PK
<head>
<script language="JavaScript" type="text/javascript">
</script>
</head>
<table cellspacing="3" align="center" width="100%" border="4" cellpadding="3">
<form action="form/conform_alp.php" method="get" onsubmit="return checkform(this);">
<input type="hidden" name="clntid" value="<?php echo"$_GET[clntid]";?>">
<input type="hidden" name="dtype" value="<?php echo"$_GET[dtype]";?>">
<input type="hidden" name="sub_c" value="<?php echo"$_GET[sub_c]";?>">
<tr>
<td valign="top" colspan="4"> <center> <h3> CERTIFICATE OF FUMIGATION </h3> </center>
</td>
</tr>
<tr>
<td valign="top" colspan="4"><strong>Dte PPQS Regd.No.104/MB</strong></td></tr>
<td valign="top" colspan="2"><strong>Treatment Certificate No.</strong>:<em>Auto assigned</em></td>
<td valign="top" colspan="2"><input type="text" name="dat" value="<?php echo date('d-m-Y'); ?>" /></td>
</tr>
<tr><td colspan="4"> This is to certify that consignment has been treated as per details listed below and that
subject consigenmentis believed <br> to be substantially free from any injurious pests.</td></tr>
<!--tr>
<td valign="top" colspan="2"><strong>Name of Importer/Exporter</em></strong>:</td><td colspan="2"><?php
$sqlb = "SELECT headname,headaddress From head where headid='".$_GET['clntid']."'";
$resultb = mysql_query($sqlb) or die('error in getting Sub client details');
$rowb = mysql_fetch_array($resultb);
echo $rowb['headname'].",".$rowb['headaddress'];
?></td>
</tr-->
<?php
//echo"<input type=hidden name=clntid value=$_GET[clntid]>";
echo"<input type=hidden name=dtype value=$_GET[dtype]>";
$sql="SELECT * From head WHERE headid='$_GET[clntid]'";
$result=mysql_query($sql) or die('error in getting client details');
while($row=mysql_fetch_array($result))
{
if($_GET['dtype']=='import')
{
$clnitsid = $_GET['clntid'];
echo "<input type=hidden name=declarednameaddress value=$clnitsid>";
echo "<tr>
<td align=left colspan=2><b>Name and address of consignor/exporter</b>:</td>
<td align=center colspan=2>";
/*
echo "<select name=nameaddress>";
$sqlb="SELECT * From clients where subname<>'.' AND subname<>'' AND subname<>'..' ORDER BY subname ASC";
$resultb=mysql_query($sqlb) or die('error in getting Sub client details');
echo"<option value='1121'>.</option>";
while($rowb=mysql_fetch_array($resultb))
{
$subid="{$rowb['subid']}";
$subname="{$rowb['subname']}";
echo"<option value=$subid>".substr($subname,0,25)." -> ".substr($rowb['subaddress'],0,25)."</option>";
}
echo"</select>";
*/
?>
<input name='nameaddress' id="exporterslist" size="80" type="text" />
<?
echo "</td>
</tr>
<br>
<tr>
<td colspan=2><b>Name & address of consignee</b>:</td>
<td align=center colspan=2>
<b>{$row['headname']}</b><br>{$row['headaddress']}<br>{$row['headphone']}
</td>
</tr>
";
}
else
{
$clnitsid = $_GET['clntid'];
echo "<input type=hidden name=nameaddress value=$clnitsid>";
echo "<tr>
<td colspan=2><b>Name and address of consignor/exporter</b>:</td>
<td align=center colspan=3>
<b>{$row['headname']}</b><br>{$row['headaddress']}<br>{$row['headphone']}
</td>
</tr>
<br>
<tr>
<td colspan=2><b>Name & address of consignee</b>:</td>
<td align=center colspan=3>";
/*
echo <select name=declarednameaddreZZ>";
$sqlb="SELECT * From clients where subname<>'.' AND subname<>'' AND subname<>'..' ORDER BY subname ASC";
$resultb=mysql_query($sqlb) or die('error in getting Sub client details');
echo"<option value='1121'>.</option>";
while($rowb=mysql_fetch_array($resultb))
{
$subid="{$rowb['subid']}";
$subname="{$rowb['subname']}";
echo"<option value=$subid>".substr($subname,0,25)." -> ".substr($rowb['subaddress'],0,25)."</option>";
}
echo"</select>";
*/
?>
<input name='declarednameaddress' id="exporterslist" size="80" type="text" />
<?
