<td align="right" width="45%"><span class="required">*</span> DID Number:</td>
<td align="left" width="55%"><input type="text" value="" name="didnumber" id="didnumber" maxlength="50" class="textfield"></td>
</tr>
<tr>
<td align="right" width="45%"><span class="required">*</span> Carrier Name:</td>
<td align="left">
<select name="carrierid" id="carrierid" class="textfield carrierid">
<?php echo show_carrier_select_box();?>
</select>
</td>
</tr>
<tr>
<td align="right" width="45%"><span class="required">*</span> Customer Name:</td>
<td align="left">
<select name="customerid" id="customerid" class="textfield customerid">
<?php echo customer_drop_down();?>
</select>
</td>
</tr>
<tr>
<td align="right" colspan="2"> </td>
</tr>
<tr>
<td align="center" colspan="2"><input border="0" id="submitadddidForm" type="image" src="<?php echo base_url();?>assets/images/btn-submit.png"></td>
</tr>
</tbody></table>
</form>
</td>
</tr>
<tr>
<td align="right" width="45%"><span class="required">*</span> DID Number:</td>
<td align="left" width="55%"><input type="text" value="<?php echo $did_number; ?>" name="didnumber" id="didnumber" maxlength="50" class="textfield"></td>
</tr>
<tr>
<td align="right" width="45%"><span class="required">*</span> Carrier Name:</td>
<td align="left">
<select name="carrierid" id="carrierid" class="textfield carrierid">
<?php echo show_carrier_select_box($carrier_id);?>
</select>
</td>
</tr>
<tr>
<td align="right" width="45%"><span class="required">*</span> Customer Name:</td>
<td align="left">
<select name="customerid" id="customerid" class="textfield customerid">
<?php echo customer_drop_down($customer_id);?>
</select>
</td>
</tr>
<tr>
<td align="right" colspan="2"> </td>
</tr>
<tr>
<td align="center" colspan="2"><input border="0" id="submitadddidForm" type="image" src="<?php echo base_url();?>assets/images/btn-submit.png"></td>
</tr>
</tbody></table>
</form>
</td>
</tr>
<tr>