'facilityrequest', 'id' => 'form-facilityrequest', 'method' => 'POST')); ?>

'150px')); ?>

Please Fill this form properly and submit to UNHLS as per the NMS Distribution Schedule

'col-sm-2')); ?> 'form-control col-sm-4')); ?> has('facility_id')): ?> first('facility_id'); ?>

'col-sm-2')); ?> 'form-control col-sm-4')); ?> 'col-sm-2')); ?> 'form-control col-sm-4')); ?>

'col-sm-2')); ?> 'form-control standard-datepicker-nofuture','required'=>'required','id'=>'start_date')); ?> 'col-sm-2')); ?> 'form-control standard-datepicker-nofuture','required'=>'required','id'=>'_date')); ?>

'col-sm-2 ')); ?> name,array('class' => 'form-control col-sm-4', 'readonly')); ?> 'col-sm-2 ')); ?> 'form-control standard-datepicker-nofuture','required'=>'required','id'=>'expiry_date')); ?>

'col-sm-2 ')); ?> 'form-control col-sm-4')); ?>

Item/Commodity	UoM	Total Number of Samples (Collected during the reporting period)	Opening Balance at start of opening cycle	Qty Received during the reporting period	Total Consumption during the reporting period	Losses / Adjustments (-/+)	Total Closing Balance	Maximum Stock Quantity Required	Quantity To Order	Comments

".trans('messages.save'), array('class' => 'btn btn-primary', 'onclick' => 'submit()')); ?>