<div class="card card-body report-form-daily xymon-form-card">
  <h5 class="card-title">Xymon Daily Availability Report</h5>
  <form method="POST" action="&SCRIPT_NAME">
    <input type="hidden" name="type" value="day">
    <div class="d-flex flex-wrap align-items-end xymon-date-row">
      <div>
        <label class="form-label">Month</label>
        <select name="month" class="form-select">&REPMONLIST</select>
      </div>
      <div>
        <label class="form-label">Day</label>
        <select name="day" class="form-select">&REPDAYLIST</select>
      </div>
      <div>
        <label class="form-label">Year</label>
        <select name="year" class="form-select">&REPYEARLIST</select>
      </div>
    </div>
    <button type="submit" name="SUB" value="View Report" class="btn btn-primary">View Report</button>
  </form>
</div>
