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<form name="myForm" onSubmit="return DataValidation();" method="POST" style="display:inline" action="12validateform.php">
<table width="620" border="0" cellpadding="5" cellspacing="0" class="fonttable">
<tr>
<td colspan="4" class="linebg"><table width="100%" border="1" cellpadding="0" cellspacing="0" class="fonttable">
<tr>
<td><strong>Alle felter skal udfyldes for at vi kan udføre ordren
korrekt.</strong></td>
</tr>
</table>
</td>
</tr>
<tr>
<td colspan="3" class="linebg"><table width="500" height="125" border="1" cellpadding="0" cellspacing="0" class="fonttable">
<tr>
<td height="25">Bestillingsdato:</td>
<td><input name="bestildato" type="text" id="bestildato2">
</td>
<td colspan="2"> </td>
</tr>
<tr>
<td width="171" height="25">Dit navn:</td>
<td width="156"><input name="name" type="text" id="name2">
</td>
<td colspan="2"> </td>
</tr>
<tr>
<td height="25">Din E-mail adresse:</td>
<td><input name="email" type="text" id="email2">
</td>
<td colspan="2"> </td>
</tr>
<tr>
<td height="25">Telefon:</td>
<td><input name="telefon" maxlength="8" type="text" id="telefon2" >
</td>
<td colspan="2"> </td>
</tr>
<tr>
<td height="25">Ønsket afhentningsdato:</td>
<td><input name="afhent" type="text" id="afhent2" >
</td>
<td width="25"><a href="java script:show_calendar('document.myForm.afhent', document.myForm.afhent.value);"><img src="bestilfiler/cal.gif" width="16" height="16" border="0" alt="Åben kalender"></a> </td>
<td width="148">Åben kalender</td>
</tr>
</table>
</td>
<td width="45" class="linebg"> </td>
</tr>
<tr valign="top">
<td width="351" height="40" class="backline"><div align="left"><strong><font size="2">Varebetegnelse</font></strong></div>
</td>
<td width="113" class="backline"><div align="right"><strong><font size="2">Enhed</font><br>
</strong>kg eller stk.</div>
</td>
<td width="131" class="backline"><div align="right"><strong><font size="2">Pris<br>
</font></strong>kr./kg eller kr./stk.</div>
</td>
<td class="backline"><div align="right"><strong><font size="2">Antal</font></strong></div>
</td>
</tr>
<tr>
<td class="linebg"><strong>Hele ferske lam:</strong></td>
<td class="linebg"> </td>
<td class="linebg"> </td>
<td class="linebg"> </td>
</tr>
<tr>
<td class="backline">Finparteret</td>
<td class="backline"><div align="right">18-25 kg</div>
</td>
<td class="backline"><div align="right">65 kr./kg</div>
</td>
<td class="backline"><div align="right">
<input name="Finparteret" type="text" id="message34" value="" size="4" maxlength="3">
</div></td>
</tr>
<tr>
<td class="linebg">Tillæg for vakumpakning</td>
<td class="linebg"> </td>
<td class="linebg"><div align="right">200 kr./lam</div>
</td>
<td class="linebg"><div align="right">
<input name="vakuumpakning" type="text" id="message35" value="" size="4" maxlength="3">
</div></td>
</tr>
<tr>
<td height="30" colspan="4" class="backline"><img src="../billeder/spacer10x10.gif" width="10" height="10"></td>
</tr>
<tr>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
</tr>
<tr>
<td class="linebg"><strong>Udskæringer:</strong></td>
<td class="linebg"> </td>
<td class="linebg"> </td>
<td class="linebg"> </td>
</tr>
<tr>
<td class="backline">Lammekølle</td>
<td class="backline"><div align="right">Ca. 3 kg</div>
</td>
<td class="backline"><div align="right">125 kr./kg</div>
</td>
<td class="backline"><div align="right">
<input name="Lammekoelle" type="text" id="Lammekoelle" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="linebg">Udbenet lammekølle</td>
<td class="linebg"><div align="right">Ca. 1,2 kg</div>
</td>
<td class="linebg"><div align="right">148 kr./kg</div>
</td>
<td class="linebg"><div align="right">
<input name="Udbenet_lammekoelle" type="text" id="Udbenet_lammekoelle" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="backline">Lammeskank</td>
<td class="backline"><div align="right">Ca. 0,4 kg </div>
</td>
<td class="backline"><div align="right">78 kr./kg</div>
</td>
<td class="backline"><div align="right">
<input name="Lammeskank" type="text" id="Lammeskank" value="" size="4">
</div>
</td>
</tr>
<tr>
