Mohon Bantuannya.... Data Tidak Tersimpan Ke Database
Muhammad · Dec 11, 2015
Hai Semua....
Saya Baru Belajar PHP dan mendapatkan LKP di kampus mengenai PHP....
Setelah saya buat tampilan dan koneksi ternyata data yang diinput tidak masuk ke database, hanya tampil halaman blank..... saat dibuka databasenya tidak ada data yang baru yang masuk
Mohon Bantuannya....
Berikut Codingnya.....
Ini Tabelnya
CREATE TABLE IF NOT EXISTS `dtalumni` (
“no_urut†int (4) NOT NULL AUTO_INCREMENT,
“jurusan†varchar (35) NOT NULL,
“n_ija3†varchar (20) NOT NULL,
“n_reg3†varchar(35) NOT NULL,
“t_yud3†varchar (25) NOT NULL,
“n_ipk3†varchar (4) NOT NULL,
“lulus3†varchar (25) NOT NULL,
“prodi3†varchar (25) NOT NULL,
“n_ija4†varchar (20) NOT NULL,
“n_reg4†varchar (35) NOT NULL,
“t_yud4†varchar (25) NOT NULL,
“n_ipk4†varchar (4) NOT NULL,
“lulus4†varchar (25) NOT NULL,
“prodi4†varchar (25) NOT NULL,
“nama†varchar (35) NOT NULL,
“kerja†varchar (35) NOT NULL,
“ttl_nya†varchar (35) NOT NULL,
“nip_nya†varchar (25) NOT NULL,
“alamat†varchar (50) NOT NULL,
“inst_nya†varchar (50) NOT NULL,
“hand_nya†varchar (15) NOT NULL,
“a_inst†varchar (50) NOT NULL,
“kelamin†varchar (15) NOT NULL,
“t_kerja†varchar (4) NOT NULL,
“kr_pes†varchar (35) NOT NULL,
Primary Key (“n_ija3â€));
Ini file koneksi.php
<?php
$host = "localhost";
$user = "root";
$password = "";
$database_name = "alumni";
mysql_connect($host, $user, $password);
mysql_select_db($alumni);
?>
Ini file input.php
<?php
include"koneksi.php";
$no_urut=strip_tags(@$_POST);
$jurusan=strip_tags(@$_POST);
$n_ija3=strip_tags(@$_POST);
$n_reg3=strip_tags(@$_POST);
$t_yud3=strip_tags(@$_POST);
$n_ipk3=strip_tags(@$_POST);
$lulus3=strip_tags(@$_POST);
$prodi3=strip_tags(@$_POST);
$n_ija4=strip_tags(@$_POST);
$n_reg4=strip_tags(@$_POST);
$t_yud4=strip_tags(@$_POST);
$n_ipk4=strip_tags(@$_POST);
$lulus4=strip_tags(@$_POST);
$prodi4=strip_tags(@$_POST);
$nama=strip_tags(@$_POST);
$kerja=strip_tags(@$_POST);
$ttl_nya=strip_tags(@$_POST);
$nip_nya=strip_tags(@$_POST);
$alamat=strip_tags(@$_POST);
$inst_nya=strip_tags(@$_POST);
$hand_nya=strip_tags(@$_POST);
$a_ inst=strip_tags(@$_POST);
$kelamin=strip_tags(@$_POST);
$t_kerja=strip_tags(@$_POST);
$kr_pes=strip_tags(@$_POST);
mysql_query("Insert Into dtalumni(no_urut,jurusan,n_ija3,n_reg3,t_yud3,n_ipk3,lulus3,prodi3,n_ija4,n_reg4,t_yud4,n_ipk4,lulus4,prodi4,nama,kerja,ttl_nya,nip_nya,alamat,inst_nya,hand_nya,a_ inst,kelamin,t_kerja,kr_pes)values('', '$jurusan’ , '$n_ija3’, '$ n_reg3’, '$t_yud3’, '$n_ipk3’, '$lulus3’, '$prodi3’, '$n_ija4’, '$n_reg4’, '$t_yud4’, '$n_ipk4’, '$lulus4’, '$prodi4’, '$nama’, '$kerja’, '$ttl_nya’, '$nip_nya’, '$alamat’, '$inst_nya’, '$hand_nya’, '$a_ inst’, '$kelamin’, '$t_kerja’, '$kr_pes’)")or die(mysql_error());
?>
Ini ini file entry_data.php
<html>
<head>
<title>Data Alumni</title>
<style type="text/css">
.labelfrm{
display:block;
font-size:small;
margin-top:5px;
}
.error{
font-size:small;
color:red;
}
</style>
</head>
<body>
<form name="input_data" action="input.php" method="post" id="frm">
<table border="0" bordercolor="black" bgcolor="" cellpadding="0" cellspacing="0" width="100%">
<tr>
<th Colspan="0" align="left"></th>
</tr>
</table>
<marquee direction="left" scrollamount="10" align="center"><font size="6" color="blue"><b>SELAMAT DATANG DI APLIKASI PENDATAAN ALUMNI</b></font></marquee>
