<section class="content-header">

<h1>
Surat Eligibilitas Peserta
</h1>
<ol class="breadcrumb">
<li><a href="#"><i class="fa fa-dashboard"></i> SEP</a></li>
<li class="active">Index</li>
</ol>
</section>

form input SEP

<section class="content">
<input type="hidden" id="txturl" value="https://vclaim.bpjs-
kesehatan.go.id/VClaim">
<input type="hidden" id="txtnmprovider" value="KLINIK MATA MOJOAGUNG">
<input type="hidden" id="txtid" value="0197S001">
<input type="hidden" id="txtpks" value="1">
<input type="hidden" id="txtidApprove">
<input type="hidden" id="txtflaglibur">
<input type="hidden" id="txtketlibur">
<input type="hidden" id="txtfp" value="0">
<input type="hidden" id="txttipe" value="0">
<div class="row">
<div class="col-md-12">
<div id="divHeader">
<div class="box box-success">
<div class="box-header with-border">
<div class="pull-right col-md-3 col-sm-3 col-xs-12">
<div class="input-group">
<input type="text" class="form-control"
id="txtNoSepCari" placeholder="ketik nomor sep" maxlength="19">
<span class="input-group-btn">
<button type="button" id="btnCariNoSEP"
class="btn btn-info">
Cari SEP
</button>
</span>

</div>
</div>

</div>
<!-- /.box-header -->
<!-- form start -->
<form class="form-horizontal">
<div class="box-body">
<div class="form-group" id="div_rdpilih">
<label class="col-md-2 col-sm-2 col-xs-12 control-
label">Pilih</label>
<div class="col-md-5 col-sm-5 col-xs-12">
<label>
<input type="radio" name="rdpilih"
id="rbcarirujukan" value="2" checked="">
Rujukan
</label>&nbsp;
<label>
<input type="radio" name="rdpilih"
id="rbcarikartu" value="0">
Rujukan Manual/IGD
 </label>&nbsp;
</div>
</div>
<div id="divCariRujukan">

<div class="form-group">
<label class="col-md-2 col-sm-2 col-xs-12
control-label"><label style="color:gray;font-size:x-small">(yyyy-mm-dd)</label>
Tgl.Sep</label>
<div class="col-md-3 col-sm-3 col-xs-12">
<div class="input-group date">
<input type="text" class="form-control
datepicker" id="txtTanggal_0" 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">
<label class="col-md-2 col-sm-2 col-xs-12
control-label">Asal Rujukan</label>
<div class="col-md-3 col-sm-3 col-xs-12">
<select class="form-control"
id="cbasalrujukan_0">
<option value="1">Faskes Tingkat
1</option>
<option value="2">Faskes Tingkat
2</option>
</select>
</div>
</div>
<div class="form-group">
<label class="col-md-2 col-sm-2 col-xs-12
control-label">No.Rujukan</label>
<div class="col-md-6 col-sm-6 col-xs-12">
<div class="input-group">
<input type="text" class="form-control"
id="txtNoRujukan_0" placeholder="ketik nomor rujukan faskes" maxlength="19">
<span class="input-group-btn">
<button type="button"
id="btnRujukanLain" class="btn btn-flat">
<i class="fa fa-list">
No.Kartu</i>
</button>
</span>
</div>

</div>
</div>
</div>
<div id="divCarikartu" style="display: none;">
<div class="form-group">
<label class="col-md-2 col-sm-2 col-xs-12
control-label">Pelayanan</label>
<div class="col-md-3 col-sm-3 col-xs-12">
<select class="form-control"
id="cbpelayanan_1">
<option value="2">Rawat Jalan</option>
<option value="1">Rawat Inap</option>
</select>
</div>
</div>
<div class="form-group">
<label class="col-md-2 col-sm-2 col-xs-12
control-label"><label style="color:gray;font-size:x-small">(yyyy-mm-dd)</label>
Tgl.Sep</label>
<div class="col-md-3 col-sm-3 col-xs-12">
<div class="input-group date">
<input type="text" class="form-control
datepicker" id="txtTanggal" placeholder="yyyy-MM-dd" maxlength="10">
<span class="input-group-addon">
<span class="fa fa-calendar">
</span>
</span>
</div>

