-<label id="crepair-request-label" class="crepair-label" for="crepair-request">{{$label_request}}</label>
-<input type="text" id="crepair-request" class="crepair-input" name="request" value="{{$request}}" />
-<div class="clear"></div>
-
-<label id="crepair-confirm-label" class="crepair-label" for="crepair-confirm">{{$label_confirm}}</label>
-<input type="text" id="crepair-confirm" class="crepair-input" name="confirm" value="{{$confirm}}" />
-<div class="clear"></div>