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Rev 4208 Rev 5387
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                <tr >
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                <tr >
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                    <td >IFSC Code: </td>
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                    <td >IFSC Code: </td>
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                    <td ><input type="text" name="ifscCode" class="required"/> </td>
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                    <td ><input type="text" name="ifscCode" class="required"/> </td>
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                </tr>
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                </tr>
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                <tr >
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                <tr >
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                    <td >Self Pickup: </td>
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                    <td ><input type="checkbox" name="selfPickup" checked="checked"/></td>
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                </tr>
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				<tr >
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                    <td >Amount: </td>
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                    <td >Amount: </td>
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                    <td ><input id="bulk-order-total-amount" type="text" readonly name="amount" value="0"/></td>
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                    <td ><input id="bulk-order-total-amount" type="text" readonly name="amount" value="0"/></td>
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                </tr>
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                </tr>
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                <tr ></tr>
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                <tr ></tr>
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                <tr ></tr>
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                <tr ></tr>