</div>
</div>
<!-- rujukan online -->

<div class="form-group">
<label class="col-md-2 col-sm-2 col-xs-12
control-label">PPK Asal Peserta <label style="color:red;font-
size:small">*</label></label>
<div class="col-md-5 col-sm-5 col-xs-12">
<input type="text" class="form-control ui-
autocomplete-input" id="txtppkasalrujukan_OL" placeholder="ketik kode atau nama ppk
asal rujukan min 3 karakter" autocomplete="off">
<input type="hidden" class="form-control"
id="txtkdppkasalrujukan_OL">
<input type="hidden" class="form-control"
id="txtjarkom" value="0">
<input type="hidden" class="form-control"
id="txtpascainap">
</div>
</div>
<!-- end rujukan online -->
<div class="form-group">
<label class="col-md-2 col-sm-2 col-xs-12
control-label">Nomor</label>
<div class="col-md-5 col-sm-5 col-xs-12">
<div class="input-group">
<input type="text" class="form-control"
id="txtNokartu" placeholder="ketik nomor" maxlength="13">
<span class="input-group-addon">
<label><input type="radio"
name="rbnomor" value="0" id="rbkartubpjs" checked=""> BPJS</label>
<label><input type="radio"
name="rbnomor" value="1" id="rbkartunik"> NIK(eKTP)</label>
<label><input type="radio"
name="rbnomor" value="2" id="rbkartunik"> eKTP-Reader</label>
</span>
</div>
</div>
</div>
 <div class="alert alert-info alert-dismissible"
id="divInfoJarkom">
<h4><i class="icon fa fa-commenting-o"></i>
Pembuatan SEP rawat jalan menggunakan no.kartu hanya bisa :</h4>
<p>
1. Untuk PPK yang tidak menggunakan
jaringan komunikasi dapat manual.<br>
2. Untuk PPK yang mempunyai jaringan
komunikasi data hanya bisa menerbitkan SEP Gawat Darurat.
</p>

</div>

</div>
</div>
<!-- /.box-body -->
<div class="box-footer">
<button type="button" id="btnCari" class="btn btn-
primary pull-left">Cari</button>
</div>
<!-- /.box-footer -->
</form>
</div>
<div class="alert alert-danger alert-dismissible"
id="divPengajuanPenjaminan" style="display: none;">
<h4><i class="icon fa fa-ban"></i> PERHATIAN!</h4>
<p id="pInfoJaminan"></p>
<a id="myLinkPengajuanPenjaminan" href="#"> Klik Disini
Pengajuan Form</a>
</div>

</div>
</div>
<!-- -->
<!--- ------------------------------------- detail -->
<div id="divDetail" style="display: none;">
<div class="col-md-3">
<!-- Profile Image -->

<div class="box box-widget widget-user-2">

<div class="widget-user-header bg-aqua-active">
<div class="widget-user-image">
<img class="img-circle" src="/VClaim/image/male.png"
alt="User Avatar" id="imgMale">
<img class="img-circle" src="/VClaim/image/female.png"
alt="User Avatar" id="imgFemale">
</div>
<h4 class="widget-user-username" id="lblnama">Nama
Peserta</h4>
<p class="widget-user-desc" id="lblnoka">Nomor Kartu</p>
<input type="hidden" id="txtkelamin">
<input type="hidden" id="txtkdstatuspst">

</div>

<!-- /.box-body -->

 <!-- /.box -->
<!-- About Me Box -->

<!-- /.box-header -->

<div class="box-body">
<div class="nav-tabs-custom">
<ul class="nav nav-tabs">
<li class="active"><a title="Profile Peserta"
href="#tab_1" data-toggle="tab"><span class="fa fa-user"></span></a></li>
<li><a href="#tab_2" title="COB" data-
toggle="tab"><span class="fa fa-building"></span></a></li>
<li><a href="#tab_3" title="Histori" data-
toggle="tab" id="tabHistori"><span class="fa fa-list"></span></a></li>
</ul>
<div class="tab-content">
<div class="tab-pane active" id="tab_1">
<ul class="list-group list-group-unbordered">
<li class="list-group-item">
<span class="fa fa-sort-numeric-
asc"></span> <a title="NIK" class="pull-right-container" id="lblnik">NIK</a>
</li>
<li class="list-group-item">
<span class="fa fa-credit-card"></span>
<a title="No.Kartu Bapel JKK" class="pull-right-container"
id="lblnokartubapel">NOKARTUBAPEL</a>
</li>
<li class="list-group-item">
<span class="fa fa-calendar"></span> <a
title="Tanggal Lahir" class="pull-right-container" id="lbltgllahir">tgllahir</a>
</li>
<li class="list-group-item">
<span class="fa fa-user"></span> <a
title="PISA" class="pull-right-container" id="lblpisa">PISA</a>
</li>

