#!/usr/bin/perl -w
use CGI qw/:all/;
use CGI::Carp qw(fatalsToBrowser);
use DBI;

my $dbh=DBI->connect('dbi:mysql:parc_demog:localhost','parcdemog','parc9904')or die "Couldn't connect to database: " . DBI->errstr;
#my $dbh=DBI->connect('dbi:mysql:parc_demog:localhost:3306','root','root') or die "Unable to connect: $DBI::errstr\n";

my $locCode = param("locCode");
my $ShID = param("ShID");
#start direct entry
my $dow = param("dow");
my $slNo = trim(param("slNo"));
# end
$intCount=0;
$invCode=0;
$url="";
sub trim
{
	$out="";
	$str=$_[0];
	$str=~ s/^\s+//;
	$str =~ s/\s+$//;
	$out=$str;	
	return $out;
}


if($ShID eq "" || $dow eq "" || $slNo eq "" || $locCode eq "")
{
	$invCode=1;
	#$url = "http://localhost:8081/cfuae/cfend.pl?cod=$invCode";
	$url = "http://www.arabdemog.com/cfuae/cfend.pl?cod=$invCode/";
	print "Location: $url\n\n";
}
if($slNo ne "")
{
	$strSlno="select slNo from cf_entry where slNo='$slNo'";
	$strSl=$dbh->prepare($strSlno);
	$strSl->execute;
	$intCount=$strSl->rows;
	if($intCount > 0)
	{
		$invCode=2;
		#$url = "http://localhost:8081/cfuae/cfend.pl?cod=$invCode";
		$url = "http://www.arabdemog.com/cfuae/cfend.pl?cod=$invCode";
		#$url ="/var/www/vhosts/arabdemog.com/cfuae/cfend.pl?cod=jjj";
		print "Location: $url\n\n";
	}

}
if($slNo ne "")
{
	$strPlanDet="select * from cf_slNo where slNo='$slNo'";
	$strPlDet=$dbh->prepare($strPlanDet);
	$strPlDet->execute;
	while($srl=$strPlDet->fetchrow_hashref())
	{
		$strsrlno=trim("$srl->{'slNo'}");
		$strlocCode= trim(uc "$srl->{'locCode'}");
		$strdow= trim(uc "$srl->{'DOW'}");

	}
	$nlocCode= trim(uc $locCode);
	$ndow= trim(uc $dow);
	
	if($strsrlno != trim($slNo) || $strlocCode ne trim($nlocCode) || $strdow ne trim($ndow))
	{
		$invCode=3;
		#$url = "http://localhost:8081/cfuae/cfend.pl?cod=$invCode";
		$url = "http://www.arabdemog.com/cfuae/cfend.pl?cod=$invCode";
		print "Location: $url\n\n";
	}
}

if($ShID ne "")
{
	$strShprDet="select S.*,N.natName as nName from shpr S, nationality N where S.nationality=N.natCode and ShID=$ShID";
	$strShpr=$dbh->prepare($strShprDet);
	$strShpr->execute;
	$shidcnt=$strShpr->rows;
	if($shidcnt > 0)
	{
		while($shppr=$strShpr->fetchrow_hashref())
		{
			$fName="$shppr->{'fName'}";
			$lName="$shppr->{'lName'}";
			$Nationality="$shppr->{'nationality'}";
			$Gender="$shppr->{'gender'}";
			$Age="$shppr->{'age'}";
			$natName="$shppr->{'nName'}";
			
		}


	}
	else
	{
		$invCode=4;
		#$url = "http://localhost:8081/cfuae/cfend.pl?cod=$invCode";
		$url = "http://www.arabdemog.com/cfuae/cfend.pl?cod=$invCode";
		print "Location: $url\n\n";
	}

}

my $questNo = param("qno");
my $visitCode=param('visitCode');

#my $Nationality = param("Nationality");
#my $Gender = param("Gender");
#my $Age = param("Age");
#my $fName = param("fName");
#my $natName = param("natName");
my $genName="";
if($Gender == 1)
{
	$genName='Male';
}
elsif($Gender == 2)
{
	$genName='Female';
}

$strLOC="select * from cf_location where locCode='$locCode'";
$sthL=$dbh->prepare($strLOC);
$sthL->execute;
		$conCode=0;
		$conName="";
		$cityCode=0;
		$cityName="";
		$locName="";
		$typeCode=0;
		$typeName="";
while ($Locaton=$sthL->fetchrow_hashref())
   	{
		$conCode="$Locaton->{'conCode'}";
		$conName="$Locaton->{'conName'}";
		$cityCode="$Locaton->{'cityCode'}";
		$cityName="$Locaton->{'cityName'}";
		$locName="$Locaton->{'locName'}";
		$typeCode="$Locaton->{'typeCode'}";
		$typeName="$Locaton->{'typeName'}";

	}
my $strQuery="select dcode,dname from cfDOW";
$sthD=$dbh->prepare($strQuery);
$sthD->execute;

#my $strQuery="select lcode,lname from alkLocation";
#$sthL=$dbh->prepare($strQuery);
#$sthL->execute;

print <<blk1;

<html>
<head>
<meta name=Author content="Ayyappan Pillai Sujith Kumar/Shebin">
<meta http-equiv="Content-Type" content="text/html; charset=UTF-8" />
<meta http-equiv="Pragma" content="no-cache">
<title>Pan Arab Research Center</title>
<script language="javaScript" type="text/javascript" src="calendar4.js"></script>
<script language="javaScript" type="text/javascript" src="validation.js"></script>
   <link href="calendar.css" rel="stylesheet" type="text/css">
   <style type="text/css">
INPUT.text
{
 BORDER-RIGHT: #AAC6FF 1px solid;
 PADDING-RIGHT: 4px;
 BORDER-TOP: #AAC6FF 1px solid;
 PADDING-LEFT: 4px;
 PADDING-BOTTOM: 1px;
 BORDER-LEFT: #AAC6FF 1px solid;
 COLOR: #AAC6FF;
 PADDING-TOP: 1px;
 BORDER-BOTTOM: #AAC6FF 1px solid;

