2
<h1 class="header">Add/Update Private Health Unit</h1>
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<form method="post" action="privatefacility">
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<span type="form" name="privatefacility:id"></span>
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<table class="multiFormTable" border="0" cellpadding="0" cellspacing="0">
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<th colspan="2">Private Health Unit Information</th>
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<span type="form" name="privatefacility:name" showhead="default"></span>
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<span type="form" name="privatefacility:name_ignore" ifset="name_ignore"></span>
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<span type="form" name="privatefacility:owner" showhead="default"></span>
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<span type="form" name="privatefacility:owner_phone" showhead="default"></span>
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<span type="form" name="privatefacility:owner_email" showhead="default"></span>
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<span type="form" name="privatefacility:supervisor" showhead="default"></span>
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<span type="form" name="privatefacility:supervisor_phone" showhead="default"></span>
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<span type="form" name="privatefacility:supervisor_email" showhead="default"></span>
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<span type="form" name="privatefacility:service_type" showhead="default"></span>
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<span type="form" name="privatefacility:privatefacility_type" showhead="default"></span>
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<span type="form" name="privatefacility:location" showhead="default"></span>
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<tr class="submitCell">