{AJAXCONTENT}
<form method="POST" action="{PHP_SELF}?module={MODULE}&action={FORMACTION}" id="theform" name="theform" enctype="multipart/form-data">
	<table cellpadding="0" cellspacing="0" border="0" width="100%" height="500px"   align="center" bgcolor="#C6DEFF">
		<tr>
			<td>
				<table cellpadding="0" cellspacing="0" border="0" width="650px" height="400px" bgcolor="#FFFFFF" align="center">
					<tr bgcolor="#cccccc">
						<td	class="subhead" height="30px" colspan="4" align="center"><FONT  size="2" COLOR="#000099"><B>Dependent Details</B></FONT></td>
					</tr>
					<tr>
						<td colspan="4">
							<table id="refTable1" border="0" cellpadding="3" cellspacing="3" width="100%" >
								<tr>
									<td colspan="6"><B>Number of Dependants:<font color="red">*</font></b>
										<input type="text" name="noofdepedents" id="refv" class="texts" value="{NOOFDEPENDENTS}" style="width:50px" >
									</td>	
								</tr>	
								<tr>
									<td colspan="6" >
										<INPUT class="texts" type="button" value="Add Row" onclick="add('ref');" />
										<INPUT class="texts"  type="button" value="Delete Row" onclick="remove('ref');" /> 
									</td>
								</tr>
								<tr>
									<td colspan="1"class="sleft" >Relation Type</td>
									<td colspan="1"class="sleftn" ><select  class="texts" name="rtype" style="width:100px" value="{RELATIONTYPE}" >{RELATIONS}</select></td>
									<td colspan="1"class="sleft" >Relative Name</td>
									<td colspan="1" class="sleftn" ><input type="text" class="texts" name="rname" style="width:100px" value="{RELATIONNAME}"  /></td>
									<td colspan="1" class="sleft" >Date of Birth</td>
									<td colspan="1" class="sleftn"><input type="text" class="texts" name="dob" style="width:100px" value="{RELATIONSDOB}" id="datepicker" />
									</td>	
								</tr>	
								<tr id="ref1" style="display:none" >
									<td colspan="1"class="sleft" >Relation Type</td>
									<td colspan="1"class="sleftn" ><select  class="texts" name="rtype1" style="width:100px" value="{RELATIONTYPE1}" >{RELATIONS1}</select></td>
									<td colspan="1"class="sleft" >Relative Name</td>
									<td colspan="1" class="sleftn" ><input type="text" class="texts" name="rname1" style="width:100px" value="{RELATIONNAME1}" /></td>
									<td colspan="1" class="sleft" >Date of Birth</td>
									<td colspan="1" class="sleftn"><input type="text" class="texts" name="dob1" style="width:100px" value="{RELATIONSDOB1}" id="datepicker1" /></td>
								</tr>
								<tr id="ref2" style="display:none">
									<td colspan="1"class="sleft" >Relation Type</td>
									<td colspan="1"class="sleftn" ><select  class="texts" name="rtype2" style="width:100px" value="{RELATIONTYPE2}" >{RELATIONS2}</select></td>
									<td colspan="1"class="sleft" >Relative Name</td>
									<td colspan="1" class="sleftn" ><input type="text" class="texts" name="rname2" style="width:100px" value="{RELATIONNAME2}" /></td>
									<td colspan="1" class="sleft" >Date of Birth</td>
									<td colspan="1" class="sleftn"><input type="text" class="texts" name="dob2" style="width:100px" value="{RELATIONSDOB2}" id="datepicker2" /></td>
								</tr>
								<tr id="ref3" style="display:none">
									<td colspan="1"class="sleft" >Relation Type</td>
									<td colspan="1"class="sleftn" ><select  class="texts" name="rtype3" style="width:100px" value="{RELATIONTYPE3}" >{RELATIONS3}</select></td>
									<td colspan="1"class="sleft" >Relative Name</td>
									<td colspan="1" class="sleftn" ><input type="text" class="texts" name="rname3" style="width:100px" value="{RELATIONNAME3}" /></td>
									<td colspan="1" class="sleft" >Date of Birth</td>
									<td colspan="1" class="sleftn"><input type="text" class="texts" name="dob3" style="width:100px" value="{RELATIONSDOB3}" id="datepicker3"/>
									</td>
								</tr>	
								<tr id="ref4" style="display:none" >
									<td colspan="1"class="sleft" >Relation Type</td>
									<td colspan="1"class="sleftn" ><select  class="texts" name="rtype4" style="width:100px" value="{RELATIONTYPE4}" >{RELATIONS4}</select></td>
									<td colspan="1"class="sleft" >Relative Name</td>
									<td colspan="1" class="sleftn" ><input type="text" class="texts" name="rname4" style="width:100px" value="{RELATIONNAME4}" /></td>
									<td colspan="1" class="sleft" >Date of Birth</td>
									<td colspan="1" class="sleftn"><input type="text" class="texts" name="dob4" style="width:100px" value="{RELATIONSDOB4}"id="datepicker4" />
									</td>
								</tr>
								<tr id="ref5" style="display:none" >
