        <table class="tbl-input">
        <tbody>

            <tr>
                <td style="width:200px;">Kode Outlet</td>
                <td>
                    <input type="text" id="outlet_code" class="input w-75"
                    name="outlet_code" value="<?php echo $outlet_code?>">
                </td>
            </tr>
            <tr>
                <td style="width:200px;">Nama Outlet</td>
                <td>
                    <input type="text" id="outlet_name" class="input w-75"
                    name="outlet_name" value="<?php echo $outlet_name ?>">
                </td>
            </tr>
            <tr>
                <td style="width:200px;">Alamat</td>
                <td> <textarea class="input w-75" name="outlet_addr"><?php echo $outlet_addr ?></textarea>
                </td>
            </tr>
            <tr>
                <td style="width:200px;">No Telp</td>
                <td>
                    <input type="text" id="outlet_phone" class="input w-75"
                    name="outlet_phone" value="<?php echo $outlet_phone ?>">
                </td>
            </tr>
            <tr>
            	<td colspan="2" class="tl">

	                <input type="button" class="btn btn-sm btn-success" 
                    value="<?php echo $act_desc?>"  onclick="valid_save('save')">
                    <input type="hidden" name="act" value="<?php echo $act?>">
                    <input type="hidden" name="autoid" id="autoid" value="<?php echo $autoid?>">
					<input type="button" class="btn btn-dark btn-sm" value="Back" onclick="dosubmit('index<?php echo $page_filter?>')">
                </td>
            </tr>
		</tbody>
		</table>