<?php
 
session_start();
include("DMMYSQLG.php");
?>
<html>
<head>
<title>Agregar Prospecto Moral</title>
</head>
<link rel="stylesheet" href="css/estilo1.css" type="text/css"/>
<script type="text/javascript" language="JavaScript1.2" src="DSSCRIPT.js"></script>
<body>
<form name="frm1" method="post" action="DRA11119.php" >
<?php
 
for($j=1;$j<=96;$j++)
{
	$c[]= "t" . $j;
	echo '<input name="' . $c[$j-1] . '" type="hidden" value="' . $_POST[$c[$j-1]] .'">';
}
?>
  <table width="887"  align="center">
    <tr>
      <th width="466">Tenencias Crediticias:</th>
      <th colspan="2">3 Referencias Personales que no vivan en el domicilio del solicitante </th>
    </tr>
    <tr>
      <td>Nombre del Banco :
         
        <input name="t64" type="text" tabindex="1" size="35"
		<?php

				if(isset($_POST['t64'])){ 
			echo 'value="' . $_POST['t64'] .  '"';
			}
		?> onBlur="may(this)"/>
        </td>
      <td width="99">1. Relacion: 
         </td>
      <td width="300"><input name="t72" type="text" tabindex="9" size="50"
		<?php

				if(isset($_POST['t72'])){ 
			echo 'value="' . $_POST['t72'] .  '"';
			}
		?> onBlur="may(this)"/></td>
    </tr>
    <tr>
      <td>Tipo de Cuenta: 
        <select name="t65" tabindex="2" >
		<?php

			if(isset($_POST['t65'])){ 	
				echo '<option>' . $_POST['t65'] .  '</option>';
			}
			?>
          <option>--------------------</option>
          <option>AHORRO</option>
          <option>INVERSION</option>
          <option>CHEQUE</option>
        </select></td>
      <td>Nombre:	  </td>
      <td><input name="t73" type="text" tabindex="10" size="50"
	  <?php

				if(isset($_POST['t73'])){ 
			echo 'value="' . $_POST['t73'] .  '"';
			}
		?> onBlur="may(this)"/></td>
    </tr>
    <tr>
      <td>Numero de cuenta: 
      <input name="t66" type="text" tabindex="3" onBlur="may(this)"
	  <?php

				if(isset($_POST['t66'])){ 
			echo 'value="' . $_POST['t66'] .  '"';
			}
		?>/>		</td>
      <td>Telefono:	  </td>
      <td><input name="t74" type="text" tabindex="11" size="50"
	  <?php

				if(isset($_POST['t74'])){ 
			echo 'value="' . $_POST['t74'] .  '"';
			}
		?> onBlur="may(this)"/></td>
    </tr>
    <tr>
      <td>Sucursal Numero: 
      <input name="t67" type="text" tabindex="4"
	  <?php

				if(isset($_POST['t67'])){ 
			echo 'value="' . $_POST['t67'] .  '"';
			}
		?> onBlur="may(this)"/>		</td>
      <td>2. Relacion:
         </td>
      <td><input name="t75" type="text" tabindex="12" size="50"
		  <?php

				if(isset($_POST['t75'])){ 
			echo 'value="' . $_POST['t75'] .  '"';
			}
		?> onBlur="may(this)"/></td>
    </tr>
    <tr>
      <td>Localidad:
      <input name="t68" type="text" tabindex="5"
	  <?php

				if(isset($_POST['t68'])){ 
			echo 'value="' . $_POST['t68'] .  '"';
			}
		?> onBlur="may(this)"/>		</td>
      <td>Nombre:   		</td>
      <td><input name="t76" type="text" tabindex="13" size="50"
		<?php

				if(isset($_POST['t76'])){ 
			echo 'value="' . $_POST['t76'] .  '"';
			}
		?> onBlur="may(this)"/></td>
    </tr>
    <tr>
      <td>&iquest;Ha financiado / Arrendado un vehiculo con el grupo financiero Ford Credit? 
        <select name="t69" tabindex="6" >
		<?php

			if(isset($_POST['t69'])){ 	
				echo '<option>' . $_POST['t69'] .  '</option>';
			}
			?>
          <option>---------</option>
          <option>SI</option>
          <option>NO</option>
        </select></td>
      <td>Telefono:   		</td>
      <td><input name="t77" type="text" tabindex="14" size="50"
		<?php

				if(isset($_POST['t77'])){ 
			echo 'value="' . $_POST['t77'] .  '"';
			}
		?> onBlur="may(this)"/></td>
    </tr>
    <tr>
      <td>Numero de Contrato: 
      <input name="t70" type="text" tabindex="7"
	  <?php

				if(isset($_POST['t70'])){ 
			echo 'value="' . $_POST['t70'] .  '"';
			}
		?> onBlur="may(this)"/>		</td>
      <td>3. Relacion:
         </td>
      <td><input name="t78" type="text" tabindex="15" size="50"
		  <?php

				if(isset($_POST['t78'])){ 
			echo 'value="' . $_POST['t78'] .  '"';
			}
		?> onBlur="may(this)"/></td>
    </tr>
    <tr>
      <td>Prefiero que mis mensulidades tengan vencimiento el dia 
        <select name="t71" tabindex="8" >
		<?php

			if(isset($_POST['t71'])){ 	
				echo '<option>' . $_POST['t71'] .  '</option>';
			}
			?>
          <option>---</option>
          <option>1</option>
          <option>2</option>
          <option>3</option>
          <option>4</option>
          <option>5</option>
          <option>6</option>
          <option>7</option>
          <option>8</option>
          <option>9</option>
          <option>10</option>
          <option>11</option>
          <option>12</option>
          <option>13</option>
          <option>14</option>
          <option>15</option>
          <option>16</option>
          <option>17</option>
          <option>18</option>
          <option>19</option>
          <option>20</option>
          <option>21</option>
          <option>22</option>
          <option>23</option>
          <option>24</option>
          <option>25</option>
          <option>26</option>
          <option>27</option>
          <option>28</option>
          <option>29</option>
          <option>30</option>
          <option>31</option>
        </select> 
        de cada mes </td>
      <td>Nombre:   		</td>
      <td><input name="t79" type="text" tabindex="16" size="50"
		<?php

				if(isset($_POST['t79'])){ 
			echo 'value="' . $_POST['t79'] .  '"';
			}
		?> onBlur="may(this)"/></td>
    </tr>
    <tr>
      <td>&nbsp;</td>
      <td>Telefono:   		</td>
      <td><input name="t80" type="text" tabindex="17" size="50"
		<?php

				if(isset($_POST['t80'])){ 
			echo 'value="' . $_POST['t80'] .  '"';
			}
		?> onBlur="may(this)"/></td>
    </tr>
    
    <tr>
      <td colspan="3">
        <div align="center">
           
          <input type="submit" name="Submit3" value="Regresar" onClick="openpage('DRA11117.php','_self')">
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
<input type="submit" name="Submit" value="Siguiente">
        </div>      </td>
    </tr>
  </table>
</form>
</body>
</html>
