Anda di halaman 1dari 3

form membuat rujukan

<div class="col-md-12">
<div class="box box-success" id="divHeadAction">
<div class="box-header with-border">
<h3 class="box-title">Action</h3>
</div>
<div class="box-body">
<div>
<div class="nav-tabs-custom">
<ul class="nav nav-tabs">
<li class=""><a title="Cari Nomor SEP"
href="#tab_1" data-toggle="tab" aria-expanded="false"><span class="fa fa-file-text-
o"></span> Nomor SEP</a></li>
<li class="active"><a href="#tab_2" title="List
Rujukan" data-toggle="tab" aria-expanded="true"><span class="fa fa-list-ul"></span>
List Rujukan</a></li>
</ul>
<div class="tab-content">
<div class="tab-pane" id="tab_1">
<form class="form-horizontal">
<div class="form-group">
<label class="col-md-3 col-sm-3 col-xs-
12 control-label">No.SEP</label>
<div class="col-md-3 col-sm-3 col-xs-
12">
<input type="text" class="form-
control" id="txtnosep_0" placeholder="ketik nomor sep" maxlength="19">
</div>
</div>
<div class="form-group">
<div class="col-md-3 col-sm-3 col-xs-
12"></div>
<div class="col-md-3 col-sm-3 col-xs-
12">
<button class="btn btn-primary"
id="btnCari" type="button"> <i class="fa fa-search"></i> Cari</button>
</div>
</div>
</form>
</div>
<div class="tab-pane active" id="tab_2">
<form class="form-horizontal">
<div class="form-group">
<label class="col-md-3 col-sm-3 col-xs-
12 control-label">Tanggal</label>
<div class="col-md-5 col-sm-5 col-xs-
12">
<div class="input-group date">
<input type="text" class="form-
control datepicker" id="txtTgl1" placeholder="yyyy-MM-dd" maxlength="10">
<span class="input-group-
addon">
<span class="fa fa-
calendar">
</span>
</span>
<span class="input-group-
addon">
s.d
</span>
<input type="text" class="form-
control datepicker" id="txtTgl2" placeholder="yyyy-MM-dd" maxlength="10">
<span class="input-group-
addon">
<span class="fa fa-
calendar">
</span>
</span>
</div>

</div>
</div>
<div class="form-group">
<div class="col-md-3 col-sm-3 col-xs-
12"></div>
<div class="col-md-3 col-sm-3 col-xs-
12">
<button class="btn btn-success"
id="btnCariTanggal" type="button"> <i class="fa fa-search"></i> Cari</button>
</div>
</div>
</form>
<div id="tblRujukan_wrapper"
class="dataTables_wrapper form-inline dt-bootstrap no-footer"><div class="row"><div
class="col-sm-6"></div><div class="col-sm-6"></div></div><div class="row"><div
class="col-sm-12"><table class="table table-bordered table-striped dataTable no-
footer" id="tblRujukan" style="font-size: small; width: 100%;" role="grid" aria-
describedby="tblRujukan_info" width="100%" cellpadding="0">
<thead>
<tr role="row"><th class="sorting_asc"
tabindex="0" aria-controls="tblRujukan" rowspan="1" colspan="1" style="width: 0px;"
aria-sort="ascending" aria-label="No.: activate to sort column
descending">No.</th><th class="sorting" tabindex="0" aria-controls="tblRujukan"
rowspan="1" colspan="1" style="width: 0px;" aria-label="No.Rujukan: activate to
sort column ascending">No.Rujukan</th><th class="sorting" tabindex="0" aria-
controls="tblRujukan" rowspan="1" colspan="1" style="width: 0px;" aria-
label="Tgl.Rujukan: activate to sort column ascending">Tgl.Rujukan</th><th
class="sorting" tabindex="0" aria-controls="tblRujukan" rowspan="1" colspan="1"
style="width: 0px;" aria-label="RI/RJ: activate to sort column
ascending">RI/RJ</th><th class="sorting" tabindex="0" aria-controls="tblRujukan"
rowspan="1" colspan="1" style="width: 0px;" aria-label="No.SEP: activate to sort
column ascending">No.SEP</th><th class="sorting" tabindex="0" aria-
controls="tblRujukan" rowspan="1" colspan="1" style="width: 0px;" aria-
label="No.Kartu: activate to sort column ascending">No.Kartu</th><th
class="sorting" tabindex="0" aria-controls="tblRujukan" rowspan="1" colspan="1"
style="width: 0px;" aria-label="Nama: activate to sort column
ascending">Nama</th><th class="sorting" tabindex="0" aria-controls="tblRujukan"
rowspan="1" colspan="1" style="width: 0px;" aria-label="PPK Rujuk: activate to sort
column ascending">PPK Rujuk</th></tr>
</thead>
<tbody><tr class="odd"><td colspan="8"
class="dataTables_empty" valign="top">No data available in
table</td></tr></tbody></table><div id="tblRujukan_processing"
class="dataTables_processing" style="display:
none;">Processing...</div></div></div><div class="row"><div class="col-sm-5"><div
class="dataTables_info" id="tblRujukan_info" role="status" aria-
live="polite">Showing 0 to 0 of 0 entries</div></div><div class="col-sm-7"><div
class="dataTables_paginate paging_simple_numbers" id="tblRujukan_paginate"><ul
class="pagination"><li class="paginate_button previous disabled"
id="tblRujukan_previous"><a href="#" aria-controls="tblRujukan" data-dt-idx="0"
tabindex="0">Previous</a></li><li class="paginate_button next disabled"
id="tblRujukan_next"><a href="#" aria-controls="tblRujukan" data-dt-idx="1"
tabindex="0">Next</a></li></ul></div></div></div></div>
</div>
</div>
</div>

</div>

</div>

</div>
</div>