<!-- Form Start -->
<div class="block">
    <div class="title lightTextShadow"><?php echo $this->lang->line('checkup_create'); ?></div>
    <br />   

    <div class="content">
        <?php echo form_open_multipart('checkup/admin_checkup/create_alert/', array('id' => 'checkup_new')) ?>
        <fieldset class="form boxStyle">                                
            <?php echo $this->template->flash_msg(); ?>                          

            <label for="chx_days" class="label">أيام التنبيه للمعاينات القادمة</label>
            <input id="checkup_name" class="textBox sml rnd5" name="chx_days" value="<?= set_value('chx_days',$alert->chx_days) ?>"  /> يوم
            <?php echo form_error('chx_days'); ?>
            <br />

            <div class="center">
                <input id="submit" type="reset" value="تفريغ الحقول" class="button sub inlineBlock rnd3 lightTextShadow" />
                <input id="submit" type="submit" value="أدخل" class="button sml inlineBlock rnd5 drkTextShadow" />
            </div>
        </fieldset>
        <?php echo form_close(); ?>
    </div>
</div>