}
</STYLE>

<script type="text/javascript">
extArray = new Array(".jpg");
function dosave()
{
	allowSubmit = false;
    if(document.getElementById('photo').value=="" )
	{
		alert('Please attach the receipt to continue');
		return false;
	}

	else
	{
		fl = document.getElementById('photo').value;
		ext = fl.slice(fl.lastIndexOf(".")).toLowerCase();
			for (var i = 0; i < extArray.length; i++)
			{
				if (extArray[i] == ext) 
				{ 
					allowSubmit = true; 
					break;
				}
			}
		if(allowSubmit)
		{	 
			document.frmMain.method="post";
			document.frmMain.action="http://www.arabdemog.com/cf/cfenter.pl"
            //document.frmMain.action="http://localhost:8081/cfuae/cfenter.pl"
			document.frmMain.submit();
			
			return true;
		}
		else
		{
			alert("Attach receipt in 'jpg' format");
			return false;

		}
	
	}
}

function plcdetails()
{
	frm=document.frmMain;
	frm.conCode.value="$conCode";
	frm.conName.value="$conName";
	frm.cityCode.value="$cityCode";
	frm.cityName.value="$cityName";
	frm.locCode.value= "$locCode";
	frm.locName.value="$locName";
	frm.typeCode.value="$typeCode";
	frm.typeName.value="$typeName";
	frm.shID.value="$ShID";
	//frm.questNo.value="$questNo";
	frm.nat.value="$Nationality";
	frm.nat1.value="$natName";
	frm.gender.value="$Gender";
	frm.gender1.value="$genName";

	frm.age.value="$Age";
	frm.visitCode.value="$visitCode";

	if('$typeCode'==1)
	{
		document.getElementById('5').style.display='';
		document.frmMain.q1[0].value='3';
		document.frmMain.q2[0].value='3';
		document.frmMain.q3[0].value='4';
		document.frmMain.q4[0].value='5';

	}
	if('$typeCode'==2)
	{
		document.getElementById('5').style.display='none';
		document.frmMain.q1[0].value='5';
		document.frmMain.q2[0].value='5';
		document.frmMain.q3[0].value='5';
	}
}
function getDOW1()
{
var weekday=new Array(7);
weekday[0]="2";
weekday[1]="3";
weekday[2]="4";
weekday[3]="5";
weekday[4]="6";
weekday[5]="7";
weekday[6]="1";
var dateString = document.getElementById('dt').value //"03/20/2008";  // mm/dd/yyyy [IE, FF]
//var strDate=dateString.substring(3,5) + "-" + dateString.substring(0,2) + "-" + dateString.substring(6,10);
var strDate=dateString.substring(3,5) + "/" + dateString.substring(0,2) + "/" + dateString.substring(6,10);
var myDate = new Date(strDate);
document.getElementById('DOW').value=weekday[myDate.getDay()]
}

function stname()
{
	document.getElementById('tdvrea').style.display='none';
	document.getElementById('stname').disabled='';
	document.getElementById('stname').style.background='';
	document.getElementById('vreason').selectedIndex=0;
}

function invreason()
{
	document.getElementById('stname').value='';
	document.getElementById('tdvrea').style.display='';
	document.getElementById('stname').style.background='#CCCCCC';
	document.getElementById('stname').disabled='TRUE';
}

function gensel(sel)
{
    var myindex  = sel.selectedIndex
    var SelValue = sel.options[myindex].value
	
	if(myindex==0)
	{
		document.getElementById('tdmale').style.display='none';
		document.getElementById('tdfemale').style.display='none';
		
		for(i=0;i < 5;i++)
		{	
			document.frmMain.groom[i].checked=false; 
		}
	}
    else if(myindex==1)
	{
		document.getElementById('tdmale').style.display='';
		document.getElementById('tdfemale').style.display='none';
		for(i=3;i < 5;i++)
		{	
			document.frmMain.groom[i].checked=false; 
		}
	}
	else if(myindex==2)
	{
		document.getElementById('tdmale').style.display='none';
		document.getElementById('tdfemale').style.display='';
		for(i=0;i < 3;i++)
		{	
			document.frmMain.groom[i].checked=false; 
		}
	}
}

function dayCheck(dowId)
	{
		var dowInd  = dowId.selectedIndex
		var dowValue = dowId.options[dowInd].text
		if(dowValue.toUpperCase() != '$dow'.toUpperCase())
		{
			alert("Date Selection Does Not Match with the Allocated Day");
			document.getElementById("dt").focus();
			return false;
		}
		else
		{
			return true;
		}
	}
</script>
</head>

<body >
<form  name="frmMain" enctype="multipart/form-data">
  $strSlno - $intCount - $url
  <TABLE borderColor="#000080" cellSpacing=0 cellPadding=0 width="100%" border=1 id='trmain' ><font face="Verdana, Arial, Helvetica, sans-serif">
  
  <tr>
    <td><table width="100%" border="0" >
          <tr> 
			<td align="left" bgcolor="#AAC6FF" width="25%">
				
				<b>
					<font  size="2" face="Verdana, Arial, Helvetica, sans-serif">&nbsp;Serial No. - </font><font  size="3" face="Verdana, Arial, Helvetica, sans-serif">$slNo
					</font>
				</b>
			</td>
			<td bgcolor="#AAC6FF" align="Right">
			<b>
					<font  size="2" face="Verdana, Arial, Helvetica, sans-serif">&nbsp;Shopper Name - </font><font  size="3" face="Verdana, Arial, Helvetica, sans-serif">$fName&nbsp;$lName &nbsp;&nbsp;
					</font>
				</b>
				
			</td>
<!--            <td align="Right" width="15%">  <a href="/cf/cfar.pl?shID=$shID&Nationality=$Nationality&Gender=$Gender&Age=$Age&fName=$fName&natName=$natName&locCode=$locCode&conCode=$conCode&visitCode=$visitCode" target="_self">  عربي </a> </td> --> 
          </tr>
        </table></td>
  </tr>
  
  <tr id='tr1'>
    
  <!--  <td>
    <table width="100%"> -->
    
    
    <td>
    
    <table width="100%" border="1" bordercolor="#AAC6FF">
          
		  <tr> 
            
            <td width="25%" bgcolor="#AAC6FF"><b><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> Country:</font></b>
                <font  size="2">&nbsp;</font>
                        <IMG style="DISPLAY: none" src="stars.gif"  border="0" name="contimg" id="contimg">
            </td>
            
            <td width="25%"><font  size="2" face="Verdana, Arial, Helvetica, sans-serif">
                <input type="text" id="conName" name="conName" readonly style="background-color:#CCCCCC"> </font>
            </td>
            
            <td width="25%" bgcolor="#AAC6FF"><b><font  size="2" face="Verdana, Arial, Helvetica, sans-serif">City:</font></b>
                <font  size="2">&nbsp;</font>
                        <IMG style="DISPLAY: none" src="stars.gif"  border="0" name="cityimg" id="cityimg">
            </td>
            
