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@@ -232,15 +232,6 @@
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<div class="mb-2">
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<div class="mb-2">
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<input type="text" name="reason2" placeholder="Reason 2" class="form-control form-control-sm">
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<input type="text" name="reason2" placeholder="Reason 2" class="form-control form-control-sm">
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</div>
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</div>
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- <div class="mb-2">
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- <input type="text" name="serviceLocation" placeholder="Service Location" class="form-control form-control-sm">
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- </div>
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- <div class="mb-2">
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- <input type="text" name="modifier" placeholder="Modifier" class="form-control form-control-sm">
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- </div>
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- <div class="mb-2">
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- <input type="number" name="numberOfUnits" placeholder="Number of Units" class="form-control form-control-sm">
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- </div>
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<div class="">
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<div class="">
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<button class="btn btn-primary btn-sm" submit>Submit</button>
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<button class="btn btn-primary btn-sm" submit>Submit</button>
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<button class="btn btn-default border btn-sm" cancel>Cancel</button>
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<button class="btn btn-default border btn-sm" cancel>Cancel</button>
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@@ -407,15 +398,6 @@
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<div class="mb-2">
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<div class="mb-2">
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<input type="text" name="reason2" placeholder="Reason 2" class="form-control form-control-sm">
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<input type="text" name="reason2" placeholder="Reason 2" class="form-control form-control-sm">
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</div>
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</div>
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- <div class="mb-2">
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- <input type="text" name="serviceLocation" placeholder="Service Location" class="form-control form-control-sm">
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- </div>
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- <div class="mb-2">
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- <input type="text" name="modifier" placeholder="Modifier" class="form-control form-control-sm">
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- </div>
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- <div class="mb-2">
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- <input type="number" name="numberOfUnits" placeholder="Number of Units" class="form-control form-control-sm">
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- </div>
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<div class="">
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<div class="">
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<button class="btn btn-primary btn-sm" submit>Submit</button>
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<button class="btn btn-primary btn-sm" submit>Submit</button>
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<button class="btn btn-default border btn-sm" cancel>Cancel</button>
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<button class="btn btn-default border btn-sm" cancel>Cancel</button>
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