date('H:i:s')?}">
              </div>
            </div>
            <div class="form-group">
              <label for="" class="col-sm-3 control-label">Resep Non-Racik</label>
              <div class="col-sm-4">
                <input type="text" name="obat_eresep" class="form-control" placeholder="Nama obat/BHP" value="">
              </div>
              <label for="" class="col-sm-2 control-label">Racikan</label>
              <div class="col-sm-3">
                <input type="text" name="racikan_er