<div class="form-group">
              <label for="tgl_perawatan" class="col-sm-3 control-label">Tanggal</label>
              <div class="col-sm-4">
                <input type="text" id="tgl_perawatan" name="tgl_perawatan" class="form-control tanggal" value="{?=date('Y-m-d')?}">
              </div>
              <label for="pnd" class="col-sm-2 control-label">Jam</label>
              <div class="col-sm-3">
                <input type="text" id="jam_reg" name="jam_reg" class="form-control jam" value="{?=