<table>
<tr>
<td><b>A. DATA AKADEMIK</b></td>
</tr>
</table>
<table border="0" bordercolor="black" bgcolor="" cellpadding="4" cellspacing="0" width="100%">
<tr>
<td width="1%">1.</td>
<td width="15%"><label for="jurusan" class="labelfrm">Jurusan</label></td>
<td width="1%">:</td>
<td width="10%"><select name="jurusan" id="jurusan" class="required">
<option value="Keperawatan">Keperawatan</option>
<option value="Kebidanan">Kebidanan</option>
<option value="Keperawatan Gigi">Keperawatan Gigi</option>
<option value="Kesehatan Lingkungan">Kesehatan Lingkungan</option>
<option value="Gizi">Gizi</option>
<option value="Farmasi">Farmasi</option></td>
<td width="68%"></td>
</tr>
</table>
<table border="0" bordercolor="black" bgcolor="silver" cellpadding="4" cellspacing="0" width="100%">
<tr>
<td></td>
</tr>
<tr>
<td width="1%">2.</td>
<td width="15%"><label for="n_ija3" class="labelfrm">Nomor Ijazah Diploma 3</label></td>
<td width="1%">:</td>
<td width="10%"><input type="text" name="n_ija3" id="n_ija3" maxlength="20" class="required" size="15"/></td>
<td width="1%"></td>
<td width="19%"><label for="n_ija4" class="labelfrm">Nomor Ijazah Diploma 4</label></td>
<td width="1%">:</td>
<td width="15%"><input type="text" name="n_ija4" id="n_ija4" maxlength="20" class="required" size="15"/></td>
</tr>
<tr>
<td width="1%">3.</td>
<td width="15%"><label for="n_reg3" class="labelfrm">Nomor Registrasi Ijazah Diploma 3</label></td>
<td width="1%">:</td>
<td width="10%"><input type="text" name="n_reg3" id="n_reg3" maxlength="35" class="required" size="20"/></td>
<td width="1%"></td>
<td width="19%"><label for="n_reg4" class="labelfrm">Nomor Registrasi Ijazah Diploma 4</label></td>
<td width="1%">:</td>
<td width="15%"><input type="text" name="n_reg4" id="n_reg4" maxlength="25" class="required" size="20"/></td>
</tr>
<tr>
<td width="1%">4.</td>
<td width="15%"><label for="t_yud3" class="labelfrm">Tanggal Yudisium Diploma 3</label></td>
<td width="1%">:</td>
<td width="10%"><input type="text" name="t_yud3" id="t_yud3" maxlength="25" class="required" /></td>
<td width="1%"></td>
<td width="19%"><label for="t_yud4" class="labelfrm">Tanggal Yudisium Diploma 4</label></td>
<td width="1%">:</td>
<td width="15%"><input type="text" name="t_yud4" id="t_yud4" maxlength="25" class="required" /></td>
</tr>
<tr>
<td width="1%">5.</td>
<td width="15%"><label for="n_ipk3" class="labelfrm">Indeks Prestasi Kumulatif Diploma 3</label></td>
<td width="1%">:</td>
<td width="10%"><input type="text" name="n_ipk3" id="n_ipk3" maxlength="4" class="required" size="5"/></td>
<td width="1%"></td>
<td width="19%"><label for="n_ipk4" class="labelfrm">Indeks Prestasi Kumulatif Diploma 4</label></td>
<td width="1%">:</td>
<td width="15%"><input type="text" name="n_ipk4" id="n_ipk4" maxlength="4" class="required" size="5"/></td>
</tr>
<tr>
<td width="1%">6.</td>
<td width="15%"><label for="lulus3" class="labelfrm">Tanggal Lulus Diploma 3</label></td>
<td width="1%">:</td>
<td width="10%"><input type="text" name="lulus3" id="lulus3" maxlength="20" class="required" /></td>
<td width="1%"></td>
<td width="19%"><label for="lulus4" class="labelfrm">Tanggal Lulus Diploma 4</label></td>
<td width="1%">:</td>
<td width="15%"><input type="text" name="lulus4" id="lulus4" maxlength="20" class="required" /></td>
