Ver original<head><meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1" /><title>Registro de Casos</title><style type="text/css"><!--body {background-color: #FFFFFF;background-image: url(b09.jpg);}.Estilo1 {font-family: Verdana, Arial, Helvetica, sans-serif;font-weight: bold;font-size: 18px;color: #000000;}.Estilo2 {color: #FFFFFF;font-weight: bold;}.Estilo3 {color: #FFFFFF}.Estilo4 {font-family: Verdana, Arial, Helvetica, sans-serif; font-weight: bold; font-size: 18px; color: #0066CC; }--></style></head><body><table width="918" border="0" align="center" cellpadding="0" cellspacing="0"> <!--DWLayoutTable--> <tr> <td width="36" height="108"></td> <td colspan="3" valign="top"><p> </p> <p align="center" class="Estilo4">_________________________________________________________________</p></td> <td width="28"></td> </tr><tr><td height="19"></td><td width="11"> </td><td width="831" valign="top" bgcolor="#0066CC"><!--DWLayoutEmptyCell--> </td><td width="12"> </td><td></td></tr> <tr> <td height="862"></td> <td colspan="3" align="center" valign="top"><form id="form1" name="form1" method="post" action=""> <table width="789" border="0" align="center" cellspacing="1" bordercolor="#FFFFFF" bgcolor="#FFFFFF"> <!--DWLayoutTable--> <tr> <td height="24" colspan="2" valign="top"><div align="right">Fecha de Revision: </div></td> <td width="175" align="left" valign="top"><label> <input name="fecha_actual" type="text" id="fecha_actual" tabindex="1" /> </label></td> <td width="51"> </td> <td width="58"></td> <td width="225"></td> <td width="74"></td> <td width="4"></td> </tr> <tr> <td width="94" height="24"></td> <td width="83"></td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> </tr><tr> <td height="21" colspan="3" bgcolor="#0066CC"><div align="center"><span class="Estilo2">EXPEDIENTE ADMINISTRATIVO </span></div></td> <td rowspan="5"></td> <td colspan="2" bgcolor="#0066CC"><div align="center"><span class="Estilo2">DATOS DEL ADMINISTRADO </span></div></td> <td rowspan="5"></td> <td></td> </tr> <tr> <td height="24" colspan="2" align="right"><div align="right">Nro. Expediente: </div></td> <td align="left"><label> <label> <input name="nro_expediente" type="text" id="nro_expediente" tabindex="2" /> </label></td> <td><div align="right">Cargo:</div></td> <td align="left" valign="middle"><div align="left"> <label> <input name="cargo_empleado" type="text" id="cargo_empleado" tabindex="5" /> </label> </div> <label></label></td> <td></td> </tr> <tr> <td height="24" colspan="2" align="right" valign="top"><div align="right">Causa penal: </div></td><td align="left"><label> <label><input name="fecha_inicio" type="text" id="fecha_inicio" tabindex="3" /></label> </label></td><td><div align="right">Nombre:</div></td><td align="left" valign="middle"><label><input name="nombre_empleado" type="text" id="nombre_empleado" tabindex="6" /></label><label></label></td><td></td></tr><tr><td height="2"></td><td></td><td align="left"></td><td></td><td align="left"></td><td></td></tr><tr><td height="24" colspan="2" align="left"><div align="right">Fecha de inicio: </div></td><td align="left"><label><label><input name="fecha_ultima_actualizacion" type="text" id="fecha_ultima_actualizacion" tabindex="4" /></label></label></td><td><div align="right">Apellido:</div></td><td align="left" valign="middle"><div align="left"><label><input name="apellido_empleado" type="text" id="apellido_empleado" tabindex="7" /></label></div><label></label></td><td></td></tr><tr><td height="24" colspan="2"><div align="right">Fecha ultima actualización:</div></td><td align="left"><label></label> <label> <label><input type="text" name="textfield" tabindex="4" /></label></label></td><td></td><td><div align="right">Cedula:</div></td><td align="left" valign="middle"><div align="left"><label><input name="cedula_empleado" type="text" id="cedula_empleado" tabindex="8" /></label></div><label></label></td><td></td><td></td></tr><tr><td