<div class="card card-body acknowledge-form xymon-form-card">
  <form method="GET" action="&SCRIPT_NAME">
    <input type="hidden" name="ACTION" value="Ack">
    <div class="row align-items-end xymon-field-row">
      <div class="col-auto">
        <label class="form-label">Estimated time to resolve (minutes)</label>
        <input type="text" name="DELAY" value="60" maxlength="4" class="form-control ack-delay">
      </div>
    </div>
    <div class="xymon-field">
      <label class="form-label">Explanation / Cause of problem</label>
      <input type="text" name="MESSAGE" maxlength="80" class="form-control">
    </div>
    <div class="xymon-field">
      <label class="form-label">Acknowledgment Code</label>
      <input type="text" name="NUMBER" maxlength="7" class="form-control ack-number">
    </div>
    <button type="submit" name="Send" value="Send" class="btn btn-primary">Send</button>
  </form>
</div>
