<fieldset>
	<legend>ADSL Service Details</legend>

	<div class="row">
		<?php echo Form::input('plugin[service_number]',NULL,array('class'=>'span2','label'=>'Service Number','placeholder'=>'Service Number','required')); ?>
	</div> <!-- /row -->

	<div class="row">
		<?php echo Form::input('plugin[service_address]',NULL,array('class'=>'span6','label'=>'Service Address','placeholder'=>'Service Address','required')); ?>
	</div> <!-- /row -->
</fieldset>