            <td width="25%">
                <input type="text" name="cityName" id="cityName" readonly style="background-color:#CCCCCC">
            </td>
          
          </tr>	

<!--    -------------	-->
		  <tr>	
				<td width="25%" bgcolor="#AAC6FF"><b><font  size="2" face="Verdana, Arial, Helvetica, sans-serif">Store Type:</font></b>
					<font  size="2">&nbsp;</font>
                        <IMG style="DISPLAY: none" src="stars.gif"  border="0" name="storeimg" id="storeimg">
				 </td>
				 <td width="25%">
					<input type="text" name="typeName" id="typeName" readonly style="background-color:#CCCCCC">
				 </td>
				  <td width="25%" bgcolor="#AAC6FF"><b><font  size="2" face="Verdana, Arial, Helvetica, sans-serif">Location:</font></b>
					<font  size="2">&nbsp;</font>
                        <IMG style="DISPLAY: none" src="stars.gif"  border="0" name="locimg" id="locimg">
				 </td>
				 <td width="25%">
					<input type="text" name="locName" id="locName" readonly style="background-color:#CCCCCC">
				 </td>
		  </tr>

<!--    -------------	-->	 
<tr>
			<td width="25%" bgcolor="#AAC6FF"><b><font  size="2" face="Verdana, Arial, Helvetica, sans-serif">Questionnaire No:</font></b>
				<font  size="2">&nbsp;</font>
                		<IMG style="DISPLAY: none" src="stars.gif"  border="0" name="qnoimg" id="qnoimg">
            </td>
            <td width="25%">
            	<input type="text" maxlength="15" name="questNo" id="questNo" value="123" readonly style="background-color:#CCCCCC">
            </td>

			<td width="25%" bgcolor="#AAC6FF"><b><font  size="2" face="Verdana, Arial, Helvetica, sans-serif">Receipt No.</font></b>
                <font  size="2">&nbsp;</font>
                        <IMG style="DISPLAY: none" src="stars.gif"  border="0" name="rnoimg" id="rnoimg">
            </td>
            
            <td width="25%"><font  size="2" face="Verdana, Arial, Helvetica, sans-serif">
                <input type="text" maxlength="20" id="receipt" name="receipt" onKeyPress="return valalphanum();"> </font>
            </td>
			
			

		</tr>

<!--    -------------	-->	     
          <tr> 
            
            <td width="25%" bgcolor="#AAC6FF"><b><font size="2" face="Verdana, Arial, Helvetica, sans-serif">Date: </font></b>
                <font  size="2">&nbsp;</font>
                        <IMG style="DISPLAY: none" src="stars.gif"  border="0" name="dtimg" id="dtimg">
            </td>
            
            <td width="25%">
                <input type="text" name="datum1" id="dt" readonly ><a href="#" onClick="setYears(2010, 2020); showCalender(this, 'datum1');">
                <img src="calender.png"></a>
            </td>
            
            <td width="25%" bgcolor="#AAC6FF"><b><font  size="2" face="Verdana, Arial, Helvetica, sans-serif">Arrival Time(HH:MM):</font></b>
                <font  size="2">&nbsp;</font>
                        <IMG style="DISPLAY: none" src="stars.gif"  border="0" name="atmimg" id="atmimg">
            </td>
            
            <td width="25%">
                <font  size="2" face="Verdana, Arial, Helvetica, sans-serif">
                <select name="ath" id="ath"  style="width:50px">
                    <option value="0">-HH-</option>
                    <option value="1">01</option>
                    <option value="2">02</option>
                    <option value="3">03</option>
                    <option value="4">04</option>
                    <option value="5">05</option>
                    <option value="6">06</option>
                    <option value="7">07</option>
                    <option value="8">08</option>
                    <option value="9">09</option>
                    <option value="10">10</option>
                    <option value="11">11</option>
                    <option value="12">12</option>
                </select>
                 <select name="atm" id="atm" style="width:50px">
                    <option value="0">-MM-</option>
                    <option value="1">00</option>
                    <option value="2">01</option>
                    <option value="3">02</option>
                    <option value="4">03</option>
                    <option value="5">04</option>
                    <option value="6">05</option>
                    <option value="7">06</option>
                    <option value="8">07</option>
                    <option value="9">08</option>
                    <option value="10 ">09</option>
                    <option value="11">10</option>
                    <option value="12">11</option>
                    <option value="13">12</option>
                    <option value="14">13</option>
                    <option value="15">14</option>
                    <option value="16">15</option>
                    <option value="17">16</option>
                    <option value="18">17</option>
                    <option value="19">18</option>
                    <option value="20">19</option>
                    <option value="21">20</option>
                    <option value="22">21</option>
                    <option value="23">22</option>
                    <option value="24">23</option>
                    <option value="25">24</option>
                    <option value="26">25</option>
                    <option value="27">26</option>
                    <option value="28">27</option>
                    <option value="29">28</option>
                    <option value="30">29</option>
                    <option value="31">30</option>
                    <option value="32">31</option>
                    <option value="33">32</option>
                    <option value="34">33</option>
                    <option value="35">34</option>
                    <option value="36">35</option>
                    <option value="37">36</option>
                    <option value="38">37</option>
                    <option value="39">38</option>
                    <option value="40">39</option>
                    <option value="41">40</option>
                    <option value="42">41</option>
                    <option value="43">42</option>
                    <option value="44">43</option>
                    <option value="45">44</option>
                    <option value="46">45</option>
                    <option value="47">46</option>
                    <option value="48">47</option>
                    <option value="49">48</option>
                    <option value="50">49</option>
                    <option value="51">50</option>
                    <option value="52">51</option>
                    <option value="53">52</option>
                    <option value="54">53</option>
                    <option value="55">54</option>
                    <option value="56">55</option>
                    <option value="57">56</option>
                    <option value="58">57</option>
                    <option value="59">58</option>
                    <option value="60">59</option>
                    
                </select>
                <select name="atap" id="atap"  style="width:45px">
                    <option value="0">--</option>
                    <option value="1">AM</option>                    
                    <option value="2">PM</option>                                        
                </select>
                </font>
            </td>
          
