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<div class="fieldgrp">
<label>Raison sociale</label>
<div class="field">
<input type="text" name="nom" value="<?=$this->nom?>"/>
</div>
</div>
<div class="fieldgrp">
<label>Adresse</label>
<div class="field">
<input type="text" name="adresse_num" size="4" value="<?=$this->adresse_num?>"/>
<input type="text" name="adresse_btq" size="1" value="<?=$this->adresse_btq?>"/>
<input type="text" name="adresse_codvoie" size="4" value="<?=$this->adresse_codvoie?>"/>
<input type="text" name="adresse_libvoie" size="32" value="<?=$this->adresse_libvoie?>"/>
</div>
</div>
<div class="fieldgrp">
<label>Adresse complément</label>
<div class="field">
<input type="text" name="adresse_comp" size="40" value="<?=$this->adresse_comp?>"/>
</div>
</div>
<div class="fieldgrp">
<label>CP</label>
<div class="field">
<input type="text" name="adresse_cp" value="<?=$this->adresse_cp?>"/>
</div>
</div>
<div class="fieldgrp">
<label>Ville</label>
<div class="field">
<input type="text" name="adresse_ville" value="<?=$this->adresse_ville?>"/>
</div>
</div>
<input type="hidden" name="adresse_pays" value="FRA" />
<div class="fieldgrp">
<label>Téléphone</label>
<div class="field">
<input type="text" name="tel" />
</div>
</div>
<div class="fieldgrp">
<label>Fax</label>
<div class="field">
<input type="text" name="fax" />
</div>
</div>
<div class="fieldgrp">
<label>Web</label>
<div class="field">
http://<input type="text" name="web" />
</div>
</div>
<div class="fieldgrp">
<label>Forme Juridique</label>
<div class="field">
Liste des formes juridiques
</div>
</div>
<div class="fieldgrp">
<label>Code NAF</label>
<div class="field">
Liste des codes NAFs
</div>
</div>