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<div class="control-group ticket_section"> <label class=" control-label cf_typ_av_skada_3547013-label " for="helpdesk_ticket_cf_typ_av_skada_3547013">Typ av skada</label> <div class="controls "> <select class=" dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_typ_av_skada_3547013]" id="helpdesk_ticket_custom_field_cf_typ_av_skada_3547013"><option value="">...</option> <option data-id="203000134847" value="Stenskottslagning">Stenskottslagning</option> <option data-id="203000134848" value="Rutbyte">Rutbyte</option></select> </div> </div> <div class="control-group ticket_section"> <label class=" control-label cf_skadedatum_3547013-label " for="helpdesk_ticket_cf_skadedatum_3547013">Skadedatum</label> <div class="controls support-date-field "> <input type="text" name="helpdesk_ticket[custom_field][cf_skadedatum_3547013]" id="helpdesk_ticket_custom_field_cf_skadedatum_3547013" class=" date section_field datepicker_popover" readonly="readonly" data-show-image="true" data-date-format="d M, yy" placeholder="" /> </div> </div> <div class="control-group ticket_section"> <label class=" required control-label cf_stadort_3547013-label " for="helpdesk_ticket_cf_stadort_3547013">Stad/Ort</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_stadort_3547013]" id="helpdesk_ticket_custom_field_cf_stadort_3547013" /> </div> </div> <div class="control-group ticket_section"> <label class=" required control-label cf_frskringsbolag_3547013-label " for="helpdesk_ticket_cf_frskringsbolag_3547013">Försäkringsbolag</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_frskringsbolag_3547013]" id="helpdesk_ticket_custom_field_cf_frskringsbolag_3547013" /> </div> </div> <div class="control-group ticket_section"> <label class=" required control-label cf_registreringsnummer995842_3547013-label " for="helpdesk_ticket_cf_registreringsnummer995842_3547013">Registreringsnummer</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_registreringsnummer995842_3547013]" id="helpdesk_ticket_custom_field_cf_registreringsnummer995842_3547013" /> </div> </div>
<div class="control-group ticket_section"> <label class=" required control-label cf_registreringsnummer995842_3547013-label " for="helpdesk_ticket_cf_registreringsnummer995842_3547013">Registreringsnummer</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_registreringsnummer995842_3547013]" id="helpdesk_ticket_custom_field_cf_registreringsnummer995842_3547013" /> </div> </div>
<div class="control-group ticket_section"> <label class=" required control-label cf_registreringsnummer995842_3547013-label " for="helpdesk_ticket_cf_registreringsnummer995842_3547013">Registreringsnummer</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_registreringsnummer995842_3547013]" id="helpdesk_ticket_custom_field_cf_registreringsnummer995842_3547013" /> </div> </div> <div class="control-group ticket_section"> <label class=" control-label cf_typ_av_skada_3547013-label " for="helpdesk_ticket_cf_typ_av_skada_3547013">Typ av skada</label> <div class="controls "> <select class=" dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_typ_av_skada_3547013]" id="helpdesk_ticket_custom_field_cf_typ_av_skada_3547013"><option value="">...</option> <option data-id="203000134847" value="Stenskottslagning">Stenskottslagning</option> <option data-id="203000134848" value="Rutbyte">Rutbyte</option></select> </div> </div> <div class="control-group ticket_section"> <label class=" control-label cf_vilken_ruta398084_3547013-label " for="helpdesk_ticket_cf_vilken_ruta398084_3547013">Vilken ruta</label> <div class="controls "> <select class=" dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_vilken_ruta398084_3547013]" id="helpdesk_ticket_custom_field_cf_vilken_ruta398084_3547013"><option value="">...</option> <option data-id="203000251345" value="Framruta">Framruta</option> <option data-id="203000251346" value="Sidoruta">Sidoruta</option> <option data-id="203000251347" value="Bakruta">Bakruta</option></select> </div> </div> <div class="control-group ticket_section"> <label class=" required control-label cf_stadort_3547013-label " for="helpdesk_ticket_cf_stadort_3547013">Stad/Ort</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_stadort_3547013]" id="helpdesk_ticket_custom_field_cf_stadort_3547013" /> </div> </div>
<div class="control-group ticket_section"> <label class=" required control-label cf_stadort_3547013-label " for="helpdesk_ticket_cf_stadort_3547013">Stad/Ort</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_stadort_3547013]" id="helpdesk_ticket_custom_field_cf_stadort_3547013" /> </div> </div> <div class="control-group ticket_section"> <label class=" required control-label cf_registreringsnummer995842_3547013-label " for="helpdesk_ticket_cf_registreringsnummer995842_3547013">Registreringsnummer</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_registreringsnummer995842_3547013]" id="helpdesk_ticket_custom_field_cf_registreringsnummer995842_3547013" /> </div> </div>
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