<!doctype html>
<html  {$html_attrs}>
	<head>
						<meta http-equiv="X-UA-Compatible" content="IE=Edge">
	<meta name="viewport" content="width=device-width, initial-scale=1.0">
	<title>{$pagetitle}</title>
	<meta http-equiv="Content-Type" content="text/html; charset=utf-8">
	<base href="{$projectPath}">
		{BEGIN styleCSSFiles}
<link REL="stylesheet" href="{$stylepath}" type="text/css">
{END styleCSSFiles}
			
	</head>

	<body class="{$stylename} function-edit" {$bodyattrs}>
	{BEGIN body}
		{$header}
		<style>
			{$containerCss}
		</style>
		{$locking}
		<div class="r-small-page" 
			data-body-align="center"
			data-body-width="standard"
		>
							{BEGIN top_block}
<div class="r-form" data-location="top" id="form_top_{$pageid}" data-makeup="small" {$form_top} data-pageid="{$pageid}" data-page="augmentation_portal_request_edit"
		data-v-width="4"
	data-v-margin="1"
	
>		
	 
		<div class="row">
			 
				<div 
	data-cellId="top_c1" data-pageid="{$pageid}"	{$cell_top_c1}
	class=" r-ori-vert			col-md-12
	">
	 
		<h2 data-itemtype="edit_header" data-itemid="edit_header" {$item_edit_header}="" data-pageid="{$pageid}" >{$pagetitlelabel augmentation_portal_request edit}</h2>
	</div>					</div>
	</div>		
{END top_block}
									{BEGIN above-grid_block}
<div class="r-form" data-location="above-grid" id="form_above-grid_{$pageid}" data-makeup="small" {$form_above-grid} data-pageid="{$pageid}" data-page="augmentation_portal_request_edit"
		data-v-width="4"
	data-v-margin="1"
	
>		
	 
		<div class="row">
			 
				<div 
	data-cellId="above-grid_c1" data-pageid="{$pageid}"	{$cell_above-grid_c1}
	class=" r-ori-vert			col-md-12
	">
	 
		<div data-itemtype="edit_message" data-itemid="edit_message" {$item_edit_message}="" data-pageid="{$pageid}" class="alert {$message_class}" role="alert">
<h5>{$message}</h5>
<div>
{BEGIN message_back_button}
			<button class="btn btn-sm btn-default" {$backbutton_attrs}>{mlang_message BACK_TO_LIST}</button>
	{END message_back_button}
{BEGIN message_view_page_button}
		<a class="btn btn-sm btn-default" href="augmentation_portal_request_view.php?{$editlink}" {$view_page_button_attrs}>{mlang_message VIEW}</a>
{END message_view_page_button}
</div>
</div>
	</div>					</div>
	</div>		
{END above-grid_block}
									{BEGIN grid_block}




 
	 
												<table 
	data-body-align="center"
	data-location="grid" id="form_grid_{$pageid}" data-makeup="small" {$form_grid} data-pageid="{$pageid}" data-page="augmentation_portal_request_edit" 
	class="r-edit-form" cellpadding="0" cellspacing="0" 
	{$grid_hiddenattr} 
		data-form-width="1"
		
		data-v-width="4"
	>
	<tbody>
										<tr {$row_grid_0} >
										

{BEGIN cellblock_grid_c3}
<td
	{$cell_grid_c3}
	class=" r-ori-vert"
	
				data-fullwidth
		
			data-cellId="grid_c3" data-pageid="{$pageid}"
		data-v-cell="4"
		
>
	<div edit-form-cell class="clearfix">
				
{BEGIN portal_request_no_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_portal_request_no}  r-vertical-field" 
	data-signal-error-for="portal_request_no{$id}" {$required_attr_portal_request_no}
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field" {$item_integrated_edit_field}="" data-pageid="{$pageid}" data-field="portal_request_no" data-fieldname="portal_request_no" >

	<label class="r-edit-label control-label {$portal_request_no_label_class}" for="{$labelfor_portal_request_no}">
		{BEGIN portal_request_no_label}
			{$portal_request_no_forward_control}
			{$label augmentation_portal_request portal_request_no }			{END portal_request_no_label}
		<span class="icon-required"></span>
	</label>
	<div class="r-edit-field">
		{$portal_request_no_editcontrol}	</div>
		<div class="r-edit-tooltip" data-helpfor="portal_request_no" {$tooltipAttr augmentation_portal_request portal_request_no } >
		<div class="text-muted" >
		{$tooltip augmentation_portal_request portal_request_no }		</div>
	</div>
	</div>


