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<head>
<title>ใบขออนุญาตใช้รถยนต์กลาง</title>
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<?
$data = explode("-", $date);
$newdata2 = $data[2]."/".$data[1]."/".$data[0];
?>
<font color="#000000" font face="Angsana New"> </font></p>
<font color="#000000" font face="Angsana New"><table width="650" height="300" border="0" cellpadding="1" cellspacing="1">
<tr>
<td height="8" colspan="11"> <div align="center">
<p><strong><font color="#000000" size="6">ใบอนุญาตใช้รถยนต์ส่วนกลาง</font></strong></p>
</div></td>
<td width="40"><font size="4">เลขที่</font></td>
<td colspan="2"><div align="center"><font size="4"><? echo $no ; ?></font></div></td>
<td width="2"> </td>
<td width="14"> </td>
</tr>
<tr>
<td height="24" colspan="11"><div align="center"><font color="#000000" size="4"><strong><font size="4">โรงพยาบาลสัตหีบ
กม.10 สำนักงานสาธารณสุขจังหวัดชลบุรี</font><font face="Angsana New"></strong></font></div></td>
<td> </td>
<td colspan="2"> </td>
<td width="2"> </td>
<td width="14"> </td>
</tr>
<tr>
<td height="16" colspan="11"> <p align="center"><font color="#000000" size="4.5" face="Angsana New"><? echo $newdata2; ?>
</font></p></td>
<td height="16"><font size="4">เวลา</font></td>
<td width="61" height="16"><div align="center"><font color="#000000" size="4" face="Angsana New"><? echo $inputtime; ?></font></div></td>
<td width="15"><div align="center"><font color="#000000" size="4" face="Angsana New">น.</font></div></td>
<td width="2"> </td>
<td width="14"> </td>
</tr>
<tr>
<td height="26"><div align="left">
<p><font size="3">เรียน </font></p>
</div></td>
<td height="26" colspan="4"><font size="3">ผู้อำนวยการโรงพยาบาลสัตหีบกม.10
</font></td>
<td height="26"><font size="3"> </font></td>
<td width="5" height="26"><font size="3"> </font></td>
<td height="26"><font size="3"> </font></td>
<td height="26" colspan="6"><font size="3"> </font><font size="3"> </font><font size="3"> </font><font size="3"> </font><font size="3"> </font></td>
<td width="2"> </td>
<td width="14"> </td>
</tr>
<tr>
<td height="8"><font size="3">ข้าพเจ้า </font></td>
<td height="8" colspan="13"><font color="#000000" size="3" face="Angsana New"><? echo $name ?>
</font><font size="3"> </font><font size="3"> </font><font size="3"> </font><font size="3"> </font><font size="3"> </font><font size="3"> </font><font size="3"> </font><font size="3"> </font></td>
<td width="2"> </td>
<td width="14"> </td>
</tr>
<tr>
<td height="25" colspan="2"><font size="3">ขออนุญาตใช้รถยนต์ </font></td>
<td height="25" colspan="12"><font color="#000000" size="3" face="Angsana New"><? echo $target ; ?></font><font size="3"> </font><font size="3"> </font><font size="3"> </font><font size="3"> </font><font size="3"> </font><font size="3"> </font><font size="3"> </font><font size="3"> </font></td>
<td width="2"> </td>
<td width="14"> </td>
</tr>
<tr>
<td height="8"><font size="3" face="Angsana New">เพื่อ</font></td>
<td height="8" colspan="9"><font size="3" face="Angsana New"><? echo $reason ; ?></font><font size="3"> </font><font size="3"> </font><font size="3"> </font><font size="3"> </font><font size="3"> </font><font size="3"> </font></td>
<td width="35" height="8"><font size="3"> จำนวน</font></td>
<td height="8"><div align="center"><font size="3"><? echo $person ;?></font></div></td>
<td height="8" colspan="2"><div align="center"><font size="3"> </font></div>
<font size="3">คน</font></td>
<td width="2"> </td>
<td width="14"> </td>
</tr>
<tr>
<td height="16"><font size="3">ตั้งแต่วันที่<font color="#000000" face="Angsana New"></font></font></td>
<td width="74" height="16"><div align="center"><font size="3"><? echo $date1 ;?></font></div></td>
<td width="64" height="16"><div align="center"><font size="3">เวลา</font></div></td>
<td width="81"><div align="center"><font size="3"><? echo $time1 ;?><font color="#000000" face="Angsana New">
</font></font></div></td>
<td width="15"><font size="3"><font color="#000000" face="Angsana New">น.</font></font></td>
<td height="16" colspan="4"><font size="3"><font color="#000000" face="Angsana New" >
<div align="left">ถึงวันที่</div>
</font></td>
<td width="76" height="16"><div align="center"><font size="3"><? echo $date2 ;?></font></div></td>
<td height="16"><div align="left"><font size="3"> เวลา</font></div></td>
<td height="16"><div align="center"><font size="3"><? echo $time2 ;?></font></div></td>
<td height="16" colspan="2"><font size="3">น.</font></td>
<td width="2"> </td>
<td width="14"> </td>
</tr>
<tr>
<td height="16" colspan="5"><font size="3">รายชื่อผู้ร่วมใช้รถ</font><font size="3"> </font><font size="3"> </font></td>
<td height="16"><font size="3"> </font></td>
<td height="16"><font size="3"> </font></td>
<td height="16"><font size="3"> </font></td>
