<div class="modal-content">
    <div class="modal-header">
        <h5 class="modal-title"><?php echo @$title ?></h5>
        <button type="button" class="close" data-dismiss="modal" aria-label="Close"><span aria-hidden="true">&times;</span></button>
    </div>
    <div class="modal-body">
        <div class="form-group row">
            <label class="col-sm-3 col-form-label">Kode Member</label>
            <div class="col-sm-9">
                <input type="text" class="form-control" id="kode" name="kode" value="<?php echo @$kode ?>" required>
            </div>
        </div>
        <div class="form-group row">
            <label class="col-sm-3 col-form-label">Nama Member</label>
            <div class="col-sm-9">
                <input type="text" class="form-control" id="member" name="member" value="<?php echo @$member ?>" required>
            </div>
        </div>
        <div class="form-group row">
            <label class="col-sm-3 col-form-label">Jenis Kelamin</label>
            <div class="col-sm-9">
                <div class="form-check">
                    <input class="form-check-input" type="radio" name="jekel" id="jekel" value="L" <?php if (@$jekel=='L') echo 'checked' ?> required>
                    <label class="form-check-label">Laki-Laki</label>
                </div>
                <div class="form-check">
                    <input class="form-check-input" type="radio" name="jekel" id="jekel" value="P" <?php if (@$jekel=='P') echo 'checked' ?> required>
                    <label class="form-check-label">Perempuan</label>
                </div>
            </div>
        </div>
        <div class="form-group row">
            <label class="col-sm-3 col-form-label">Tempat Lahir</label>
            <div class="col-sm-9">
                <input type="text" class="form-control" id="tempat" name="tempat" value="<?php echo @$tempat ?>">
            </div>
        </div>
        <div class="form-group row">
            <label class="col-sm-3 col-form-label">Tanggal Lahir</label>
            <div class="col-sm-3">
                <input type="date" class="form-control" id="tgl" name="tgl" value="<?php echo @$tgl ?>">
            </div>
        </div>
        <div class="form-group row">
            <label class="col-sm-3 col-form-label">Telepon/HP</label>
            <div class="col-sm-9">
                <input type="text" class="form-control" id="telepon" name="telepon" value="<?php echo @$telepon ?>" required>
            </div>
        </div>
        <div class="form-group row">
            <label class="col-sm-3 col-form-label">Email</label>
            <div class="col-sm-9">
                <input type="email" class="form-control" id="email" name="email" value="<?php echo @$email ?>">
            </div>
        </div>
        <div class="form-group row">
            <label class="col-sm-3 col-form-label">Alamat</label>
            <div class="col-sm-9">
                <textarea class="form-control" id="alamat" name="alamat"><?php echo @$alamat ?></textarea>
            </div>
        </div>
        <div class="form-group row">
            <label class="col-sm-3 col-form-label">Berlakukan Poin</label>
            <div class="col-sm-9">
                <div class="form-check">
                    <input class="form-check-input" type="radio" name="poin" id="poin" value="Y" <?php if (@$poin=='Y') echo 'checked' ?>>
                    <label class="form-check-label">Ya</label>
                </div>
                <div class="form-check">
                    <input class="form-check-input" type="radio" name="poin" id="poin" value="" <?php if (@$poin=='') echo 'checked' ?>>
                    <label class="form-check-label">Tidak</label>
                </div>
            </div>
        </div>
        <div class="form-group row">
            <label class="col-sm-3 col-form-label">Harga Jual yang Berlaku</label>
            <div class="col-sm-3">
                <select class="form-control" name="jual" id="jual">
                    <option value="1" <?php if (@$jual=='1') echo 'selected' ?>>Harga Jual 1</option>
                    <option value="2" <?php if (@$jual=='2') echo 'selected' ?>>Harga Jual 2</option>
                    <option value="3" <?php if (@$jual=='3') echo 'selected' ?>>Harga Jual 3</option>
                </select>
            </div>
        </div>
    </div>
    <input type="hidden" name="id" id="id" value="<?php echo @$kode ?>">
    <input type="hidden" name="aksi" id="aksi" value="<?php echo @$aksi ?>">
    <div class="modal-footer right-content-between">
        <button type="submit" class="btn bg-gradient-success"><i class="fa fa-save"></i> <?php echo @$aksi ?></button>
        <button type="button" class="btn bg-gradient-danger" data-dismiss="modal"><i class="fa fa-times"></i> Batal</button>
    </div>
</div>