{END portal_request_no_fieldblock}
											
{BEGIN portal_user_id_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_portal_user_id}  r-vertical-field" 
	data-signal-error-for="portal_user_id{$id}" {$required_attr_portal_user_id}
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field1" {$item_integrated_edit_field1}="" data-pageid="{$pageid}" data-field="portal_user_id" data-fieldname="portal_user_id" >

	<label class="r-edit-label control-label {$portal_user_id_label_class}" for="{$labelfor_portal_user_id}">
		{BEGIN portal_user_id_label}
			{$portal_user_id_forward_control}
			{$label augmentation_portal_request portal_user_id }			{END portal_user_id_label}
		<span class="icon-required"></span>
	</label>
	<div class="r-edit-field">
		{$portal_user_id_editcontrol}	</div>
		<div class="r-edit-tooltip" data-helpfor="portal_user_id" {$tooltipAttr augmentation_portal_request portal_user_id } >
		<div class="text-muted" >
		{$tooltip augmentation_portal_request portal_user_id }		</div>
	</div>
	</div>


{END portal_user_id_fieldblock}
											
{BEGIN request_date_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_request_date}  r-vertical-field" 
	data-signal-error-for="request_date{$id}" {$required_attr_request_date}
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field2" {$item_integrated_edit_field2}="" data-pageid="{$pageid}" data-field="request_date" data-fieldname="request_date" >

	<label class="r-edit-label control-label {$request_date_label_class}" for="{$labelfor_request_date}">
		{BEGIN request_date_label}
			{$request_date_forward_control}
			{$label augmentation_portal_request request_date }			{END request_date_label}
		<span class="icon-required"></span>
	</label>
	<div class="r-edit-field">
		{$request_date_editcontrol}	</div>
		<div class="r-edit-tooltip" data-helpfor="request_date" {$tooltipAttr augmentation_portal_request request_date } >
		<div class="text-muted" >
		{$tooltip augmentation_portal_request request_date }		</div>
	</div>
	</div>


{END request_date_fieldblock}
											
{BEGIN region_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_region}  r-vertical-field" 
	data-signal-error-for="region{$id}" {$required_attr_region}
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field3" {$item_integrated_edit_field3}="" data-pageid="{$pageid}" data-field="region" data-fieldname="region" >

	<label class="r-edit-label control-label {$region_label_class}" for="{$labelfor_region}">
		{BEGIN region_label}
			{$region_forward_control}
			{$label augmentation_portal_request region }			{END region_label}
		<span class="icon-required"></span>
	</label>
	<div class="r-edit-field">
		{$region_editcontrol}	</div>
		<div class="r-edit-tooltip" data-helpfor="region" {$tooltipAttr augmentation_portal_request region } >
		<div class="text-muted" >
		{$tooltip augmentation_portal_request region }		</div>
	</div>
	</div>


{END region_fieldblock}
											
{BEGIN province_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_province}  r-vertical-field" 
	data-signal-error-for="province{$id}" {$required_attr_province}
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field4" {$item_integrated_edit_field4}="" data-pageid="{$pageid}" data-field="province" data-fieldname="province" >

	<label class="r-edit-label control-label {$province_label_class}" for="{$labelfor_province}">
		{BEGIN province_label}
			{$province_forward_control}
			{$label augmentation_portal_request province }			{END province_label}
		<span class="icon-required"></span>
	</label>
	<div class="r-edit-field">
		{$province_editcontrol}	</div>
		<div class="r-edit-tooltip" data-helpfor="province" {$tooltipAttr augmentation_portal_request province } >
		<div class="text-muted" >
		{$tooltip augmentation_portal_request province }		</div>
	</div>
	</div>


{END province_fieldblock}
											
{BEGIN requesting_office_lgu_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_requesting_office_lgu}  r-vertical-field" 
	data-signal-error-for="requesting_office_lgu{$id}" {$required_attr_requesting_office_lgu}
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field5" {$item_integrated_edit_field5}="" data-pageid="{$pageid}" data-field="requesting_office_lgu" data-fieldname="requesting_office_lgu" >