</tr>
<tr>
<td width="1%">7.</td>
<td width="15%"><label for="Prodi3" class="labelfrm">Program Studi Diploma 3</label></td>
<td width="1%">:</td>
<td width="10%"><select name="Prodi3" id="Prodi3" class="required">
<option value="Keperawatan">D III Keperawatan Banda Aceh</option>
<option value="Keperawatan">D III Keperawatan Meulaboh</option>
<option value="Keperawatan">D III Keperawatan Langsa</option>
<option value="Kebidanan">D III Kebidanan Banda Aceh</option>
<option value="Kebidanan">D III Kebidanan Meulaboh</option>
<option value="Kebidanan">D III Kebidanan Langsa</option>
<option value="Keperawatan Gigi">D III Keperawatan Gigi</option>
<option value="Kesehatan Lingkungan">D III Kesehatan Lingkungan</option>
<option value="Gizi">D III Gizi</option>
<option value="Farmasi">D III Farmasi</option></select></td>
<td width="1%"></td>
<td width="15%"><label for="Prodi4" class="labelfrm">Program Studi Diploma 4</label></td>
<td width="1%">:</td>
<td width="10%"><select name="Prodi4" id="Prodi4" class="required">
<option value="Keperawatan">D IV Keperawatan</option>
<option value="Kebidanan">D IV Kebidanan</option>
<option value="Keperawatan Gigi">D IV Keperawatan Gigi</option>
<option value="Kesehatan Lingkungan">D IV Kesehatan Lingkungan</option>
<option value="Gizi">D IV Gizi</option></select></td>
</tr>
</table>
<table>
<tr>
<td></td>
</tr>
<tr>
<td></td>
</tr>
<tr>
<td></td>
</tr>
<tr>
<td width="50%"><b>B. DATA ALUMNI</b></td>
<td width="29%"><b>C. DATA PENYERAPAN ALUMNI</b></td>
</tr>
</table>
<table border="0" bordercolor="black" bgcolor="silver" cellpadding="4" cellspacing="0" width="100%">
<tr>
<td></td>
</tr>
<tr>
<td width="1%">1.</td>
<td width="15%"><label for="nama" class="labelfrm">Nama Alumni</label></td>
<td width="1%">:</td>
<td width="15%"><input type="text" name="nama" id="nama" maxlength="25" class="required" size="30"/></td>
<td width="1%">1.</td>
<td align="left"><label for="Kerja" class="labelfrm">Pekerjaan Alumni</label></td>
<td align="left">:</td>
<td align="left"><select name="Kerja" id="Kerja" class="required">
<option value="Pegawai Negeri Sipil">Pegawai Negeri Sipil</option>
<option value="TNI">TNI</option>
<option value="Polri">Polri</option>
<option value="Tenaga Honorer">Tenaga Honorer</option>
<option value="Tenaga Kontrak">Tenaga Kontrak</option>
<option value="Tenaga Bhakti">Tenaga Bhakti</option>
<option value="Wiraswasta">Wiraswasta</option>
<option value="Petani">Petani</option>
<option value="Nelayan">Nelayan</option>
<option value="Belum Bekerja">Belum Bekerja</option></select>
</td>
</tr>
<tr>
<td width="1%">2.</td>
<td width="15%"><label for="ttl_nya" class="labelfrm">Tempat / Tanggal Lahir</label></td>
<td width="1%">:</td>
<td width="10%"><input type="text" name="ttl_nya" id="ttl_nya" maxlength="35" class="required" /></td>
<td width="1%">2.</td>
<td width="19%"><label for="nip_nya" class="labelfrm">Nomor Induk Pegawai ( <i>PNS, TNI dan Polri</i> )</label></td>
<td width="1%">:</td>
<td width="15%"><input type="text" name="nip_nya" id="nip_nya" maxlength="25" class="required" /></td>
</tr>
<tr>
<td width="1%">3.</td>
<td width="15%"><label for="alamat" class="labelfrm">Alamat Rumah</label></td>
<td width="1%">:</td>