									<td colspan="1"class="sleft" >Relation Type</td>
									<td colspan="1"class="sleftn" ><select  class="texts" name="rtype5" style="width:100px" value="{RELATIONTYPE5}" >{RELATIONS5}</select></td>
									<td colspan="1"class="sleft" >Relative Name</td>
									<td colspan="1" class="sleftn" ><input type="text" class="texts" name="rname5" style="width:100px" value="{RELATIONNAME5}" /></td>
									<td colspan="1" class="sleft" >Date of Birth</td>
									<td colspan="1" class="sleftn"><input type="text" class="texts" name="dob5" style="width:100px" value="{RELATIONSDOB5}" id="datepicker5"/>
									</td>	
								</tr>
								<tr id="ref6" style="display:none">
									<td colspan="1"class="sleft" >Relation Type</td>
									<td colspan="1"class="sleftn" ><select  class="texts" name="rtype6" style="width:100px" value="{RELATIONTYPE6}" >{RELATIONS6}</select></td>
									<td colspan="1"class="sleft" >Relative Name</td>
									<td colspan="1" class="sleftn" ><input type="text" class="texts" name="rname6" style="width:100px" value="{RELATIONNAME6}" /></td>
									<td colspan="1" class="sleft" >Date of Birth</td>
									<td colspan="1" class="sleftn"><input type="text" class="texts" name="dob6" style="width:100px" value="{RELATIONSDOB6}"id="datepicker6" />
									</td>
								</tr>
								<tr id="ref7" style="display:none">
									<td colspan="1"class="sleft" >Relation Type</td>
									<td colspan="1"class="sleftn" ><select  class="texts" name="rtype7" style="width:100px" value="{RELATIONTYPE7}" >{RELATIONS7}</select></td>
									<td colspan="1"class="sleft" >Relative Name</td>
									<td colspan="1" class="sleftn" ><input type="text" class="texts" name="rname7" style="width:100px" value="{RELATIONNAME7}" /></td>
									<td colspan="1" class="sleft" >Date of Birth</td>
									<td colspan="1" class="sleftn"><input type="text" class="texts" name="dob7" style="width:100px" value="{RELATIONSDOB7}" id="datepicker7" />
									</td>									
								</tr>
								<tr id="ref8" style="display:none">
									<td colspan="1"class="sleft" >Relation Type</td>
									<td colspan="1"class="sleftn" ><select  class="texts" name="rtype8" style="width:100px" value="{RELATIONTYPE8}" >{RELATIONS8}</select></td>
									<td colspan="1"class="sleft" >Relative Name</td>
									<td colspan="1" class="sleftn" ><input type="text" class="texts" name="rname8" style="width:100px" value="{RELATIONNAME8}" /></td>
									<td colspan="1" class="sleft" >Date of Birth</td>
									<td colspan="1" class="sleftn"><input type="text" class="texts" name="dob8" style="width:100px" value="{RELATIONSDOB8}" id="datepicker8" />
									</td>									
								</tr>
								<tr id="ref9" style="display:none">
									<td colspan="1"class="sleft" >Relation Type</td>
									<td colspan="1"class="sleftn" ><select  class="texts" name="rtype9" style="width:100px" value="{RELATIONTYPE9}" >{RELATIONS9}</select></td>
									<td colspan="1"class="sleft" >Relative Name</td>
									<td colspan="1" class="sleftn" ><input type="text" class="texts" name="rname9" style="width:100px" value="{RELATIONNAME9}" /></td>
									<td colspan="1" class="sleft" >Date of Birth</td>
									<td colspan="1" class="sleftn"><input type="text" class="texts" name="dob9" style="width:100px" value="{RELATIONSDOB9}" id="datepicker9" />
									</td>									
								</tr>
								<tr id="ref10" style="display:none">
									<td colspan="1"class="sleft" >Relation Type</td>
									<td colspan="1"class="sleftn" ><select  class="texts" name="rtype10" style="width:100px" value="{RELATIONTYPE10}" >{RELATIONS10}</select></td>
									<td colspan="1"class="sleft" >Relative Name</td>
									<td colspan="1" class="sleftn" ><input type="text" class="texts" name="rname10" style="width:100px" value="{RELATIONNAME10}" /></td>
									<td colspan="1" class="sleft" >Date of Birth</td>
									<td colspan="1" class="sleftn"><input type="text" class="texts" name="dob10" style="width:100px" value="{RELATIONSDOB10}" id="datepicker10" />
									</td>									
								</tr><input type="hidden" id="rc" name="ref"  value="0"/>
							</table>
						</td>
					</tr>	
					<tr>
						<td align="center" colspan="6">
							<input class="texts" type="submit" name="save" value="Submit" onclick="return formCheck(theform)"/>
						</td>
					</tr> 
				</table>
			</td>
		</tr>
	<input type="hidden" name="rcount" id="rcount" value="{RCOUNT}" /> 
	<input type="hidden" name="userdependencyinfo"  value="{USERDEPENDENCYINFO}" />		
	</table>
		</form>
<script>
	
