id="0">Select Name</option>
		<option id="0">Select Name</option>
	</select></td>
    <th width="19%">User</th>
    <td width="29%" colspan="2"><select style="width:195px">
		<option id="0">Select Name</option>
		<option id="0">Select Name</option>
		<option id="0">Select Name</option>
	</select></td>
  </tr>
  
</table>
</div>
<h3>Spare Parts</h3>
	<!--Table 1 Start --><div>
	
	<table width="100%" border="0" cellspacing="2" cellpadding="1">
  <tr>
    <th width="14%">Part Code</th>
    <td width="11%"><input name="tt_no." type="text" style="width:80px;" /></td>
    <th width="14%">Item Name</th>
    <td width="11%"><input name="tt_no." type="text" style="width:80px;" /></td>
    <th width="10%">Uom</th>
    <td width="11%"><input name="tt_no." type="text" style="width:80px;" /></td>
    <th width="17%">Rate</th>
    <td width="12%"><input name="tt_no." type="text" style="width:80px;" /></td>
  </tr>
  <tr>
    <th>Total Amt</th>
    <td><input name="tt_no." type="text" style="width:80px;" /></td>
    <th>Discount type</th>
    <td><input name="tt_no." type="text" style="width:80px;" /></td>
    <th>Discount</th>
    <td><input name="tt_no." type="text" style="width:80px;" /></td>
    <th>Discounted Amount</th>
    <td><input name="tt_no." type="text" style="width:80px;" /></td>
  </tr>
</table>

	
	

</div>


<h3>&nbsp;</h3>
	<!--Table 1 Start --><div style="width:300px; float:right;">
	
<table width="100%" border="0" cellspacing="2" cellpadding="1">
  <tr>
    <th width="49%">Basic Amount</th>
    <td width="51%"><input name="ba" type="text" style="width:150px;" /></td>
  </tr>
  <tr>
    <th>Discounted Amount</th>
    <td><input name="ba" type="text" style="width:150px;" /></td>
  </tr>
  <tr>
    <th>Excise Duty</th>
    <td><input name="ba" type="text" style="width:150px;" /></td>
  </tr>
  <tr>
    <th>E-Cess</th>
    <td><input name="ba" type="text" style="width:150px;" /></td>
  </tr>
  <tr>
    <th>H-E-Cess</th>
    <td><input name="ba" type="text" style="width:150px;" /></td>
  </tr>
  <tr>
    <th>Total Taxable Amt</th>
    <td><input name="ba" type="text" style="width:150px;" /></td>
  </tr>
  <tr>
    <th>Vat/Cst</th>
    <td><input name="ba" type="text" style="width:150px;" /></td>
  </tr>
  <tr>
    <th>Freight</th>
    <td><input name="ba" type="text" style="width:150px;" /></td>
  </tr>
  <tr>
    <th>Installation Charges</th>
    <td><input name="ba" type="text" style="width:150px;" /></td>
  </tr>
  <tr>
    <th>Pkg Charges</th>
    <td><input name="ba" type="text" style="width:150px;" /></td>
  </tr>
  <tr>
    <th>Other Charges</th>
    <td><input name="ba" type="text" style="width:150px;" /></td>
  </tr>
  <tr>
    <th>Grand Total</th>
    <td><input name="ba" type="text" style="width:150px;" /></td>
  </tr>
</table>
</div>

<div style="clear:both;"></div>

<input type="button"  class="bottonsview" value="Save" />


</form>
</fieldset>
</div>