<li class="list-group-item">
<span class="fa fa-hospital-o"></span>
<a title="Hak Kelas Rawat" class="pull-right-container" id="lblhakkelas">hak
kelas</a>
<input type="hidden" id="txtpisa">
<input type="hidden" id="txtkdklspst">
</li>
<li class="list-group-item">
<span class="fa fa-stethoscope"></span>
<a title="Faskes Tingkat 1" class="pull-right-container" id="lblfktp">fktp</a>
<input type="hidden"
id="txtppkasalpst">
</li>
<li class="list-group-item">
<span class="fa fa-calendar"></span>
<a title="TMT dan TAT Peserta" class="pull-right-container"
id="lbltmt_tat">tmt/tat</a>
<input id="txttmtpst" type="hidden">
</li>
<li class="list-group-item">
<span class="fa fa-calendar"></span>
<a title="Jenis Peserta" class="pull-right-container" id="lblpeserta">Peserta</a>
<input type="hidden" id="txtjnspst">
</li>
 </ul>
</div>
<!-- /.tab-pane -->
<div class="tab-pane" id="tab_2">
<ul class="list-group list-group-unbordered">
<li class="list-group-item">
<span class="fa fa-sort-numeric-
asc"></span> <a title="No. Asuransi" class="pull-right-container"
id="lblnoasu">Asuransi</a>
<input type="hidden" id="txtkdasu">
</li>
<li class="list-group-item">
<span class="fa fa-windows"></span> <a
title="Nama Asuransi" class="pull-right-container" id="lblnmasu">Nama Asuransi</a>

</li>
<li class="list-group-item">
<span class="fa fa-calendar"></span> <a
title="TMT dan TAT Asuransi" class="pull-right-container"
id="lbltmt_tatasu">TMT/TAT</a>
<input type="hidden" id="txttmtasu">
<input type="hidden" id="txttatasu">
</li>
<li class="list-group-item">
<span class="fa fa-bank"></span> <a
title="Nama Badan Usaha" class="pull-right-container" id="lblnamabu">Nama BU</a>
<input type="hidden" id="txtkdbu">
</li>
</ul>
</div>
<div class="tab-pane" id="tab_3">
<div id="divHistori" class="list-group">
</div>
<div>
<button type="button" id="btnHistori"
class="btn btn-xs btn-default btn-block"><span class="fa fa-cubes"></span>
Histori</button>
</div>
</div>
</div>
<!-- /.tab-content -->
</div>
<div id="divriwayatKK" style="display: none;">
<button type="button" id="btnRiwayatKK" class="btn btn-
danger btn-block"><span class="fa fa-th-list"></span> Pasien Memiliki Riwayat
KLL/KK/PAK <br><i>(klik lihat data)</i></button>
</div>