<td class="linebg">Lammeculotte/tyksteg</td>
<td class="linebg"><div align="right">Ca. 0,4 kg</div>
</td>
<td class="linebg"><div align="right">160 kr./kg</div>
</td>
<td class="linebg"><div align="right">
<input name="Lammeculotte" type="text" id="Lammeculotte" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="backline">Lammebovkølle, udbenet med skaft</td>
<td class="backline"><div align="right">Ca. 1,3 kg</div>
</td>
<td class="backline"><div align="right">128 kr./kg</div>
</td>
<td class="backline"><div align="right">
<input name="Lammebovkoelle" type="text" id="Lammebovkoelle" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="linebg">Farseret lammebov, lammefars med urter</td>
<td class="linebg"><div align="right">Ca. 1,5 kg</div>
</td>
<td class="linebg"><div align="right">128 kr./kg</div>
</td>
<td class="linebg"><div align="right">
<input name="Farseret_lammebov" type="text" id="Farseret_lammebov" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="backline">Fyldt lammebov, soltørrede tomater og feta</td>
<td class="backline"><div align="right">Ca. 1,5 kg</div>
</td>
<td class="backline"><div align="right">128 kr./kg</div>
</td>
<td class="backline"><div align="right">
<input name="Fyldt_lammebov" type="text" id="Fyldt_lammebov" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="linebg">Dobbelt lammeryg</td>
<td class="linebg"><div align="right">Ca. 1,5 kg</div>
</td>
<td class="linebg"><div align="right">138 kr./kg</div>
</td>
<td class="linebg"><div align="right">
<input name="Dobbelt_lammeryg" type="text" id="Dobbelt_lammeryg" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="backline">Lammefilét</td>
<td class="backline"><div align="right">Ca. 0,75 kg</div>
</td>
<td class="backline"><div align="right">240 kr./kg</div>
</td>
<td class="backline"><div align="right">
<input name="Lammekrone" type="text" id="Lammekrone" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="linebg">Lammemørbrad</td>
<td class="linebg"><div align="right">Ca. 0,3 kg</div>
</td>
<td class="linebg"><div align="right">300 kr./kg</div>
</td>
<td class="linebg"><div align="right">
<input name="Lammemoerbrad" type="text" id="Lammemoerbrad" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="backline">Lammekoteletter</td>
<td class="backline"><div align="right">Ca. 0,3 kg</div>
</td>
<td class="backline"><div align="right">138 kr./kg</div>
</td>
<td class="backline"><div align="right">
<input name="Lammekoteletter" type="text" id="Lammekoteletter" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="linebg">Lammekoteletter med kort skaft</td>
<td class="linebg"><div align="right">Ca. 0,3 kg</div>
</td>
<td class="linebg"><div align="right">110 kr./kg</div>
</td>
<td class="linebg"><div align="right">
<input name="Lammehalssteaks" type="text" id="Lammehalssteaks" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="backline">Hakket lammekød</td>
<td class="backline"><div align="right">Ca. 0,4 kg</div>
</td>
<td class="backline"><div align="right">98 kr./kg</div>
</td>
<td class="backline"><div align="right">
<input name="Hakket_lammekoed" type="text" id="Hakket_lammekoed" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="linebg">Lammesmåkød</td>
<td class="linebg"><div align="right">Ca. 0,4 kg</div>
</td>
<td class="linebg"><div align="right">104 kr./kg</div>
</td>
<td class="linebg"><div align="right">
<input name="Lammesmaakoed" type="text" id="Lammesmaakoed" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="backline">Lammenyrer</td>
<td class="backline"><div align="right">Ca. 0,3 kg</div>
</td>
<td class="backline"><div align="right">68 kr./kg </div>
</td>
<td class="backline"><div align="right">
<input name="Lammenyrer" type="text" id="Lammenyrer" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="linebg">Lammelever</td>
<td class="linebg"><div align="right">Ca. 0,5 kg</div>
</td>
<td class="linebg"><div align="right">68 kr./kg </div>
</td>
<td class="linebg"><div align="right">
<input name="Lammelever" type="text" id="Lammelever2" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="backline">Lammehjerter, fyldt med persille</td>
