m-2">
                    <input type="text" name="kandungan_eresep" class="form-control" value="" />
                  </div>
                </div>
              </div>
              <div class="form-group">
                <label for="" class="col-sm-3 control-label">Keterangan</label>
                <div class="col-sm-9">
                  <textarea name="keterangan_eresep" id="keterangan_eresep" rows="2" class="form-control"></textarea>
                </div>
              </div>
            </div>
  