	<label class="r-edit-label control-label {$requesting_office_lgu_label_class}" for="{$labelfor_requesting_office_lgu}">
		{BEGIN requesting_office_lgu_label}
			{$requesting_office_lgu_forward_control}
			{$label augmentation_portal_request requesting_office_lgu }			{END requesting_office_lgu_label}
		<span class="icon-required"></span>
	</label>
	<div class="r-edit-field">
		{$requesting_office_lgu_editcontrol}	</div>
		<div class="r-edit-tooltip" data-helpfor="requesting_office_lgu" {$tooltipAttr augmentation_portal_request requesting_office_lgu } >
		<div class="text-muted" >
		{$tooltip augmentation_portal_request requesting_office_lgu }		</div>
	</div>
	</div>


{END requesting_office_lgu_fieldblock}
											
{BEGIN disaster_type_id_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_disaster_type_id}  r-vertical-field" 
	data-signal-error-for="disaster_type_id{$id}" {$required_attr_disaster_type_id}
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field6" {$item_integrated_edit_field6}="" data-pageid="{$pageid}" data-field="disaster_type_id" data-fieldname="disaster_type_id" >

	<label class="r-edit-label control-label {$disaster_type_id_label_class}" for="{$labelfor_disaster_type_id}">
		{BEGIN disaster_type_id_label}
			{$disaster_type_id_forward_control}
			{$label augmentation_portal_request disaster_type_id }			{END disaster_type_id_label}
		<span class="icon-required"></span>
	</label>
	<div class="r-edit-field">
		{$disaster_type_id_editcontrol}	</div>
		<div class="r-edit-tooltip" data-helpfor="disaster_type_id" {$tooltipAttr augmentation_portal_request disaster_type_id } >
		<div class="text-muted" >
		{$tooltip augmentation_portal_request disaster_type_id }		</div>
	</div>
	</div>


{END disaster_type_id_fieldblock}
											
{BEGIN disaster_type_other_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_disaster_type_other}  r-vertical-field" 
	data-signal-error-for="disaster_type_other{$id}" {$required_attr_disaster_type_other}
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field7" {$item_integrated_edit_field7}="" data-pageid="{$pageid}" data-field="disaster_type_other" data-fieldname="disaster_type_other" >

	<label class="r-edit-label control-label {$disaster_type_other_label_class}" for="{$labelfor_disaster_type_other}">
		{BEGIN disaster_type_other_label}
			{$disaster_type_other_forward_control}
			{$label augmentation_portal_request disaster_type_other }			{END disaster_type_other_label}
		<span class="icon-required"></span>
	</label>
	<div class="r-edit-field">
		{$disaster_type_other_editcontrol}	</div>
		<div class="r-edit-tooltip" data-helpfor="disaster_type_other" {$tooltipAttr augmentation_portal_request disaster_type_other } >
		<div class="text-muted" >
		{$tooltip augmentation_portal_request disaster_type_other }		</div>
	</div>
	</div>


{END disaster_type_other_fieldblock}
											
{BEGIN purpose_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_purpose}  r-vertical-field" 
	data-signal-error-for="purpose{$id}" {$required_attr_purpose}
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field8" {$item_integrated_edit_field8}="" data-pageid="{$pageid}" data-field="purpose" data-fieldname="purpose" >

	<label class="r-edit-label control-label {$purpose_label_class}" for="{$labelfor_purpose}">
		{BEGIN purpose_label}
			{$purpose_forward_control}
			{$label augmentation_portal_request purpose }			{END purpose_label}
		<span class="icon-required"></span>
	</label>
	<div class="r-edit-field">
		{$purpose_editcontrol}	</div>
		<div class="r-edit-tooltip" data-helpfor="purpose" {$tooltipAttr augmentation_portal_request purpose } >
		<div class="text-muted" >
		{$tooltip augmentation_portal_request purpose }		</div>
	</div>
	</div>


{END purpose_fieldblock}
											
{BEGIN delivery_address_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_delivery_address}  r-vertical-field" 
	data-signal-error-for="delivery_address{$id}" {$required_attr_delivery_address}
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field9" {$item_integrated_edit_field9}="" data-pageid="{$pageid}" data-field="delivery_address" data-fieldname="delivery_address" >

	<label class="r-edit-label control-label {$delivery_address_label_class}" for="{$labelfor_delivery_address}">
		{BEGIN delivery_address_label}
			{$delivery_address_forward_control}
			{$label augmentation_portal_request delivery_address }			{END delivery_address_label}
		<span class="icon-required"></span>
	</label>
	<div class="r-edit-field">
		{$delivery_address_editcontrol}	</div>
		<div class="r-edit-tooltip" data-helpfor="delivery_address" {$tooltipAttr augmentation_portal_request delivery_address } >
		<div class="text-muted" >
		{$tooltip augmentation_portal_request delivery_address }		</div>
	</div>
	</div>