          </tr>
<!--    -------------	-->
           
		  <tr> 


			<td width="25%" bgcolor="#AAC6FF"><b><font  size="2" face="Verdana, Arial, Helvetica, sans-serif">Day of Week:</font></b>
                <font  size="2">&nbsp;</font>
                        <IMG style="DISPLAY: none" src="stars.gif"  border="0" name="dowimg" id="dowimg">
            </td>
            
            <td width="25%">
                <select name="DOW" id="DOW"  style="width:155px" onChange='getDOW1()'>
                    <option value="0">-DAY-</option>
blk1
    while (@dow=$sthD->fetchrow_array())
    {
        
        print "<option value=$dow[0]>$dow[1]</option>";
    }
	$dbh->disconnect();
print <<blk2;
                </select>
            </td>

			<td width="25%" bgcolor="#AAC6FF"><b><font  size="2" face="Verdana, Arial, Helvetica, sans-serif">Departure Time(HH:MM):</font></b>
                <font  size="2">&nbsp;</font>
                        <IMG style="DISPLAY: none" src="stars.gif"  border="0" name="dtmimg" id="dtmimg">
            </td>
            
            <td width="25%">
                <font  size="2" face="Verdana, Arial, Helvetica, sans-serif">
                <select name="dth" id="dth"  style="width:50px">
                    <option value="0">-HH-</option>
                    <option value="1">01</option>
                    <option value="2">02</option>
                    <option value="3">03</option>
                    <option value="4">04</option>
                    <option value="5">05</option>
                    <option value="6">06</option>
                    <option value="7">07</option>
                    <option value="8">08</option>
                    <option value="9">09</option>
                    <option value="10">10</option>
                    <option value="11">11</option>
                    <option value="12">12</option>
                </select>
                 <select name="dtm" id="dtm"  style="width:50px">
                    <option value="0">-MM-</option>
                    <option value="1">00</option>
                    <option value="2">01</option>
                    <option value="3">02</option>
                    <option value="4">03</option>
                    <option value="5">04</option>
                    <option value="6">05</option>
                    <option value="7">06</option>
                    <option value="8">07</option>
                    <option value="9">08</option>
                    <option value="10">09</option>
                    <option value="11">10</option>
                    <option value="12">11</option>
                    <option value="13">12</option>
                    <option value="14">13</option>
                    <option value="15">14</option>
                    <option value="16">15</option>
                    <option value="17">16</option>
                    <option value="18">17</option>
                    <option value="19">18</option>
                    <option value="20">19</option>
                    <option value="21">20</option>
                    <option value="22">21</option>
                    <option value="23">22</option>
                    <option value="24">23</option>
                    <option value="25">24</option>
                    <option value="26">25</option>
                    <option value="27">26</option>
                    <option value="28">27</option>
                    <option value="29">28</option>
                    <option value="30">29</option>
                    <option value="31">30</option>
                    <option value="32">31</option>
                    <option value="33">32</option>
                    <option value="34">33</option>
                    <option value="35">34</option>
                    <option value="36">35</option>
                    <option value="37">36</option>
                    <option value="38">37</option>
                    <option value="39">38</option>
                    <option value="40">39</option>
                    <option value="41">40</option>
                    <option value="42">41</option>
                    <option value="43">42</option>
                    <option value="44">43</option>
                    <option value="45">44</option>
                    <option value="46">45</option>
                    <option value="47">46</option>
                    <option value="48">47</option>
                    <option value="49">48</option>
                    <option value="50">49</option>
                    <option value="51">50</option>
                    <option value="52">51</option>
                    <option value="53">52</option>
                    <option value="54">53</option>
                    <option value="55">54</option>
                    <option value="56">55</option>
                    <option value="57">56</option>
                    <option value="58">57</option>
                    <option value="59">58</option>
                    <option value="60">59</option>
                </select>
                <select name="dtap" id="dtap"  style="width:45px">
                    <option value="0">--</option>
                    <option value="1">AM</option>                    
                    <option value="2">PM</option>                                        
                </select>
                </font>
            </td>

         
          </tr>

<!--    -------------	-->	
		  
		 <tr>
				 <td width="25%" bgcolor="#AAC6FF"><b><font  size="2" face="Verdana, Arial, Helvetica, sans-serif">Tilt Number:</font></b>
					<font  size="2">&nbsp;</font>
                        <IMG style="DISPLAY: none" src="stars.gif"  border="0" name="tiltimg" id="tiltimg">
				 </td>
				 <td width="25%">
					<input type="text" name="tilt" id="tilt">
				 </td>
				<td width="25%" bgcolor="#AAC6FF"><b><font  size="2" face="Verdana, Arial, Helvetica, sans-serif">Amount Spent:</font></b>
					<font  size="2">&nbsp;</font>
                        <IMG style="DISPLAY: none" src="stars.gif"  border="0" name="amtimg" id="amtimg">
				</td>
            
				<td width="25%">
					<input type="text" maxlength="6" name="amount" id="amount" onKeyPress="return valamt();">
				</td>
		  </tr>

<!--  28-11  -------------	-->	
		  
		 <tr>
				 <td width="25%" bgcolor="#AAC6FF"><b><font  size="2" face="Verdana, Arial, Helvetica, sans-serif">Was Staff Name Visible:</font></b>
					<font  size="2">&nbsp;</font>
                        <IMG style="DISPLAY: none" src="stars.gif"  border="0" name="visimg" id="visimg">
				 </td>
				 <td width="25%">
					<input type="radio" value="1" name="visrad" id="visrad" onClick='stname();' checked> Yes &nbsp;&nbsp;<input type="radio" value="2" name="visrad" id="visrad" onClick='invreason();'> NO
				 </td>
				 <td colspan='2' id="tdvrea" style='display:none'>
					<font  size="2" face="Verdana, Arial, Helvetica, sans-serif">
					<select name="vreason" id="vreason" style="width:240px">
						<option value="0">-Reason-</option>
						<option value="1">Flipped</option>
						<option value="2">No name (no ID worn)</option>
						<option value="3">Covered by the clothing</option>
						<option value="4">Covered by the cashier’s desk</option>
					</select>
                	</font>
					<IMG style="DISPLAY: none" src="stars.gif"  border="0" name="optimg" id="optimg">
				 </td>
				
