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