<td width="15%"><input type="text" name="alamat" id="alamat" maxlength="100" class="required" /></td>
<td width="1%">3.</td>
<td width="19%"><label for="inst_nya" class="labelfrm">Institusi Tempat Bekerja</label></td>
<td width="1%">:</td>
<td width="1%"><input type="text" name="inst_nya" id="inst_nya" maxlength="50" class="required" /></td>
</tr>
<tr>
<td width="1%">4.</td>
<td width="15%"><label for="hand_nya" class="labelfrm">Nomor Hanphone ( HP )</label></td>
<td width="1%">:</td>
<td width="15%"><input type="text" name="hand_nya" id="hand_nya" maxlength="15" class="required" /></td>
<td width="1%">4.</td>
<td width="19%"><label for="a_inst" class="labelfrm">Alamat Institusi Tempat Bekerja</label></td>
<td width="1%">:</td>
<td width="1%"><input type="text" name="a_inst" id="a_inst" maxlength="100" class="required" /></td>
</tr>
<tr>
<td width="1%">5</td>
<td width="15%"><label for="kelamin" class="labelfrm">Jenis Kelamin</label></td>
<td width="1%">:</td>
<td width="10%"><select name="kelamin" id="kelamin" class="required">
<option value="Laki">Laki-Laki</option>
<option value="Perempuan">Perempuan</option></select></td>
<td width="1%">5.</td>
<td width="15%"><label for="t_kerja" class="labelfrm">Tahun Mulai Bekerja</label></td>
<td width="1%">:</td>
<td width="10%"><input type="text" name="t_kerja" id="t_kerja" maxlength="4" class="required" /></td>
</tr>
</table>
<h4><label for="kr_pes" class="labelfrm">Ketik Kritik Atau Saran Anda :</label></h4>
<textarea name="kr_pes" cols="120" rows="5"></textarea>
<input type="submit" name="input" value="Simpan Data" id="input"/>
<input type="reset" name="clear" value="Kosongkan Form Entry" id="clear"/>
</form>
</body>
</html>
Saya Baru Belajar PHP dan mendapatkan LKP di kampus mengenai PHP....
Setelah saya buat tampilan dan koneksi ternyata data yang diinput tidak masuk ke database, hanya tampil halaman blank..... saat dibuka databasenya tidak ada data yang baru yang masuk
Mohon Bantuannya....
Berikut Codingnya.....
Ini Tabelnya
CREATE TABLE IF NOT EXISTS `dtalumni` (
“no_urut†int (4) NOT NULL AUTO_INCREMENT,
“jurusan†varchar (35) NOT NULL,
“n_ija3†varchar (20) NOT NULL,
“n_reg3†varchar(35) NOT NULL,
“t_yud3†varchar (25) NOT NULL,
“n_ipk3†varchar (4) NOT NULL,
“lulus3†varchar (25) NOT NULL,
“prodi3†varchar (25) NOT NULL,
“n_ija4†varchar (20) NOT NULL,
“n_reg4†varchar (35) NOT NULL,
“t_yud4†varchar (25) NOT NULL,
“n_ipk4†varchar (4) NOT NULL,
“lulus4†varchar (25) NOT NULL,
“prodi4†varchar (25) NOT NULL,
“nama†varchar (35) NOT NULL,
“kerja†varchar (35) NOT NULL,
“ttl_nya†varchar (35) NOT NULL,
“nip_nya†varchar (25) NOT NULL,
“alamat†varchar (50) NOT NULL,
“inst_nya†varchar (50) NOT NULL,
“hand_nya†varchar (15) NOT NULL,
“a_inst†varchar (50) NOT NULL,
“kelamin†varchar (15) NOT NULL,
“t_kerja†varchar (4) NOT NULL,
“kr_pes†varchar (35) NOT NULL,
Primary Key (“n_ija3â€));
Ini file koneksi.php
<?php
$host = "localhost";
$user = "root";
$password = "";
$database_name = "alumni";
mysql_connect($host, $user, $password);
mysql_select_db($alumni);
?>
Ini file input.php
<?php
include"koneksi.php";
$no_urut=strip_tags(@$_POST);
$jurusan=strip_tags(@$_POST);
$n_ija3=strip_tags(@$_POST);
$n_reg3=strip_tags(@$_POST);
$t_yud3=strip_tags(@$_POST);
$n_ipk3=strip_tags(@$_POST);
$lulus3=strip_tags(@$_POST);
$prodi3=strip_tags(@$_POST);