		  </tr>


<!--  end  -------------	-->	          

		<tr>
				 <td width="25%" bgcolor="#AAC6FF"><b><font  size="2" face="Verdana, Arial, Helvetica, sans-serif">Staff Name:</font></b>
					<font  size="2">&nbsp;</font>
                        <IMG style="DISPLAY: none" src="stars.gif"  border="0" name="staffnameimg" id="staffnameimg">
				 </td>
				 <td width="25%">
					<input type="text" name="stName" id="stName">
				 </td>
				 <td width="25%" bgcolor="#AAC6FF"><b><font  size="2" face="Verdana, Arial, Helvetica, sans-serif">Shopper Id:</font></b>
					<font  size="2">&nbsp;</font>
                        <IMG style="DISPLAY: none" src="stars.gif"  border="0" name="idimg" id="idimg">
				 </td>
            
				 <td width="25%">
					<font  size="2" face="Verdana, Arial, Helvetica, sans-serif"><input type="text" maxlength="10" id="shID" name="shID" readonly  style="background-color:#CCCCCC"> </font>
				 </td>
       </tr>


<!--    -------------	-->	          
		<tr>
				<td width="25%" bgcolor="#AAC6FF"><b><font  size="2" face="Verdana, Arial, Helvetica, sans-serif">Staff Gender:</font></b>
					<font  size="2">&nbsp;</font>
                        <IMG style="DISPLAY: none" src="stars.gif"  border="0" name="staffgenimg" id="staffgenimg">
				</td>
            
				<td width="25%">
					<font  size="2" face="Verdana, Arial, Helvetica, sans-serif">
					<select name="stGender" id="stGender" style="width:155px" onchange='gensel(this.form.stGender);'>
						<option value="0">-GENDER-</option>
						<option value="1">MALE</option>
						<option value="2">FEMALE</option>
					</select>
                
					</font>
			    </td>
				
				<td width="25%" bgcolor="#AAC6FF"><b><font  size="2" face="Verdana, Arial, Helvetica, sans-serif">Shopper Nationality:</font></b>
					<font  size="2">&nbsp;</font>
                        <IMG style="DISPLAY: none" src="stars.gif"  border="0" name="natimg" id="natimg">
				</td>
            
				<td width="25%">
					<font  size="2" face="Verdana, Arial, Helvetica, sans-serif">
					<input type="text" id="nat1" name="nat1" readonly style="background-color:#CCCCCC" >


					</font>
				</td>
            
		</tr>


<!--    -------------	-->	          
		     
		<tr>
			<td width="25%" bgcolor="#AAC6FF"><b><font  size="2" face="Verdana, Arial, Helvetica, sans-serif">Shopper Age:</font></b>
                <font  size="2">&nbsp;</font>
                        <IMG style="DISPLAY: none" src="stars.gif"  border="0" name="ageimg" id="ageimg">
            </td>
            
            <td width="25%">
                <font  size="2" face="Verdana, Arial, Helvetica, sans-serif">
                <input type="text" id="age" name="age" readonly style="background-color:#CCCCCC">                  
				</font>
            </td>
			<td width="25%" bgcolor="#AAC6FF"><b><font  size="2" face="Verdana, Arial, Helvetica, sans-serif">Shopper Gender:</font></b>
					<font  size="2">&nbsp;</font>
                        <IMG style="DISPLAY: none" src="stars.gif"  border="0" name="shoppergenimg" id="shoppergenimg">
			</td>
			<td width="25%">
					<font  size="2" face="Verdana, Arial, Helvetica, sans-serif">
						<input type="text" id="gender1" name="gender1" readonly style="background-color:#CCCCCC">
					</font>
			 </td>
		</tr>

<!--    -------------	-->	          
		
          
        <!--</table></td>-->
        
        </table>
        
        </td>
  </tr>
    
  <!--
  Staff Appearance
  -->

  <tr><td>&nbsp;</td></tr>

<!-- 28-11  -->

<tr id='trapp'>
    <td>
        <table width="100%" border="1" bordercolor="#AAC6FF" >
             
            <tr bgcolor="#FFFFFF" id="trgroom" border="1" bordercolor="#AAC6FF" > 
                
                <td width="1%">&nbsp;&nbsp;<b>A.</b></td>
                
                <td width="40%">
                    <font  size="2 em" face="Verdana, Arial, Helvetica, sans-serif"> 
                       <b> Was the staff well presentable</b>
					   <IMG style="DISPLAY: none" src="stars.gif"  border="0" name="preimg" id="preimg">
                    </font>
                    <font  size="2">&nbsp;</font>
                </td>
					
				<td colspan='2' style='Display:none' id='tdmale'>
					<font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> 
                        <input type="radio" value="1" name="groom" id="groom"> &nbsp;Clean Shaved &nbsp;
						<input type="radio" value="2" name="groom" id="groom"> &nbsp;Beard Trimmed &nbsp;
						<input type="radio" value="3" name="groom" id="groom"> &nbsp;Not Shaved/Not Trimmed&nbsp;
					</font>
				</td>
				<td colspan='2' style='Display:none' id='tdfemale'>
					<font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> 
                        <input type='radio'  value='4' name='groom' id='groom'/>&nbsp;With Make-up&nbsp;
						<input type='radio'  value='5' name='groom' id='groom'/>&nbsp;Without Make-up&nbsp;
                    </font>
				</td>
                
            </tr>
		</table>
	</td>
</tr>

 <tr><td>&nbsp;</td></tr>


<!--  End -->

  <tr id='tr4'>
    <td>
        <table width="100%" border="1" bordercolor="#AAC6FF" >
             
            <tr bgcolor="#AAC6FF" id="trsa"> 
                <td colspan="2"  >
                  <strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> 
                    Staff Appearance
                  </font></strong> </td>
                <td width="4%" align="center">
                    <strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> Yes </font></strong>
                </td>
                <td width="4%" align="center">
                    <strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> No </font></strong>
                </td>
                <td width="4%" align="center">
                    <strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> NA </font></strong>
                </td>
                <td align="center" width="34%">
                    <strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> Comments </font></strong>
                </td>
            </tr>
             
                                    
            <tr bgcolor="#FFFFFF" id="1" border="1" bordercolor="#AAC6FF" > 
                
                <td width="4%">&nbsp;&nbsp;<b>1.</b></td>
                
                <td  width="50%" colspan="5">
                    <font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> 
                        Is the cashier presentable in full uniform (Tie, ID, Badge: Does not apply when cashiers are wearing a promotional T-shirts or Polo&acute;s)
                    </font>
                    <font  size="2">&nbsp;</font>
                </td>
                
