<div class="row">
  <!--REFERENCE-->
  <label for="inputKey" class="col-md-1">Réf.</label>
  <div
    form-field
    fti="ftis.anomalie"
    ftid="ftis.anomalie.uid"
    map="map"
    class="col-md-3"
    attname="'REFERENCE'"
    default=""
    initvalue="res['anomalie']"
    res="res['anomalie'].properties"
  ></div>
  <label for="inputValue" class="col-md-1">Date</label>
  <!--DATE_SAISIE-->
  <div
    form-field
    fti="ftis['anomalie']"
    ftid="ftis['anomalie'].uid"
    map="map"
    class="col-md-6"
    attname="'DATE_SAISIE'"
    default=""
    initvalue="res['anomalie']"
    res="res['anomalie'].properties"
  ></div>
</div>

<div class="row">
  <label for="inputValue" class="col-md-1">Date</label>
  <!--DATE_SAISIE-->
  <div
    form-field
    fti="ftis['int_recherche_fuite']"
    ftid="ftis['int_recherche_fuite'].uid"
    map="map"
    class="col-md-4"
    attname="'datedemande'"
    default=""
    initvalue="res['int_recherche_fuite']"
    res="res['int_recherche_fuite'].properties"
  ></div>
  <label for="inputValue" class="col-md-1">Agent</label>
  <!--DATE_SAISIE-->
  <div
    form-field
    fti="ftis['int_recherche_fuite']"
    ftid="ftis['int_recherche_fuite'].uid"
    map="map"
    class="col-md-4"
    attname="'id_agent'"
    default=""
    initvalue="res['int_recherche_fuite']"
    res="res['int_recherche_fuite'].properties"
  ></div>
</div>
<div class="row">
  <h4>Localisation</h4>
</div>
<div class="row">
  <label for="inputValue" class="col-md-1">Origine</label>
  <!--DATE_SAISIE-->
  <div
    form-field
    fti="ftis['int_recherche_fuite']"
    ftid="ftis['int_recherche_fuite'].uid"
    map="map"
    class="col-md-4"
    attname="'id_typeintrech'"
    default=""
    initvalue="res['int_recherche_fuite']"
    res="res['int_recherche_fuite'].properties"
  ></div>
</div>
<div class="row">
  <div class="checkbox">
    <label>
      <input type="checkbox" value="" />
      Chaussée
    </label>
  </div>
  <div class="checkbox">
    <label>
      <input type="checkbox" value="" />
      Trottoir
    </label>
  </div>
  <div class="checkbox">
    <label>
      <input type="checkbox" value="" />
      Pleine terre
    </label>
  </div>
  <div class="checkbox">
    <label>
      <input type="checkbox" value="" />
      Autre
    </label>
  </div>
</div>
<div class="row">
  <h4>Voie</h4>
</div>
<div class="row">
  <div class="checkbox">
    <label>
      <input type="checkbox" value="" />
      Public
    </label>
  </div>
  <div class="checkbox">
    <label>
      <input type="checkbox" value="" />
      Privé
    </label>
  </div>
</div>
<div class="row">
  <h4>Traffic</h4>
</div>
<div class="row">
  <div class="checkbox">
    <label>
      <input type="checkbox" value="" />
      Modere
    </label>
  </div>
  <div class="checkbox">
    <label>
      <input type="checkbox" value="" />
      Faible
    </label>
  </div>
  <div class="checkbox">
    <label>
      <input type="checkbox" value="" />
      Inexistant
    </label>
  </div>
  <div class="checkbox">
    <label>
      <input type="checkbox" value="" />
      Important
    </label>
  </div>
</div>
<div class="row">
  <h4>Materiel de Localisation</h4>
</div>
<div class="row">
  <div class="checkbox">
    <label>
      <input type="checkbox" value="" />
      Corrélation acoustique
    </label>
  </div>
  <div class="checkbox">
    <label>
      <input type="checkbox" value="" />
      Appareil d'ecoute
    </label>
  </div>
  <div class="checkbox">
    <label>
      <input type="checkbox" value="" />
      Autre
    </label>
  </div>
</div>