function editrow(rvalue){		
		 //alert(rvalue);
		 var idref='ref';
		 for(var i=0;i<=rvalue;i++)
		 {
		 
		 
		 //alert(idref);
		 if(i==0)
		 {
		// document.getElementById(idref).style.display="block";
		 }
		 else
		 {
		 //alert(idref+i);
		 document.getElementById(idref+i).style.display="";
		 }
		 
		}
		document.getElementById('rc').value=rvalue;
	}

$(function() {
		$('#datepicker').datepicker({
			changeMonth: true,
			changeYear: true
		});
	});

	
$(function() {
		$('#datepicker1').datepicker({
			changeMonth: true,
			changeYear: true
		});
	});
$(function() {
		$('#datepicker2').datepicker({
			changeMonth: true,
			changeYear: true
		});
	});

	$(function() {
		$('#datepicker3').datepicker({
			changeMonth: true,
			changeYear: true
		});
	});
	
	$(function() {
		$('#datepicker4').datepicker({
			changeMonth: true,
			changeYear: true
		});
	});
	$(function() {
		$('#datepicker5').datepicker({
			changeMonth: true,
			changeYear: true
		});
	});
	
	$(function() {
		$('#datepicker6').datepicker({
			changeMonth: true,
			changeYear: true
		});
	});

	$(function() {
		$('#datepicker7').datepicker({
			changeMonth: true,
			changeYear: true
		});
	});
	
	$(function() {
		$('#datepicker8').datepicker({
			changeMonth: true,
			changeYear: true
		});
	});
	
	$(function() {
		$('#datepicker9').datepicker({
			changeMonth: true,
			changeYear: true
		});
	});
	
	$(function() {
		$('#datepicker10').datepicker({
			changeMonth: true,
			changeYear: true
		});
	});

function add(idname){
		
		
		
		var	loopval = "";
		
		

		loopval = document.theform.ref.value;

		if(loopval >= 0 && loopval < 20){
			document.theform.ref.value = ++loopval;
		}

		 var s = "";
		 for(var i=1;i<=loopval;i++){
			s = document.getElementById(idname+i);
			s.style.display = "";
		 }
			
	}
	function remove(idname){		
		 var	loopval = "";

		 if(idname == "ref")
			loopval = document.theform.ref.value;
		 else
			loopval = document.theform.cons.value;

			
		 if(loopval >=1 && loopval <=20){			
			var s = document.getElementById(idname+loopval);
			s.style.display = "none";
			if(idname == "ref")
				document.theform.ref.value = --loopval;
			else
				document.theform.cons.value = --loopval;
		}
	}

	
	/*function hide(idname){		
		 var s = "";
		 for(var i=1;i<=20;i++){
			s = document.getElementById(idname+i);
			s.style.display = "none";
		 }
	}*/

		window.onload= function() {
		var val=document.getElementById('rcount').value;
		editrow(val);
		//hide('ref');	
		
		
		
		<!-- IF MASTERFIELDCOUNT > "0" -->
			for(var i=1;i<={MASTERFIELDCOUNT};i++){
				add('ref');
			}
		<!-- ENDIF -->

	}

	
	
	
function loadTwo(iframe1URL,iframe2URL)
	{ 
		parent.viewframe.location.href=iframe1URL,
		parent.viewgraph.location.href=iframe2URL 
		} 
	
	
	
function checklength(nextfield,chars,currfield) {

  x= document.theform[currfield].value.length
  if (x == chars) {
    eval('document.theform.' + nextfield + '.focus();');
  }

}


	function formCheck(theform) {
	
		updatedepedencydetails();
		return false;
	}

</script>