<div>
  <h1>
    <span name="form_title">Remote Service Directory</span>
  </h1>
  <p>
    Select InfoManager Service To Use For Each Directory
  </p>
  <p>Define or configure additional <a href="auto_list/view?type=csd_info_manager">InfoManagers</a></p>
  
  <div name="data_container">
    
    <div class="dataTable">
      <table border="0" cellspacing="0" cellpadding="0">
	<tbody name="form_fields">
	  <tr><th >Directory</th><th>CSD InfoManager</th></tr>
	  <tr><td><span class="field_head">Health Worker Directory</span></td><td><select name='provider'/></td></tr>
	  <tr><td><span class="field_head">Facility Directory</span></td><td><select name='facility'/></td></tr>
	  <tr><td><span class="field_head">Service Directory</span></td><td><select name='service'/></td></tr>
	  <tr><td><span class="field_head">Organization Directory</span></td><td><select name='organization'/></td></tr>
	</tbody>
      </table>
    </div>
  </div>


</div>