$n_ija4=strip_tags(@$_POST);
$n_reg4=strip_tags(@$_POST);
$t_yud4=strip_tags(@$_POST);
$n_ipk4=strip_tags(@$_POST);
$lulus4=strip_tags(@$_POST);
$prodi4=strip_tags(@$_POST);
$nama=strip_tags(@$_POST);
$kerja=strip_tags(@$_POST);
$ttl_nya=strip_tags(@$_POST);
$nip_nya=strip_tags(@$_POST);
$alamat=strip_tags(@$_POST);
$inst_nya=strip_tags(@$_POST);
$hand_nya=strip_tags(@$_POST);
$a_ inst=strip_tags(@$_POST);
$kelamin=strip_tags(@$_POST);
$t_kerja=strip_tags(@$_POST);
$kr_pes=strip_tags(@$_POST);
mysql_query("Insert Into dtalumni(no_urut,jurusan,n_ija3,n_reg3,t_yud3,n_ipk3,lulus3,prodi3,n_ija4,n_reg4,t_yud4,n_ipk4,lulus4,prodi4,nama,kerja,ttl_nya,nip_nya,alamat,inst_nya,hand_nya,a_ inst,kelamin,t_kerja,kr_pes)values('', '$jurusan’ , '$n_ija3’, '$ n_reg3’, '$t_yud3’, '$n_ipk3’, '$lulus3’, '$prodi3’, '$n_ija4’, '$n_reg4’, '$t_yud4’, '$n_ipk4’, '$lulus4’, '$prodi4’, '$nama’, '$kerja’, '$ttl_nya’, '$nip_nya’, '$alamat’, '$inst_nya’, '$hand_nya’, '$a_ inst’, '$kelamin’, '$t_kerja’, '$kr_pes’)")or die(mysql_error());
?>
Ini ini file entry_data.php
<html>
<head>
<title>Data Alumni</title>
<style type="text/css">
.labelfrm{
display:block;
font-size:small;
margin-top:5px;
}
.error{
font-size:small;
color:red;
}
</style>
</head>
<body>
<form name="input_data" action="input.php" method="post" id="frm">
<table border="0" bordercolor="black" bgcolor="" cellpadding="0" cellspacing="0" width="100%">
<tr>
<th Colspan="0" align="left"></th>
</tr>
</table>
<marquee direction="left" scrollamount="10" align="center"><font size="6" color="blue"><b>SELAMAT DATANG DI APLIKASI PENDATAAN ALUMNI</b></font></marquee>
<table>
<tr>
<td><b>A. DATA AKADEMIK</b></td>
</tr>
</table>
<table border="0" bordercolor="black" bgcolor="" cellpadding="4" cellspacing="0" width="100%">
<tr>
<td width="1%">1.</td>
<td width="15%"><label for="jurusan" class="labelfrm">Jurusan</label></td>
<td width="1%">:</td>
<td width="10%"><select name="jurusan" id="jurusan" class="required">
<option value="Keperawatan">Keperawatan</option>
<option value="Kebidanan">Kebidanan</option>
<option value="Keperawatan Gigi">Keperawatan Gigi</option>
<option value="Kesehatan Lingkungan">Kesehatan Lingkungan</option>
<option value="Gizi">Gizi</option>
<option value="Farmasi">Farmasi</option></td>
<td width="68%"></td>
</tr>
</table>
<table border="0" bordercolor="black" bgcolor="silver" cellpadding="4" cellspacing="0" width="100%">
<tr>
<td></td>
</tr>
<tr>
<td width="1%">2.</td>
<td width="15%"><label for="n_ija3" class="labelfrm">Nomor Ijazah Diploma 3</label></td>
<td width="1%">:</td>
<td width="10%"><input type="text" name="n_ija3" id="n_ija3" maxlength="20" class="required" size="15"/></td>
<td width="1%"></td>
<td width="19%"><label for="n_ija4" class="labelfrm">Nomor Ijazah Diploma 4</label></td>
<td width="1%">:</td>
<td width="15%"><input type="text" name="n_ija4" id="n_ija4" maxlength="20" class="required" size="15"/></td>
</tr>
<tr>
<td width="1%">3.</td>
<td width="15%"><label for="n_reg3" class="labelfrm">Nomor Registrasi Ijazah Diploma 3</label></td>
<td width="1%">:</td>
<td width="10%"><input type="text" name="n_reg3" id="n_reg3" maxlength="35" class="required" size="20"/></td>
<td width="1%"></td>
<td width="19%"><label for="n_reg4" class="labelfrm">Nomor Registrasi Ijazah Diploma 4</label></td>
