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Rev 25683 Rev 25759
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					   	<input placeholder="Title" id="title" name="title" type="text" value="" class="form-control input-sm">
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					   	<input placeholder="Title" id="title" name="title" type="text" value="" class="form-control input-sm">
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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>
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			<div class="col-lg-4">
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				<div class="row">
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				<div class="row">
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					<div class="col-lg-5 form-group">
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					<div class="col-lg-5 form-group">
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						<p class="bold-details">Message</p>
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						<p class="bold-details">Message</p>
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					</div>
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					</div>
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					<div class="col-lg-6 form-group">
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					<div class="col-lg-6 form-group">
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					   	<textarea rows="3" cols="90" placeholder="Message" id="message" name="message" type="text" value="" class="form-control input-sm"></textarea>
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					   	<textarea rows="3" cols="90" placeholder="Message" id="message" name="message" type="text" value="" class="form-control input-sm"></textarea>
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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>
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			<div class="col-lg-4">
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				<div class="row">
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				<div class="row">
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					<div class="col-lg-5 form-group">
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					<div class="col-lg-5 form-group">
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						<p class="bold-details">Type</p>
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						<p class="bold-details">Type</p>
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					</div>
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					</div>
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					<div class="col-lg-6 form-group">
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					<div class="col-lg-6 form-group">
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				<div class="row">
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				<div class="row">
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					<div class="col-lg-5 form-group">
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					<div class="col-lg-5 form-group">
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						<p class="bold-details">Url</p>
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						<p class="bold-details">Url</p>
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					</div>
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					</div>
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					<div class="col-lg-6 form-group">
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					<div class="col-lg-6 form-group">
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						<select class='form-control input-sm' id='selectedUrl' onchange="changeUrl()" >
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	                       <option selected disabled>Url</option>
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						   <option value='http://app.smartdukaan.com/pages/home/dashboard'>http://app.smartdukaan.com/pages/home/dashboard</option>
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						   <option value='http://app.smartdukaan.com/pages/home/notifications'>http://app.smartdukaan.com/pages/home/notifications</option>
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						   <option value='http://app.smartdukaan.com/pages/home/services'>http://app.smartdukaan.com/pages/home/services</option>
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						   <option value='http://app.smartdukaan.com/pages/home/recharge'>http://app.smartdukaan.com/pages/home/recharge</option>
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						   <option value='http://app.smartdukaan.com/pages/home/damageProtectioninfo'>http://app.smartdukaan.com/pages/home/damageProtectioninfo</option>
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						   <option value='other'>other</option>
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						</select>
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	                   <br>
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					   	<input placeholder="Url" id="url" name="url" type="text" value="" class="form-control input-sm">
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					   	<input placeholder="Url" id="url" name="url" type="text" value="" class="form-control input-sm">
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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="row">
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				 <div class="row">
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				<div class="col-lg-5 form-group">
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				<div class="col-lg-5 form-group">
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					<p class="bold-details">DOCUMENT</p>
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					<p class="bold-details">DOCUMENT</p>
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				</div>
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				</div>
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				<div class="col-lg-6 form-group">
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				<div class="col-lg-6 form-group">
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					<label class="btn btn-file">
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					<label class="btn btn-file">
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						Browse<input type="file" id="notifyDocument" name="notifyDocument"  style="display:none">
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						Browse<input type="file" id="notifyDocument" name="notifyDocument"  style="display:none">
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					</label>
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					</label>
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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>
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                <div class="col-lg-4">
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					<div class="row">
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				<div class="row">
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					<div class="col-lg-5 form-group">
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					<div class="col-lg-5 form-group">
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						<p class="bold-details">Image Url</p>
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						<p class="bold-details">Image Url</p>
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					</div>
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					</div>
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					<div class="col-lg-6 form-group">
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					<div class="col-lg-6 form-group">
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					   	<input placeholder="Image Url" id="imageUrl" name="imageUrl" type="text" value="" class="form-control input-sm">
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					   	<input placeholder="Image Url" id="imageUrl" name="imageUrl" type="text" value="" class="form-control input-sm">
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					<div class="col-lg-5 form-group">
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					<div class="col-lg-5 form-group">
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					 <input style="zoom:1.3;" type="checkbox" name="showImage"  id = "showImage" value="false">
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					 <input style="zoom:1.3;" type="checkbox" name="showImage"  id = "showImage" value="false">
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					 <span style="font-size:14px;" class="bold-details">Show Image</span>
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					 <span style="font-size:14px;" class="bold-details">Show Image</span>
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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>
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             <div class="col-lg-4">
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			  <div class="row">
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			  <div class="row">
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					<div class="col-lg-5 form-group">
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					<div class="col-lg-5 form-group">
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						<p class="bold-details">Expiresat</p>
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						<p class="bold-details">Expiresat</p>
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					</div>
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					</div>