esep" class="form-control" placeholder="Nama racikan" value="">
              </div>
            </div>
          </div>
        </div>
      </div>
    </div>
    <div class="col-md-12">
      <div id="obat_eresep"></div>
      <div id="racikan_eresep"></div>
      <div id="obat_racikan"></div>
      <div class="panel panel-default">
        <div class="panel-body">
          <div class="form-horizontal">
            <div class="form-group">
              <label for="tgl_perawatan" class="col-sm-3 control-