   <button type="button" class="btn btn-primary" data-dismiss="modal">Tutup</button>
</div>

<script type="text/javascript">
  $('select').selectator();
</script>
<script type="text/javascript">
$(document).ready(function(){
  $(".simpan").click(function(){
    var baseURL = mlite.url + '/' + mlite.admin;
    var id_pasien = $('input:text[name=no_rkm_medis]').val();
    var gg_xx = $('select[name=gg_xx]').val();
    var kondisi = $('select[name=kondisi]').val();
    var catatan = $('textarea[name=catatan]')