<table width="100%"  border="0" cellspacing="2" cellpadding="2">
                  <tr class="style1">
                    <td colspan="2"><strong>Diteruskan Kepada : </strong><b> </b></td>
                  </tr>
                  <tr class="style1">
                    <td width="5%"><input type="checkbox" name=a[] value="1"></td>
                    <td width="95%">Kasubagbin</td>
                  </tr>
                  <tr class="style1">
                    <td><input type="checkbox" name=a[] value="2"></td>
                    <td>Kasi Intel</td>
                  </tr>
                  <tr class="style1">
                    <td>
                      <input type="checkbox" name=a[] value="3">
                    </td>
                    <td>Kasi Pidum </td>
                  </tr>
                  <tr class="style1">
                    <td>
                      <input type="checkbox" name=a[] value="4">
                    </td>
                    <td>Kasi Pidsus </td>
                  </tr>
                  <tr class="style1">
                    <td><input type="checkbox" name=a[] value="5"></td>
                    <td>Kasi Datun </td>
                  </tr>
                  <tr class="style1">
                    <td><input type="checkbox" name=a[] value="6"></td>
                    <td>Kasi BB &amp; Rampasan </td>
                  </tr>
                  <tr class="style1">
                    <td><input type="checkbox" name=a[] value="7"></td>
                    <td>Kaur TU </td>
                  </tr>
                  <tr class="style1">
                    <td><input type="checkbox" name=a[] value="8"></td>
                    <td>Kasubsi 
                      <input name="kasubsi" type="text" id="kasubsi">
                    
                      </td>
                  </tr>
                  <tr class="style1">
                    <td><input type="checkbox" name=a[] value="9"></td>
                    <td>Bendahara
                      
                    </td>
                  </tr>
                  <tr class="style1">
                    <td><input type="checkbox" name=a[] value="x"></td>
                    <td>
                      <input type="extra" name="extra">
</td>
                  </tr>
                  <tr class="style1">
                    <td>&nbsp;</td>
                    <td>*Ketikan arah Surat Beri tanda koma apabila banyak </td>
                  </tr>
              </table>
