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I need assistance as

<div class="control-group ticket_section">
                     <label class="  control-label cf_system_name_1748162-label " for="helpdesk_ticket_cf_system_name_1748162">System Name(s)</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_system_name_1748162]" id="helpdesk_ticket_custom_field_cf_system_name_1748162" />
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_is_this_the_system_of_record_1748162-label " for="helpdesk_ticket_cf_is_this_the_system_of_record_1748162">Is this the System of Record?</label>
            <div class="controls   ">
              <select class="  dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_is_this_the_system_of_record_1748162]" id="helpdesk_ticket_custom_field_cf_is_this_the_system_of_record_1748162"><option value="">...</option>
<option data-id="66000555597" value="Yes">Yes</option>
<option data-id="66000555598" value="No">No</option></select>
            </div> 
                  </div>
                  <div class="control-group ticket_section">
                     <label class="  control-label cf_what_kind_of_info_is_this_eg_hr_data_finance_data_etc_1748162-label " for="helpdesk_ticket_cf_what_kind_of_info_is_this_eg_hr_data_finance_data_etc_1748162">What kind of info is this? (e.g. HR data, Finance data, etc.)</label>
            <div class="controls   ">
              <input class="  text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_what_kind_of_info_is_this_eg_hr_data_finance_data_etc_1748162]" id="helpdesk_ticket_custom_field_cf_what_kind_of_info_is_this_eg_hr_data_finance_data_etc_1748162" />
            </div> 
                  </div>

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