<div class="page-section">
<table>
<tr>
<td><label for="f0">Completeness of the reproduction code :</label></td>
<td><label for="f0">Completeness of the reproduction code:</label></td>
<td>
<select name="f0" id="f0">
[% IF ( f0 == "" ) %]
</td>
</tr>
<td><label for="f1">Qualifier type :</label></td>
<td><label for="f1">Qualifier type:</label></td>
<select name="f1" id="f1">
[% IF ( f1 == "l" ) %]
<td><label for="f3">Number of units under embargo :</label></td>
<td><label for="f3">Number of units under embargo:</label></td>
<input name="f3" id="f3" inputmode="numeric" pattern="\d{1,2}" value="[% f3 | html %]" />
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