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fieldset.html
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<div id="company_info">
<table class="table_result company_val">
<tbody>
<tr>
<td>Company ID</td>
<td id="com_id"></td>
</tr>
<tr>
<td>Company Name</td>
<td id="com_name"></td>
</tr>
<tr>
<td>Company Address</td>
<td id="com_addr"></td>
</tr>
<tr>
<td>Contact Number</td>
<td id="contact_num"></td>
</tr>
</tbody>
</table>
</div>
<div id="modification">
<table class="table_result patient_val">
<tbody>
<tr>
<td>Patient ID</td>
<td id="patient_id_val">Design</td>
</tr>
<tr>
<td>Patient Name</td>
<td id="patient_name_val">Design</td>
</tr>
</table>
<table class="table_result lens_val">
<thead>
<tr>
<th></th>
<th class="lens_val_re">Right Eye</th>
<th class="lens_val_le">Left Eye</th>
</tr>
</thead>
<tbody>
<tr>
<td>Rx</td>
<td class="lens_val_re" id="rx_re"></td>
<td class="lens_val_le" id="rx_le"></td>
</tr>
<tr>
<td>Flat K</td>
<td class="lens_val_re" id="flat_k_re"></td>
<td class="lens_val_le" id="flat_k_le"></td>
</tr>
<tr>
<td>Flat e</td>
<td class="lens_val_re" id="flat_e_re"></td>
<td class="lens_val_le" id="flat_e_le"></td>
</tr>
<tr>
<td>Steep K</td>
<td class="lens_val_re" id="steep_k_re"></td>
<td class="lens_val_le" id="steep_k_le"></td>
</tr>
<tr>
<td>Steep e</td>
<td class="lens_val_re" id="steep_e_re"></td>
<td class="lens_val_le" id="steep_e_le"></td>
</tr>
<tr>
<td>HVID</td>
<td class="lens_val_re" id="hvid_re"></td>
<td class="lens_val_le" id="hvid_le"></td>
</tr>
<tr>
<td>Pupil Size</td>
<td class="lens_val_re" id="pupil_size_re"></td>
<td class="lens_val_le" id="pupil_size_le"></td>
</tr>
<tr>
<td>Recommended Design</td>
<td class="lens_val_re" id="design_re"></td>
<td class="lens_val_le" id="design_le"></td>
</tr>
<tr>
<td>BC Design</td>
<td class="lens_val_re" id="bc_design_re"></td>
<td class="lens_val_le" id="bc_design_le"></td>
</tr>
</tbody>
</table>
</div>
<div class="confirmation_info">
<div id="confirmation_re">
<p class="confirm_title confirm_title_re">Right Eye</p>
<table class="table_result confirm_val_re">
<tbody>
<tr>
<td>Model</td>
<td id="model_re"></td>
<td></td>
<td>Flat</td>
<td>Steep</td>
</tr>
<tr>
<td>Material</td>
<td id="material_re"></td>
<td>BC</td>
<td id="bc_flat_re"></td>
<td id="bc_steep_re"></td>
</tr>
<tr>
<td>Design</td>
<td id="design2_re"></td>
<td>AC1</td>
<td id="ac1_flat_re"></td>
<td id="ac1_steep_re"></td>
</tr>
<tr>
<td>Lens Diameter</td>
<td id="ld_re"></td>
<td>AC2</td>
<td id="ac2_flat_re"></td>
<td id="ac2_steep_re"></td>
</tr>
<tr>
<td>Lens Power</td>
<td id="lp_re"></td>
<td>PC</td>
<td id="pc_flat_re"></td>
<td id="pc_steep_re"></td>
</tr>
<tr>
<td>Central Thickness</td>
<td id="thickness_re"></td>
<td>Modified</td>
<td id="made_re">-</td>
<td></td>
</tr>
<tr>
<td>BC Width</td>
<td id="bc_width_re"></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr>
<td>Remarks</td>
<td id="remarks_re"></td>
<td></td>
<td></td>
<td></td>
</tr>
</tbody>
</table>
</div>
<div id="confirmation_le">
<p class="confirm_title confirm_title_le">Left Eye</p>
<table class="table_result confirm_val_le">
<tbody>
<tr>
<td>Model</td>
<td id="model_le"></td>
<td></td>
<td>Flat</td>
<td>Steep</td>
</tr>
<tr>
<td>Material</td>
<td id="material_le"></td>
<td>BC</td>
<td id="bc_flat_le"></td>
<td id="bc_steep_le"></td>
</tr>
<tr>
<td>Design</td>
<td id="design2_le"></td>
<td>AC1</td>
<td id="ac1_flat_le"></td>
<td id="ac1_steep_le"></td>
</tr>
<tr>
<td>Lens Diameter</td>
<td id="ld_le"></td>
<td>AC2</td>
<td id="ac2_flat_le"></td>
<td id="ac2_steep_le"></td>
</tr>
<tr>
<td>Lens Power</td>
<td id="lp_le"></td>
<td>PC</td>
<td id="pc_flat_le"></td>
<td id="pc_steep_le"></td>
</tr>
<tr>
<td>Central Thickness</td>
<td id="thickness_le"></td>
<td>Modified</td>
<td id="made_le">-</td>
<td></td>
</tr>
<tr>
<td>BC Width</td>
<td id="bc_width_le"></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr>
<td>Remarks</td>
<td id="remarks_le"></td>
<td></td>
<td></td>
<td></td>
</tr>
</tbody>
</table>
</div>
<div id="confirmation_price">
<p class="confirm_price"></p>
</div>
</div>