<td width="1%">:</td>
<td width="15%"><input type="text" name="n_reg4" id="n_reg4" maxlength="25" class="required" size="20"/></td>
</tr>
<tr>
<td width="1%">4.</td>
<td width="15%"><label for="t_yud3" class="labelfrm">Tanggal Yudisium Diploma 3</label></td>
<td width="1%">:</td>
<td width="10%"><input type="text" name="t_yud3" id="t_yud3" maxlength="25" class="required" /></td>
<td width="1%"></td>
<td width="19%"><label for="t_yud4" class="labelfrm">Tanggal Yudisium Diploma 4</label></td>
<td width="1%">:</td>
<td width="15%"><input type="text" name="t_yud4" id="t_yud4" maxlength="25" class="required" /></td>
</tr>
<tr>
<td width="1%">5.</td>
<td width="15%"><label for="n_ipk3" class="labelfrm">Indeks Prestasi Kumulatif Diploma 3</label></td>
<td width="1%">:</td>
<td width="10%"><input type="text" name="n_ipk3" id="n_ipk3" maxlength="4" class="required" size="5"/></td>
<td width="1%"></td>
<td width="19%"><label for="n_ipk4" class="labelfrm">Indeks Prestasi Kumulatif Diploma 4</label></td>
<td width="1%">:</td>
<td width="15%"><input type="text" name="n_ipk4" id="n_ipk4" maxlength="4" class="required" size="5"/></td>
</tr>
<tr>
<td width="1%">6.</td>
<td width="15%"><label for="lulus3" class="labelfrm">Tanggal Lulus Diploma 3</label></td>
<td width="1%">:</td>
<td width="10%"><input type="text" name="lulus3" id="lulus3" maxlength="20" class="required" /></td>
<td width="1%"></td>
<td width="19%"><label for="lulus4" class="labelfrm">Tanggal Lulus Diploma 4</label></td>
<td width="1%">:</td>
<td width="15%"><input type="text" name="lulus4" id="lulus4" maxlength="20" class="required" /></td>
</tr>
<tr>
<td width="1%">7.</td>
<td width="15%"><label for="Prodi3" class="labelfrm">Program Studi Diploma 3</label></td>
<td width="1%">:</td>
<td width="10%"><select name="Prodi3" id="Prodi3" class="required">
<option value="Keperawatan">D III Keperawatan Banda Aceh</option>
<option value="Keperawatan">D III Keperawatan Meulaboh</option>
<option value="Keperawatan">D III Keperawatan Langsa</option>
<option value="Kebidanan">D III Kebidanan Banda Aceh</option>
<option value="Kebidanan">D III Kebidanan Meulaboh</option>
<option value="Kebidanan">D III Kebidanan Langsa</option>
<option value="Keperawatan Gigi">D III Keperawatan Gigi</option>
<option value="Kesehatan Lingkungan">D III Kesehatan Lingkungan</option>
<option value="Gizi">D III Gizi</option>
<option value="Farmasi">D III Farmasi</option></select></td>
<td width="1%"></td>
<td width="15%"><label for="Prodi4" class="labelfrm">Program Studi Diploma 4</label></td>
<td width="1%">:</td>
<td width="10%"><select name="Prodi4" id="Prodi4" class="required">
<option value="Keperawatan">D IV Keperawatan</option>
<option value="Kebidanan">D IV Kebidanan</option>
<option value="Keperawatan Gigi">D IV Keperawatan Gigi</option>
<option value="Kesehatan Lingkungan">D IV Kesehatan Lingkungan</option>
<option value="Gizi">D IV Gizi</option></select></td>
</tr>
</table>
<table>
<tr>
<td></td>
</tr>
<tr>
<td></td>
</tr>
<tr>
<td></td>
</tr>
<tr>
<td width="50%"><b>B. DATA ALUMNI</b></td>
<td width="29%"><b>C. DATA PENYERAPAN ALUMNI</b></td>
</tr>
</table>
<table border="0" bordercolor="black" bgcolor="silver" cellpadding="4" cellspacing="0" width="100%">
<tr>
<td></td>
</tr>
<tr>
<td width="1%">1.</td>
