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	<table  width="100%" align="center" cellpadding="10" cellspacing="10" border="0">
		<tr>
			<td>	
				<table bgcolor="#C6DEFF" align="center" cellpadding="10" cellspacing="10" width="70%" style="border-collapse:collapse;border:0px solid {TABLEBORDERCOLOR}" >
					<TR>
						<td colspan="2" bgcolor="#6594ED"  align="center" width="100%"><font color="white" style="class:headings;"><B>Select Multiple Location</B></font><br/>
						</td>
					</TR>
					<TR>
						<td align="left">&nbsp; Engineer</td>								
						<td><input type="text" style='width:200px;' class="texts" name="country" disabled="disabled"/></td>
					</tr>
					<tr>
						<td align="left">&nbsp; Constituency</td>
						<td><input type="text" style='width:200px;' class="texts" name="state" disabled="disabled"/></td>
					</tr>
					<tr>
						<td align="left">&nbsp;&nbsp;Division</td>
						<td><input type="text" style='width:200px;' class="texts" name="district" disabled="disabled"/></td>
					</tr>
					<tr>
						<td align="left">&nbsp;&nbsp;Sub-division</td>
						<td><input type="text" style='width:200px;' class="texts" name="district" disabled="disabled"/></td>
					</tr>
					<tr>
						<td align="left">&nbsp;&nbsp;Ward</td>
						<td><input type="text" style="width:200px" class="texts" name="zonal_engineer" disabled="disabled" /></td>
					</tr>	
					<tr>
						<td  align="left">&nbsp;&nbsp;AE</td>
						<td><input type="text" style="width:200px" class="texts" name="zonal_engineer" disabled="disabled" /></td>
					</tr>
					<tr>
						<td  align="left" colspan="1" >&nbsp;&nbsp;JE</td>
						<td><input type="text" style="width:200px" class="texts" name="zonal_engineer" disabled="disabled" /></td>
					</tr>
					<tr>
						<td  align="left" colspan="1" >&nbsp;&nbsp;EE</td>
						<td><input type="text" style="width:200px" class="texts" name="zonal_engineer" disabled="disabled" /></td>
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		</td>
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</table>

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