height="21" colspan="5"> </td><td> </td><td> </td><td></td></tr><tr><td height="21" colspan="3" bgcolor="#0066CC"><div align="center"><span class="Estilo2">CAUSA DISCIPLINARIA </span></div></td><td colspan="2"> </td><td> </td><td> </td><td></td></tr><tr><td height="24" align="center" valign="middle"><div align="right">1- Ley:</div></td><td colspan="6"><div align="left"><label><select name="select1" id="select1" tabindex="9"><option>Ley de Regimen Disciplinario de los Funcionarios Policiales de las Fuerzas Armadas del Estado Lara</option><option>Ley de Estatuto de la Funcion Publica</option><option>Otro</option><option>N/A</option></select></label></div></td><td></td></tr><tr><td height="24" align="center" valign="middle"><div align="right">Articulo:</div></td><td colspan="2" align="left" valign="top"><label><input name="articulo1" type="text" id="articulo1" tabindex="10" /></label></td><td colspan="4" rowspan="3" valign="top"><!--DWLayoutEmptyCell--> </td><td></td></tr><tr><td height="1"></td><td align="left"></td><td align="left"></td><td></td></tr><tr><td rowspan="2" align="center" valign="middle"><div align="right">Especifique:</div></td><td colspan="2" rowspan="2" align="left"><label><input name="especificacion1" type="text" id="especificacion1" tabindex="11" /></label></td><td height="23"></td></tr><tr><td height="0"></td><td></td><td></td><td></td><td></td></tr><tr><td height="24" align="center" valign="middle"><div align="right">2- Ley:</div></td><td colspan="6" align="left"><div align="left"><label><select name="select2" tabindex="12"><option>Ley de Regimen Disciplinario de los Funcionarios Policiales de las Fuerzas Armadas del Estado Lara</option><option>Ley de Estatuto de la Funcion Publica</option><option>Otro</option><option>N/A</option></select></label></div></td><td></td></tr><tr><td height="24" align="center" valign="middle"><div align="right">Articulo:</div></td><td colspan="2" align="left"><label><input name="articulo2" type="text" id="articulo2" tabindex="13" /></label></td><td colspan="4" rowspan="3"><!--DWLayoutEmptyCell--> </td><td></td></tr><tr><td height="24" align="center" valign="middle"><div align="right">Especifique:</div></td> <td colspan="2" align="left"> <label> <input name="especificacion2" type="text" id="especificacion2" tabindex="14" /> </label></td> <td></td> </tr> <tr> <td height="0"></td> <td></td> <td></td> <td></td> </tr> <tr> <td height="21" colspan="5"> </td> <td> </td> <td> </td> <td></td> </tr> <tr> <td height="21" colspan="3" bgcolor="#0066CC"><div align="center"><span class="Estilo3"><strong>FALTA O DELITO </strong></span></div></td> <td colspan="2"> </td> <td> </td> <td> </td> <td></td> </tr> <tr> <td height="85" colspan="7"><label> <textarea name="textarea" cols="100" rows="5"></textarea> </label></td> <td></td> </tr> <tr> <td height="21"> </td> <td> </td> <td> </td> <td colspan="2"> </td> <td bordercolor="#FFFFFF"> </td> <td bordercolor="#FFFFFF"> </td> <td></td> </tr> <tr> <td height="21" colspan="3" valign="bottom" bgcolor="#0066CC"><span class="Estilo3"> <label><strong>OBSERVACIONES Y CONSIDERACIONES </strong> </label></span></td> <td colspan="2"></td> <td bordercolor="#FFFFFF"></td> <td bordercolor="#FFFFFF"></td> <td></td> </tr> <tr> <td height="1"></td> <td></td> <td></td> <td colspan="2"></td> <td bordercolor="#FFFFFF"></td> <td bordercolor="#FFFFFF"></td> <td></td> </tr> <tr> <td height="85" colspan="7" align="left"><textarea name="textarea3" cols="100" rows="5"></textarea></td> <td></td> </tr> </table> <table width="246" border="0" align="center" bordercolor="#0066CC"> <tr> <td width="111"><label> <input type="submit" name="Submit" value="Guardar registro" /> </label></td> <td width="125"><label> <input type="reset" name="Submit2" value="Limpiar formulario" /> </label></td> </tr> </table> </form></td> <td></td> </tr> <tr> <td height="2"></td> <td valign="top"></td> <td valign="top"></td> <td valign="top"></td> <td></td> </tr></table></body></html>