            </tr>
                    
            <tr bgcolor="#FFFFFF" id="2" border="1" bordercolor="#AAC6FF" > 
                <td width="4%">&nbsp;&nbsp;<b>1.1</b></td>
                <td width="50%">
                    <font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> 
                        Shirt tucked in and cuffs buttoned 
                    </font>
                    <font  size="2">&nbsp;</font>
                        <IMG style="DISPLAY: none" src="stars.gif"  border="0" name="img1" id="img1">
                </td>
                <td width="4%" align="center">
                    <input type="radio" value="3" name="q1" id="q1">
                </td>
                <td width="4%" align="center">
                    <input type="radio" value="0" name="q1" id="q1">
                </td>
                <td width="4%" align="center">
                    <input type="radio" value="-1" name="q1" id="q1">
                </td>
                <td align="left" width="34%">
                    <input type="text" name="c1" size="63" id="c1">
                </td>
            </tr>
            
            <tr bgcolor="#FFFFFF" id="3" border="1" bordercolor="#AAC6FF" > 
                <td width="4%">&nbsp;&nbsp;<b>1.2</b></td>
                <td width="50%">
                    <font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> 
                        Tie worn properly 
                    </font>
                    <font  size="2">&nbsp;</font>
                        <IMG style="DISPLAY: none" src="stars.gif"  border="0" name="img2" id="img2">
                </td>
                <td width="4%" align="center">
                    <input type="radio" value="3" name="q2" id="q2">
                </td>
                <td width="4%" align="center">
                    <input type="radio" value="0" name="q2" id="q2">
                </td>
                <td width="4%" align="center">
                    <input type="radio" value="-1" name="q2" id="q2">
                </td>
                <td align="left" width="34%">
                    <input type="text" name="c2" size="63" id="c2">
                </td>
            </tr>
            
            <tr bgcolor="#FFFFFF" id="4" border="1" bordercolor="#AAC6FF" > 
                <td width="4%">&nbsp;&nbsp;<b>1.3</b></td>
                <td width="50%">
                    <font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> 
                        ID worn correctly not inside out 
                    </font>
                    <font  size="2">&nbsp;</font>
                        <IMG style="DISPLAY: none" src="stars.gif"  border="0" name="img3" id="img3">
                </td>
                <td width="4%" align="center">
                    <input type="radio" value="4" name="q3" id="q3">
                </td>
                <td width="4%" align="center">
                    <input type="radio" value="0" name="q3" id="q3">
                </td>
                <td width="4%" align="center">&nbsp;
                   <!-- <input type="radio" value="-1" name="q3" id="q3"> -->
                </td>
                <td align="left" width="34%">
                    <input type="text" name="c3" size="63" id="c3">
                </td>
            </tr>          
            
            <tr bgcolor="#FFFFFF" id="5" border="1" bordercolor="#AAC6FF" style='display:none'> 
                <td width="4%">&nbsp;&nbsp;<b>1.4</b></td>
                <td width="50%">
                    <font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> 
                        Badge is worn above the ID and not covering it 
                    </font>
                    <font  size="2">&nbsp;</font>
                        <IMG style="DISPLAY: none" src="stars.gif"  border="0" name="img4" id="img4">
                </td>
                <td width="4%" align="center">
                    <input type="radio" value="5" name="q4" id="q4">
                </td>
                <td width="4%" align="center">
                    <input type="radio" value="0" name="q4" id="q4">
                </td>
                <td width="4%" align="center">&nbsp;
                    <!-- <input type="radio" value="-1" name="q4" id="q4"> -->
                </td>
                <td align="left" width="34%">
                    <input type="text" name="c4" size="63" id="c4">
                </td>
            </tr>          


        </table>
    </td>
  </tr>
  
      <tr><td>&nbsp;</td></tr>

     <!-- Cleanliness -->
                                

  <tr id='tr5'>
    <td>
        <table width="100%" border="1" bordercolor="#AAC6FF" >
             
            <tr bgcolor="#AAC6FF" id="trce"> 
                <td colspan="2"  >
                  <strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> 
                    Cleanliness
                  </font></strong> </td>
                <td width="4%" align="center">
                    <strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> Yes </font></strong>
                </td>
                <td width="4%" align="center">
                    <strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> No </font></strong>
                </td>
                <td width="4%" align="center">
                    <strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> NA </font></strong>
                </td>
                <td align="center" width="34%">
                    <strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> Comments </font></strong>
                </td>
            </tr>
            
            <tr bgcolor="#FFFFFF" id="6" border="1" bordercolor="#AAC6FF" > 
                <td width="4%">&nbsp;&nbsp;<b>2.</b></td>
                <td width="50%">
                    <font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> 
                        Is the counter clean
                    </font>
                    <font  size="2">&nbsp;</font>
                        <IMG style="DISPLAY: none" src="stars.gif"  border="0" name="img5" id="img5">
                </td>
                <td width="4%" align="center">
                    <input type="radio" value="10" name="q5" id="q5">
                </td>
                <td width="4%" align="center">
                    <input type="radio" value="0" name="q5" id="q5">
                </td>
                <td width="4%" align="center"> &nbsp;
                   <!-- <input type="radio" value="-1" name="q5" id="q5"> -->
                </td>
                <td align="left" width="34%">
                    <input type="text" name="c5" size="63" id="c5">
                </td>
            </tr>           
                    
    </table>
    </td>
  </tr>


      <tr><td>&nbsp;</td></tr>

     <!-- Welcome / Greetings -->
                                

  <tr id='tr6'>
    <td>
        <table width="100%" border="1" bordercolor="#AAC6FF" >
             
            <tr bgcolor="#AAC6FF" id="trwg"> 
                <td colspan="2"  >
                  <strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> 
                    Welcome / Greetings
                  </font></strong> </td>
                <td width="4%" align="center">
                    <strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> Yes </font></strong>
                </td>
                <td width="4%" align="center">
                    <strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> No </font></strong>
                </td>
                <td width="4%" align="center">
                    <strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> NA </font></strong>
                </td>
                <td align="center" width="34%">
                    <strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> Comments </font></strong>
                </td>
            </tr>
            
            <tr bgcolor="#FFFFFF" id="7" border="1" bordercolor="#AAC6FF" > 
                <td width="4%">&nbsp;&nbsp;<b>3.1</b></td>
                <td width="50%">
                    <font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> 
						Did the cashier smile?
					</font>
                    <font  size="2">&nbsp;</font>
                        <IMG style="DISPLAY: none" src="stars.gif"  border="0" name="img6" id="img6">
                </td>
                <td width="4%" align="center">
                    <input type="radio" value="5" name="q6" id="q6">
                </td>
                <td width="4%" align="center">
                    <input type="radio" value="0" name="q6" id="q6">
                </td>
                <td width="4%" align="center"> &nbsp;
                   <!-- <input type="radio" value="-1" name="q6" id="q6"> -->
                </td>
                <td align="left" width="34%">
                    <input type="text" name="c6" size="63" id="c6">
                </td>
            </tr> 

