<select name="status" class="form-control"> <option>Accepted</option> <option>Pending</option> </select> </div> <!-- <div class="form-group"> <label>QTY Received</label> <input name='quantity_received' id='quantity_received' class="form-control" type="text" placeholder="" minlength="1" required=""> </div> --> <div class="form-group"> <label for="disabledSelect">Current time and Date</label> <input id="currentTimeDate" name="currentTimeDate" class="form-control" type="text" disabled="" placeholder=""> </div> </div> <?php echo $formelem->hidden(array('id' => 'delivery_report_id', 'name' => 'delivery_report_id', 'placeholder' => '', 'class' => '', 'value' => '')); ?> <div class="modal-footer"> <button type="button" class="btn btn-primary" data-dismiss="modal">Close</button> <?php echo $formelem->button(array('id' => 'btn-save', 'name' => 'btn-save', 'class' => 'btn btn-primary', 'value' => 'Save')); ?> </div> <?php echo $formelem->close(); ?> </div> </div> </div> <!-- /.modal -->