<td height="16" colspan="6"><font size="3"> </font><font size="3"> </font><font size="3"> </font><font size="3"> </font><font size="3"> </font></td>
<td width="2"> </td>
<td width="14"> </td>
</tr>
<tr>
<td height="8"><div align="right">
<p><font size="3">1.</font></p>
</div></td>
<td height="8" colspan="4"><font color="#000000" size="3" face="Angsana New"><? echo $u1 ;?></font></td>
<td height="8" colspan="4"><font size="3"><font color="#000000" face="Angsana New">
<div align="left">ลงชื่อ</div>
</font></td>
<td colspan="3"></td>
<td colspan="4"><font size="3">ผู้ขออนุญาต</font></td>
</tr>
<tr>
<td height="8"><font size="3">
<div align="right"> 2.</div>
</font></td>
<td height="8" colspan="4"><font size="3"><? echo $u2 ;?></font></td>
<td height="8"><font size="3"> </font></td>
<td height="8"><font size="3"> </font></td>
<td height="8" colspan="7"><font size="3"><font color="#000000" face="Angsana New">
<div align="center">( <? echo $name ?> )</div>
</font></td>
<td width="2"> </td>
<td width="14"> </td>
</tr>
<tr>
<td width="60" height="16"><font size="3">
<div align="right"> 3.</div>
</font></td>
<td colspan="4"><font color="#000000" size="3" face="Angsana New"><? echo $u3 ;?></font><font size="3"> </font><font size="3"> </font></td>
<td width="5" height="16"><div align="center"><font size="3"></font></div></td>
<td><font size="3"> </font></td>
<td><font size="3"> </font></td>
<td width="50"><div align="right"></div></td>
<td colspan="2"> </td>
<td><div align="right"></div></td>
<td colspan="2"><font size="3"> </font></td>
<td width="2"> </td>
<td width="14"> </td>
</tr>
<tr>
<td height="8"><font size="3">
<div align="right"> 4.</div>
</font></td>
<td height="8" colspan="4"><font color="#000000" size="3" face="Angsana New"><? echo $u4 ;?></font><font size="3"> </font><font size="3"> </font></td>
<td height="8" colspan="4"><font size="3">
<div align="left">ลงนาม</div>
</font></td>
<td colspan="3"><div align="center"></div></td>
<td colspan="4"><font size="3">ผู้มีอำนาจสั่งใช้รถ</font></td>
</tr>
<tr>
<td height="16"><font size="3">
<div align="right"> 5.</div>
</font></td>
<td height="16" colspan="4"><font size="3"><? echo $u5 ;?></font><font size="3"> </font><font size="3"> </font></td>
<td height="16"><font size="3"> </font></td>
<td height="16"><font size="3"> </font></td>
<td height="16" colspan="7"><font size="3">
<div align="center">( <? echo $nameboss ;?> )</div>
</font></td>
<td width="2"> </td>
<td width="14"> </td>
</tr>
<tr>
<td height="5"> </td>
<td height="5" colspan="4"> </td>
<td height="5"> </td>
<td height="5"> </td>
<td width="4" height="5"> </td>
<td height="5" colspan="6"> </td>
<td width="2"> </td>
<td width="14"> </td>
</tr>
<tr>
<td height="16"><div align="left"><font size="3"></font></div></td>
<td height="16" colspan="4"><font size="3"> </font></td>
<td height="16" colspan="4"><font size="3">
<div align="left"> ทะเบียนรถ</div>
</font></td>
<td height="16"><div align="center"><font size="3"><? echo $car_id ; ?></font></div></td>
<td height="16"><div align="center"><font color="#000000" size="3" face="Angsana New">พขร.</font></div></td>
<td height="16" colspan="5"><font size="3"><? echo $driver ; ?></font></td>
</tr>
<tr>
<td height="26" colspan="3"><font size="3"><font color="#000000" face="Angsana New">
<div align="left">วันที่ออกเดินทาง....................................</div>
</font></td>
<td height="26" colspan="4"><font size="3">เวลา<font color="#000000" face="Angsana New">.................................</font></font><font size="3"> </font><font size="3"> </font></td>
<td height="26" colspan="3"><font size="3">
<div align="left">วันที่กลับ............................</div>
</font></td>
<td height="26" colspan="6"><font size="3">
<div align="left">เวลา............................................</div>
</font></td>
</tr>
<tr>
<td height="16" colspan="8"><div align="left"><font size="3">เลขระยะทางก่อนออกเดินทาง...........................................................</font></div>
<td height="16" colspan="8"><p align="left"><font size="3">เลขระยะทางกลับมาถึง...............................................................</font></p></td>
</tr>
<tr>
<td height="4"><div align="center"></div></td>
<td height="4" colspan="4"> </td>
<td height="4"> </td>
<td height="4"> </td>
<td height="4"> </td>
<td height="4" colspan="6"> </td>
<td width="2"> </td>
<td width="14"> </td>
</tr>
<tr>
<td height="8"> </td>
<td height="8" colspan="4"> </td>
<td height="8"> </td>
<td height="8"> </td>
<td height="8"> </td>
<td height="8" colspan="6"> </td>
<td width="2"> </td>
<td width="14"> </td>
</tr>
<tr>
<td height="16"> </td>
<td height="16" colspan="4"> </td>
<td height="16"> </td>
<td height="16"> </td>
<td height="16"> </td>
<td height="16" colspan="6"><div align="center"></div>
<div align="left"></div></td>
<td width="2"> </td>
<td width="14"> </td>
</tr>
</table>
</font>
</body>
</html>