Jason Jordan
5 lines
249 B
Plaintext
5 lines
249 B
Plaintext
<% (1..12).each do |n| %>
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<div class="pl-1 pt-2 w-full">
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<%= provider_fields.text_field "claim_to_#{n}".to_sym, label: { text: "Claim To Line #{n}" }, data: { general_form_target: "providerField"}, class: "w-full" %>
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</div>
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<% end %> |