<td class="backline"><div align="right">Ca. 0,3 kg</div>
</td>
<td class="backline"><div align="right">68 kr./kg </div>
</td>
<td class="backline"><div align="right">
<input name="Lammehjerter" type="text" id="Lammehjerter" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
</tr>
<tr>
<td class="linebg"><strong>Pålægsvarer m.v.:</strong></td>
<td class="linebg"> </td>
<td class="linebg"> </td>
<td class="linebg"> </td>
</tr>
<tr>
<td class="backline">Lammeleverpostej, rå</td>
<td class="backline"><div align="right">Ca. 0,25 kg</div>
</td>
<td class="backline"><div align="right">70 kr./kg</div>
</td>
<td class="backline"><div align="right">
<input name="Raa_lammeleverpostej" type="text" id="Raa_lammeleverpostej" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="linebg">Lammelevermousse, rå</td>
<td class="linebg"><div align="right">Ca. 0,3 kg</div>
</td>
<td class="linebg"><div align="right">150 kr./kg</div>
</td>
<td class="linebg"><div align="right">
<input name="Raa_lammelevermousse" type="text" id="Raa_lammelevermousse" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="backline">Lammepaté</td>
<td class="backline"><div align="right">Ca. 0,25 kg</div>
</td>
<td class="backline"><div align="right">98 kr./kg</div>
</td>
<td class="backline"><div align="right">
<input name="Lammepate" type="text" id="Lammepate" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="linebg">Lammesylte</td>
<td class="linebg"><div align="right">Ca. 0,3 kg</div>
</td>
<td class="linebg"><div align="right">80 kr./kg</div>
</td>
<td class="linebg"><div align="right">
<input name="Lammesylte" type="text" id="Lammesylte" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="backline">Lammemedister</td>
<td class="backline"><div align="right">Ca. 0,5 kg</div>
</td>
<td class="backline"><div align="right">70 kr./kg</div>
</td>
<td class="backline"><div align="right">
<input name="Lammemedister" type="text" id="Lammemedister" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="linebg">Lammerullepølse, kogt</td>
<td class="linebg"><div align="right">Ca. 0,4 kg</div>
</td>
<td class="linebg"><div align="right">148 kr./kg</div>
</td>
<td class="linebg"><div align="right">
<input name="Lammerullepoelse" type="text" id="Lammerullepoelse2" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="backline">Spegepølse med cognac</td>
<td class="backline"><div align="right">Ca. 0,6 kg</div>
</td>
<td class="backline"><div align="right">150 kr./kg</div>
</td>
<td class="backline"><div align="right">
<input name="Spegepoelse_peber" type="text" id="Spegepoelse_peber2" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="linebg">Spegepølse med knust sort peber</td>
<td class="linebg"><div align="right">Ca. 0,4 kg</div>
</td>
<td class="linebg"><div align="right">150 kr./kg</div>
</td>
<td class="linebg"><div align="right">
<input name="Spegepoelse_peber2" type="text" id="Spegepoelse_peber22" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="backline">Grillpølser</td>
<td class="backline"><div align="right">Ca. 0,5 kg</div>
</td>
<td class="backline"><div align="right">108 kr./kg</div>
</td>
<td class="backline"><div align="right">
<input name="Grillpoelser" type="text" id="Grillpoelser" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="linebg">Grillmedister</td>
<td class="linebg"><div align="right">Ca. 0,5 kg </div>
</td>
<td class="linebg"><div align="right">80 kr./kg</div>
</td>
<td class="linebg"><div align="right">
<input name="Grillmedister" type="text" id="Grillmedister" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="backline">Røget lammekølle Special</td>
<td class="backline"><div align="right">Ca. 1,7 kg</div>
</td>
<td class="backline"><div align="right">250 kr./kg</div>
</td>
<td class="backline"><div align="right">
<input name="Roegetlammekoelle_special" type="text" id="Roegetlammekoelle_special" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="linebg">Røget inderlår</td>
<td class="linebg"><div align="right">Ca. 0,5 kg</div>
</td>
<td class="linebg"><div align="right">180 kr./kg</div>
</td>