</div>
<!-- /.box-body -->
</div>
<!-- /.box -->

</div>
<!-- form sep -->
<div class="col-md-9">
<div class="alert alert-danger alert-dismissible"
id="divInformasi">
<h4><i class="icon fa fa-ban"></i> PERHATIAN!</h4>
<p id="pProlanis"></p>
<p id="pDinsos"></p>
<input type="hidden" id="txtdinsos">
</div>
<div class="callout callout-info" id="divInformasiKontrolLagi"
style="display: none;">
<p id="pKontrol"></p>
</div>
<div class="callout callout-danger" id="divPotensiPRB"
style="display: none;">
<p id="pPotensiPRB"></p>
<input type="hidden" id="txtpotensiprb">
</div>
<div class="alert alert-info alert-dismissible" id="divInfoKatarak"
style="display: none;">
<h4><i class="icon fa fa-volume-up"></i> INFORMASI....</h4>
<p id="pKatarak"></p>
</div>
<div class="box box-success">
<div class="box-header with-border">
<h3 class="box-title"><label class="pull-right"
style="font-size:larger" id="lblnosep"></label> </h3>
<label class="pull-right" style="font-size:larger"
id="lbljenpel"></label>
<input type="hidden" id="txtjenpel">
</div>
<form class="form-horizontal" id="theform">
<input type="hidden" id="txtprsklaimsep">
<div class="box-body">
<div>
<label style="color:red;font-size:small">* Wajib
Diisi</label>
</div>
<div class="form-group" id="divPoli">
<label class="col-md-3 col-sm-3 col-xs-12 control-
label">Spesialis/SubSpesialis <label style="color:red;font-
size:small">*</label></label>
<div class="col-md-9 col-sm-9 col-xs-12">
<div class="input-group">
<span class="input-group-addon">
<label><input type="checkbox"
id="chkpoliesekutif"> Eksekutif</label>
</span>
<input type="text" class="form-control ui-
autocomplete-input" id="txtnmpoli" maxlength="10" placeholder="ketik kode atau nama
Spesialis/Subspesialis min 3 karakter" autocomplete="off">
<input type="hidden" class="form-control"
id="txtkdpoli">
</div>
</div>
</div>
<div id="divRujukan">
<div class="form-group">
<label class="col-md-3 col-sm-3 col-xs-12
control-label">Asal Rujukan</label>
<div class="col-md-9 col-sm-9 col-xs-12">
<select class="form-control"
id="cbasalrujukan">
<option value="1">Faskes Tingkat
1</option>
<option value="2">Faskes Tingkat
2</option>
</select>
</div>
</div>
<div class="form-group">
<label class="col-md-3 col-sm-3 col-xs-12
control-label">PPK Asal Rujukan <label style="color:red;font-
size:small">*</label></label>
<div class="col-md-9 col-sm-9 col-xs-12">
<input type="text" class="form-control ui-
autocomplete-input" id="txtppkasalrujukan" placeholder="ketik kode atau nama ppk
asal rujukan min 3 karakter" autocomplete="off">
<input type="hidden" class="form-control"
id="txtkdppkasalrujukan">
</div>
</div>
<div class="form-group">
<label class="col-md-3 col-sm-3 col-xs-12
control-label"><label style="color:gray;font-size:x-small">(yyyy-mm-dd)</label>
Tgl.Rujukan</label>
<div class="col-md-3 col-sm-3 col-xs-12">
<div class="input-group date">
<input type="text" class="form-control
datepicker" id="txttglrujukan" 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">
<label class="col-md-3 col-sm-3 col-xs-12
control-label">No. Rujukan <label style="color:red;font-
size:small">*</label></label>
<div class="col-md-9 col-sm-9 col-xs-12">
<input type="text" class="form-control"
id="txtnorujukan" placeholder="ketik nomor rujukan" maxlength="19">
</div>
</div>
</div>
<!-- kontrol -->
<div id="divkontrol" style="display: none;">
<div class="form-group">
<label class="col-md-3 col-sm-3 col-xs-12
control-label" id="lblkontrol">No.Surat Kontrol/SKDP <label style="color:red;font-
size:small">*</label></label>
<div class="col-md-9 col-sm-9 col-xs-12">
<input type="text" class="form-control"
id="txtnosuratkontrol" placeholder="ketik nomor surat kontrol" onkeypress="return
event.charCode >= 48 &amp;&amp; event.charCode <= 57" maxlength="6">
<input type="hidden" id="txtidkontrol"
value="0">
<input type="hidden"
id="txtnosuratkontrollama">
 <input type="hidden"
id="txtpoliasalkontrol">
<input type="hidden"
id="txttglsepasalkontrol">
</div>
</div>
<div class="form-group">
<label class="col-md-3 col-sm-3 col-xs-12
control-label">DPJP Pemberi Surat SKDP/SPRI <label style="color:red;font-
size:small">*</label></label>
<div class="col-md-9 col-sm-9 col-xs-12">
<input type="text" class="form-control ui-
autocomplete-input" id="txtnmdpjp" placeholder="ketik nama dokter DPJP Pemberi
Surat SKDP/SPRI" autocomplete="off">
<input type="hidden" id="txtkddpjp">
</div>
</div>
</div>
<!-- end kontrol -->
<div class="clearfix"></div>
<!-- sep -->
<div class="form-group">
<label class="col-md-3 col-sm-3 col-xs-12 control-
label"><label style="color:gray;font-size:x-small">(yyyy-mm-dd)</label> Tgl.
SEP</label>
<div class="col-md-3 col-sm-3 col-xs-12">
<div class="input-group date">
<input type="text" class="form-control
datepicker" id="txttglsep" placeholder="yyyy-MM-dd" maxlength="10" disabled="">
<span class="input-group-addon">
<span class="fa fa-calendar">
</span>
</span>
</div>
</div>
</div>
<div class="form-group">
<label class="col-md-3 col-sm-3 col-xs-12 control-
label">No. MR <label style="color:red;font-size:small">*</label></label>
<div class="col-md-4 col-sm-4 col-xs-12">
<div class="input-group">
<input type="text" class="form-control"
id="txtnomr" placeholder="ketik nomor MR" maxlength="10">
<span class="input-group-addon">
<label><input type="checkbox"
id="chkCOB" disabled=""> Peserta COB</label>
</span>
</div>
</div>
</div>
<div class="form-group" id="divkelasrawat">
<label class="col-md-3 col-sm-3 col-xs-12 control-
label">Kelas Rawat</label>
<div class="col-md-9 col-sm-9 col-xs-12">
<select class="form-control"
id="cbKelas"></select>
</div>
</div>
<div class="form-group">
 <label class="col-md-3 col-sm-3 col-xs-12 control-
label">Diagnosa <label style="color:red;font-size:small">*</label></label>
<div class="col-md-9 col-sm-9 col-xs-12">
<input type="text" class="form-control ui-
autocomplete-input" id="txtnmdiagnosa" maxlength="10" placeholder="ketik kode atau
nama diagnosa min 3 karakter" autocomplete="off">
<label id="lblDxSpesialistik"
style="color:red"></label>
<input type="hidden" class="form-control"
id="txtkddiagnosa">
</div>
</div>

