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- <form action="javascript:void(0);" id="ProsesPengaturanVclaim" autocomplete="off">
- <div class="row mb-3 mt-3">
- <div class="col-md-4 mb-2">
- <label for="profile_pengaturan">Nama Pengaturan</label>
- </div>
- <div class="col-md-8 mb-2">
- <input type="text" name="profile_pengaturan" id="profile_pengaturan" class="form-control">
- </div>
- </div>
- <div class="row mb-3 mt-3">
- <div class="col-md-4 mb-2">
- <label for="url_api">Url Service</label>
- </div>
- <div class="col-md-8 mb-2">
- <input type="url" name="url_api" id="url_api" class="form-control">
- </div>
- </div>
- <div class="row mb-3 mt-3">
- <div class="col-md-4 mb-2">
- <label for="cons_id">Cons ID</label>
- </div>
- <div class="col-md-8 mb-2">
- <input type="text" name="cons_id" id="cons_id" class="form-control">
- </div>
- </div>
- <div class="row mb-3 mt-3">
- <div class="col-md-4 mb-2">
- <label for="user_key">User Key</label>
- </div>
- <div class="col-md-8 mb-2">
- <input type="text" name="user_key" id="user_key" class="form-control">
- </div>
- </div>
- <div class="row mb-3 mt-3">
- <div class="col-md-4 mb-2">
- <label for="secret_key">Secret Key</label>
- </div>
- <div class="col-md-8 mb-2">
- <input type="text" name="secret_key" id="secret_key" class="form-control">
- </div>
- </div>
- <div class="row mb-3 mt-3">
- <div class="col-md-4 mb-2">
- <label for="kode_ppk">Kode PPK</label>
- </div>
- <div class="col-md-8 mb-2">
- <input type="text" name="kode_ppk" id="kode_ppk" class="form-control">
- </div>
- </div>
- <div class="row mb-3 mt-3">
- <div class="col-md-4 mb-2">
- <label for="status">Status</label>
- </div>
- <div class="col-md-8 mb-2">
- <select name="status" id="status" class="form-control">
- <option value="">Pilihan</option>
- <option value="Active">Active</option>
- <option value="Non Active">Non Active</option>
- </select>
- </div>
- </div>
- </form>
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