<link rel="stylesheet" href="css/new_mxerp.css">

<div class="body_contain">
<div class="tab_div">



<form action="" method="post">



<h1>Trouble Ticket Creation</h1>
<table width="100%" border="1" cellspacing="0" cellpadding="3" style="border:#999999 solid 1px;">
  <tr>
    <td class="tabledata1">Branch</td>
    <td colspan="2">
	<select name="transport" style="width:100%">
		 	<option selected Value="">Selection your option</option>
		 	<option selected Value="">Selection your option</option>
		 	<option selected Value="">Selection your option</option>
		</select>
	
	
	
	</td>
    <td class="tabledata1">Ticket No.</td>
    <td colspan="2">
		<input type="text" style="width:100%" />
		

	
	</td>
  </tr>

  <tr>
    <td class="tabledata1">Party Name</td>
    <td colspan="2">
	<select name="transport" style="width:100%">
		 	<option selected Value="">Selection your option</option>
		 	<option selected Value="">Selection your option</option>
		 	<option selected Value="">Selection your option</option>
		</select>
	
	
	
	</td>
    <td class="tabledata1">Product Name</td>
    <td colspan="2">
		<select name="transport" style="width:100%">
		 	<option selected Value="">Selection your option</option>
		 	<option selected Value="">Selection your option</option>
		 	<option selected Value="">Selection your option</option>
		</select>

	
	</td>
  </tr>

  <tr>
    <td class="tabledata1">Priority</td>
    <td colspan="2">
	<select name="transport" style="width:100%">
		 	<option selected Value="">Selection your option</option>
		 	<option selected Value="">Selection your option</option>
		 	<option selected Value="">Selection your option</option>
		</select>
	
	
	
	</td>
    <td class="tabledata1">Category</td>
    <td colspan="2">
		<select name="transport" style="width:100%">
		 	<option selected Value="">Selection your option</option>
		 	<option selected Value="">Selection your option</option>
		 	<option selected Value="">Selection your option</option>
		</select>

	
	</td>
  </tr>

  <tr>
    <td class="tabledata1">Scope of service</td>
    <td colspan="2">
	<select name="transport" style="width:100%">
		 	<option selected Value="">Selection your option</option>
		 	<option selected Value="">Selection your option</option>
		 	<option selected Value="">Selection your option</option>
		</select>
	
	
	
	</td>
    <td class="tabledata1">Mode of complaint</td>
    <td>
		<select name="transport" style="width:100%">
		 	<option selected Value="">Selection your option</option>
		 	<option selected Value="">Selection your option</option>
		 	<option selected Value="">Selection your option</option>
		</select>

	
	</td>
  </tr>

  <tr>
    <td class="tabledata1">Mode of Contract</td>
    <td colspan="2">
	<select name="transport" style="width:100%">
		 	<option selected Value="">Selection your option</option>
		 	<option selected Value="">Selection your option</option>
		 	<option selected Value="">Selection your option</option>
		</select>
	
	
	
	</td>
    <td class="tabledata1">Assigned User</td>
    <td colspan="2">
		<select name="transport" style="width:100%">
		 	<option selected Value="">Selection your option</option>
		 	<option selected Value="">Selection your option</option>
		 	<option selected Value="">Selection your option</option>
		</select>

	
	</td>
  </tr>
  
  
    <tr>
    <td class="tabledata1" scope="row">Problem Desc.</td>
    <td colspan="5"><input name="RemarksIfAny" type="text" id="RemarksIfAny" value="" style="width:100%; height:50px;"></td>
	</tr>
  
</table>

<br />
<div style="width:810px; overflow:auto; border:#006699 solid 2px;">
<p style="padding-left:0px; margin:0; text-align:left;"><input type="button" value="Add Spare Part" class="heading_button" />&nbsp;&nbsp;<input type="button" value="Add Service" class="heading_button" /></p>

<table width="100%" border="1" cellspacing="0" cellpadding="3">
  <tr>
    <td class="tabledata">Sr. No.</td>
    <td class="tabledata">Item Name</td>
    <td class="tabledata">Qty in Stock </td>
    <td class="tabledata">Req. Qty.</td>
    <td class="tabledata">Price</td>
    <td class="tabledata">Total amount</td>
  </tr>
<tr bgcolor="#c1c1c1">
    <td>&nbsp;</td>
    <td>&nbsp;</td>
    <td>&nbsp;</td>
    <td>&nbsp;</td>
    <td>&nbsp;</td>
    <td>&nbsp;</td>
  </tr>
</table>

<p style="padding-left:5px;padding-top:5px; margin:0; text-align:left;"><input type="button" value="Add" class="submit_button" />&nbsp;&nbsp;<input type="button" value="Delete" class="submit_button" /></p>

<div style="width:32%; float:right;">
<table width="100%" border="1" cellspacing="0" cellpadding="3" style="border:#999999 solid 1px;">
  <tr>
    <td class="tabledata" style="width:120px;">Basic Amt.</td>
    <td>&nbsp;</td>
  </tr>
  <tr>
    <td class="tabledata">Excise Duty</td>
    <td>&nbsp;</td>
  </tr>
  <tr>
    <td class="tabledata">E-cess</td>
    <td>&nbsp;</td>
  </tr>
  <tr>
    <td class="tabledata">She-cess</td>
    <td>&nbsp;</td>
  </tr>
  <tr>
    <td class="tabledata">Total Taxable</td>
    <td>&nbsp;</td>
  </tr>
  <tr>
    <td class="tabledata">Vat/Cst</td>
    <td>&nbsp;</td>
  </tr>
  <tr>
    <td class="tabledata">Other Charges</td>
    <td>&nbsp;</td>
  </tr>
  <tr>
    <td class="tabledata">Grand Total</td>
    <td>&nbsp;</td>
  </tr>
</table>




</div>




<div class="cl"></div>
</div>









<p align="center"><input type="submit" name="save" value="Save" onclick="return check_po()"/>
<input type="submit" name="cancel" value="Cancel" /></p>
</form>

</div></div>

