<tr align="left" valign="top"> <td align="right" valign="middle" class="text"><?php echo getlang(452); ?> : </td> <td align="left" class="text"><input name="abbrege" type="text" class="formStyle" id="abbrege" /></td> </tr> <tr align="left" valign="top"> <td align="right" valign="middle" class="text"><?php echo getlang(169); ?> : </td> <td align="left" class="text"><select name="typebeneficiaire" id="typebeneficiaire" class="formStyle"> <option value="0"></option> <?php echo selectTypeBeneficiaire(); ?> </select> <span class="mandatory"> *</span></td> </tr> <tr align="left" valign="top"> <td align="right" valign="middle" class="text"><?php echo getlang(154); ?> : </td> <td align="left" class="text"><select name="province" class="formStyle" id="province"> <option value="0"></option> <?php echo selectProvince(); ?> </select>
?> abbrégé : </td> <td align="left" class="text"><input name="abbrege" type="text" class="formStyle" id="abbrege" value="<?php echo $abbrege; ?> " /></td> </tr> <tr align="left" valign="top"> <td align="right" valign="middle" class="text"><?php echo getlang(169); ?> : </td> <td align="left" class="text"><select name="typebeneficiaire" id="typebeneficiaire" class="formStyle"> <option value="0"></option> <?php echo selectTypeBeneficiaire($typebeneficiaire); ?> </select> <span class="mandatory"> *</span></td> </tr> <tr align="left" valign="top"> <td align="right" valign="middle" class="text">Province : </td> <td align="left" class="text"><select name="province" class="formStyle" id="province"> <option value="0"></option> <?php echo selectProvince($province); ?> </select> <span class="mandatory"> *</span></td> </tr> <tr align="left" valign="top">