<div class="form-group">
<label class="col-md-3 col-sm-3 col-xs-12 control-
label">No. Telepon <label style="color:red;font-size:small">*</label></label>
<div class="col-md-9 col-sm-9 col-xs-12">
<input type="text" class="form-control"
id="txtnotelp" placeholder="ketik nomor telepon yang dapat dihubungi"
onkeypress="return event.charCode >= 48 &amp;&amp; event.charCode <= 57"
maxlength="15">
</div>
</div>

<div class="form-group">
<label class="col-md-3 col-sm-3 col-xs-12 control-
label">Catatan</label>
<div class="col-md-9 col-sm-9 col-xs-12">
<textarea class="form-control" id="txtcatatan"
rows="2" placeholder="ketik catatan apabila ada"></textarea>
</div>
</div>
<!-- katarak-->
<div class="form-group" id="divkatarak" style="display:
none;">
<label class="col-md-3 col-sm-3 col-xs-12 control-
label">Katarak <input type="checkbox" id="chkkatarak"></label>
<div class="col-md-9 col-sm-9 col-xs-12">
<p class="text-muted well well-sm no-
shadow">Centang Katarak <i class="fa fa-check"></i>, Jika Peserta Tersebut
Mendapatkan Surat Perintah Operasi katarak</p>
</div>
</div>

<!-- lakalantas-->
<div class="form-group">
<label class="col-md-3 col-sm-3 col-xs-12 control-
label">Status Kecelakaan <label style="color:red;font-size:small">*</label></label>
<div class="col-md-9 col-sm-9 col-xs-12">
<select class="form-control " id="cbstatuskll">
<option value="-">-- Silahkan Pilih
--</option>
<option value="0" title="Kasus bukan akibat
kecelakaan lalu lintas dan kerja">Bukan Kecelakaan</option>
<option value="1" title="Kasus KLL Tidak
Berhubungan dengan Pekerjaan">Kecelakaan LaluLintas dan Bukan Kecelakaan
Kerja</option>
<option value="2" title="1).Kasus KLL
Berhubungan dengan Pekerjaan. 2).Kasus KLL Berangkat dari Rumah menuju tempat
Kerja. 3).Kasus KLL Berangkat dari tempat Kerja menuju rumah.">Kecelakaan
LaluLintas dan Kecelakaan Kerja</option>
<option value="3" title="1).Kasus
Kecelakaan Berhubungan dengan pekerjaan. 2).Kasus terjadi di tempat kerja.Kasus
terjadi pada saat kerja.">Kecelakaan Kerja</option>
</select>

