<div style="width:800px; margin-right:auto; margin-left:auto;">
<fieldset style="margin:0px;text-align:left;">
<h2 align="center">DAILY FIELD MARKETING</h2>

<h3>General Info</h3>
	<!--Table 1 Start --><div>
	
	<table width="100%" border="0" cellspacing="1" cellpadding="2">
  <tr>
    <th width="11%">Sr No.</th>
    <td width="24%"><input name="text2" type="text" style="width:175px;" /></td>
    <th width="15%">Date</th>
    <td width="17%"><input type="text" style="width:130px;" /></td>
    <th width="16%">Employee Name</th>
    <td width="17%"><select style="width:130px;">
			<option id="0">1</option>
			<option id="0">2</option>
			<option id="0">3</option>
	
	</select></td>
  </tr>
  <tr>
    <th width="11%">Dept.</th>
    <td width="24%"><select style="width:175px;">
			<option id="0">1</option>
			<option id="0">2</option>
			<option id="0">3</option>
	
	</select></td>
    <th width="15%">Designation</th>
    <td width="17%"><select style="width:130px;">
			<option id="0">1</option>
			<option id="0">2</option>
			<option id="0">3</option>
	
	</select></td>
    <th width="16%">Branch</th>
    <td width="17%"><input type="text" style="width:130px;" /></td>
  </tr>

 

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



<h3 style="text-align:left;">Field Vist Report</h3>
	<!--Table 1 Start --><div>
	<table width="100%" border="0" cellspacing="1" cellpadding="2">
  <tr>
    <th width="21%">Client Name</th>
    <td width="17%"><input type="text" style="width:125px;" />
</td>
    <th width="13%">Location</th>
    <td width="16%"><input type="text" style="width:125px;" /></td>
    <th width="16%">City</th>
    <td width="17%"><input type="text" style="width:125px;" /></td>
  </tr>

  <tr>
    <th width="21%">Contact Person</th>
    <td width="17%"><input type="text" style="width:125px;" /></td>
    <th width="13%">Mob. No</th>
    <td width="16%"><input type="text" style="width:125px;" /></td>
    <th width="16%">Off. No.</th>
    <td width="17%"><input type="text" style="width:125px;" /></td>
  </tr>
  <tr>
    <th width="21%">Email</th>
    <td width="17%"><input type="text" style="width:125px;" /></td>
    <th width="13%">Website</th>
    <td width="16%"><input type="text" style="width:125px;" /></td>
    <th width="16%">Meeting Type</th>
    <td width="17%"><select style="width:125px;">
			<option id="0">1</option>
			<option id="0">2</option>
			<option id="0">3</option>
	
	</select></td>
  </tr>
  <tr>
    <th width="21%">Purpose Assigned</th>
    <td width="17%" colspan="5"><input type="text" style="width:485px;" /></td>
  </tr>
	<tr>
    <th width="13%">Meeting Description</th>
    <td width="16%" colspan="5"><input type="text" style="width:485px;" /></td>
	</tr>

</table>
	</div><!--Table 2 Start -->
<h3 style="text-align:left;">Expense Information</h3>
	<!--Table 1 Start --><div>
	<table width="100%" border="0" cellspacing="1" cellpadding="2">
  <tr>
    <th width="18%">From</th>
    <td width="17%"><input type="text" style="width:125px;" />
</td>
    <th width="13%">To</th>
    <td width="16%"><input type="text" style="width:125px;" /></td>
    <th width="16%">Mode</th>
    <td width="20%"><select style="width:125px;">
			<option id="0">1</option>
			<option id="0">2</option>
			<option id="0">3</option>
	
	</select></td>
  </tr>

  <tr>
    <th width="18%">Total Km</th>
    <td width="17%"><input type="text" style="width:125px;" /></td>
    <th width="13%">Rate/Unit</th>
    <td width="16%"><input type="text" style="width:125px;" /></td>
    <th width="16%">Total Ta</th>
    <td width="20%"><input type="text" style="width:125px;" /></td>
  </tr>
  <tr>
    <th width="18%">Fooding</th>
    <td width="17%"><input type="text" style="width:125px;" /></td>
    <th width="13%">Other Charges</th>
    <td width="16%"><input type="text" style="width:125px;" /></td>
    <th width="16%">Total Amt</th>
    <td width="20%"><input type="text" style="width:125px;" /></td>
  </tr>
  <tr>
    <th width="18%">Report To</th>
    <td><select style="width:125px;">
			<option id="0">1</option>
			<option id="0">2</option>
			<option id="0">3</option>
	
	</select></td>
    <th width="13%">Paid Status</th>
    <td colspan="3"><input type="text" size="56"  /></td>
  </tr>
  
  <tr>
    <th width="18%">Narration</th>
    <td colspan="5"><input type="text" style="width:485px;" /></td>
  </tr>

</table>
	</div><!--Table 2 Start -->

	
	<br />
	<center>
	<div style="width:300px; margin-left:auto; margin-right:auto;">
		
		<input name="save" type="button" value="Save" class="bottonsview" />&nbsp;&nbsp;&nbsp;		<input name="save" type="button" value="Cancel" class="bottonsview" />
	
	</div></center>
	<br />

</fieldset>
</div>

