<div class="modal fade" id="service-status-modal" tabindex="-1" role="dialog" aria-labelledby="service-status-modal-label" aria-hidden="true">
      <div class="modal-dialog">
        <div class="modal-content">
          <div class="modal-header">
            <button type="button" class="close" data-dismiss="modal" aria-hidden="true">&times;</button>
            <h4 class="modal-title" id="service-status-modal-label">SERVICE-STATUS</h4>
          </div>
          <div class="modal-body">
            <form id="service_status_form" role="form" action="" method="POST">
              <div class="form-group">
                <label for="rpc_name">rpc-name</label>
                <input type="text" class="form-control" name="rpc_name" id="rpc_name">
              </div>
              <div class="form-group">
                <label for="final_indicator">final-indicator</label>
                <input type="text" class="form-control" name="final_indicator" id="final_indicator">
              </div>
              <div class="form-group">
                <label for="request_status">request-status</label>
                <input type="text" class="form-control" name="request_status" id="request_status">
              </div>
              <div class="form-group">
                <label for="rpc_action">rpc-action</label>
                <input type="text" class="form-control" name="rpc_action" id="rpc_action">
              </div>
              <div class="form-group">
                <label for="l3sdn_action">l3sdn-action</label>
                <input type="text" class="form-control" name="l3sdn_action" id="l3sdn_action">
              </div>
              <div class="form-group">
                <label for="l3sdn_subaction">l3sdn-subaction</label>
                <input type="text" class="form-control" name="l3sdn_subaction" id="l3sdn_subaction">
              </div>
              <div class="form-group">
                <label for="response_message">response-message</label>
                <input type="text" class="form-control" name="response_message" id="response_message">
              </div>
              <div class="form-group">
                <label for="response_code">response-code</label>
                <input type="text" class="form-control" name="response_code" id="response_code">
              </div>
              <div class="form-group">
                <label for="response_timestamp">response-timestamp</label>
                <input type="text" class="form-control" name="response_timestamp" id="response_timestamp">
              </div>

<!--
			<div class="form-group">
                                <input type="hidden" name="uf_action" id="uf_action">
                <button type="button" class="btn btn-primary" onclick="submit(this.form);">Submit</button>
				<button type="button" class="btn btn-default" data-dismiss="modal">Cancel</button>
              </div>
-->
           </form>
          </div>
      </div>
    </div>
  </div>

<script type="text/javascript">
function submit(form){
	$('#service-status-modal').modal('hide');
	form.action = form.uf_action.value;
	form.submit();
	return;
}
</script>