{END delivery_address_fieldblock}
											
{BEGIN contact_person_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_contact_person}  r-vertical-field" 
	data-signal-error-for="contact_person{$id}" {$required_attr_contact_person}
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field10" {$item_integrated_edit_field10}="" data-pageid="{$pageid}" data-field="contact_person" data-fieldname="contact_person" >

	<label class="r-edit-label control-label {$contact_person_label_class}" for="{$labelfor_contact_person}">
		{BEGIN contact_person_label}
			{$contact_person_forward_control}
			{$label augmentation_portal_request contact_person }			{END contact_person_label}
		<span class="icon-required"></span>
	</label>
	<div class="r-edit-field">
		{$contact_person_editcontrol}	</div>
		<div class="r-edit-tooltip" data-helpfor="contact_person" {$tooltipAttr augmentation_portal_request contact_person } >
		<div class="text-muted" >
		{$tooltip augmentation_portal_request contact_person }		</div>
	</div>
	</div>


{END contact_person_fieldblock}
											
{BEGIN contact_number_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_contact_number}  r-vertical-field" 
	data-signal-error-for="contact_number{$id}" {$required_attr_contact_number}
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field11" {$item_integrated_edit_field11}="" data-pageid="{$pageid}" data-field="contact_number" data-fieldname="contact_number" >

	<label class="r-edit-label control-label {$contact_number_label_class}" for="{$labelfor_contact_number}">
		{BEGIN contact_number_label}
			{$contact_number_forward_control}
			{$label augmentation_portal_request contact_number }			{END contact_number_label}
		<span class="icon-required"></span>
	</label>
	<div class="r-edit-field">
		{$contact_number_editcontrol}	</div>
		<div class="r-edit-tooltip" data-helpfor="contact_number" {$tooltipAttr augmentation_portal_request contact_number } >
		<div class="text-muted" >
		{$tooltip augmentation_portal_request contact_number }		</div>
	</div>
	</div>


{END contact_number_fieldblock}
											
{BEGIN status_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_status}  r-vertical-field" 
	data-signal-error-for="status{$id}" {$required_attr_status}
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field12" {$item_integrated_edit_field12}="" data-pageid="{$pageid}" data-field="status" data-fieldname="status" >

	<label class="r-edit-label control-label {$status_label_class}" for="{$labelfor_status}">
		{BEGIN status_label}
			{$status_forward_control}
			{$label augmentation_portal_request status }			{END status_label}
		<span class="icon-required"></span>
	</label>
	<div class="r-edit-field">
		{$status_editcontrol}	</div>
		<div class="r-edit-tooltip" data-helpfor="status" {$tooltipAttr augmentation_portal_request status } >
		<div class="text-muted" >
		{$tooltip augmentation_portal_request status }		</div>
	</div>
	</div>


{END status_fieldblock}
											
{BEGIN verified_by_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_verified_by}  r-vertical-field" 
	data-signal-error-for="verified_by{$id}" {$required_attr_verified_by}
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field13" {$item_integrated_edit_field13}="" data-pageid="{$pageid}" data-field="verified_by" data-fieldname="verified_by" >

	<label class="r-edit-label control-label {$verified_by_label_class}" for="{$labelfor_verified_by}">
		{BEGIN verified_by_label}
			{$verified_by_forward_control}
			{$label augmentation_portal_request verified_by }			{END verified_by_label}
		<span class="icon-required"></span>
	</label>
	<div class="r-edit-field">
		{$verified_by_editcontrol}	</div>
		<div class="r-edit-tooltip" data-helpfor="verified_by" {$tooltipAttr augmentation_portal_request verified_by } >
		<div class="text-muted" >
		{$tooltip augmentation_portal_request verified_by }		</div>
	</div>
	</div>


{END verified_by_fieldblock}
											
{BEGIN verified_at_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_verified_at}  r-vertical-field" 
	data-signal-error-for="verified_at{$id}" {$required_attr_verified_at}
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field14" {$item_integrated_edit_field14}="" data-pageid="{$pageid}" data-field="verified_at" data-fieldname="verified_at" >

	<label class="r-edit-label control-label {$verified_at_label_class}" for="{$labelfor_verified_at}">
		{BEGIN verified_at_label}
			{$verified_at_forward_control}
			{$label augmentation_portal_request verified_at }			{END verified_at_label}
		<span class="icon-required"></span>
	</label>
	<div class="r-edit-field">
		{$verified_at_editcontrol}	</div>
		<div class="r-edit-tooltip" data-helpfor="verified_at" {$tooltipAttr augmentation_portal_request verified_at } >
		<div class="text-muted" >
		{$tooltip augmentation_portal_request verified_at }		</div>
	</div>
	</div>