echo "</td>
</tr>
";
}
}
?>
<td valign="top" colspan="2"><strong>Invoice No</strong>:</td><td colspan="2"><input type="text" name="invoice"></td>
</tr>
<tr>
<td valign="top" colspan="2"><strong>Description of Consigenment</strong>:</td><td colspan="2"><input type="text" name="desc"></td>
</tr>
<tr>
<td valign="top" colspan="2"><strong>Type and No. of Packges</strong>:</td><td colspan="2"><input type="text" name="pack"></td>
</tr>
<tr>
<td valign="top" colspan="2"><strong>Container No. or Vessel</strong>:</td><td colspan="2"><textarea name="vessel" cols="28" rows="3"></textarea></td>
</tr>
<tr>
<td valign="top" colspan="2"><strong>Means of Conveyance</strong>:</td><td colspan="2"><input type="text" name="convey"></td>
</tr>
<tr>
<td valign="top" colspan="2"><strong>Destination Port</strong>:</td><td colspan="2"><input type="text" name="destinat"></td>
</tr>
<br>
<tr><td valign="top" colspan="4">
<center><h3>
SCHEDULE OF TREATMENT <h3> </center>
</td></tr>
<BR>
<tr>
<td valign="top" colspan="2 "><strong>Chemical(Fumigant)</strong>:</td>
<td colspan="2">
<select name="chem">
<option>METHYL BROMIDE</option>
<option>ALUMINIUM PHOSPHIDE</option>
</select></td>
</tr>
<tr>
<td valign="top" colspan="2"><strong>Dosage</strong>:</td>
<td colspan="2">
<select name="dosage">
<option>3 LBS Per 1000 Cubic Ft.</option>
<option>9 Gms Per Ton</option>
<option>12 Gms Per Ton</option>
<option>6 Gms Per Cubic Meter</option>
<option>16 Gms Per Cubic Meter</option>
<option>24 Gms Per Cubic Meter</option>
<option>32 Gms Per Cubic Meter</option>
<option>40 Gms Per Cubic Meter</option>
<option>48 Gms Per Cubic Meter</option>
<option>56 Gms Per Cubic Meter</option>
<option>64 Gms Per Cubic Meter</option>
<option>80 Gms Per Cubic Meter</option>
<option>88 Gms Per Cubic Meter</option>
<option>96 Gms Per Cubic Meter</option>
<option>100 Gms Per Cubic Meter</option> </select></td>
</tr>
<tr>
<td valign="top" colspan="2"><strong>Temperature</strong>:</td><td colspan="2"><input type="text" name="temp"></td>
</tr>
<tr>
<td valign="top" colspan="2"><strong>Duration of Exposure</strong>:</td>
<td colspan="2">
<select name="durat">
<option>24 Hour</option>
<option>48 Hour</option>
<option>72 Hour</option>
<option>7 days</option>
</select></td>
</tr>
<tr>
<td valign="top" colspan="2"> <strong>Date of Fumigation</strong>:</td><td colspan="2"><input type="text" name="Dfumigation"></td>
</tr>
<tr>
<td valign="top" colspan="2"><strong>Remark</strong>:</td><td colspan="2"><textarea name="remark" cols="35" rows="3"></textarea></td>
</tr>
<tr>
<td valign="top" colspan="2"><strong>Encloser Area of Fumigation</strong>:</td><td colspan="2"><input type="text" name="container20feet" /> Cubic meters</td>
</tr>
<tr><td align="center" colspan="4"><br>
<table align="center" width="100%" border="1" cellpadding="0" cellspacing="0">
<tr><td colspan="2" align="right"><center>
<strong>MAKE INVOICE:</strong>
</center> </td><td colspan="2">For agent:-
<input name='ajtname' id="agentslist" size="80" type="text" />
<!--select name="ajtname">
<option value="0">Select an agent</option>
<?php
$sql="SELECT ajcomp,ajid FROM ajent order by ajcomp";
$result=mysql_query($sql) or die('error in fetch');
if
(mysql_num_rows($result) == 0)
{ echo "<option value=0>no agents found</option>";
}
while($row=mysql_fetch_array($result))
{
echo"<option value='".$row['ajid']."'>{$row['ajcomp']}</option>";
}
?></select-->
</td></tr>
<tr><td colspan="2" align="right"><strong>Fumigation Amount</strong> :</td>
<td align="center" colspan="2"> Rs.<input type="text" name="famount">/-</td></tr>
<tr>
<tr><td colspan="2" align="right"><strong>Travel Expenses</strong> :</td>
<td align="center" colspan="2"> Rs.<input type="text" name="tamount">/-</td></tr>
<tr>
<tr><td colspan="2" align="right"><strong>Miscellaneous</strong> :</td>
<td align="center" colspan="2"> Rs.<input type="text" name="mamount">/-</td></tr>
<tr>
<td colspan="2" align="right"> Discount:<em>(in %age)</em></td>
<td colspan="2" align="center">
<input type="text" name="discount" size="4" value="0" onfocus="this.value=''">
%</td>
</tr>
<tr><td colspan="2" align="right"><input type="checkbox" name="stax" value="yes" checked> ServiceTax :</td><td colspan="4" align="center">
<input type="text" name="srtax" value="12.36" size="4">%</td></tr>
<tr><td colspan="2" align="center" valign="middle">Particulars</td><td colspan="2"><textarea name="particular" rows="2" cols="40"></textarea></td></tr>
<tr><td colspan="4" align="center"><br><center><input type="submit" value="» Please Check & Confirm »" class="amo-submit"></center></td></tr>
</form>
</table>
</td></tr>
</table>
PK 99