<!--#include file="funcoes.asp"-->
<html>

<head>
<meta http-equiv="Content-Language" content="en-us">
<meta http-equiv="Content-Type" content="text/html; charset=windows-1252">
<title>VIDA SIMPLES - CONTROLE DE PROPOSTA</title>
<base target="meio">
</head>

<% 

wProposta=request.item("Proposta")
wCliente=request.item("Cliente")
wPlano=request.item("Plano")
wAlt=request.item("Alteracao")
wID=request.item("ID")
%>

<body topmargin="0" leftmargin="0" rightmargin="0" bottommargin="0" marginwidth="0" marginheight="0" background="images/Fundo.bmp">

<div align="center">
	<table border="0" width="700" cellspacing="0" cellpadding="0" height="100%" id="table1">
		<tr>
			<td style="border-left-style: solid; border-left-width: 1px; border-right-style: solid; border-right-width: 1px; border-top-width: 1px; border-bottom-width: 1px" bgcolor="#FFFFFF" valign="top">
			<div align="center">
				<table border="0" width="590" id="table2">
					<tr>
						<td width="565" colspan="3">
						<p align="center"><b><font face="Arial" size="2">
						Beneficiário</font></b></td>
					</tr>
					<form method="POST" action="Cad_Beneficiario_Confirma.asp" onSubmit="">
						<tr>
							<td width="101"><b><font face="Arial" size="2">Nome</font></b></td>
							<td width="5"><b><font face="Arial" size="2">:</font></b></td>
							<td width="470">
							<input type="text" name="Nome" size="65" maxlength="50" value="<%=request.item("Nome")%>"></td>
						</tr>
						<tr>
							<td width="101"><b><font face="Arial" size="2">
							Parentesco</font></b></td>
							<td width="5"><b><font face="Arial" size="2">:</font></b></td>
							<td width="470">
							<select size="1" name="Parentesco">
							<option>Cônjuge</option>
							<option>Filho</option>
							<option>Filha</option>
							<option>Pai(Mãe)</option>
							<option>Sogro(a)</option>
							<option>Outros</option>
							</select></td>
						</tr>
						<tr>
							<td width="101"><b><font face="Arial" size="2">Dt. 
							Nascimento</font></b></td>
							<td width="5"><b><font face="Arial" size="2">:</font></b></td>
							<td width="470">
							<input type="text" name="DT_Nascimento" size="11" maxlength="50" value="<%=request.item("Dt_Nascimento")%>"></td>
						</tr>
						<tr>
							<td width="101"><b><font face="Arial" size="2">
							Porcentagem</font></b></td>
							<td width="5"><b><font face="Arial" size="2">:</font></b></td>
							<td width="470">
							<input type="text" name="Porcentagem" size="11" maxlength="50" value="<%=request.item("Porcentagem")%>"></td>
						</tr>
						<tr>
							<td width="101">&nbsp;</td>
							<td width="5">&nbsp;</td>
							<td width="470">
							<p style="margin-right: 50px; margin-top: 0; margin-bottom: 0">
							<input type="submit" value="Cadastrar" name="B1"></td>
						</tr>
						<input type="hidden" name="Cliente" value="<%=wCliente%>">
						<input type="hidden" name="Plano" value="<%=wPlano%>">
						<input type="hidden" name="Proposta" value="<%=wProposta%>">
						<input type="hidden" name="Alteracao" value="<%=wAlt%>">
						<input type="hidden" name="ID" value="<%=wID%>">
					</form>
				</table>
			</div>
			</td>
		</tr>
	</table>
</div>

</body>

</html>