{END verified_at_fieldblock}
											
{BEGIN approved_by_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_approved_by}  r-vertical-field" 
	data-signal-error-for="approved_by{$id}" {$required_attr_approved_by}
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field15" {$item_integrated_edit_field15}="" data-pageid="{$pageid}" data-field="approved_by" data-fieldname="approved_by" >

	<label class="r-edit-label control-label {$approved_by_label_class}" for="{$labelfor_approved_by}">
		{BEGIN approved_by_label}
			{$approved_by_forward_control}
			{$label augmentation_portal_request approved_by }			{END approved_by_label}
		<span class="icon-required"></span>
	</label>
	<div class="r-edit-field">
		{$approved_by_editcontrol}	</div>
		<div class="r-edit-tooltip" data-helpfor="approved_by" {$tooltipAttr augmentation_portal_request approved_by } >
		<div class="text-muted" >
		{$tooltip augmentation_portal_request approved_by }		</div>
	</div>
	</div>


{END approved_by_fieldblock}
											
{BEGIN approved_at_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_approved_at}  r-vertical-field" 
	data-signal-error-for="approved_at{$id}" {$required_attr_approved_at}
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field16" {$item_integrated_edit_field16}="" data-pageid="{$pageid}" data-field="approved_at" data-fieldname="approved_at" >

	<label class="r-edit-label control-label {$approved_at_label_class}" for="{$labelfor_approved_at}">
		{BEGIN approved_at_label}
			{$approved_at_forward_control}
			{$label augmentation_portal_request approved_at }			{END approved_at_label}
		<span class="icon-required"></span>
	</label>
	<div class="r-edit-field">
		{$approved_at_editcontrol}	</div>
		<div class="r-edit-tooltip" data-helpfor="approved_at" {$tooltipAttr augmentation_portal_request approved_at } >
		<div class="text-muted" >
		{$tooltip augmentation_portal_request approved_at }		</div>
	</div>
	</div>


{END approved_at_fieldblock}
											
{BEGIN disapproved_by_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_disapproved_by}  r-vertical-field" 
	data-signal-error-for="disapproved_by{$id}" {$required_attr_disapproved_by}
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field17" {$item_integrated_edit_field17}="" data-pageid="{$pageid}" data-field="disapproved_by" data-fieldname="disapproved_by" >

	<label class="r-edit-label control-label {$disapproved_by_label_class}" for="{$labelfor_disapproved_by}">
		{BEGIN disapproved_by_label}
			{$disapproved_by_forward_control}
			{$label augmentation_portal_request disapproved_by }			{END disapproved_by_label}
		<span class="icon-required"></span>
	</label>
	<div class="r-edit-field">
		{$disapproved_by_editcontrol}	</div>
		<div class="r-edit-tooltip" data-helpfor="disapproved_by" {$tooltipAttr augmentation_portal_request disapproved_by } >
		<div class="text-muted" >
		{$tooltip augmentation_portal_request disapproved_by }		</div>
	</div>
	</div>


{END disapproved_by_fieldblock}
											
{BEGIN disapproved_at_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_disapproved_at}  r-vertical-field" 
	data-signal-error-for="disapproved_at{$id}" {$required_attr_disapproved_at}
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field18" {$item_integrated_edit_field18}="" data-pageid="{$pageid}" data-field="disapproved_at" data-fieldname="disapproved_at" >

	<label class="r-edit-label control-label {$disapproved_at_label_class}" for="{$labelfor_disapproved_at}">
		{BEGIN disapproved_at_label}
			{$disapproved_at_forward_control}
			{$label augmentation_portal_request disapproved_at }			{END disapproved_at_label}
		<span class="icon-required"></span>
	</label>
	<div class="r-edit-field">
		{$disapproved_at_editcontrol}	</div>
		<div class="r-edit-tooltip" data-helpfor="disapproved_at" {$tooltipAttr augmentation_portal_request disapproved_at } >
		<div class="text-muted" >
		{$tooltip augmentation_portal_request disapproved_at }		</div>
	</div>
	</div>


