<script type="text/javascript" src="js/jquery.js"></script>
<?php
//session_start();
include "../config/conn.php";
if($_GET['permohonanid']!="undefined") { 
  	$sql_lokasi="SELECT * FROM t_pemohon_ka WHERE pemohon_id='".$_GET['permohonanid']."'";	
  	$query_lokasi=mysql_query($sql_lokasi);
	$redit_detail=mysql_fetch_array($query_lokasi);
}
//}
?>
<form id="upload_form" enctype="multipart/form-data" method="post">
<input type="hidden" id="permohonanid" name="permohonanid" value="<?php echo $redit_detail['pemohon_id'];?>" />
<input type="hidden" id="kode" name="kode" value="<?php echo $redit_detail['pemohon_kode'];?>" />
<!--strong><em>Form Input Lokasi</em></strong-->
<div class="row">
<div class="col-xs-4">
<table width="100%" border="0" cellpadding="3" cellspacing="3">
 <tr>
    <td width="13%" valign="top"><strong>Nomor Permohonan</strong></td>
    <td width="40%" valign="top">: <strong><?php echo $redit_detail['pemohon_kode'];?></strong></td>
    </tr>
  <tr>
    <td valign="top"><strong>Nama Instansi</strong></td>
    <td valign="top">: <?php echo $redit_detail['pemohon_instansi'];?></td>
    </tr>
  <tr>
    <td valign="top"><strong>Alamat Instansi</strong></td>
    <td valign="top">: <?php echo $redit_detail['pemohon_instansi_alamat'];?></td>
    </tr>
  <tr>
    <td valign="top"><strong>DATA PEMOHON</strong></td>
    <td valign="top">&nbsp;</td>
    </tr>
  <tr>
    <td valign="top"><strong>Nama Pemohon</strong></td>
    <td valign="top">: <?php echo $redit_detail['pemohon_nama'];?></td>
    </tr>
  <tr>
    <td valign="top"><strong>No.Telepon Pemohon</strong></td>
    <td valign="top">: <?php echo $redit_detail['pemohon_hp'];?></td>
    </tr>
  <tr>
    <td valign="top"><strong>Tanggal Pengajuan</strong></td>
    <td valign="top">: <?php echo $redit_detail['pemohon_tgl_input'];?></td>
    </tr>
  <tr>
    <td valign="top"><strong>Status Permohonan</strong></td>
    <td valign="top">: <input type="radio" id="status" name="status" value="Permohonan Baru" <?php if($redit_detail['pemohon_status_permohonan']=="Permohonan Baru") { echo 'checked="checked"';}?> /> <font color="#FF0000">Permohonan Baru</font>
    <input type="radio" id="status" name="status" value="Verifikasi Data"  <?php if($redit_detail['pemohon_status_permohonan']=="Verifikasi Data") { echo 'checked="checked"';}?> /> <font color="#FF0000">Verifikasi data</font>
    <input type="radio" id="status" name="status" value="Di Terima"  <?php if($redit_detail['pemohon_status_permohonan']=="Di Terima") { echo 'checked="checked"';}?>/> <font color="#FF0000">Di Terima</font>
    <input type="radio" id="status" name="status" value="Di Tolak"  <?php if($redit_detail['pemohon_status_permohonan']=="Di Tolak") { echo 'checked="checked"';}?>/> <font color="#FF0000">Di Tolak</font>
    <input type="radio" id="status" name="status" value="Sudah Diterima Pemohon"  <?php if($redit_detail['pemohon_status_permohonan']=="Sudah Diterima") { echo 'checked="checked"';}?>/> <font color="#FF0000">Sudah Diterima Pemohon</font>
    </td>
    </tr>
  <tr>
	<td></td>
    <td valign="top"><button type="button" data-dismiss="modal" class="refresh" onClick="rload()">Tutup</button>
      <input type="submit" id="simpan" name="simpan" class="simpan" value="Simpan" /></td>
  </tr
></table>
<br />
</div>
</div>
<br />
<div class="modal-footer" align="right"></div>
</form>