<!-- 28-11 -->
			<tr bgcolor="#FFFFFF" id="7a" border="1" bordercolor="#AAC6FF" > 
                <td width="4%">&nbsp;&nbsp;<b>3.2</b></td>
                <td width="50%">
                    <font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> 
						Did the cashier greet the customer (Good morning/afternoon/evening Sir/Madam)
					</font>
                    <font  size="2">&nbsp;</font>
                        <IMG style="DISPLAY: none" src="stars.gif"  border="0" name="img6a" id="img6a">
                </td>
                <td width="4%" align="center">
                    <input type="radio" value="15" name="q6a" id="q6a">
                </td>
                <td width="4%" align="center">
                    <input type="radio" value="0" name="q6a" id="q6a">
                </td>
                <td width="4%" align="center"> &nbsp;
                   <!-- <input type="radio" value="-1" name="q6a" id="q6a"> -->
                </td>
                <td align="left" width="34%">
                    <input type="text" name="c6a" size="63" id="c6a">
                </td>
            </tr>    
<!-- End -->

    </table>
    </td>
  </tr>

     <tr><td>&nbsp;</td></tr>

    <tr id='tr7'>
    <td>
        <table width="100%" border="1" bordercolor="#AAC6FF" >
             
            <tr bgcolor="#AAC6FF" id="trsb"> 
                <td colspan="2"  >
                  <strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> 
                    Staff Behaviour
                  </font></strong> </td>
                <td width="4%" align="center">
                    <strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> Yes </font></strong>
                </td>
                <td width="4%" align="center">
                    <strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> No </font></strong>
                </td>
                <td width="4%" align="center">
                    <strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> NA </font></strong>
                </td>
                <td align="center" width="34%">
                    <strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> Comments </font></strong>
                </td>
            </tr>
            
            <tr bgcolor="#FFFFFF" id="8" border="1" bordercolor="#AAC6FF" > 
                <td width="4%">&nbsp;&nbsp;<b>4.</b></td>
                <td width="50%">
                    <font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> 
                        Did the cashier clearly announce the bill amount (Sir/Ma’am you bill is xxx dirhams)
                    </font>
                    <font  size="2">&nbsp;</font>
                        <IMG style="DISPLAY: none" src="stars.gif"  border="0" name="img7"  id="img7">
                </td>
                <td width="4%" align="center">
                    <input type="radio" value="15" name="q7" id="q7">
                </td>
                <td width="4%" align="center">
                    <input type="radio" value="0" name="q7" id="q7">
                </td>
                <td width="4%" align="center">&nbsp;
                   <!-- <input type="radio" value="-1" name="q7" id="q7"> -->
                </td>
                <td align="left" width="34%">
                    <input type="text" name="c7" size="63" id="c7">
                </td>
            </tr> 
            
            <tr bgcolor="#FFFFFF" id="9" border="1" bordercolor="#AAC6FF" > 
                <td width="4%">&nbsp;&nbsp;<b>5.</b></td>
                <td width="50%">
                    <font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> 
                        Did the cashier clearly count the change to the customer (Sir/Madam your change is xxx dirhams) or politely ask the customer to sign the credit card receipt (Sir/Madam please sign the receipt)
                    </font>
                    <font  size="2">&nbsp;</font>
                        <IMG style="DISPLAY: none" src="stars.gif"  border="0" name="img8" id="img8">
                </td>
                <td width="4%" align="center">
                    <input type="radio" value="15" name="q8" id="q8">
                </td>
                <td width="4%" align="center">
                    <input type="radio" value="0" name="q8" id="q8">
                </td>
                <td width="4%" align="center"> &nbsp;
                    <input type="radio" value="-1" name="q8" id="q8"> 
                </td>
                <td align="left" width="34%">
                    <input type="text" name="c8" size="63" id="c8">
                </td>
            </tr>          
                    
    </table>
    </td>
  </tr>
    
 <tr><td>&nbsp;</td></tr>

    <tr id='tr8'>
    <td>
        <table width="100%" border="1" bordercolor="#AAC6FF" >
             
            <tr bgcolor="#AAC6FF" id="trfw"> 
                <td colspan="2"  >
                  <strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> 
                    Farewell
                  </font></strong> </td>
                <td width="4%" align="center">
                    <strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> Yes </font></strong>
                </td>
                <td width="4%" align="center">
                    <strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> No </font></strong>
                </td>
                <td width="4%" align="center">
                    <strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> NA </font></strong>
                </td>
                <td align="center" width="34%">
                    <strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> Comments </font></strong>
                </td>
            </tr>
            
            <tr bgcolor="#FFFFFF" id="10" border="1" bordercolor="#AAC6FF" > 
                <td width="4%">&nbsp;&nbsp;<b>6.</b></td>
                <td width="50%">
                    <font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> 
                        Did the cashier smile and say &quot;Thank you, Please come again&quot;
                    </font>
                    <font  size="2">&nbsp;</font>
                        <IMG style="DISPLAY: none" src="stars.gif"  border="0" name="img9" id="img9">
                </td>
                <td width="4%" align="center">
                    <input type="radio" value="15" name="q9" id="q9">
                </td>
                <td width="4%" align="center">
                    <input type="radio" value="0" name="q9" id="q9">
                </td>
                <td width="4%" align="center">&nbsp;
                   <!-- <input type="radio" value="-1" name="q9" id="q9"> -->
                </td>
                <td align="left" width="34%">
                    <input type="text" name="c9" size="63" id="c9">
                </td>
            </tr> 
            
            <tr bgcolor="#FFFFFF" id="11" border="1" bordercolor="#AAC6FF" > 
                <td width="4%">&nbsp;&nbsp;<b>7.</b></td>
                <td width="50%">
                    <font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> 
                        Did the cashier fully complete the current customer before attending to the next customer?
                    </font>
                    <font  size="2">&nbsp;</font>
                        <IMG style="DISPLAY: none" src="stars.gif"  border="0" name="img10" id="img10">
                </td>
                <td width="4%" align="center">
                    <input type="radio" value="10" name="q10" id="q10">
                </td>
                <td width="4%" align="center">
                    <input type="radio" value="0" name="q10" id="q10">
                </td>
                <td width="4%" align="center"> &nbsp;
                   <!-- <input type="radio" value="-1" name="q10" id="q10"> -->
                </td>
                <td align="left" width="34%">
                    <input type="text" name="c10" size="63" id="c10">
                </td>
            </tr>
			        