{END disapproved_at_fieldblock}
											
{BEGIN disapproval_reason_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_disapproval_reason}  r-vertical-field" 
	data-signal-error-for="disapproval_reason{$id}" {$required_attr_disapproval_reason}
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field19" {$item_integrated_edit_field19}="" data-pageid="{$pageid}" data-field="disapproval_reason" data-fieldname="disapproval_reason" >

	<label class="r-edit-label control-label {$disapproval_reason_label_class}" for="{$labelfor_disapproval_reason}">
		{BEGIN disapproval_reason_label}
			{$disapproval_reason_forward_control}
			{$label augmentation_portal_request disapproval_reason }			{END disapproval_reason_label}
		<span class="icon-required"></span>
	</label>
	<div class="r-edit-field">
		{$disapproval_reason_editcontrol}	</div>
		<div class="r-edit-tooltip" data-helpfor="disapproval_reason" {$tooltipAttr augmentation_portal_request disapproval_reason } >
		<div class="text-muted" >
		{$tooltip augmentation_portal_request disapproval_reason }		</div>
	</div>
	</div>


{END disapproval_reason_fieldblock}
											
{BEGIN imported_augmentation_request_id_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_imported_augmentation_request_id}  r-vertical-field" 
	data-signal-error-for="imported_augmentation_request_id{$id}" {$required_attr_imported_augmentation_request_id}
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field20" {$item_integrated_edit_field20}="" data-pageid="{$pageid}" data-field="imported_augmentation_request_id" data-fieldname="imported_augmentation_request_id" >

	<label class="r-edit-label control-label {$imported_augmentation_request_id_label_class}" for="{$labelfor_imported_augmentation_request_id}">
		{BEGIN imported_augmentation_request_id_label}
			{$imported_augmentation_request_id_forward_control}
			{$label augmentation_portal_request imported_augmentation_request_id }			{END imported_augmentation_request_id_label}
		<span class="icon-required"></span>
	</label>
	<div class="r-edit-field">
		{$imported_augmentation_request_id_editcontrol}	</div>
		<div class="r-edit-tooltip" data-helpfor="imported_augmentation_request_id" {$tooltipAttr augmentation_portal_request imported_augmentation_request_id } >
		<div class="text-muted" >
		{$tooltip augmentation_portal_request imported_augmentation_request_id }		</div>
	</div>
	</div>


{END imported_augmentation_request_id_fieldblock}
											
{BEGIN imported_at_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_imported_at}  r-vertical-field" 
	data-signal-error-for="imported_at{$id}" {$required_attr_imported_at}
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field21" {$item_integrated_edit_field21}="" data-pageid="{$pageid}" data-field="imported_at" data-fieldname="imported_at" >

	<label class="r-edit-label control-label {$imported_at_label_class}" for="{$labelfor_imported_at}">
		{BEGIN imported_at_label}
			{$imported_at_forward_control}
			{$label augmentation_portal_request imported_at }			{END imported_at_label}
		<span class="icon-required"></span>
	</label>
	<div class="r-edit-field">
		{$imported_at_editcontrol}	</div>
		<div class="r-edit-tooltip" data-helpfor="imported_at" {$tooltipAttr augmentation_portal_request imported_at } >
		<div class="text-muted" >
		{$tooltip augmentation_portal_request imported_at }		</div>
	</div>
	</div>


{END imported_at_fieldblock}
											
{BEGIN imported_by_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_imported_by}  r-vertical-field" 
	data-signal-error-for="imported_by{$id}" {$required_attr_imported_by}
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field22" {$item_integrated_edit_field22}="" data-pageid="{$pageid}" data-field="imported_by" data-fieldname="imported_by" >

	<label class="r-edit-label control-label {$imported_by_label_class}" for="{$labelfor_imported_by}">
		{BEGIN imported_by_label}
			{$imported_by_forward_control}
			{$label augmentation_portal_request imported_by }			{END imported_by_label}
		<span class="icon-required"></span>
	</label>
	<div class="r-edit-field">
		{$imported_by_editcontrol}	</div>
		<div class="r-edit-tooltip" data-helpfor="imported_by" {$tooltipAttr augmentation_portal_request imported_by } >
		<div class="text-muted" >
		{$tooltip augmentation_portal_request imported_by }		</div>
	</div>
	</div>


{END imported_by_fieldblock}
											
{BEGIN remarks_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_remarks}  r-vertical-field" 
	data-signal-error-for="remarks{$id}" {$required_attr_remarks}
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field23" {$item_integrated_edit_field23}="" data-pageid="{$pageid}" data-field="remarks" data-fieldname="remarks" >

