<input name=department_2 size=16 maxlength=75 tabindex=3 value="$form->{department_2}"></td>
<td><input name=shiptodepartment_1 size=16 maxlength=75 value="$form->{shiptodepartment_1}">
<input name=shiptodepartment_2 size=16 maxlength=75 value="$form->{shiptodepartment_2}"></td>
<input name=department_2 size=16 maxlength=75 tabindex=3 value="$form->{department_2}"></td>
<td><input name=shiptodepartment_1 size=16 maxlength=75 value="$form->{shiptodepartment_1}">
<input name=shiptodepartment_2 size=16 maxlength=75 value="$form->{shiptodepartment_2}"></td>