</div>
</div>

<div id="divJaminanHistori" class="text-muted well

well-sm no-shadow col-md-12 col-sm-12 col-xs-12" style="display: none;">
<input type="hidden" id="txtkasuslaka" value="0">
<input type="hidden" id="txtnosepjaminanhistori">
<input type="hidden" id="txtnosepjaminanhistori2">
<input type="hidden" id="txtkasuskejadian2">
<input type="hidden" id="txtstatusdijamin">
<p style="margin-top: 10px;" id="pketerangan"></p>
</div>
<div id="divJaminan" class="text-muted well well-sm no-
shadow">
<div class="form-group">
<label class="col-md-3 col-sm-3 col-xs-12
control-label">Tanggal Kejadian</label>
<div class="col-md-3 col-sm-3 col-xs-12">
<div class="input-group date">
<input type="text" class="form-control
datepicker" id="txtTglKejadian" 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 ">

<label class="col-md-3 col-sm-3 col-xs-12
control-label">Lokasi Kejadian</label>
<div class="col-md-7 col-sm-7 col-xs-12">
<select class="form-control"
id="cbpropinsi"><option value="">-- Silahkan Pilih Propinsi --</option><option
value="16">BALI</option><option value="15">BANTEN</option><option
value="07">BENGKULU</option><option value="13">D I YOGYAKARTA</option><option
value="10">DKI JAKARTA</option><option value="27">GORONTALO</option><option
value="05">JAMBI</option><option value="11">JAWA BARAT</option><option
value="12">JAWA TENGAH</option><option value="14">JAWA TIMUR</option><option
value="19">KALIMANTAN BARAT</option><option value="21">KALIMANTAN
SELATAN</option><option value="20">KALIMANTAN TENGAH</option><option
value="22">KALIMANTAN TIMUR</option><option value="34">KALIMANTAN
UTARA</option><option value="09">KEP. BANGKA BELITUNG</option><option
value="33">KEPULAUAN RIAU</option><option value="08">LAMPUNG</option><option
value="99">LUAR NEGERI</option><option value="28">MALUKU</option><option
value="29">MALUKU UTARA</option><option value="01">NANGGROE ACEH
DARUSSALAM</option><option value="17">NUSA TENGGARA BARAT</option><option
value="18">NUSA TENGGARA TIMUR</option><option value="30">PAPUA</option><option
value="31">PAPUA BARAT</option><option value="04">RIAU</option><option
value="32">SULAWESI BARAT</option><option value="25">SULAWESI
SELATAN</option><option value="24">SULAWESI TENGAH</option><option
value="26">SULAWESI TENGGARA</option><option value="23">SULAWESI
UTARA</option><option value="03">SUMATERA BARAT</option><option value="06">SUMATERA
SELATAN</option><option value="02">SUMATERA UTARA</option></select>
</div>
</div>
<div class="form-group">
<label class="col-md-3 col-sm-3 col-xs-12
control-label"></label>
<div class="col-md-7 col-sm-7 col-xs-12">
<select class="form-control"
id="cbkabupaten"></select>
</div>
</div>
<div class="form-group">
<label class="col-md-3 col-sm-3 col-xs-12
control-label"></label>
<div class="col-md-7 col-sm-7 col-xs-12">
<select class="form-control"
id="cbkecamatan"></select>
</div>
</div>
<div class="form-group">
<label class="col-md-3 col-sm-3 col-xs-12
control-label">Keterangan Kejadian</label>
<div class="col-md-9 col-sm-9 col-xs-12">
<textarea class="form-control"
id="txtketkejadian" rows="2" placeholder="ketik keterangan kejadian"></textarea>
</div>
</div>
</div>
<!-- end lakalantas-->

</div>
<div class="box-footer">
<div id="divSimpan">
<button type="button" id="btnSimpan" class="btn
btn-success pull-left"><i class="fa fa-save"></i> Simpan</button>
</div>
<div id="divEditSEP" style="display: none;">
<button type="button" id="btnEdit" class="btn btn-
info pull-left col-md-1 col-sm-1 col-xs-12">Edit</button>
<button type="button" id="btnHapus" class="btn btn-
danger pull-left col-md-1 col-sm-1 col-xs-12">Hapus</button>
<button type="button" id="btnCetak" class="btn btn-
warning pull-left col-md-1 col-sm-1 col-xs-12">Cetak</button>
</div>
<button type="button" id="btnBatal" class="btn btn-
danger pull-right">Batal</button>
</div>
</form>
</div>
</div>

</div>
 <!-- end detail -->

</div>

</section>