<div class="row">
	<div class="col-12 bg-white py-5">

		<div class="row">
			<div class="col-4 mx-auto py-5 text-center">
				<img src="<?php echo base_url('assets/images/logo/salihin-logo.png'); ?>" class="img img-fluid">
				<h5 class="text-uppercase mt-3"><b><?php echo (!empty($submission_department))?$submission_department:''; ?> claim <?php echo (!empty($submission_month))?$submission_month:''; ?></b></h5>
			</div>
		</div>


		<div class="row">
			<div class="col-12 table-responsive mb-5">

				<table class="table table-bordered bg-white">
					<thead>
						<tr>
							<th rowspan="3">NO</th>
							<th rowspan="3">Name</th>
							<th rowspan="3">Overtime</th>
							<th colspan="3">Allowance</th>
							<th colspan="7">Other</th>
							<th colspan="6">Travelling, Lodging, Accomodation</th>
							<th colspan="2" rowspan="2">Entertainment / Refreshment</th>
							<th rowspan="3">Membership</th>
							<th rowspan="3">Total</th>
						</tr>
						<tr>
							<th rowspan="2">Mileage</th>
							<th rowspan="2">Meal All.</th>
							<th rowspan="2">Outstation All.</th>

							<th rowspan="2">SSM</th>
							<th rowspan="2">Oath</th>
							<th rowspan="2">Medical</th>
							<th rowspan="2">Dental/Optical</th>
							<th rowspan="2">Courier/Po Stage</th>
							<th rowspan="2">Printing Stationary</th>
							<th rowspan="2">Motor Vehicle</th>
							
							<th rowspan="2">Toll</th>
							<th rowspan="2">Petrol</th>
							<th rowspan="2">Parking</th>
							<th rowspan="2">Grab/Uber/LRT/KLIA Express</th>
							<th rowspan="2">Flight</th>
							<th rowspan="2">Hotel/Accomodation</th>
						</tr>
						<tr>
							<th>Staff</th>
							<th>Client</th>
						</tr>
						
					</thead>
					<tbody>
                        
                            
                            <tr>
                                <td>no</td>
                                <td>name</td>
                                <td>0.00</td>
                                <td>0.00</td>
                                <td>0.00</td>
                                <td>0.00</td>
                                <td>0.00</td>
                                <td>0.00</td>
                                <td>0.00</td>
                                <td>0.00</td>
                                <td>0.00</td>
                                <td>0.00</td>
                                <td>0.00</td>
                                <td>0.00</td>
                                <td>0.00</td>
                                <td>0.00</td>
                                <td>0.00</td>
                                <td>0.00</td>
                                <td>0.00</td>
                                <td>0.00</td>
                                <td>0.00</td>
                                <td>0.00</td>
                                <td>0.00</td>
                            </tr>

                       
                          

                    </tbody>
					<tfoot>
						<tr>
							<td class="text-right" colspan="2"><strong>TOTAL</strong></td>
							<td>0.00</td>
							<td>0.00</td>

							<td>0.00</td>
							<td>0.00</td>
							<td>0.00</td>
							<td>0.00</td>
							<td>0.00</td>
							<td>0.00</td>
							<td>0.00</td>
							<td>0.00</td>
							<td>0.00</td>
							<td>0.00</td>
							<td>0.00</td>
							<td>0.00</td>
							<td>0.00</td>
							<td>0.00</td>
							<td>0.00</td>
							<td>0.00</td>
							<td>0.00</td>
							<td>0.00</td>
							<td>0.00</td>
						</tr>
					</tfoot>
				</table>
			</div>
		</div>

		<div class="row">
			<div class="col-4">
				PREPARED BY : 
			</div>
			<div class="col-4">
				VERIFIED BY:
				<br>
				<br>
				<br>
				<br>
				<br>
				<br>
				SHAFIANA MOHAMED SALLEH
			</div>
			<div class="col-4">
				APPROVED BY:

			</div>
		</div>

	
	</div>
</div>