<td class="linebg"><div align="right">
<input name="Roeget_inderlaar" type="text" id="Roeget_inderlaar" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="backline">Røget klump</td>
<td class="backline"><div align="right">Ca. 0,4 kg</div>
</td>
<td class="backline"><div align="right">165 kr./kg</div>
</td>
<td class="backline"><div align="right">
<input name="Roeget_klump" type="text" id="Roeget_klump2" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="linebg">Gravad filét</td>
<td class="linebg"><div align="right">Ca. 0,3 kg</div>
</td>
<td class="linebg"><div align="right">258 kr./kg</div>
</td>
<td class="linebg"><div align="right">
<input name="gravad-filet" type="text" id="gravad-filet" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td height="30" colspan="4" class="backline"><div align="right"><img src="../billeder/spacer10x10.gif" width="10" height="10"></div>
<div align="right"></div>
</td>
</tr>
<tr>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
</tr>
<tr>
<td colspan="4" class="linebg"><strong>Vin:</strong> <div align="right"></div> <div align="right"></div> <div align="right"></div>
</td>
</tr>
<tr>
<td class="backline">Can Vendrell, rød</td>
<td class="backline"><div align="right">1 flaske</div>
</td>
<td class="backline"><div align="right">42 kr./flaske</div>
</td>
<td class="backline"><div align="right">
<input name="Vendrell" type="text" id="Vendrell" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="linebg">Tempranillo, rød</td>
<td class="linebg"><div align="right">1 flaske</div>
</td>
<td class="linebg"><div align="right">55 kr./flaske</div>
</td>
<td class="linebg"><div align="right">
<input name="tempranillo" type="text" id="tempranillo" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="backline">Lignum Negre, rød</td>
<td class="backline"><div align="right">1 flaske</div>
</td>
<td class="backline"><div align="right">69 kr./flaske</div>
</td>
<td class="backline"><div align="right">
<input name="lignum_negre" type="text" id="lignum_negre" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="linebg">Xarello, hvid</td>
<td class="linebg"><div align="right">1 flaske</div>
</td>
<td class="linebg"><div align="right">49 kr./flaske</div>
</td>
<td class="linebg"><div align="right">
<input name="xarello_hvid" type="text" id="xarello_hvid" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="backline">Pinot Noir Classic</td>
<td class="backline"><div align="right">1 flaske</div>
</td>
<td class="backline"><div align="right">59 kr./flaske</div>
</td>
<td class="backline"><div align="right">
<input name="pinot_noir_classic" type="text" id="pinot_noir_classic" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td> </td>
<td><div align="right"></div>
</td>
<td><div align="right"></div>
</td>
<td><div align="right"></div>
</td>
</tr>
<tr>
<td class="linebg"><strong>Garvede lammeskind:</strong></td>
<td class="linebg"> </td>
<td class="linebg"> </td>
<td class="linebg"> </td>
</tr>
<tr>
<td class="backline">Klassisk garvning</td>
<td class="backline"><div align="right">1 stk.</div>
</td>
<td class="backline"><div align="right">750 kr./stk.</div>
</td>
<td class="backline"><div align="right">
<input name="Klassisk_garvning" type="text" id="Klassisk_garvning" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td class="linebg">Vaskbar kvalitet</td>
<td class="linebg"><div align="right">1 stk.</div>
</td>
<td class="linebg"><div align="right">850 kr./stk.</div>
</td>
<td class="linebg"><div align="right">
<input name="Vaskbar_kvalitet" type="text" id="Vaskbar_kvalitet" value="" size="4" maxlength="3">
</div>
</td>
</tr>
<tr>
<td height="30" colspan="4" class="backline"> </td>
</tr>
<tr>
<td colspan="4"> </td>
</tr>
<tr>
<td>
<div align="left">
<input name="Submit" type="submit" id="Submit2" value="Print" Onclick="print()";>
</div></td>
<td> </td>
<td colspan="2"><div align="right">
<input type="submit" name="Submit2" value="Send bestilling">
</div></td>
</tr>
<tr>
<td> </td>
<td> </td>
<td colspan="2"> </td>
</tr>
</table>
</form>
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