	<label class="r-edit-label control-label {$remarks_label_class}" for="{$labelfor_remarks}">
		{BEGIN remarks_label}
			{$remarks_forward_control}
			{$label augmentation_portal_request remarks }			{END remarks_label}
		<span class="icon-required"></span>
	</label>
	<div class="r-edit-field">
		{$remarks_editcontrol}	</div>
		<div class="r-edit-tooltip" data-helpfor="remarks" {$tooltipAttr augmentation_portal_request remarks } >
		<div class="text-muted" >
		{$tooltip augmentation_portal_request remarks }		</div>
	</div>
	</div>


{END remarks_fieldblock}
											
{BEGIN created_at_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_created_at}  r-vertical-field" 
	data-signal-error-for="created_at{$id}" {$required_attr_created_at}
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field24" {$item_integrated_edit_field24}="" data-pageid="{$pageid}" data-field="created_at" data-fieldname="created_at" >

	<label class="r-edit-label control-label {$created_at_label_class}" for="{$labelfor_created_at}">
		{BEGIN created_at_label}
			{$created_at_forward_control}
			{$label augmentation_portal_request created_at }			{END created_at_label}
		<span class="icon-required"></span>
	</label>
	<div class="r-edit-field">
		{$created_at_editcontrol}	</div>
		<div class="r-edit-tooltip" data-helpfor="created_at" {$tooltipAttr augmentation_portal_request created_at } >
		<div class="text-muted" >
		{$tooltip augmentation_portal_request created_at }		</div>
	</div>
	</div>


{END created_at_fieldblock}
											
{BEGIN updated_at_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_updated_at}  r-vertical-field" 
	data-signal-error-for="updated_at{$id}" {$required_attr_updated_at}
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field25" {$item_integrated_edit_field25}="" data-pageid="{$pageid}" data-field="updated_at" data-fieldname="updated_at" >

	<label class="r-edit-label control-label {$updated_at_label_class}" for="{$labelfor_updated_at}">
		{BEGIN updated_at_label}
			{$updated_at_forward_control}
			{$label augmentation_portal_request updated_at }			{END updated_at_label}
		<span class="icon-required"></span>
	</label>
	<div class="r-edit-field">
		{$updated_at_editcontrol}	</div>
		<div class="r-edit-tooltip" data-helpfor="updated_at" {$tooltipAttr augmentation_portal_request updated_at } >
		<div class="text-muted" >
		{$tooltip augmentation_portal_request updated_at }		</div>
	</div>
	</div>


{END updated_at_fieldblock}
											
{BEGIN city_municipality_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_city_municipality}  r-vertical-field" 
	data-signal-error-for="city_municipality{$id}" {$required_attr_city_municipality}
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field26" {$item_integrated_edit_field26}="" data-pageid="{$pageid}" data-field="city_municipality" data-fieldname="city_municipality" >

	<label class="r-edit-label control-label {$city_municipality_label_class}" for="{$labelfor_city_municipality}">
		{BEGIN city_municipality_label}
			{$city_municipality_forward_control}
			{$label augmentation_portal_request city_municipality }			{END city_municipality_label}
		<span class="icon-required"></span>
	</label>
	<div class="r-edit-field">
		{$city_municipality_editcontrol}	</div>
		<div class="r-edit-tooltip" data-helpfor="city_municipality" {$tooltipAttr augmentation_portal_request city_municipality } >
		<div class="text-muted" >
		{$tooltip augmentation_portal_request city_municipality }		</div>
	</div>
	</div>


{END city_municipality_fieldblock}
											
{BEGIN barangay_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_barangay}  r-vertical-field" 
	data-signal-error-for="barangay{$id}" {$required_attr_barangay}
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field27" {$item_integrated_edit_field27}="" data-pageid="{$pageid}" data-field="barangay" data-fieldname="barangay" >

	<label class="r-edit-label control-label {$barangay_label_class}" for="{$labelfor_barangay}">
		{BEGIN barangay_label}
			{$barangay_forward_control}
			{$label augmentation_portal_request barangay }			{END barangay_label}
		<span class="icon-required"></span>
	</label>
	<div class="r-edit-field">
		{$barangay_editcontrol}	</div>
		<div class="r-edit-tooltip" data-helpfor="barangay" {$tooltipAttr augmentation_portal_request barangay } >
		<div class="text-muted" >
		{$tooltip augmentation_portal_request barangay }		</div>
	</div>
	</div>