    </table>
    </td>
  </tr>

<!-- 28-11 -->

 <tr><td>&nbsp;</td></tr>

<tr id='trhp'>
  	<td>
    	<table width="100%" border="1" bordercolor="#AAC6FF" >
        	 
            <tr bgcolor="#AAC6FF" id="trhp"> 
            	<td colspan="3"  >
            	  <strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> 
            	   	Helpfulness (Rate the following attributes on a scale of 1 - 5)
            	    </font></strong>
                 </td>
                <td width="9%" align="center">
                	<strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> 1. Not at all Helpful </font></strong>
                </td>
                <td width="9%" align="center">
	            	<strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> 2. </font></strong>
                </td>
                <td width="9%" align="center">
                	<strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> 3. </font></strong>
                </td>
                <td width="9%" align="center">
	            	<strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> 4. </font></strong>
                </td>
                <td width="9%" align="center">
                	<strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> 5. Very Helpful </font></strong>
                </td>
                <td width="6%" align="center">
                	<strong><font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> NA </font></strong>
                </td>
			</tr>
           	<tr id="tr8a" border="1" bordercolor="#AAC6FF" bgcolor="#FFFFFF"> 
            	<td width="2%"><b>8.</b></td>
                <td colspan="2"width="47%">
                	<font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> 
						How helpful is the staff to provide correct location/direction
                   	</font>
                   	<font  size="2">&nbsp;</font>
                   		<IMG style="DISPLAY: none" src="stars.gif"  border="0" name="img8a" id="img8a">
                </td>
                <td width="9%" align="center">
               	  <input type="radio" value="1" name="q8a" id="q8a">
                </td>
                <td width="9%" align="center">
            	  <input type="radio" value="2" name="q8a" id="q8a">
                </td>
                <td width="9%" align="center">
               	  <input type="radio" value="3" name="q8a" id="q8a">
                </td>
                <td width="9%" align="center">
            	  <input type="radio" value="4" name="q8a" id="q8a">
                </td>
                <td width="9%" align="center">
               	  <input type="radio" value="5" name="q8a" id="q8a">
                </td>
                <td width="6%" align="center">
				<!--	<input type="radio" value="-1" name="q8a" id="q8a"> -->
                </td>
			</tr>
    </table>
  </td>
</tr>



<!-- end -->

 <tr id='tr9'>
    <td>
        <table width="100%" border="1" bordercolor="#AAC6FF" >
           <tr id="12" border=".1" bordercolor="#AAC6FF" bgcolor="#FFFFFF"> 
            	<td colspan="6" valign='center'>
                	&nbsp;<b>9.</b> &nbsp;
					<font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> 
					<b>Other Observations:</b>
                   				</font>
                   				<font  size="2">&nbsp;&nbsp;&nbsp;&nbsp;
                   					
									<textarea rows="2" cols="94" name="c11"  id="c11"></textarea></font>
                </td> 
			</tr>  
        </table>
	</td>
 </tr>

<tr id='tr10'>
    <td>
        <table width="100%" border="1" bordercolor="#AAC6FF" >
           <tr><td colspan="6" style="border:0px">&nbsp;</td></tr>
		   <tr id="12" border=".1" bordercolor="#AAC6FF" bgcolor="#FFFFFF"> 
            	<td style="border:0px" colspan="6" valign='center' align='center'>
                	
					<font  size="2" face="Verdana, Arial, Helvetica, sans-serif"> 
					<b>Upload Receipt :</b>
                   				</font>
                   				<font  size="2">&nbsp;&nbsp;&nbsp;&nbsp;
                   					
									<input type="file" name="photo" id="photo" style="width:500px"/>&nbsp;&nbsp;<b>( *.jpg )</b></font>
                </td> 
			</tr>
			<tr><td style="border:0px" colspan="6">&nbsp;</td></tr>
        </table>
	</td>
 </tr>
  
    <tr id="s"> 
                <td colspan="6" align="right">
                    <input type="button" name="butsav1" value="Save" onClick="if(valall()){if(dayCheck(this.form.DOW)){dosave();}} else {return false};"> &nbsp;
                    <input type="reset" Value="Reset">
                </td> 
    </tr>
    
  
  </font>
  </TABLE>   
	<input type="hidden" name="conCode" />
	<input type="hidden" name="cityCode" />
	<input type="hidden" name="typeCode" />
	<input type="hidden" name="locCode" />
	<input type="hidden" name="nat" id='nat' />
	<input type="hidden" name="gender" id='gender' />
	<input type="hidden" name="visitCode" id='visitCode' />
	<input type="hidden" name="lang" id="lang" value="E"/>

	<input type="hidden" name="slNo" id='slNo' value='$slNo' />

</form>


<!-- Calender Script  --> 

    <table id="calenderTable">
        <tbody id="calenderTableHead">
          <tr>
            <td colspan="4" align="center">
              <select onChange="showCalenderBody(createCalender(document.getElementById('selectYear').value,
               this.selectedIndex, false));" id="selectMonth">
                  <option value="0">Jan</option>
                  <option value="1">Feb</option>
                  <option value="2">Mar</option>
                  <option value="3">Apr</option>
                  <option value="4">May</option>
                  <option value="5">Jun</option>
                  <option value="6">Jul</option>
                  <option value="7">Aug</option>
                  <option value="8">Sep</option>
                  <option value="9">Oct</option>
                  <option value="10">Nov</option>
                  <option value="11">Dec</option>
              </select>
            </td>
            <td colspan="2" align="center">
                <select onChange="showCalenderBody(createCalender(this.value, 
                document.getElementById('selectMonth').selectedIndex, false));" id="selectYear">
                </select>
            </td>
            <td align="center">
                <a href="#" onClick="closeCalender();"><font color="#003333" size="+1">X</font></a>
            </td>
          </tr>
       </tbody>
       <tbody id="calenderTableDays">
         <tr style="">
           <td>Sun</td><td>Mon</td><td>Tue</td><td>Wed</td><td>Thu</td><td>Fri</td><td>Sat</td>
         </tr>
       </tbody>
       <tbody id="calender"></tbody>
    </table>

<!-- End Calender Script  --> 

</body>
</html>
blk2

