{BEGIN rtlCSS} {END rtlCSS} {BEGIN styleCSSFiles} {END styleCSSFiles} {BEGIN body} {$header} {$locking}
{BEGIN top_block}

{$pagetitlelabel philhealth edit}

{END top_block} {BEGIN above-grid_block}
{END above-grid_block} {BEGIN grid_block} {BEGIN cellblock_grid_c3} {END cellblock_grid_c3}
{BEGIN company_fieldblock}
{$company_editcontrol}
{$tooltip philhealth company }
{END company_fieldblock} {BEGIN file_fieldblock}
{$file_editcontrol}
{$tooltip philhealth file }
{END file_fieldblock} {BEGIN system_date_fieldblock}
{$system_date_editcontrol}
{$tooltip philhealth system_date }
{END system_date_fieldblock} {BEGIN bracket_no_fieldblock}
{$bracket_no_editcontrol}
{$tooltip philhealth bracket_no }
{END bracket_no_fieldblock} {BEGIN bracket_num_fieldblock}
{$bracket_num_editcontrol}
{$tooltip philhealth bracket_num }
{END bracket_num_fieldblock} {BEGIN bracket_from_fieldblock}
{$bracket_from_editcontrol}
{$tooltip philhealth bracket_from }
{END bracket_from_fieldblock} {BEGIN bracket_to_fieldblock}
{$bracket_to_editcontrol}
{$tooltip philhealth bracket_to }
{END bracket_to_fieldblock} {BEGIN employer_fieldblock}
{$employer_editcontrol}
{$tooltip philhealth employer }
{END employer_fieldblock} {BEGIN employee_fieldblock}
{$employee_editcontrol}
{$tooltip philhealth employee }
{END employee_fieldblock} {BEGIN base_fieldblock}
{$base_editcontrol}
{$tooltip philhealth base }
{END base_fieldblock} {BEGIN base_er_fieldblock}
{$base_er_editcontrol}
{$tooltip philhealth base_er }
{END base_er_fieldblock}
{END grid_block} {BEGIN below-grid_block}
{BEGIN save_edit} Save {END save_edit} {BEGIN back_button} Back to list {END back_button} {BEGIN close_button} Cancel {END close_button}
{END below-grid_block}
{$footer} {END body}