{END barangay_fieldblock}
											
{BEGIN office_lgu_name_fieldblock}


<div class="r-integrated-field form-group clearfix {$fielddispclass_office_lgu_name}  r-vertical-field" 
	data-signal-error-for="office_lgu_name{$id}" {$required_attr_office_lgu_name}
	data-itemtype="integrated_edit_field" data-itemid="integrated_edit_field28" {$item_integrated_edit_field28}="" data-pageid="{$pageid}" data-field="office_lgu_name" data-fieldname="office_lgu_name" >

	<label class="r-edit-label control-label {$office_lgu_name_label_class}" for="{$labelfor_office_lgu_name}">
		{BEGIN office_lgu_name_label}
			{$office_lgu_name_forward_control}
			{$label augmentation_portal_request office_lgu_name }			{END office_lgu_name_label}
		<span class="icon-required"></span>
	</label>
	<div class="r-edit-field">
		{$office_lgu_name_editcontrol}	</div>
		<div class="r-edit-tooltip" data-helpfor="office_lgu_name" {$tooltipAttr augmentation_portal_request office_lgu_name } >
		<div class="text-muted" >
		{$tooltip augmentation_portal_request office_lgu_name }		</div>
	</div>
	</div>


{END office_lgu_name_fieldblock}
	
								</td>
			{END cellblock_grid_c3}
								</tr>
			</tbody></table>
{END grid_block}
									{BEGIN below-grid_block}
<div class="r-form" data-location="below-grid" id="form_below-grid_{$pageid}" data-makeup="small" {$form_below-grid} data-pageid="{$pageid}" data-page="augmentation_portal_request_edit"
		data-v-width="4"
	data-v-margin="1"
	
>		
	 
		<div class="row">
			 
				<div 
	data-cellId="below-grid_c1" data-pageid="{$pageid}"	{$cell_below-grid_c1}
	class="			col-md-6
	">
	 
		{BEGIN save_edit}
<span data-itemtype="edit_save" data-itemid="edit_save" {$item_edit_save}="" data-pageid="{$pageid}" data-small="" data-button-item>
	<a type="button" title="" class="btn btn-primary   
	" {$savebutton_attrs} >
							{mlang_message SAVE}			</a>
</span>
{END save_edit}
	 
		{BEGIN back_button}
<span data-itemtype="edit_back_list" data-itemid="edit_back_list" {$item_edit_back_list}="" data-pageid="{$pageid}" data-small="" data-button-item>
	<a type="button" title="" class="btn btn-default   
	" {$backbutton_attrs} >
							{mlang_message BACK_TO_LIST}			</a>
</span>
{END back_button}
	 
		{BEGIN close_button}
<span data-itemtype="edit_close" data-itemid="edit_close" {$item_edit_close}="" data-pageid="{$pageid}" data-small="" data-button-item>
	<a type="button" title="" class="btn btn-default   
	" {$closebutton_attrs} >
							{mlang_message CANCEL}			</a>
</span>
{END close_button}
	</div>			 
				<div 
	data-cellId="below-grid_c2" data-pageid="{$pageid}"	{$cell_below-grid_c2}
	class="r-align-right r-ori-vert			col-md-6
	">
	 
		<span data-itemtype="hamburger" data-itemid="hamburger" {$item_hamburger}="" data-pageid="{$pageid}" data-small="" data-button-item>
	<span class="dropdown dropup">
		<button type="button" title="" class="btn btn-default   dropdown-toggle" data-toggle="dropdown" aria-haspopup="true" aria-expanded="false">		
										<span class="glyphicon glyphicon-menu-hamburger"></span>
												<span class="caret"></span>
		</button>
		<ul class="dropdown-menu">
							{BEGIN reset_button}
	<li data-itemtype="edit_reset" data-itemid="edit_reset" {$item_edit_reset}="" data-pageid="{$pageid}" data-small="" >
				<a  {$resetbutton_attrs}  title="" >
				
		{mlang_message RESET}		
		</a>
	</li>
{END reset_button}
							{BEGIN view_page_button}
	<li data-itemtype="edit_view" data-itemid="edit_view" {$item_edit_view}="" data-pageid="{$pageid}" data-small="" >
				<a  href="augmentation_portal_request_view.php?{$editlink}" {$view_page_button_attrs}  title="" >
				
		{mlang_message VIEW}		
		</a>
	</li>
{END view_page_button}
					</ul>
	</span>
</span>
	</div>					</div>
	</div>		
{END below-grid_block}
			</div>
		{$footer}
	{END body}
	</body>
</html>
