Mini Shell

<div class="modal fade" id="exampleModal" tabindex="-1" role="dialog" aria-labelledby="exampleModalLabel">
  <div class="modal-dialog" role="document">
    <div class="modal-content">
      <div class="modal-header">
        <button type="button" class="close" data-dismiss="modal" aria-label="Close"><span aria-hidden="true">&times;</span></button>
        <h4 class="modal-title" id="exampleModalLabel">แก้ไขประวัติการลา</h4>
      </div>
      <div class="modal-body">
          <form method="post" id="form1" name="form1" action="insertmodal_la.php" novalidate>
   
          <input type="hidden" name="lahistoryID" id="lahistoryID">   
          <div class="form-group">
            <label for="recipient-name" class="control-label">ปีการศึกษา</label>
            <input id="year" name="year" type="text" class="form-control" id="recipient-name" minlength="4" maxlength="4" data-smk-msg="กรุณากรอกปีการศึกษา 4 หลัก" required >
          </div>
             <div class="form-group">
            <label for="recipient-name" class="control-label">ลาป่วย</label>
            <input id="lasick" name="lasick" type="text" class="form-control" id="recipient-name">
          </div>
               <div class="form-group">
            <label for="recipient-name" class="control-label">ลากิจ</label>
            <input id="laerrand" name="laerrand" type="text" class="form-control" id="recipient-name">
          </div>
            <div class="form-group">
            <label for="recipient-name" class="control-label">ลาคลอด</label>
            <input id="lamaternity" name="lamaternity" type="text" class="form-control" id="recipient-name">
          </div>
        
      </div>
      <div class="modal-footer">
        <button type="button" class="btn btn-default" data-dismiss="modal">ปิด</button>
        <button type="submit" id="submit" name="submit" class="btn btn-primary">แก้ไขข้อมูล</button>
      </div>
     </form>
    </div>
  </div>
</div>