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January 28, 2013 03:44
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<meta charset="utf-8" /> | |
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<meta name="viewport" content="width=device-width" /> | |
<title>Replace Modul Request</title> | |
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<h1><img src="huawei.png" class="inline"/></h1> | |
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<div class="nine columns"> | |
<ul class="nav-bar right"> | |
<li><a href="#">Home</a></li> | |
<li><a href="#">About</a></li> | |
<li><a href="#">Help</a></li> | |
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<!-- Main Page --> | |
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<span> | |
<a href="#print" > | |
<img src="icon_print.gif" title="Print this Page" /> Print This Page | |
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</div> | |
<h4>REPLACE MODULE REQUEST</h4><br /> | |
<div class="row"> | |
<div class="four columns"> | |
<label class="inline">RMR reference number</label> | |
</div> | |
<div class="seven columns"> | |
<input type="text" disabled placeholder="121203-948-24" class="five"/> | |
</div> | |
</div> | |
<hr /> | |
<p><strong>Requested Module : JA10Bi</strong></p> | |
<p>Please provide the following Module(s) within contracted MTTR:</p> | |
<table class="twelve"> | |
<thead> | |
<tr> | |
<th class="inline">Nr.</th> | |
<th>Type</th> | |
<th>Name</th> | |
<th>HW code/ID</th> | |
<th class="inline">QTY</th> | |
<th>Site/Remaks</th> | |
</tr> | |
</thead> | |
<tbody> | |
<tr> | |
<td class="inline right">1</td> | |
<td>3065</td> | |
<td>PSC6-A</td> | |
<td>C08953.B3B</td> | |
<td>1</td> | |
<td>MBULIANHC</td> | |
</tr> | |
<tr> | |
<td class="inline right">2</td> | |
<td>3065</td> | |
<td>SWCOP-A</td> | |
<td>C08953.B3B</td> | |
<td>1</td> | |
<td>MBULIANHC</td> | |
</tr> | |
<tr> | |
<td class="inline right">3</td> | |
<td>3065</td> | |
<td>ESB26</td> | |
<td>C108885C.01</td> | |
<td>1</td> | |
<td>MBULIANHC</td> | |
</tr> | |
</tbody> | |
</table> | |
<hr /> | |
<p><strong>Delivery Address : JA10Bi</strong></p> | |
<p>Please deliver the Module(s) to the following address for area: ____________________</p> | |
<table class="twelve"> | |
<thead> | |
<tr> | |
<th>NSN Office</th> | |
<th>Address</th></th> | |
<th>Region</th> | |
<th>Requested by</th> | |
<th>Phone</th> | |
<th>Fax</th> | |
</tr> | |
</thead> | |
<tbody> | |
<tr> | |
<td>Robby.FH</td> | |
<td>Jl. Moh. Toha No.3</td> | |
<td>2</td> | |
<td>Eza</td> | |
<td></td> | |
<td></td> | |
</tr> | |
</tbody> | |
</table> | |
<hr /> | |
<div class="row"> | |
<div class="three columns"> | |
<p><strong>Date and Time : </strong></p> | |
</div> | |
<div class="two columns"> | |
<label class="inline"><input type="checkbox" id="checkbox1"> WIB</label> | |
</div> | |
<div class="two columns"> | |
<label class="inline"><input type="checkbox" id="checkbox2"> WITA</label> | |
</div> | |
<div class="five columns"> | |
<label class="inline"><input type="checkbox" id="checkbox3"> WIT</label> | |
</div> | |
</div> | |
<table class="twelve"> | |
<thead> | |
<tr> | |
<th colspan="5">Initial Request (NSN)</th> | |
<th colspan="5">Request Received (CC)</th> | |
</tr> | |
<tr> | |
<th colspan="3">Date</th> | |
<th class="inline">Time</th> | |
<th>Reference</th> | |
<th colspan="3">Date</th> | |
<th class="inline">Time</th> | |
<th>Call Centre Officer</th> | |
</tr> | |
</thead> | |
<tbody> | |
<tr> | |
<td class="inline">01</td> | |
<td class="inline">01</td> | |
<td class="inline">01</td> | |
<td>3065</td> | |
<td>PSC6-A</td> | |
<td class="inline">01</td> | |
<td class="inline">01</td> | |
<td class="inline">01</td> | |
<td>3065</td> | |
<td>PSC6-A</td> | |
</tr> | |
<tr> | |
<td class="inline">01</td> | |
<td class="inline">01</td> | |
<td class="inline">01</td> | |
<td>3065</td> | |
<td>PSC6-A</td> | |
<td class="inline">01</td> | |
<td class="inline">01</td> | |
<td class="inline">01</td> | |
<td>3065</td> | |
<td>PSC6-A</td> | |
</tr> | |
</tbody> | |
</table> | |
<hr /> | |
<div class="row"> | |
<div class="three columns"> | |
<p><strong>Request type : </strong></p> | |
</div> | |
<div class="two columns"> | |
<label class="inline"><input type="checkbox" id="checkbox1"> Fax</label> | |
</div> | |
<div class="seven columns"> | |
<label class="inline"><input type="checkbox" id="checkbox2"> Mail</label> | |
</div> | |
</div> | |
<hr /> | |
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<p>© Copyright 2013 Sparelog.</p> | |
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<li><a href="#">About</a></li> | |
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