<h2 align="center"><strong>Sales Return Form</strong></h2>
<form name="form1" action="" method="post" >


<table width="100%" border="1" cellpadding="3" cellspacing="0">
<tr>
    <th width="13%"><strong>Form No.</strong></th>
    <td width="20%">
		<input name="" type="text" style="width:100%;" value="" />
	</td>
    <th width="13%">Form Date</th>
    <td width="20%">
		<input name="" type="text" style="width:100%;" class="datepicker" value="" />
	</td>
    <th width="13%">Return Type Date</th>
    <td>
		<select style="width:100%;">
			<option>--Select--</option>
    		<option>--Select--</option>
    	</select>
	</td>
</tr>

<tr> <th><strong>Customer Name</strong></th>
    <td>
      <select style="width:100%;">
		<option>--Select--</option>
    	<option>--Select--</option>
    </select>	
	</td>
    <th>Pick List No</th>
    <td>
		<select style="width:100%;">
			<option>--Select--</option>
    		<option>--Select--</option>
    	</select>	</td>
    <th>Pick List Date</th>
    <td>
		<input name="" type="text" style="width:100%;" class="datepicker" value=""/>
	</td>
</tr>

<tr>
    <th><strong> Area </strong></th>
    <td>
		<input name="" type="text" style="width:100%;" value="" />
	</td>
    <th>Sub Area</th>
    <td>
		<input name="" type="text" style="width:100%;" value="" />
	</td>
    <th>Engineer</th>
    <td>
		<input name="" type="text" style="width:100%;" value="" />
	</td>
</tr>

<tr>
    <th><strong>SOI No</strong></th>
    <td>
		<input name="" type="text" style="width:100%;" value="" />
	</td>


    
    <th> SOI Date</th>
    <td>
		<input name="" type="text" style="width:100%;" value="" />
	</td>
    <th>PO No.</th>
    <td>
		<input name="" type="text" style="width:100%;" value="" />
	</td>
</tr>

<tr>
    <th><strong>Mistake Type</strong></th>
    <td>
		<select style="width:100%;">
			<option>--Select--</option>
    		<option>--Select--</option>
    	</select>
	</td>
	
	
    <th>Responsible </th>
    <td>
		<input name="" type="text" style="width:100%;" value="" />
	</td>
    <th>Incentive Reco</th>
    <td>
		<select style="width:100%;">
			<option>--Select--</option>
    		<option>--Select--</option>
    	</select>
	</td>
</tr>
 
 <tr>
    <th><strong>Restocking Charges</strong></th>
    <td>
		<select style="width:100%;">
			<option>--Select--</option>
    		<option>--Select--</option>
    	</select>
	</td>

	
    <th><strong>Excise</strong></th>
    <td>
		<select style="width:100%;">
			<option>--Select--</option>
    		<option>--Select--</option>
    	</select>
	</td>
    <th>Party Ref No</th>
    <td>
		<input name="" type="text" style="width:100%;" value="" />
	</td>
 </tr>
 <tr>
    <th colspan="6">
	<table width="50%" border="0" align="center" cellpadding="0" cellspacing="0">
  <tr>
    <td width="10%"><strong>Sales</strong></td>
    <td width="10%">
		<input type="radio" name="" />
	</td>
    <td width="10%"><strong>Sample</strong></td>
    <td width="10%">
		<input type="radio" name="" />
	</td>
    <td width="10%"><strong>warranty</strong></td>
    <td width="10%">
		<input type="radio" name="" />
	</td>
    <td width="10%"><strong>Invoice</strong></td>
    <td>
		<input type="radio" name="" />
	</td>
  </tr>
</table>

	</th>
    </tr>
</table> 
<br />

<table width="100%" border="1" cellspacing="0" cellpadding="3">
  <tr>
    <th width="11%"><strong>Sr. No.</strong></th>
    <th width="11%"><strong>Part No.</strong></th>
    <th width="11%"><strong>Part name</strong></th>
    <th width="11%"><strong>Invoice Qty</strong></th>
	<th width="11%"><strong>Returned Qty</strong></th>
	<th width="11%"><strong>Accepted Qty </strong></th>
	<th width="11%"><strong>Rate Amount</strong></th>
	<th width="11%"><strong>Return Reason</strong></th>
    <th>Return Type</th>
  </tr>
  
  <tr>
    <td>
		<input name="" type="text" style="width:100%;" value="" readonly="" />
	</td>
    <td>
		<input name="" type="text" style="width:100%;" value="" readonly="" />
	</td>
    <td>
		<input name="" type="text" style="width:100%;" value="" readonly="" />
	</td>
    <td>
		<input name="" type="text" style="width:100%;" value="" readonly="" />
	</td>
	<td>
		<input name="" type="text" style="width:100%;" value="" readonly="" />
	</td>
	<td>
		<input name="" type="text" style="width:100%;" value="" readonly="" />
	</td>
	<td>
		<input name="" type="text" style="width:100%;" value="" readonly="" />
	</td>
	<td>
		<input name="" type="text" style="width:100%;" value="" readonly="" />
	</td>
	<td>
		<select style="width:100%;">
			<option>--Select--</option>
    		<option>--Select--</option>
    	</select>
	</td>
  </tr>
</table>	
<p align="center">
  <input type="submit" name="Submit" value="Save"  onclick="return validate()"/>
  <input type="reset" name="reset" value="View" />
  <input type="button" value="Cancel" name="Back" />
</p>
</form>