<form class="form-horizontal az-form" id="form" name="form" method="POST">
	<input type="hidden" name="idcustomer_category" id="idcustomer_category">
	<div class="form-group">
		<label class="control-label col-md-4">Kategori Pelanggan <red>*</red></label>
		<div class="col-md-5">
			<input type="text" class="form-control" id="customer_category_name" name="customer_category_name"/>
		</div>
	</div>
	<div class="form-group">
		<label class="control-label col-md-4">Jumlah Diskon <red>*</red></label>
		<div class="col-md-5">
			<div class="input-group">
				<input type="text" class="form-control" id="discount_amount" name="discount_amount"/>
				<span class="input-group-addon">%</span>
			</div>
		</div>
	</div>
</form>