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Rev 28360 Rev 28361
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			</select>
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			</select>
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		</div>
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		</div>
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		<div class="col-lg-2 form-group">
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		<div class="col-lg-2 form-group">
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			<div class="input-group">
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			<div class="input-group">
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				<input type="date" class="form-control order-date" value=" " />
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				<input type="date" class="form-control order-date" value="$date" />
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			</div>
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			</div>
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		</div>
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		</div>
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		<div class="col-lg-2  form-group">
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		<div class="col-lg-2  form-group">
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			<div class="input-group">
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			<div class="input-group">