<div class="control-group"> <label class="control-label" for="typeahead"><b>Período</b> </label> <div class="controls"> <label style="margin-top: 5px;"><?php echo str_replace("-", "/", $medicao->getRefInicio()) . ' - ' . str_replace("-", "/", $medicao->getRefFim()); ?> </label> </div> </div> <div class="control-group"> <label class="control-label" for="selectError">Item</label> <div class="controls"> <select id="selectError" data-rel="chosen" name="item"> <?php $item_medicao->listarReembolso($medicao->getId()); ?> </select> </div> </div> <div class="control-group"> <label class="control-label" for="typeahead">Quantidade </label> <div class="controls"> <input type="number" step="0.001" min="0" class="span1 typeahead" id="typeahead" data-provide="typeahead" data-items="4" name="quantidade" value="0.000"> </div> </div> <div class="control-group"> <label class="control-label" for="typeahead">Valor </label>