<td width="15%"><label for="nama" class="labelfrm">Nama Alumni</label></td>
<td width="1%">:</td>
<td width="15%"><input type="text" name="nama" id="nama" maxlength="25" class="required" size="30"/></td>
<td width="1%">1.</td>
<td align="left"><label for="Kerja" class="labelfrm">Pekerjaan Alumni</label></td>
<td align="left">:</td>
<td align="left"><select name="Kerja" id="Kerja" class="required">
<option value="Pegawai Negeri Sipil">Pegawai Negeri Sipil</option>
<option value="TNI">TNI</option>
<option value="Polri">Polri</option>
<option value="Tenaga Honorer">Tenaga Honorer</option>
<option value="Tenaga Kontrak">Tenaga Kontrak</option>
<option value="Tenaga Bhakti">Tenaga Bhakti</option>
<option value="Wiraswasta">Wiraswasta</option>
<option value="Petani">Petani</option>
<option value="Nelayan">Nelayan</option>
<option value="Belum Bekerja">Belum Bekerja</option></select>
</td>
</tr>
<tr>
<td width="1%">2.</td>
<td width="15%"><label for="ttl_nya" class="labelfrm">Tempat / Tanggal Lahir</label></td>
<td width="1%">:</td>
<td width="10%"><input type="text" name="ttl_nya" id="ttl_nya" maxlength="35" class="required" /></td>
<td width="1%">2.</td>
<td width="19%"><label for="nip_nya" class="labelfrm">Nomor Induk Pegawai ( <i>PNS, TNI dan Polri</i> )</label></td>
<td width="1%">:</td>
<td width="15%"><input type="text" name="nip_nya" id="nip_nya" maxlength="25" class="required" /></td>
</tr>
<tr>
<td width="1%">3.</td>
<td width="15%"><label for="alamat" class="labelfrm">Alamat Rumah</label></td>
<td width="1%">:</td>
<td width="15%"><input type="text" name="alamat" id="alamat" maxlength="100" class="required" /></td>
<td width="1%">3.</td>
<td width="19%"><label for="inst_nya" class="labelfrm">Institusi Tempat Bekerja</label></td>
<td width="1%">:</td>
<td width="1%"><input type="text" name="inst_nya" id="inst_nya" maxlength="50" class="required" /></td>
</tr>
<tr>
<td width="1%">4.</td>
<td width="15%"><label for="hand_nya" class="labelfrm">Nomor Hanphone ( HP )</label></td>
<td width="1%">:</td>
<td width="15%"><input type="text" name="hand_nya" id="hand_nya" maxlength="15" class="required" /></td>
<td width="1%">4.</td>
<td width="19%"><label for="a_inst" class="labelfrm">Alamat Institusi Tempat Bekerja</label></td>
<td width="1%">:</td>
<td width="1%"><input type="text" name="a_inst" id="a_inst" maxlength="100" class="required" /></td>
</tr>
<tr>
<td width="1%">5</td>
<td width="15%"><label for="kelamin" class="labelfrm">Jenis Kelamin</label></td>
<td width="1%">:</td>
<td width="10%"><select name="kelamin" id="kelamin" class="required">
<option value="Laki">Laki-Laki</option>
<option value="Perempuan">Perempuan</option></select></td>
<td width="1%">5.</td>
<td width="15%"><label for="t_kerja" class="labelfrm">Tahun Mulai Bekerja</label></td>
<td width="1%">:</td>
<td width="10%"><input type="text" name="t_kerja" id="t_kerja" maxlength="4" class="required" /></td>
</tr>
</table>
<h4><label for="kr_pes" class="labelfrm">Ketik Kritik Atau Saran Anda :</label></h4>
<textarea name="kr_pes" cols="120" rows="5"></textarea>
<input type="submit" name="input" value="Simpan Data" id="input"/>
<input type="reset" name="clear" value="Kosongkan Form Entry" id="clear"/>
</form>
</body>
</html>
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